Diagnosed with fatty liver, can it be reversed if it's NASH?
I'm 25, male, moderately overweight, don't drink or smoke. I was diagnosed with fatty liver disease in November 2012 after routine blood work showed an ALT of 65 and AST of 43...I ignored it for a couple of months because my doctor told me that it wasn't dangerous and that I could reverse it any time if I lost 10% of my body weight, but I recently looked into it and the condition appears to have much more dire consequences than I realized...I was unaware of the different "stages" of the condition, and now I am concerned that I may be at a stage beyond the ability to be reversed. I have begun an exercise regimen and have cut carbohydrates and sugars from my diet, but I am worried that losing weight will not reverse my condition.
I can't seem to find a good answer to this anywhere online so I'd like to ask here--if my fatty liver has progressed to the NASH stage, is it still possible to reverse through diet and exercise before fibrosis and cirrhosis set in? Logic would seem to dictate that if the fat causing the inflammation is gone, then the liver would no longer be agitated and could then begin to regenerate...but things I read seem to argue that NASH is a permanent and progressive condition and only NAFLD, simple first-stage fatty liver, is reversible. I was diagnosed via ultrasound and apparently it is impossible to differentiate between NAFLD and NASH unless a biopsy is performed. Should I push for a biopsy with my doctor, or at my age is it unlikely that I have had the condition long enough for it to have become NASH? As a reference, my only other blood test was in March 2012, which showed an ALT of 51. So that enzyme increased 14 points in eight months.
Thanks to anyone who can shed some light on this topic.
Yes, the prognosis of NASH can be improved by lifestyle changes such as diet, exercise and controlled blood sugar levels. I would not suggest a biopsy since it is an invasive test and would not make any difference to the management plan. I strongly recommend following your doctor’s advice for the time being and a follow up after a couple of months or so to check for improvement.
Hope this is helpful.
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