How My Liver Disease Interacts With Related Health Conditions

Hello, readers and fellow warriors. Today, I want to bring awareness to the connection between my diabetes, my liver disease, and my arthritis.

A lot of people do not realize there is a strong link between nonalcoholic steatohepatitis (NASH), also known as metabolic dysfunction-associated steatohepatitis (MASH), and many related health conditions, like diabetes and arthritis. This means one disease process often leads to another; major risk factors include aging, smoking, obesity, and underlying chronic illnesses.

Navigating a string of diagnoses

In 2018, I was diagnosed with my first autoimmune disease, called fibromyalgia. Key symptoms and characteristics include widespread pain, fatigue, sleep issues, cognitive function problems, and IBS.

After being diagnosed with fibromyalgia, my immune system started attacking itself. I began to get really fatigued and put on weight rapidly. I also had a terrible, hoarse throat and really bad headaches. After going to the doctor and having blood tests run, it turned out I have an underactive thyroid (hypothyroidism), just like my mother did.

I then started my prescription of levothyroxine, hoping this would help me start to feel better and eventually be able to start exercising again to shift the weight. I was told that because of my weight and my family history, I was pre-diabetic.

The toll of comorbidities on my liver

A few months later, the medication kicked in, and I was able to start my weight loss journey. In the meantime, I was suffering from terrible nausea; anytime I would drink alcohol, I would end up vomiting because my body was rejecting it—or rather, my liver was.

The doctor decided to order a liver function blood test for me. When the results came back, they showed I had a fatty liver. I was also given a blood test for diabetes at the same time, and unfortunately, it came back positive for type 2 diabetes. After being diagnosed with fatty liver disease and diabetes, I began to take a drug given for type 2 diabetics called metformin.

When chronic pain and liver health collide

In the midst of all of this happening, I was also diagnosed with degenerative back disease and arthritis. This meant I was unable to be as active as I needed to be to lose the weight due to high levels of chronic pain.

I was 24 years old and 24 stone, the heaviest I had ever been. I was practically bed-bound at this point due to all of my ailments and chronic pain. Depressed and relying on pain medications, I started experiencing extreme discomfort in my stomach and began to find it difficult and uncomfortable to breathe. I was also experiencing symptoms like bloating, pain in my legs, vomiting, a constant feeling of fullness, and extreme fatigue.

After going back to the doctor and explaining how I was feeling, they sent me for an ultrasound. It was the ultrasound that showed them just how enlarged my liver was. Normal-sized livers are, on average, 15 cm; mine was 30 cm. My liver was extremely enlarged and pushing against my other organs, making it uncomfortable to breathe and making me feel like I had a basketball in my stomach.

The journey to my NASH diagnosis

The next step was a liver biopsy to see how much scarring I had. Spoiler alert: if you haven't guessed already, it turns out I had a lot of scarring. This led to my NASH diagnosis in December 2021. I was then told that because of the amount of scarring on my liver and the overall state of my body and health, I would probably be dead in the next five years.

As a young woman in her mid-twenties who was already exhausted from being poked and probed, having to do test after test, and suffering from chronic pain, I was beyond gutted with the diagnosis, as you can imagine.

Slouched over in the doctor's chair with my head in my palms, feeling completely helpless and hopeless, my specialist explained that there were no drugs available that would reverse the liver damage. The only way this could happen is if I lost a significant amount of weight, changed my lifestyle, and gave up my pain medications.

Understanding NASH and its comorbidities

Over the years of living through chronic illness and chronic pain, bouncing from doctor to doctor, I don't even know how much blood I've given for excessive blood tests. I have learned there are several connections between NASH and its comorbidities. For example, diabetes and arthritis can both lead to reduced mobility and obesity, which can then cause NASH.

If you are pre-diabetic or you have rheumatoid arthritis and you are experiencing signs of fatty liver disease, please go to your doctor and speak to them for further help and clarity on the situation. As always, I hope this helps you on your journey and raises awareness of NASH. Feel free to reach out in the comments below.