Treatment for NAFLD & NASH

How do doctors treat NAFLD and NASH?

Doctors recommend weight loss to treat nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Weight loss can reduce fat in the liver; inflammation; and fibrosis, or scarring.

If you are overweight or obese, losing weight by making healthy food choices, limiting portion sizes, and being physically active can improve NAFLD and NASH. Losing at least 3 to 5 percent of your body weight can reduce fat in the liver. You may need to lose up to 10 percent of your body weight to reduce liver inflammation.7

Doctors recommend gradually losing 7 percent of your body weight or more over the course of 1 year.8 Rapid weight loss through very low calorie diets or fasting—eating and drinking nothing except water—can make NAFLD worse.

An overweight couple walking outdoors.
If you are overweight or obese, losing weight can improve NAFLD and NASH.

Medicines

No medicines have been approved to treat NAFLD and NASH. However, researchers are studying medicines that may improve these conditions.

Some studies suggest that pioglitazone (Actos), a medicine for type 2 diabetes, improves NASH in people who don’t have diabetes. Researchers need more information to find out whether this medicine is safe and effective for long-term use in people with NASH.7

A study by the National Institute of Diabetes and Digestive and Kidney Diseases’ NASH Clinical Research Network found that treatment with vitamin E or pioglitazone improved NASH in about half of the people treated.9 Doctors may recommend vitamin E for people who have NASH and don’t have diabetes or cirrhosis.7 Talk with your doctor before taking vitamin E or pioglitazone.

For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices. Some herbal remedies can actually damage your liver.

How do doctors treat the complications of NASH?

If NASH leads to cirrhosis, doctors can treat the health problems caused by cirrhosis with medicines, operations, and other medical procedures. If cirrhosis leads to liver failure, you may need a liver transplant.

How can I prevent NAFLD and NASH?

You may be able to prevent NAFLD and NASH by eating a healthy diet, limiting your portion sizes, and maintaining a healthy weight.

References

November 2016
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank:
Anna Mae Diehl, M.D., Duke University Medical Center, and Brent A. Tetri, M.D., Saint Louis University