Liver Disease (NASH)

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NASH is an advanced form of NAFLD (Nonalcoholic Fatty Liver Disease). It means fat cells are intermixed with the cells of your liver and have caused damage. Almost everyone has fat on their liver, but there is not enough research as to why, sometimes fat becomes part of your liver. It is the second leading cause of liver transplantation after Hep C.

The statistics are rather frightening. 25% of all American’s will develop Fatty Liver Disease. Of those 25%, 25% will develop NASH, And of those 25%, around 25% will develop cirrhosis due to NASH. It usually hits people at middle age, but children have been known to develop it. It is usually blamed on obesity, but you don’t need to be obese.

OK thats the clinical stuff. NASH sucks. If you can catch it before too much damage is done, it can be reversed, but many times, it’s not caught until it’s too late. I personally blame that on the fact that blood work isn’t done often enough to catch high enzymes and imaging is only done when there seems to be a problem. More and better preventive measures would save lives down the line.

Until Jamey was diagnosed with NASH, there was no routine pediatric blood work. Ed only gets it now because of his brothers condition. I know a lot of parents don’t like needle jabs, but NASH is a silent killer, wouldn’t you prefer to know before it’s too late?

Some research is testing for a genetic link, but it’s still in the research phase. Some countries are looking towards stem cells for a cure, which would be a blessing to many. Also still in the research phase. More money and research need to go into finding a cure for what can affect 25% of the people in this country.

I will do my best to keep this page updated with new research links and such as the word spreads.

  1. WebMD NASH Overview
  2. Mayo Clinic Definition
  3. The American Liver Foundation NAFLD
  4. MedScape Pathology of NASH

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We all know that alcohol can damage your liver. Alcoholism is the leading cause of cirrhosis of the liver. But you can live your life without ever touching a drop and still develop cirrhosis. Some of it is genetic, some are over the counter medications, or recreational drug use. Hepatitis A  is food borne,  Hepatitis B and Hepatitis C are blood borne.  Non Alcoholic Fatty Liver Disease is thought to be caused by obesity, but you do not have to be obese to come down with it. NAFLD can lead to NASH. I have a whole page about NASH because that is what my son has been diagnosed with.

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Tylenol is liver toxic.  Acetaminophen is widely used to treat fever and pain. As little as one dose over the recommended limits, or use over an extended period can result in liver damage. I post about it on my FaceBook quite often, especially when sports are coming into play. With injuries, strains sprains and cold season, it could be dangerous not to read labels. Acetaminophen can be found in various products both over the counter and prescription. It is very important to read the literature that comes with your medication and to read labels of over the counter (OTC) medications. It’s in cold medications, menstrual cramp relief aids, and many others. It’s not worth the chance.

 

Tylenol can cause whats known as acute liver failure, which is sudden. And it can happen to almost anyone despite their health. And it can be very very bad very very quickly. People do die from acute liver failure. It’s not something to play around with.

 

There are certain tests run to find out about the health of your liver. Blood work in the form of a hepatic panel, Liver Biopsy or fibroscan, and different imaging tests (MRI, CT. Ultrasound) It’s important that liver patients know what the tests mean and what to look for. Surprisingly, the only “liver number” used to decide MELD (Model for Endstage Liver Disease) is the Bilirubin level. Creatine is a kidney test and INR is a blood clotting factor. I’ll explain all of this below. It’s really not as complicated as it sounds.


ALT~ Normal ranges are between 7-56 depending on your clinic.

AST~ Normal ranges are between 10-40

It is important to note that ALT and AST being elevated alone does not indicate Liver Disease. And even within the normal ranges, there could be on going or severe liver damage.

INR~ A blood clotting factor (used in MELD calculation) Normal values are between 9.5-13.8 seconds.

Albumin Level~ A common blood protein that is made in the liver. Low values can mean liver disease. Normal values are 3.5-5 g/dL

Bilirubin~ The byproduct of normal red blood cell destruction. High levels can cause jaundice, or the yellowish skin that you sometimes see in newborns and liver patients This is used in MELD calculation. Normal values are 0.1-1.0 mg/dL. There are some conditions that will raise the bilirubin level. (ie Gilbert’s Syndrome)

GGTP~ This one is usually run alone for some odd reason I will never figure out. But normal values are between 9-48 U/L. It can be raised with liver damage, blockage, smoking or alcohol.

Creatinine~  This is actually a kidney function test, but it is used to calculate MELD. Normal ranges are 0.5-1.2 mg/dL.

When we first  began this journey, I had no idea what any of this meant. It’s been a rough road. But please know, even with perfect numbers, you can still have damage done to the liver. The best way to know for sure is imaging and biopsy.