Millions of People Have This “Silent” Disease—and They Don’t Even Know It

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Could you be one of them?

A staggering 16 million Americans live with a scary disease right this second. Those with type 2 diabetes, insulin resistance, and obesity have a higher risk of developing it. It’s tough to find and even tougher to treat. But here’s the kicker: Most people have never even heard of it.

It’s called nonalcoholic steatohepatitis, or NASH for short, and it’s a type of fatty liver disease that’s every bit as nasty as the version alcoholics suffer from. While having a liver lined with fat is distressingly common—it affects some 64 million Americans—in most people the fat buildup doesn’t trigger life-threatening health troubles. With NASH sufferers, however, the liver becomes inflamed, which can lead to the permanent scarring known as cirrhosis and an increased risk for liver cancer. Some experts believe NASH will surpass hepatitis infections as the biggest reason for liver transplants by 2020.

Why have doctors and patients ignored this dangerous disease for so long? “It’s because they didn’t see it,” Mark Pruzanski, CEO of Intercept Pharmaceuticals, a company that’s focused on treatments for liver diseases including NASH, told Business Insider.

Symptoms are scarcely seen in patients with early stages of NASH. To test for it, you need to get a liver biopsy, which requires removing cells from your liver using a small needle. Even then, it might be too late; the disease often leads to problems like liver failure, and no treatments currently exist.

There’s good news, though! You can prevent NASH right now by losing weight and maintaining a healthy weight and diet. Plus, doctors and pharmaceutical companies are pounding the pavement to develop a treatment. They currently have a test drug in the works, with an expected approval date in 2019.

You might want to make sure you don’t have any of these fatty liver symptoms. Keep on reading!!

9 Fatty Liver Symptoms You Need to Watch Out For

Nonalcoholic fatty liver disease is the most common liver disease in America. If you have any of these fatty liver symptoms see your doctor right away.

You tend to be a binge eater

One of the early fatty liver symptoms is binge eating, either feeling hungry all the time or having an intense craving for sugars. These eating habits only add to the fat that is already accumulating in your liver. “We have to be cognizant of what we’re eating because we are what we eat,” Rohit Loomba, MD, director of the NAFLD Research Center at the University of California at San Diego, says. “And if we consume excess calories, especially calories that are sugar-rich or carbohydrate-rich, over a long period of time, it will have negative consequences.” He recommends keeping a food log of what you eat every day to track your sugar and fat intake. This will help you to see if your eating habits are something you need to watch out for.

You store weight in your belly

People who are overweight are at an increased risk of NAFLD. Since the obesity rate in Americans is on the rise—more than one-third of the population is obese—the threat is more prevalent than ever. Dr. Loomba cautions that visceral fat (the kind stored in your abdomen that gives you a big gut) is a big concern. “As the body mass index goes up and people go from a BMI of 30 to 35 to 40, the prevalence of nonalcoholic fatty liver disease starts going up,” he says. “We’re finding that the visceral fat correlates well with liver fat especially in middle-aged and younger adults.”

You’ve got high cholesterol

High blood fat levels, either triglycerides or LDL (“bad”) cholesterol, can signal that there’s too much fat in your liver. “The cholesterol that we measure in the blood is predominantly a product of what is coming out of the liver,” Dr. Loomba explains. The liver makes cholesterol on its own and circulates it into your bloodstream, but when we eat foods high in saturated and trans fats, it releases more fat and raises cholesterol levels. Have your doctor check your cholesterol levels often to make sure they’re not one of the fatty liver signs that you need to watch out for.

You’ve been diagnosed with type 2 diabetes

If you have diabetes, Dr. Loomba says getting tested for NAFLD should be a major medical priority. In a 2016 study, he and other UC-San Diego researchers tested 100 type 2 diabetics who had no other fatty liver symptoms. All of them received an MRI of their livers. The results showed that 65 percent of the participants had NAFLD and didn’t even know it.

Your blood pressure is through the roof

When German researchers analyzed data from more than 3,000 individuals, they found that those with NAFLD were three times more likely to have hypertension than those who didn’t have the disease. Monitoring blood pressure and maintaining heart health, in general, is especially important if you have or think you may have liver disease. Cardiovascular problems are the leading cause of death in people who have NAFLD, says Dr. Malhi.

Another family member has fatty liver disease

Dr. Loomba and his colleagues recently conducted a study of 25 families who have a history of NASH cirrhosis. They found that the risk of this advanced stage of NAFLD is 13 times higher if a family member had the disease as well. This is an ongoing study, but other familial research has evidence that some people may be genetically predisposed to this disease as well.

You’re always tired

NAFLD doesn’t have any physical symptoms, which makes it virtually impossible to identify without blood tests or a liver biopsy, explains Dr. Loomba. However, once it progresses to cirrhosis, you may start to experience common symptoms like fatigue and weakness. Since the effects of cirrhosis are permanent and could lead to cancer, it’s important to visit your doctor right away if you develop these fatty liver symptoms and have any of the previous risk factors.

You have pain in the upper right abdomen

People with NAFLD sometimes have pain just below the ribs on the right front, but it’s a symptom that doesn’t usually show up unless NASH or cirrhosis have developed. At this point, fluid may gather in the abdomen (called ascites) and can cause pain. If the fluid gets infected, though, you’ll almost definitely experience pain, often with fever and chills, and you need to call your doctor or head to the emergency room. A less severe tummy issue that can result from cirrhosis is a loss of appetite.

You’re experiencing confusion

Confusion can also be added to the list of fatty liver symptoms which show up later in the disease. Since the liver is not able to metabolize properly, the toxins it normally expels get into the bloodstream and can move into the brain. If your confusion worsens or you become disoriented, contact your doctor immediately.

NEXT: NASH Treatment

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