How To Stay Ahead of MASH: The Power of Proactive Care

It can feel overwhelming to be diagnosed with metabolic dysfunction-associated steatohepatitis (MASH), a disease caused by a buildup of fat in your liver.

But there’s hope. You can take proactive steps to get ahead of MASH (originally called non-alcohol-related steatohepatitis, or NASH), and in some cases, even see improvement in your liver function.

Gastroenterologist and transplant hepatologist Sobia Laique, MD, shares ways you can stay in control of your health.

Proactive care for MASH management

Proactive care — from managing appointments and scheduling testing to talking to your doctor about treatment options — can help manage problems before they become serious issues.

Dr. Laique offers the following advice.

Keep track of your appointments

It can be hard to stay up to date on follow-ups or any additional appointments. In many cases, you may have other conditions — like obesity, heart disease and Type 2 diabetes — in addition to MASH. This may mean you need to see different healthcare providers. Each of the following could play a different role in your care:

• Hepatologist: Monitors and manages liver health
• Endocrinologist: Focuses on blood sugar and other metabolic dysfunction issues
• Cardiologist: Considers any heart risks
• Dietitian: Helps with nutrition, diet and weight management
• Primary care provider: Coordinates ongoing care

“Your healthcare team may take a multidisciplinary approach to how they manage MASH,” says Dr. Laique. “That means they’ll work together on unified treatment and a care plan for you.”

Consider using your phone’s calendar or your hospital system’s online patient portal to keep track of your appointments.

Schedule any tests

Your healthcare team may order additional or routine tests to determine your liver function. This may include:

• Blood tests: Bloodwork is used to spot potential liver damage or inflammation.
• Imaging tests: A vibration-controlled transient elastography (FibroScan®), or magnetic resonance elastography and proton density fat fraction (MRE-PDFF) can provide information on liver fibrosis. These tests are also used to assess your treatment response long-term.
• Liver biopsy: This may be ordered to definitely diagnose MASH and/or rule out other causes of liver diseases, if your provider has additional concerns.

“We use these types of tests to track the progression of MASH and monitor your overall liver health,” says Dr. Laique.

Consider lifestyle changes

Other ways you can take charge of your health and improve your liver function? Start by working toward the following lifestyle changes:

• Follow the Mediterranean diet. Take a look at the types of foods you’re eating and try to incorporate more fruits, vegetables and whole grains. You should also work on reducing the amount of processed and high-fat foods you consume.
• Focus on exercise. Try to get at least 150 minutes of moderate-intensity aerobic exercise (think walking, biking and resistance training) each week. Not sure you can manage that? It’s OK. Start small (even a five-minute walk around the block is a win!) and work your way toward that goal.
• Maintain a healthy weight. Doing so can help reduce fat and inflammation in your liver.
• Get quality sleep. Not getting enough sleep can play a role in how motivated you feel. When you’re tired, you’re more likely to avoid exercise and may turn to sugary, high-fat foods.
• Avoid alcohol. Consuming alcohol can increase your liver’s inflammation.
• Avoid smoking. This habit can lead to more liver inflammation and damage.

Discuss medication options

Your doctor may suggest medication to help manage MASH. Options include:

• Resmetiron (Rezdiffra^®): Taken orally, this drug can help reverse MASH and slow down or reverse scarring (fibrosis) in your liver.
• Semaglutide (Wegovy™): This injectable GLP-1 medication will help with weight loss, improve diabetes and help treat/reverse MASH and liver fibrosis.

Look into clinical trials

As we learn more about MASH, newer medications are becoming available. Your healthcare provider may talk to you about possibly joining a clinical trial.

“We use clinical trials to give people access to emerging therapies that aren’t yet approved by the U.S. Food and Drug Administration (FDA),” outlines Dr. Laique. “We also use clinical trials to give you access to medications that are approved but may not be covered by your insurance yet.”

There are a lot of factors to consider. While clinical trials can give you access to newer therapies, you’ll have strict rules and protocols to follow. And most trials are randomized and double-blinded, meaning there’s a chance you may receive a placebo.

Is a clinical trial right for you? Dr. Laique recommends talking to your doctor about the pros and cons of any trials available to you.

Key takeaways

Learning you have MASH may make you feel stressed and like you don’t have control over your own life. But there are proactive steps you can take to help feel more in control of your situation.

And as you navigate this new world, your healthcare team will be there with you every step of the way.

“Your healthcare providers can answer any questions you have and offer support and guidance on how best to manage MASH,” says Dr. Laique.