NASH

[suzktm]

my ALT LEVEL IS 47 AND MY AST LEVEL IS 39, MY Bilirubin, direct IS 03 AND MY ALKALINE PHOSPHATASE IS 78 WHAT SHOULD I DO. THANKS

[HectorSF]

No single test can diagnose NASH. These blood tests are within normal range so they tell us nothing about any liver disease you may have. How was NASH diagnosed? A liver biopsy? By ultrasound, CT or MRI where the fatty deposits in your liver where seen?

If you have been diagnosed with NASH (NonAlcoholic SteatoHepatitis) you should be being seen by either a gastroenterologist who is experienced with managing NASH or a hepatologist (liver specialist) at a liver transplant center near you. UCSF hear is San Francisco is a center of excellence in the treatment of liver disease here in Northern California and where I have been treated for hepatitis C, cirrhosis, liver cancer and had my liver transplant on November 16th of last year.

The disease is mostly silent and is often discovered through incidentally elevated liver enzyme levels. It is strongly associated with obesity and insulin resistance and is currently considered by many as the hepatic component of the metabolic syndrome. NASH cirrhosis is now one of the leading indications for liver transplantation in the United States.

Unfortunately there is no "cure" for NASH although work is being done in this field because NAFLD and NASH are expected to become the number reason for liver transplantation in the near future as hepatitis C which is the cause of for most liver transplants in the US becomes a completely curable infection due to the advanced in treatment that is expected over the next few years.

A diagnosis of NASH requires the best medical care which is why I recommend seeing a hepatologist at a liver transplant center because they treat NASH patients as part of their daily practice and they are aware of all of the latest develops in the field.

Here is what the National Digestive Diseases
Information Clearinghouse (NDDIC) has to say about NASH.
http://digestive.niddk.nih.gov/ddiseases/pubs/nash/#treatment

"Currently, no specific therapies for NASH exist. The most important recommendations given to persons with this disease are to reduce their weight (if obese or overweight)

* follow a balanced and healthy diet

* increase physical activity

* avoid alcohol (which is toxic to the liver)

* avoid unnecessary medications which can further stress your liver

These are standard recommendations, but they can make a difference. They are also helpful for other conditions, such as heart disease, diabetes, and high cholesterol.

A major attempt should be made to lower body weight into the healthy range. Weight loss can improve liver tests in patients with NASH and may reverse the disease to some extent. Research at present is focusing on how much weight loss improves the liver in patients with NASH and whether this improvement lasts over a period of time.

People with NASH often have other medical conditions, such as diabetes, high blood pressure, or elevated cholesterol. These conditions should be treated with medication and adequately controlled; having NASH or elevated liver enzymes should not lead people to avoid treating these other conditions.

Experimental approaches under evaluation in patients with NASH include antioxidants, such as vitamin E, selenium, and betaine. These medications act by reducing the oxidative stress that appears to increase inside the liver in patients with NASH. Whether these substances actually help treat the disease is not known, but the results of clinical trials should become available in the next few years.

Another experimental approach to treating NASH is the use of newer antidiabetic medications—even in persons without diabetes. Most patients with NASH have insulin resistance, meaning that the insulin normally present in the bloodstream is less effective for them in controlling blood glucose and fatty acids in the blood than it is for people who do not have NASH. The newer antidiabetic medications make the body more sensitive to insulin and may help reduce liver injury in patients with NASH. Studies of these medications—including metformin, rosiglitazone, and pioglitazone—are being sponsored by the National Institutes of Health and should answer the question of whether these medications are beneficial in NASH."

So NASH is a very serious medical condition which requires expert medical care for the best prognosis. Get the help you need and deserve before you need a liver transplant like myself. It is also best to keep your own parts if possible.  ;-)

Be well!
Hector

[fntn]

What you've listed isn't alarming, especially if what your title would indicate, NASH, is the case. Working on your diet and exercise should be a priority - remain committed towards making some positive changes. Good luck.