Estimated reading time: 5 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
There is a condition that experts estimate around 22 million Americans are living with today. A condition that is the fastest growing cause of liver transplants and is often undiagnosed! Called metabolic dysfunction-associated steatohepatitis (MASH), this is a liver disease that many people are unaware of. Often called a “silent” disease, MASH typically does not cause symptoms until it is at an advanced stage. Understanding if you are at a higher risk of getting MASH and the signs to watch for are the best way to catch it early. Here is a guide from PatientsLikeMe on managing this condition and preventing further complications.
What Is MASH?
MASH happens when fat builds up in the liver and there is inflammation and damage to liver cells. It is related to a broader condition called metabolic dysfunction-associated steatotic liver disease (MASLD). MASH used to be called nonalcoholic steatohepatitis (NASH). It is often associated with metabolic syndrome, a group of health issues including high blood pressure, high cholesterol, and type 2 diabetes. Although many people with MASLD never progress to MASH, around 20% do. This progression increases the risk of severe liver damage, including cirrhosis and liver failure.
Why Is MASH Hard to Detect?
MASH develops slowly and often does not cause symptoms in its early stages. Even when symptoms start to show up, they may be vague and mistaken for other conditions. For example, feeling tired or having mild discomfort in your abdomen can happen for many reasons. People often overlook this because of liver-related issues. Since MASH is a silent condition for many, routine check-ups and awareness of your risk factors are key to catching it early.
Signs and Symptoms of MASH
Part of the danger of this condition is that many people see little to no symptoms whatsoever early on. It is not until the condition progresses that a symptom might develop. Regardless, keep an eye out for any of the following if you have risk factors that increase your chances of getting MASH.
Fatigue
Extreme tiredness or a lack of energy is one of the most common symptoms of MASH. Fatigue may make it difficult to perform daily activities or enjoy things you usually love. It’s not just feeling sleepy; it is a deep exhaustion that does not go away even with rest.
Abdominal Pain
You might feel discomfort or pain in the upper right side of your abdomen, where your liver is. This pain could be due to inflammation, or an enlarged liver caused by fat buildup.
Loss of Appetite
A decreased desire to eat, feeling nauseous after meals, or finding that food tastes different can all be early signs of liver trouble.
Unintended Weight Loss
If you are losing weight without trying, this could be a sign that your liver is not processing nutrients properly. This is especially important to monitor if you have also noticed a loss of appetite.
Skin Changes
In advanced stages, you might see yellowing of the skin and eyes, called jaundice. You could also develop spiderlike blood vessels beneath the skin or easy bruising and bleeding. These symptoms happen when the liver can no longer filter toxins or produce enough clotting factors.
Swelling
You may notice swelling in your abdomen or in your legs and feet. These symptoms usually happen in advanced stages when liver function is severely compromised.
Itching
Unexplained itching without a visible rash can happen if bile salts build up in your bloodstream because your liver is not working properly.
Confusion or Disorientation
Known as hepatic encephalopathy, this happens when toxins build up in the brain because of liver dysfunction. If you are feeling confused, forgetful, or disoriented, get medical help right away.
Risk Factors for MASH
Certain health conditions make you more likely to develop MASH. These are:
- Being overweight or obese
- Type 2 diabetes or insulin resistance
- High cholesterol or triglycerides
- High blood pressure
- Metabolic syndrome (a combination of conditions like a large waist size, high blood sugar, and low “good” HDL cholesterol)
If you have any of these risk factors, get regular check-ups and blood tests to monitor liver function. When caught early, MASH can often be managed with lifestyle changes such as a healthier diet, regular exercise, and better control of conditions like diabetes and high blood pressure. Left unchecked, MASH can progress to cirrhosis or liver failure which are much harder to treat and may require a liver transplant.
MASH is a silent but serious condition that affects many people. By understanding the risk factors and symptoms, you can take steps to protect your liver health and catch potential problems early. If you are concerned about your liver or think you might have MASH, reach out to your healthcare provider. Taking action now can make a big difference in your long-term health.
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