Living With Nonalcoholic Steatohepatitis (NASH)

Living with nonalcoholic steatohepatitis (NASH) can be a challenging journey. Research shows that people living with NASH have a poorer physical and mental quality of life than those without NASH. But with the right information and support, it is possible to manage the condition and improve certain aspects of life.¹

NASH is an advanced form of nonalcoholic fatty liver disease (NAFLD). It occurs after too much fat builds up in the liver, causing inflammation and liver scarring (fibrosis). It progresses slowly over time. It is often diagnosed late in the disease course because it can be asymptomatic, or the symptoms may not show up until advanced stages. This can lead to delayed diagnosis and treatment, which can have serious effects on a person’s life.¹

Work/School and NASH

Fatigue and discomfort are symptoms of NASH, and they can affect performance at work or school. As the disease progresses, more frequent medical appointments may interfere with daily responsibilities.²

On the flip side, work can also impact health in many ways. Excessively long working hours have been linked with worsening heart disease, high blood pressure, and obesity. And experts have now added NAFLD to that list.³

A 2021 study found a link between long working hours (more than 42 hours a week) and the development of NAFLD. The occurrence of NAFLD increased as working hours increased. This was in part due to:³

• Sitting for long periods of time (sedentary behavior)
• Chronic stress from intense workloads
• Unhealthy eating habits, like relying on processed foods and fast food
• Lack of sleep, especially among shift workers

Sexual health and NASH

NAFLD and NASH can impact sexual health by causing low sex drive and performance issues. In people with a penis, they can lead to erectile dysfunction (ED) and infertility. Research shows that chronic inflammation, heart disease, and obesity – all risk factors for NAFLD and NASH – can interfere with sexual function and cause ED.⁴

Lifestyle habits with NASH (diet and exercise)

Diet and exercise are the cornerstones of NASH treatment. A balanced diet of fruits and vegetables, whole grains, and lean proteins can help you lose weight. A healthy diet can also reduce fat in the liver and lower inflammation in the body. Experts recommend that anyone with NAFLD or NASH limit processed foods, foods with added sugar such as sugary beverages, and saturated fats.^5,6

Regular exercise is just as important. Getting enough physical activity in your day can help with weight management and improve overall health, including liver health. A sedentary lifestyle can increase the risk of obesity, heart disease, and NASH.^5,6

Financial impact of NASH

With any chronic condition, there are medical bills to deal with. Treatment options can be costly. Also, lost wages due to time away from work because of illness or disability can impact financial well-being.⁷

The cost of treating NASH is particularly high. NASH is more expensive to treat because it is a more advanced form of liver disease. Those with NASH tend to use more healthcare services than people without the condition.⁷

NASH is often linked to other health conditions, like type 2 diabetes and heart disease. This adds to a person’s overall financial burden. And some people with NASH may need expensive surgeries or procedures, such as a liver transplant in severe cases, to help manage their condition.⁷

Coping with NASH

Living with a chronic illness like NASH can take a real toll on a person’s mental and emotional well-being. Fear, anxiety, depression, and frustration are common emotions experienced by people with chronic illnesses.⁸

A 2022 study found that many mental health conditions were more common in those with NAFLD and NASH than in the general population, including depression, schizophrenia, and bipolar disorder.⁹

Widespread inflammation in the body is linked with not only NAFLD/NASH but also mood disorders. Taking certain antidepressants and atypical antipsychotic medicines may increase the risk for NAFLD/NASH as well. However, more research is needed to fully understand these links.⁹

Healthy ways to express feelings and cope with the challenges of NASH include:⁸

• Getting support from loved ones
• Joining a support group
• Speaking with a therapist

Resources for people with NASH

Fortunately, there are many resources available to support those living with or caring for someone with NASH:¹⁰

• Healthcare providers – Establish a relationship with your healthcare team. Regular communication and collaboration around your treatment plan can help you feel more in control of your condition.
• Support groups – Join online or in-person support groups to connect with others facing similar health challenges.
• Educational materials – Ask your healthcare providers for more information about NASH. Knowledge is power. The more you know how to manage your or a loved one’s condition, the better you will feel.
• Dietitians/nutritionists – Diet and nutrition experts can help you develop a healthy diet plan tailored to your needs and preferences. It is important to prioritize healthy eating.
• Financial assistance programs – You may qualify for financial aid with your treatment costs. Government agencies, nonprofit organizations, or pharmaceutical companies may offer these. If you need financial help, talk with your healthcare team. They can point you in the right direction.