NASH Nonalcoholic Steatohepatitis

I was diagnosed with NASH about 3 years ago, after taking Lipitor for my cholesterol.  After taking Lipitor for 3 months, the doctor checked my liver enzymes and they were elevated, so he took me off of it.  Then he sent me to get my liver checked, first with ultrasound, then a liver biopsy.  The Specialist who performed the biopsy, said I had NASH, and that it was between stage 3 and stage 4 (of 4 stages).  He said the liver was pretty good at healing itself, but that we needed to keep an eye on my liver enzymes.  My PCP (Primary Care Physician) doesn't seem all to concerned on checking my liver enzymes routinely, to see if the NASH has progressed into the 4th and final stage, which can be fatal.  Should I be concerned?

[AngelsOnMySide2]

Sorry, I don't know much about what you're saying, but I would just ask my doctor to check it....and that would ease your mind!

[mikesimon]

You should take a look at this article:
http://www.medscape.com/viewarticle/557028?sssdmh=dm1.273356&src=nldne

New Biomarker May Provide Noninvasive Method for Assessing Nonalcoholic Fatty Liver Disease

From that article:
"...In presenting his findings, Dr. Feldstein explained that "apoptosis is prominent in NAFLD and NASH but is absent in simple steatosis."  

NASH has much more significant morbidity and mortality, and it has a progressive course. It is also associated with a number of cardiovascular risk factors.  "Simple steatosis is a benign disease that does not progress," Dr. Feldstein observed."

I would advise that you see a hepatologist about your situation. Mike

[friole]

Is there a connection between NASH and Lipotor?  My husband takes Lipotor and I would really like to know.

frijole

[mikesimon]

Fatty Liver and the Metabolic Syndrome
http://www.medscape.com/viewarticle/551796_7

"The statin class of drugs used to treat hypercholesterolemia is associated with relatively common but mild elevations of aminotransferases, rare idiosyncratic severe hepatotoxicity and rhabdomyolysis. The presumption that the aminotransferase elevations could be harbingers of subsequent severe hepatotoxicity led to cautions by the drug manufacturers to avoid the use of these drugs in patients with preexisting liver enzyme elevations, warnings that in retrospect were unfounded.[54**] A review of a national insurance claims database found no evidence that such warnings had any scientific basis, although the use of CYP3A4 inhibitors appeared to increase the risk of rhabdomyolysis.[55] A careful review of all of the data by an expert panel concluded that statins are safe in patients with preexisting liver disease except for those with decompensated cirrhosis or acute liver failure, patients in whom there are no data but extra caution is warranted.[56**] Emerging data suggest that there might even be a role of statins in the treatment of NASH.[57]"

Mike

[friole]

Hey, thanks.   I think I should have gone to medical school just so I could understand my own body!  How are you doing?  Have you stopped the interferon?  What about the anti rejection drugs -- any changes there?  I hope you are well and playing all the songs I like
frijole

[mikesimon]

I stopped the Pegasys/Ribavirin in late December 2006. The anti-rejection dose was reduced but Rapamycin was added. There is evidence that it reverses fibrosis in rats. I get the feeling that I am just another rat - but I'm breathing so I'm happy. The marvels of modern medicine! Mike