We all start with a healthy liver.  Over time fat builds up within the body and may become excessive.  The liver is not immune to storing large amounts of fat, and becomes what we call a “fatty liver.”  The fat stored in the liver causes the liver to expand in size.  Some people continue to store fat in their liver and suffer from many metabolic complications like diabetes, hypertension, obesity, and many others.  But when a patient develops liver inflammation and fatty liver, damage to the liver starts and can lead to cirrhosis, or severe liver damage. We call this unhealthy state within the liver, steatohepatitis, that is steato(fat), hepa(liver), and titis(inflammation). Many people think liver damage only occurs in people that consume large volumes of alcohol. This is not true, there are numerous causes for liver damage including; fat-related, auto-immune diseases, infections, medications, inheritable disorders, and many others.

Healthy Liver

Fatty Liver (MASLD)

Fatty Liver with Inflammation (MASH)

Liver Cirrhosis (Advanced Fibrosis)

Metabolic-associated damage to the liver, as caused by fat, is also called Metabolic-Associated Steatohepatitis (MASH). This term essentially is fatty liver with inflammation. The damage in the liver, or cell death leads to scarring, also known as fibrosis.  If the inflammation within the liver is NOT stopped, decreased or controlled, liver cells die and proceed to cause significant damage within the liver and can lead to cirrhosis. MASH results in a decreased number of healthy liver cells and makes the liver less efficient and can lead to multiple health issues.  An unhealthy liver is associated with many other diseases and will decrease a person’s quality of life.

One commonly associated risk factor seen with fatty liver is Type 2 Diabetes Mellitus. Nearly all diabetics have some degree of fatty liver, with nearly 50% having MASH or fatty liver with inflammation.  Other illnesses that occur with higher frequency in patients with fatty liver include hypothyroid disease and polycystic ovarian syndrome.  Other risk factors with MASLD/MASH include high cholesterol, high blood pressure, and obesity.  All these risk factors combined suggest that 70% or more of the population could have MASLD.

MASH is the advanced form of fatty liver and left untreated, can lead to extensive liver damage. As the chronic damage develops and scar tissue within the liver begins to outnumber healthy liver cells, liver’s ability to function and maintain life becomes severely limited, we call this setting cirrhosis. MASH related cirrhosis is a serious and life-threatening condition and is the leading reason for liver transplantation in the United States. The challenges of identifying patients with chronic liver damage is that nearly all patients do not have any symptoms, until it is too late.

Presently, there are no FDA approved medications on the market available for patients suffering from MASLD/MASH. However, there are several investigational medications monitored by the FDA available for patients with this disease. These medications are safe and effective, but not available to the general public except through research trials.  Covenant is the leader on the west coast of Florida for managing patients with fatty liver disease. We have many studies that look to halt and even reverse the fibrosis damage caused by MASH before it becomes irreversible.

See a list of currently available research opportunities

Please contact us for any questions regarding your liver.
Our staff awaits your visit to Covenant Metabolic Specialists.