NASH (no, not Steve..drats)

my dr called today with the results of the liver ultrasound. diagnosis=fatty liver with inflamation (NonAlcoholic SteatoHepatitis, called NASH for short) he thinks thats why my liver enzymes were elevated, due to the inflamation. i am to go back in the beginning of Sept to redo the blood tests. if at that point the numbers are still high he will do a liver biopsy.

i have been doing some research on my own (surprise,surprise). there is some good info out there. i checked various sites and here is a little summary. if you have a moment and want to read alot in great detail aboug NAFLD and NASH, check out medicinenet's thorough article.

• The NAFLD (Non Alchoholic Fatty Liver Disease) spectrum is thought to begin with and progress from its simplest stage, called simple fatty liver (steatosis). That is, fatty liver is the initial abnormality in the spectrum of NAFLD.The next stage and degree of severity in the NAFLD spectrum is NASH . Fortunately, only a fraction of patients with simple fatty liver will develop NASH. As mentioned, NASH involves the accumulation of fat in the liver cells as well as inflammation of the liver. Cirrhosis that is caused by NASH is the last and most severe stage in the NAFLD spectrum.


• The most frequent biochemical abnormality in the blood in NASH is persistent, mild to moderately elevated transaminases (ALT and AST). Transaminases are the liver enzymes that are most often elevated in the various types of hepatitis. (Remember that hepatitis refers to inflammation of the liver.) In NASH, their levels tend to fluctuate from month to month, and most often the ALT is greater than the AST. (my ALT was 57, AST was 49)
• The exact cause of NASH is not known. It most commonly affects people who are middle-aged and are overweight or obese, have high cholesterol and triglycerides, or have diabetes. Yet it can occur in people who have none of these risk factors.


• Although there is no clear reason why some people develop NASH while others do not, one possible explanation is that it takes two "hits" for NASH to occur. The first "hit" is the initial buildup of fat in the liver, which many people have. The second "hit" is thought to come from either a family history that makes you more likely to get the disease or from some factor in your environment. The fat buildup in the first hit makes you vulnerable to the second hit, when inflammation begins.


• Many things can lead to the buildup of fat in the liver. An increase in fat in your diet alone will not cause fatty liver disease.
  Several factors may contribute to liver damage from NASH, including:
  Resistance to insulin, which means that your body is less able to use sugar (glucose).
  Metabolic syndrome, a cluster of conditions related to the body's metabolism . These conditions include excess body fat (particularly around the waist), high triglycerides, high blood pressure, high blood sugar, and low HDL ("good") cholesterol. These all are linked to insulin resistance.
  Changes in how the liver produces fat and deals with fat that is delivered to it by the intestines.
  The release of toxic substances by fat cells.
  The breakdown of liver cells.
  Certain drugs, including some antibiotics.
  Alcohol.


• Fatty liver has also been described in several medical syndromes (groupings of abnormalities). For example, fatty liver occurs in polycystic ovarian syndrome, in which polycystic ovaries are associated with obesity, excessive hair (hirsutism), and insulin resistance.


• Losing weight and lowering your cholesterol can help stop or limit the damage done to your liver. The most effective way to do this is to modify your diet and get regular exercise. Experts recommend that you gradually lose 10% of your total body weight, at a rate of no more than 1 to 2 pounds per week. Losing just 10% of your weight can help your body use insulin more effectively. This would mean, for example, losing 20 lb if you weigh 200 lb. This can decrease the amount of fat that builds up in your liver and limit the damage it does to the cells of your liver.

(i bolded Metabolic Syndrome and PolyCystic Syndrome since these are both things i have.)

bottom line: now more than ever i need to be serious about being healthy! i don't need this to progress to something more serious...its still in somewhat of an early stage, so if i just stick my mind to losing weight i know it will help alot! 20lbs would put me in a good range...how hard can that be??