our answer:
Maybe, there is good evidence showing that the symptoms of NASH are curable. Fibrosis, the most dangerous symptom of NASH, is curable in that it can become undetectable with the correct treatment. Fixing the underlying causes of NASH can fix the most serious symptoms of NASH as well. Additionally, certain treatments have shown promise in clinical trials. However, further research is needed before we know this for sure. While certain treatments can remove the symptoms, like a cure, experts prefer the terms reversal or resolution to the term cure as NASH can always come back.
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If you have NASH, no medication is available to reverse the fat buildup in your liver. In some cases, the liver damage stops or even reverses itself. But in others, the disease continues to progress. If you have NASH, it’s important to control any conditions that may contribute to fatty liver disease.
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.
Figure 1: Weight Loss as a Cure for NASH. A small prospective cohort study showed that weight loss was associated with a significantly higher rate of NASH resolution. Among the 19 patients who had lost more than 10% of their body weight over the 4.6 years of the study, 12 patients had achieved fibrosis regression, where their fibrosis begins to go away. Among the 22 patients who did not reach this level of weight loss, only 2 achieved fibrosis regression. This was highly significant with an adjusted OR of 8.14 and a p-value of less than 0.001.
Weight loss can be a very effective treatment for NASH, even without medication. While it may not completely cure NASH, it can fix the most dangerous and concerning symptoms of NASH.
Patients in this study were followed for over four years to see whether those who lost more weight could also reduce their fibrosis.
Fibrosis is the most concerning symptom in NASH. While fatty liver itself isn't too harmful, fatty liver + fibrosis can significantly increase the risk of liver cancer and mortality.
They found that among the patients who lost over 10 pounds, 63% had achieved fibrosis regression. This isn't necessarily a cure, as many of these patients may have still had significant fibrosis.
But, it does show that as a disease, NASH is reversible with lifestyle changes.
Figure 2: Vitamin E and Pioglitazone as NASH Treatments. A large clinical trial with 247 patients showed that Vitamin E and pioglitazone can both potentially reverse and even cure NASH. 37% of patients who took vitamin E achieved NASH resolution. 47% of patients who took pioglitazone achieved NASH resolution.
Common medications and vitamins have also been shown to potentially help in NASH.
Vitamin E, which you can find in grocery stores, has been shown to resolve NASH in many patients.
A larger Phase II Clinical Trial showed that Vitamin E and Pioglitazone can help with NASH. 37% of patients who took Vitamin E for 96 weeks achieved NASH resolution. While this was not 100%, this is still a remarkable result for just a vitamin.
Additionally, 47% of those who took pioglitazone, an older diabetes drug, showed NASH resolution.
These results suggest that NASH is treatable, but we still have a long way to go before we have a safe treatment that works for all patients.
NASH is a condition caused by the presence of fat in the liver. It is a subset of non-alcoholic fatty liver disease. Over time, the fat in the liver can lead to liver inflammation, the end stage of which we call NASH.