NASH: Strategies for Management and Care
Published by Dr. Venn-Watson
Dr. Eric Venn-Watson’s Highlights
NASH is a progressive form of fatty liver disease that can lead to cirrhosis and become life-threatening.
Learning to properly manage NASH can help prevent continued liver damage.
Taking a supplement like fatty15 can help support liver function and become a vital part of your daily liver care plan.
Living with nonalcoholic steatohepatitis (NASH) means you’ll have to take an active role in your liver care. Although NASH can become life-threatening if it progresses, it is possible to live years with this condition, provided you make the necessary lifestyle changes that help prevent your liver from further damage.
If you’ve recently been told your fatty liver disease has progressed to NASH, it’s incredibly important to take steps to support your liver health. We’ll cover those and help you understand your condition, including what causes it and associated complications that can arise from it.
Along with your team of healthcare providers, you can lead a healthy life and support your longevity, even with a diagnosis of NASH. Lifestyle changes, including weight loss, are some of the best ways to keep your NASH well-managed and prevent further liver damage.
What Is NASH?
Most likely, you knew before you were told you had NASH that you had nonalcoholic fatty liver disease, also known as NAFLD. NAFLD is a condition in which excess fat builds up in the liver of a person who rarely drinks or does not drink alcohol.
What Causes Fatty Liver Disease?
Researchers aren’t completely sure why some people store excess fat in their livers and others don’t. There are, however, risk factors that are directly associated with NAFLD.
- Obesity. If you have a BMI over 30, you are at higher risk of developing NAFLD than someone who maintains a healthy body weight.
- Genetics. Some people are genetically predisposed to NAFLD. Researchers are studying a particular genetic modifier, PNPLA3, which they believe could be a key link in determining who will get fatty liver disease and who will not.
- Having metabolic syndrome. Metabolic syndrome is a cluster of conditions like insulin resistance (like type 2 diabetes), high blood pressure, excess weight (especially around the midsection), and high cholesterol.
- High triglycerides in the blood.
- Being of Hispanic descent.
Not everyone who is at risk of developing fatty liver disease will have these conditions. If you do have some of these conditions, it’s incredibly important to work closely with your healthcare provider to ensure your health is well managed and take action to help prevent the buildup of fat in your liver.
NAFLD: The First Stage of Fatty Liver Disease
The best way to keep track of your liver health is by getting annual blood tests. Your doctor uses your blood test results to check the levels of your liver enzymes. If they are elevated, they may order additional diagnostic tests to determine if you are storing fat on your liver.
The first stage of fatty liver disease is NAFLD. If you have NAFLD, it means there is excess fat on your liver, but your liver has not begun developing scar tissue (a process known as fibrosis), which can significantly impact liver function.
NAFLD is the most common liver disease among Americans. About one in three American adults develop NAFLD, along with one in every ten children. If dietary and lifestyle changes aren’t made in someone with NAFLD, their disease will progress.
NASH: The Second Stage of Fatty Liver Disease
NASH is the second stage of fatty liver disease. Someone with NASH has a liver that not only has excess fat but also inflammation. Left untreated, this damage can lead to liver scarring. Liver scarring is permanent liver damage that cannot be reversed and can lead to life-threatening conditions and even the need for a liver transplant.
NASH that is untreated can progress to fibrosis and to cirrhosis, so it’s incredibly important to ensure you are taking steps to care for your liver, especially if you have NASH.
NASH Management and Care: Seven Steps To Take Right Now
Even though NASH is serious, it’s possible to live a healthy life with this condition. Here are seven ways to help you keep your liver tissue healthy and prevent the progression of your disease.
1. Lose Weight
Weight loss is the first line of defense against fatty liver disease and NASH. The benefit of weight loss is that it not only helps arrest your condition but can also help reverse it.
Liver cells regenerate, allowing the liver to heal itself, but only if liver disease hasn’t progressed through scarring. Liver scarring that occurs in chronic liver disease like cirrhosis is not reversible.
Losing weight may seem difficult, and if you have trouble with weight loss, consult your doctor and/or a nutritionist to help you get started. Normally, weight loss includes both reduction of calories and exercise.
A handy tool is to use the acronym “TEAM.”
- Track your calories. Caloric intake is vital for weight management. Excess calories lead to weight gain. Track your calories each day to ensure you’re hitting your goals.
- Eat more whole foods. Less processed foods mean less salt, sugar, and calories. Whole foods, or foods like fresh fruits, vegetables, whole grains, and lean meats, are beneficial for your entire body and support a healthy diet.
- Aim for 30 minutes of exercise per day. Exercise helps prevent cardiovascular disease, supports your mental health, and protects your liver. Numerous health conditions are remedied by simply getting those vital 30 minutes of heart-pumping exercise each day.
- Make goals. Goals help keep you motivated to go the distance. Your journey to a healthy liver is no different. Make small, achievable goals and celebrate when you hit them. A good first stop? Losing five pounds or getting a better liver enzyme report.
Before you begin any diet or exercise program, make sure you check with your primary care provider to ensure you’ve got the right plan of action.
2. Manage Other Health Conditions
If you have type 2 diabetes or insulin resistance, it’s vital to your liver health that you ensure your condition is well managed. If your doctor has prescribed blood-sugar-lowering medications, it is imperative that you take them regularly and closely monitor your blood sugar levels for changes.
Additionally, your cholesterol levels should also be high on your priority list. If you have high cholesterol and your doctor has prescribed cholesterol-lowering medications, make sure you take them regularly and get your cholesterol levels checked frequently.
3. Avoid Alcohol
Even though NASH occurs in people who do not or seldom drink, people with this condition should avoid alcohol consumption. Alcohol directly impacts liver function and causes fat to build up on the liver. If you have NASH or NAFLD, avoiding alcohol is an easy way to avoid further liver damage.
If you do consume alcohol, discuss it with your healthcare provider. Hepatic function can be improved by discontinuing alcohol use, and there are options available to help you quit or reduce your alcohol intake.
4. Be Careful With Medication
Some medications can cause liver injury. Make sure your doctor knows which medications you take and how frequently you take them.
Over-the-counter medications can also cause liver injury, so make sure you discuss all your medications, even your over-the-counter medications, with your healthcare provider to ensure you are taking them as directed and only when necessary. There may be other options available that won’t harm your liver.
5. Consider Vaccinations for Hepatitis
Vaccinations are available for hepatitis A and hepatitis B. If you suffer from liver problems, your doctor may recommend you get vaccinated for these illnesses, which can lead to further liver damage and even liver failure.
6. Be Careful With Herbal Remedies
The FDA doesn’t regulate herbal remedies, and some of them aren’t safe for people with compromised livers. If you want to begin taking an herbal supplement, it’s best to check its liver safety with your healthcare provider to ensure it’s a good fit for you.
7. Be Fat Conscious
It might seem like avoiding fat is a good solution for protecting your liver, but that’s only partially true. Although we’ve been told for decades that all fat is bad, science no longer supports the blanket admonition to avoid fat. In fact, science supports that some fat is good and even essential for our bodies.
One such essential fat is pentadecanoic acid, also known as C15:0. This fatty acid helps our bodies thrive and is consistently associated with better health.
C15:0: The “Good” Fat
It’s important for people with NASH to pay attention to their fat intake, but avoiding all fat hasn’t given us a good track record.
In fact, the past generation of Americans has avoided fat due to dietary guidelines issued in the 1970s, and our occurrence of heart disease, type 2 diabetes, and liver disease has increased during this period. Avoiding fat wasn’t the answer, and that could be because our bodies need some healthy fats.
C15:0 was discovered by scientists and is now accepted worldwide as an essential fatty acid. C15:0 helps protect cellular health by reversing and repairing aging cells, revitalizing cellular energy, and keeping your cells strong.
C15:0 helps keep cells healthy by:
- Strengthening cell membranes. C15:0 integrates into cell membranes, which become flimsy with age, to support and fortify them. In studies, C15:0 improves cellular strength by 80%.
- Activating AMPK. AMPK is a molecule that helps clear out damaged cells and also supports total body homeostasis in functions like metabolism, heart health, liver health, and immunity.
- Restoring and repairing cellular energy. Aging cells make less ATP (cellular energy) and more reactive oxygen species, which leads to inflammation and disease. C15:0 helps rescue the mitochondria in our cells, increasing their ability to make ATP and reducing their ROS output by 45%. In one peer-reviewed study, C15:0 was shown to increase ATP levels in cells by 350%.
- Activating PPARɑ and PPARẟ receptors. These receptors play a key role in functions like mood, sleep, immunity, liver, and heart health. By activating these receptors, C15:0 helps bring back balance to these functions.
Getting enough of this important fat, however, could be difficult. It’s found in trace amounts in whole-fat dairy products like whole milk and full-fat butter. Increasing your intake of these foods would mean excess calories and bad, even-chain, saturated fats. A solution?
Fatty15: The C15:0 Supplement That Supports Your Cells
Avoiding excess calories from whole-fat dairy (and avoiding the inclusion of cows) and still getting your C15:0 is easy when you take fatty15. Fatty15 is the first and only pure C15:0 supplement. Fatty15 contains a pure, vegan-friendly, patented, award-winning C15:0 powder called FA15™.
Just one sustainable capsule per day is all you need to increase your circulating levels of C15:0 and give your cells the support they need. Fatty15 is a great way to support your liver health, in addition to your long-term wellness.
Eric Venn-Watson M.D.
Senior Scientist, Co-Founder
Eric is a physician, U.S. Navy veteran, and Co-founder and COO of Seraphina Therapeutics. Eric served over 25 years as a Navy and Marine Corps physician, working with the special forces community to improve their health and fitness. Seraphina Therapeutics is a health and wellness company dedicated to advancing global health through the discovery of essential fatty acids and micronutrient therapeutics.
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