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MASLD AI 07:59 AM
July 2025
In this session, Lavinia Iordache, PA-C, from the University of Miami, draws on a decade of experience in inpatient and outpatient hepatology to address common management questions related to MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). She provides practical guidance for gastroenterology providers navigating when to monitor versus refer patients with fibrosis, how to interpret and time non-invasive testing (NITs) such as FIB-4, and when liver biopsy may still play a role—particularly in cases with persistently elevated liver enzymes despite lifestyle improvement. Lavinia also dives into the referral criteria for hepatology, the evolving role of resmetirom in stage 2–3 fibrosis, and the critical topic of HCC screening. While current AASLD guidelines limit HCC surveillance to cirrhosis, Lavinia highlights emerging evidence and EASL recommendations supporting imaging in patients with F3 fibrosis based on individualized risk factors like diabetes, genetics, and obesity. She also explains why CT or MRI is often preferred over ultrasound in MASLD patients due to obesity-related imaging limitations. This is a must-watch for hepatology and GI teams managing liver fibrosis in metabolic disease.
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Common Questions From Patients About MASH
July 2025
In this informative video, Ellie Gonyeau, a nurse practitioner in general gastroenterology at Beth Israel in Boston, answers some of the most common questions she hears from patients about MASLD (Metabolic dysfunction-Associated Steatotic Liver Disease). With compassion and clarity, Ellie addresses concerns about the seriousness of the condition, explaining that while MASLD can progress to advanced liver disease, early intervention can make a significant difference. She emphasizes the importance of not delaying care and encourages patients to take manageable steps—like losing just 5–10% of their body weight—to reduce liver inflammation and slow disease progression. Nutrition, exercise, and proactive conversations are central to her patient-centered approach. Whether you're newly diagnosed or seeking guidance, this episode offers valuable, practical insights for anyone navigating MASLD. #MASLD #FattyLiver #LiverHealth #GIcare #BethIsrael #NursePractitioner #Gastroenterology #PatientEducation #LiverDisease #WeightLossSupport
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How is MASH severity staged? What would an ideal MASH NIT algorithm look like?
January 2025
Thank you to Madrigal for sponsoring this FAQ Video Module. In this GHAPP FAQ Video Module, Jonathan Yeh, a physician assistant at the Center for Liver Disease and Transplantation at Columbia University Irving Medical Center, discusses advancements in diagnosing and staging metabolic dysfunction-associated steatohepatitis (MASH). He explains the transition from traditional liver biopsy to non-invasive testing methods such as FibroScan and the Enhanced Liver Fibrosis (ELF) test for assessing fibrosis stages. Jonathan highlights the use of these methods, in combination with blood tests, to provide reliable staging of fibrosis in patients with MASH. For more information, visit the GHAPP website or ACE app.
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Misconceptions About Liver Health
July 2025
In this short and informative video, Miu Lai Ng, a nurse practitioner at Tufts Medical Center, debunks two of the most common myths about liver health. First, she sets the record straight on liver cleanses and detox teas—explaining that your liver already detoxifies your body daily and doesn’t need fad diets or trendy supplements. Instead, what your liver needs is support through sustainable habits like reducing alcohol intake, cutting back on processed sugars, and maintaining a healthy weight. She also highlights a critical point: liver disease is often silent, and many people with significant liver damage have no symptoms until it’s advanced. If you're at risk due to metabolic syndrome, alcohol use, or other factors, Miu Lai urges you to talk to your healthcare provider about screening options like FIB-4 or FibroScan®. Your liver works hard for you—this video is a reminder to return the favor with real, lasting care.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Scott Springer, PA-C, from Erie County Medical Center in Buffalo, NY, addresses one of the most common misconceptions in liver health—trusting over-the-counter supplements and detox products to improve liver function. Drawing from his experience in both hepatology and addiction medicine, Scott emphasizes that many non-prescribed products marketed for liver support are not only ineffective but can actually cause liver harm. He cautions against relying on unregulated supplements and urges patients to consult medical professionals before taking anything for liver health. One surprising and evidence-based recommendation he makes: drink coffee. Filtered coffee, in particular, has been shown to support liver health and may reduce the risk of liver disease progression. Scott recommends two to three cups per day, without added sugar or excess dairy—especially for patients with MASLD or MASH. This video offers practical, research-backed advice for patients and providers alike, highlighting what truly helps (and what may harm) the liver.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Gabriella McCarty, NP-C, of Northshore Gastroenterology in Cleveland, Ohio, tackles common misconceptions surrounding fatty liver disease, also known as MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease). Drawing from her clinical experience, Gabriella highlights how fatty liver is often an incidental finding during routine GI visits, even when patients present for unrelated concerns like GERD or colon screenings. She emphasizes that MASLD is not caused by alcohol, but instead driven by metabolic risk factors such as obesity, diabetes, high cholesterol, and hypertension. Gabriella dispels the myth that normal liver enzymes indicate a healthy liver, explaining that liver markers are often unreliable in detecting advanced fibrosis or cirrhosis. She also warns against unregulated liver detox products and the outdated belief that fatty liver is harmless. With MASLD now the most common liver disease worldwide and increasing rates among younger populations, Gabriella stresses the importance of early screening, lifestyle modification, and patient education. This is a must-watch for anyone looking to better understand the silent progression of fatty liver disease and the tools available for timely intervention.
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Misconceptions About Liver Health
July 2025
In this quick but powerful video, Jeremy Davis, NP from Shreveport, Louisiana, addresses some of the most common misconceptions about liver health that he encounters in clinical practice. Many patients believe that liver disease only occurs in people who drink alcohol, but Jeremy explains how conditions like MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis) can affect individuals regardless of alcohol use. He also clears up the myth that only overweight patients are at risk, pointing out that co-morbidities such as hypertension, high cholesterol, cardiovascular disease, and type 2 diabetes can contribute to liver disease—even in patients with a normal BMI. Finally, Jeremy explains why normal liver enzyme labs (ALT and AST) don’t always rule out liver disease, making it crucial to assess underlying risk factors and improve provider and patient awareness. This video is a valuable resource for both healthcare professionals and patients looking to better understand non-alcoholic liver disease and why early screening matters.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Christina Hanson, FNP-C, from South Denver Gastroenterology, dispels common myths around liver health and highlights a critical shift in how we identify and manage fatty liver disease. With the updated terminology from NAFLD/NASH to MASLD/MASH—Metabolic Dysfunction–Associated Steatotic Liver Disease—Christina explains how the new name more accurately reflects the underlying cardiometabolic drivers of the condition, such as obesity, type 2 diabetes, hypertension, and dyslipidemia. She emphasizes that liver enzyme abnormalities or incidental imaging findings should no longer be the only triggers for evaluation. Instead, clinicians—especially in primary care and endocrinology—should proactively screen high-risk patients using non-invasive tools like FIB-4 to assess for liver fibrosis. With over 50% of patients with type 2 diabetes and up to 90% of those with morbid obesity at risk for coexisting fatty liver, early identification and triage are vital to improving outcomes. This is a must-watch for healthcare providers seeking practical, guideline-driven strategies for detecting MASLD and MASH in everyday clinical practice.
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Common Questions from Patients About MASH
July 2025
In this impactful episode, Sherona Bau, NP from UCLA, addresses the most frequent and pressing questions patients ask after being diagnosed with MASLD (Metabolic dysfunction-associated steatotic liver disease) or MASH (Metabolic-associated steatohepatitis)—including concerns about life expectancy, risk of liver failure, liver cancer, and genetic impact on family members. She emphasizes the importance of risk stratification using non-invasive testing, particularly FibroScan®, to determine the extent of fat accumulation and liver fibrosis. Sherona explains that early identification of stage 2 or 3 fibrosis is critical, as treatment options are now available for these stages, offering hope for patients. She also stresses that MASLD is not just a liver disease—it's a systemic, metabolic condition—and encourages coordinated care with endocrinologists, cardiologists, and dietitians. Additionally, she discusses the hereditary nature of fatty liver and the importance of family screening, especially for children of affected individuals. This video offers clear, compassionate guidance for patients and providers navigating the complexities of fatty liver disease.
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Common Questions from Primary Care Providers About MASH
July 2025
In this informative episode, Emily Przybyl, PA-C at Erie County Medical Center in Buffalo, NY, answers two of the most common questions primary care providers have about MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis): When should I refer to hepatology? and Is it safe to prescribe statins in patients with fatty liver disease? Emily explains that any history of hepatic steatosis on imaging or elevated liver enzymes (LFTs) is reason enough to initiate referral for further workup, including non-invasive testing like FIB-4 or FibroScan®. She also debunks the common myth that statins should be avoided in this population, emphasizing that statins are not contraindicated and are critical for managing cardiometabolic risk factors that drive liver disease progression. This episode is a must-watch for clinicians navigating MASLD/MASH in primary care, with practical guidance that supports early intervention and evidence-based management.
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Misconceptions About Liver Health
July 2025
In this quick myth-busting session, Elizabeth Alqueza, PA-C from Beth Israel Deaconess Medical Center in Boston, addresses two of the most common misconceptions in hepatology related to steatotic liver disease (MASLD/MASH). First, she explains that liver disease is not always fixed or irreversible—and with proper management and elimination of the underlying cause, liver fibrosis can improve over time, a trend often monitored through FibroScan®. Second, she clarifies that significant liver improvement does not require extreme weight loss. In fact, a modest 5–10% reduction in total body weight—sometimes as little as 10–20 pounds—can lead to measurable improvements in liver inflammation and fibrosis. This video is ideal for providers and patients seeking a clearer understanding of how lifestyle changes can reverse liver disease and why timely, targeted interventions matter.
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