Estimated reading time: 6 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
Being diagnosed with metabolic dysfunction-associated steatohepatitis (MASH) can be overwhelming! You probably have a lot of questions about what comes next, how the disease affects your body, and what treatment looks like. The good news is that with the right steps, many people can slow down or even reverse the effects of MASH. This guide from PatientsLikeMe will walk you through what to expect in the first few days and weeks after your diagnosis, what your treatment plan may include, and key things to be aware of moving forward.
The First Few Days After Diagnosis
After your doctor tells you that you have MASH, you might feel uncertain or anxious. This is completely normal! Here is what you can expect in the first few days and some steps you should take.
- Follow-Up Tests: Your doctor may order more tests to find out how much damage there is to your liver. This could mean blood tests, imaging like a FibroScan or MRI, or even a liver biopsy if needed.
- Lifestyle Changes: Healthy lifestyle changes are the best way to manage the disease. Your doctor will likely talk to you about key changes, like losing weight, exercising regularly, and what your diet should look like. These are the first steps in managing MASH.
- Medication: If your case is advanced, or if lifestyle changes alone may not be enough, your doctor might talk to you about some treatment options. This can include the first FDA approved medication specifically for treating MASH with moderate to advanced fibrosis called resmetirom.
- Understanding Your Diagnosis: You will need to learn more about MASH, what it means for your health, and why managing it is important! One of the best things you can do is make sure you are educated on the condition and its potential complications. PatientsLikeMe has more resources on MASH if you need additional support.
- Emotional Adjustment: It is normal to feel a mix of emotions, from frustration to motivation. Get support from family, friends, or even a healthcare team to help you through this process.
What is the Goal of MASH Treatment?
The goal of treatment is to reduce fat and inflammation in your liver. That will in turn prevent scarring and improve your overall liver function. Here is a typical MASH treatment plan.
Weight Loss
Losing weight is the most effective way to reduce fat in your liver. Studies show that losing just 3-5% of your body weight can decrease fat in your liver, and losing 7-10% can reduce inflammation and scarring. Your doctor may recommend a structured diet and exercise plan. In some cases, weight loss surgery might be considered if other methods do not work.
Medication
As of 2024, the FDA has approved resmetirom (Rezdiffra) for treating MASH with liver fibrosis. This medication helps speed up the metabolism of liver fat and must be used along with a healthy diet and regular exercise. It can interact with other medications, so your doctor will check your prescriptions carefully before starting treatment.
Dietary Changes
A healthy diet plays a big role in managing MASH. You may need to follow a Mediterranean diet, which includes fruits, vegetables, whole grains, lean proteins, and healthy fats like olive oil. Try to avoid processed and fried foods and reduce sugar and refined carbohydrates. Finally, you should also replace unhealthy fats like butter and red meat with healthier options like salmon and nuts.
Exercise
Exercise always helps! Regular physical activity reduces liver fat and improves overall health. Aim for at least 30 minutes of exercise most days of the week. This can be a combination of cardio activities like walking, biking, swimming and strength training. Make sure you start slow if you are not used to exercising and gradually increase the intensity.
Avoiding Alcohol
Drinking alcohol can make MASH worse and increase your risk of cirrhosis. You should eliminate alcohol from your diet entirely. If you struggle with quitting, talk to your doctor about support programs.
Managing Other Health Conditions
MASH is often linked to other conditions like diabetes, high cholesterol, and high blood pressure. Your doctor will work with you to keep your blood sugar levels under control if you have diabetes. You should also try to lower your cholesterol through diet, exercise, or medication and monitor and manage high blood pressure.
FAQs About MASH
Can MASH be reversed?
Yes, the liver has the ability to heal itself if the disease is caught early and you make lifestyle changes, like losing weight and exercising regularly.
How long does it take to see improvements?
It depends on how advanced your condition is and how closely you stick to your treatment plan. Some people see improvements in liver function within a few months of making changes.
Is medication necessary?
Not always. Many people can improve MASH with lifestyle changes alone. However, if you have moderate to severe fibrosis, your doctor may recommend medication.
Can I still eat my favorite foods?
You may need to limit or change certain foods, but you do not necessarily have to give them up entirely! Work with a nutritionist to find healthier alternatives and balance your diet.
Will I need a liver transplant?
Most people with MASH do not need a liver transplant. However, those who do develop cirrhosis (5-12% of patients) may require one if the liver becomes too damaged to function. The best way to avoid this is to follow your treatment plan early.
Can I take vitamins or supplements to help my liver?
Some studies suggest that Vitamin E and coffee might help reduce liver inflammation. However, more research is needed. You should always talk to your doctor before adding supplements to your routine.
A MASH diagnosis can be a wake-up call, but it does not have to be a life sentence! With the right treatment, many people can manage the condition and prevent long-term damage. The key is to take action early, stay committed, and work closely with your doctor. By making positive changes, you can protect your liver and live a healthier life.
PatientsLikeMe is your gateway to taking control of your health, offering a supportive community and powerful tools to manage your wellness journey. By joining PatientsLikeMe, you can connect with others who understand your experiences and provide invaluable advice and encouragement. Track your symptoms, treatments, and outcomes with ease, allowing for better informed health decisions and improved communication with your healthcare team.