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Can NASH/cirrhosis progression be stopped by diet

This time of year I get a lot of questions about whether it is possible to manage NASH/cirrhosis entirely with diet and can a stage 4 liver fibrosis improve.  Most people say no.  Once you have cirrhosis it is hopeless. Is that necessarily true?

There are a lot of new year resolutions about better health and diet but what really matters? What is possible? I changed my lifestyle as my personal therapy and the question is does it work? Here is a chart of my results since diagnosis.


I am a cirrhosis patient.  I was diagnosed in 2015 with a FibroScan score of 21.5.  Anything over 14 is considered to be cirrhosis. Mine was biopsy confirmed as well.  I just had my semi-annual checkup with the hepatologist so I'm officially 5 years into management of my disease. 

In case it isn't clear what this means, in 5 years I went from an F4 cirrhosis with a stiffness score of 21.5 to a high F2 at 9.6.  That means that my liver is remodeling and is probably no longer headed toward end stage liver failure.  Risky? Certainly, but a far better situation than being an advancing fibrosis due to NASH patient.

So what is the point of this note?  We hear every day from desperate patients who are told that they have cirrhosis and there is no treatment. The next thing they learn is that cirrhosis can't be reversed but they should lose weight and exercise. It is hard to overstate the negativity that attaches to that package of messages.

The medical profession needs to be far more proactive about the potential for management of this disease.  It is certainly true that not everyone can succeed and the risk from cirrhosis is extreme but to describe it as hopeless is simply wrong.

The first real evidence that even cirrhosis could improve came from the HepC patients as they were cured of that disease. We began to see a significant portion of that population improve their fibrosis status.

My personal story was informed by that progress in the HepC patients and knowing that, it was easier for me to maintain my lifestyle change and my personal story is testimony to the possibility of improvement. The Foundation believes that early detection and reinforcing the message that it is possible to manage this disease is important. Hopelessness is not a proper therapy.

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