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November 2025
In this educational video, Summer Collier, MSN, FNP-BC, from UC San Diego Health, answers two of the most common questions she receives from patients with MASLD and MASH. She explains whether all patients with MASLD or MASH progress to advanced fibrosis and emphasizes the importance of early awareness, risk assessment, and proactive lifestyle counseling to help prevent disease progression. Summer also shares practical dietary guidance, highlighting the benefits of a Mediterranean-style or diabetes-friendly diet that limits sugary foods and beverages while focusing on long-term sustainability and cultural fit. This concise discussion offers real-world insights for clinicians and APPs looking to better counsel and support patients at risk for metabolic liver disease.
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Common Questions From Primary Care Providers About MASH
July 2025
In this insightful episode, Jessica Crimaldi, NP from the Cleveland Clinic, addresses two of the most frequently asked questions from primary care providers about MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). First, she clarifies a common concern regarding statin use in patients with liver disease, emphasizing that statins are not only safe in most cases—including compensated cirrhosis—but also beneficial in managing cardiometabolic risk factors and slowing disease progression. She explains when statins are contraindicated and encourages collaboration with hepatology if there are concerns. Second, Jessica outlines a practical pre-referral workup for suspected MASLD/MASH patients. She details the labs needed to calculate FIB-4, suggests ordering an INR, and highlights the importance of screening for viral hepatitis, autoimmune liver disease, and common genetic liver disorders. This episode offers clear, actionable guidance for providers managing fatty liver disease in primary care and is a valuable resource for improving early diagnosis and coordinated care.
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Misconceptions About Liver Health
September 2025
Elizabeth Goacher, PA-C at Duke University in Durham, North Carolina, addresses a common misconception about Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)—that it’s a “death sentence.” While early screening and awareness are critical, Elizabeth emphasizes the importance of balanced messaging: most patients with MASLD, especially those without advanced fibrosis, will not experience liver failure or require a transplant. Instead, their greatest health risks are often from cardiovascular disease and all-cause malignancy, making lifestyle changes, metabolic health management, and cardiovascular risk reduction key priorities. This discussion encourages both patients and referring providers to focus on evidence-based care, clear communication, and realistic risk assessment, ensuring that awareness doesn’t translate into unnecessary fear.
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Misconceptions About Liver Health
June 2025
In this video, Kelly Smeester, PA-C from South Denver Gastroenterology, addresses some of the most common and harmful misconceptions about liver health. One major myth she tackles is the belief that liver disease only affects those who drink excessive amounts of alcohol. Kelly explains that liver disease has many causes—including autoimmune conditions, viral infections, and metabolic dysfunction—meaning even individuals who don’t drink at all may still be at risk. She emphasizes the dangers of relying on unregulated “liver detox” supplements, clarifying that the liver is a natural detox organ and doesn’t require external cleanses, which may actually do more harm than good. Kelly also highlights how liver disease can be entirely asymptomatic, particularly in patients with conditions like type 2 diabetes, obesity, hypertension, and high cholesterol. Finally, she reinforces that cirrhosis is not solely alcohol-related and can result from steatotic liver disease, making regular liver evaluations and screenings crucial for early detection and management. This video is an essential resource for patients and providers aiming to better understand liver health beyond outdated myths.
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Misconceptions About Liver Health
October 2025
In this educational discussion, Marcella Pomeranz, NP, lead nurse practitioner at Digestive Associates in Las Vegas, addresses one of the most common misconceptions she encounters in clinical practice—patients believing that only heavy alcohol use causes liver disease. Drawing on NHANES data, Marcella explains that nearly 38% of Americans have hepatic steatosis, and the vast majority of cases stem from MASLD (Metabolic Associated Steatotic Liver Disease), not alcohol. She highlights how factors such as metabolic dysfunction, high blood pressure, high cholesterol, diabetes, viral hepatitis, autoimmune liver diseases, genetic disorders like Wilson’s disease and hemochromatosis, and even medications like NSAIDs and methotrexate contribute to liver injury and fibrosis. Marcella also discusses the impact of ethnicity, noting that Hispanic patients face a higher risk of progression to cirrhosis. By helping patients understand that liver disease is often metabolic—not self-inflicted, clinicians can reduce stigma, encourage earlier detection, and promote lifestyle optimization to prevent fibrosis and cirrhosis. This session offers valuable insights for APPs, GI specialists, and hepatology providers dedicated to improving patient education and liver health outcomes.
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Common Questions From Community GI About MASH
June 2025
In this informative video, Janet Gripshover, DNP, FNP-BC, and nurse manager for the liver transplant program at Cedars-Sinai, answers key questions about managing MASH (Metabolic Dysfunction–Associated Steatohepatitis) and navigating non-invasive testing. She addresses a common clinical challenge—what to do when FIB-4 and FibroScan results are discordant. Janet explains that while non-invasive tests are useful, they're not foolproof, and when results are unclear—especially in patients with significant metabolic risk factors—liver biopsy remains the gold standard for accurate diagnosis. She also shares expert recommendations on dietary changes for patients with fatty liver disease, emphasizing alcohol avoidance, high-protein, low-fat, and lower-carb diets, as well as achievable weight loss goals (around 5% of body weight). Janet highlights when to escalate care beyond lifestyle interventions—typically after 3 to 6 months if there’s no improvement—and discusses options such as pharmacologic therapy or bariatric surgery. This video provides practical, evidence-based guidance for healthcare providers managing the complexities of MASLD and MASH.
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Misconceptions About Liver Health With Ann Moore
September 2025
Join Ann Moore, NP from Arizona Liver Health as she tackles two of the biggest misconceptions in liver health. With over 40 years of experience, Ann explains why normal liver tests don’t always mean a healthy liver—patients with MASH and advanced fibrosis (F2–F3) can have “quiet labs” while disease silently progresses. She also dispels the outdated belief that only alcohol causes liver disease. With the new MASLD and MASH terminology, the focus is on metabolic dysfunction—including obesity, diabetes, and high cholesterol—as the main global drivers of fatty liver disease, not alcohol alone. This educational session is designed to help clinicians and patients alike understand why early detection and management of metabolic risk factors are essential for protecting long-term liver health. Stay connected with the MASLD & MASH Community Network for more expert insights and updates on fatty liver disease care.
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Common Questions from Community GI About MASH
July 2025
In this practical and timely video, Erin Tanner, NP at Gastro Health in Birmingham, Alabama, shares expert insights on how community gastroenterology providers should approach incidental findings of fatty liver (MASLD/MASH) on abdominal imaging. With over 14 years of experience in GI and hepatology, Erin emphasizes that fatty liver can no longer be ignored, even when discovered during workups for unrelated GI symptoms like reflux or diarrhea. She walks through the step-by-step use of the FIB-4 index to risk-stratify patients and explains when to follow up with further non-invasive testing such as FibroScan® or ultrasound elastography. For patients with F3 fibrosis, Erin outlines next steps including lifestyle interventions, the use of Resmetirom, and the promise of GLP-1 therapies for future treatment. This is a must-watch for GI clinicians aiming to improve outcomes by proactively managing fatty liver disease in everyday practice.
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Common Questions From Patients About MASH
August 2025
In this engaging episode from the GHAPP MASLD Community Network, Alison Moe shares practical insights into the most common questions patients ask about advanced fibrosis and fatty liver disease. Using a liver model, she explains the stages from normal liver to steatosis, fibrosis, and cirrhosis, emphasizing that with lifestyle modifications—such as weight loss, glycemic control, and now FDA-approved pharmacotherapy—fatty liver disease, including F3 fibrosis, can be reversible. Alison also addresses a critical concern: alcohol consumption. She breaks down how her guidance differs depending on the presence and stage of fibrosis, adhering to strict AASLD guidelines to protect liver health. Whether you're a healthcare provider or a patient looking for clarity, this video offers evidence-based guidance and compassionate answers.
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Common Questions From Community GI About MASH
October 2025
In this APP Insight, Tina Gregg, NP-C, from GI Associates, addresses two of the most common questions about MASLD and MASH that clinicians encounter in practice. First, she clarifies that normal liver enzymes do not rule out MASH or advanced fibrosis—up to half of biopsy-proven cases can present with normal ALT and AST levels. Tina explains why liver enzymes fluctuate, why traditional reference ranges may be misleading, and how clinicians can better interpret lab results in context. She also answers another frequent question: Are statins safe in patients with MASLD or MASH? Drawing on evidence from multiple large studies, Tina emphasizes that statins are both safe and beneficial for most patients with fatty liver disease and play a key role in managing cardiovascular risk. This session, part of the GHAPP MASLD & MASH Community Network, helps APPs dispel common misconceptions and make evidence-based decisions in liver and metabolic care.
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Common Questions From Primary Care Providers About MASH
November 2025
Join Renee Pozza, a hepatology nurse practitioner with over 25 years of experience, as she answers two of the most common questions advanced practice providers face in managing metabolic-associated steatotic liver disease (MASLD) and metabolic-associated steatohepatitis (MASH). In this educational discussion, Renee explains how primary care NPs and PAs can identify patients at risk for fatty liver disease, what non-invasive tests—such as FIB-4 and FibroScan®—can be performed in various clinical settings, and when it’s appropriate to refer patients to hepatology for further evaluation. She also outlines key lifestyle modification strategies for patients with MASLD or MASH, including weight management, exercise, diabetes control, and multidisciplinary support to reduce disease progression and improve long-term liver outcomes. For more expert guidance, educational videos, and clinical tools for APPs in hepatology, visit the MASLD Community Network to access additional resources and upcoming programs.
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