Metabolic dysfunction–associated steatotic liver disease (MASLD, formerly NAFLD) happens when fat builds up in the liver in people who often have risk factors such as extra body weight, diabetes, high cholesterol, or high blood pressure. Many people have no symptoms, but some develop liver inflammation and scarring, which can progress to cirrhosis or liver cancer if not addressed. Alcohol-related fatty liver is a separate condition due to alcohol use.
Most people feel completely well and only learn they have fatty liver from abnormal blood tests or imaging. Some people notice fatigue or vague upper abdominal discomfort.
Call the office if you have been told you have fatty liver, have abnormal liver tests, or have risk factors such as obesity or diabetes and want to know if your liver should be checked. Also call if fatigue or abdominal discomfort are worsening.
Seek emergency care if you have signs of advanced liver disease such as confusion, swelling, severe jaundice, vomiting blood, or black/tarry stools.
Evaluation focuses on confirming fat in the liver, ruling out other causes of liver disease, and determining whether there is inflammation or scarring. This may involve blood tests, ultrasound, specialized fibrosis tests, and sometimes liver biopsy.
The mainstay of treatment is improving overall metabolic health—weight loss, healthy diet, physical activity, and control of diabetes, blood pressure, and cholesterol. In some patients, medications or clinical trials may be considered.
If your insurance requires a referral or prior authorization, our billing office will make every effort to obtain it before services are rendered. If you choose to proceed without required authorization, insurance may deny coverage. If you are a Medicare patient, you may be asked to sign an Advanced Beneficiary Notice (ABN) acknowledging financial responsibility if insurance does not pay. If you are enrolled in a commercial insurance plan you will be asked to sign a non-covered services form.