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July 2025
In this insightful video, Christie Morrison, a local advanced practice provider with the GHAPP MASLD/MASH Community Network, answers two of the most frequently asked questions from community GI providers: when to refer patients with MASH to a transplant center and how to evaluate liver fibrosis when FibroScan® isn’t accessible. Christy emphasizes the importance of using non-invasive testing (NITs)—including FIB-4 and ELF (Enhanced Liver Fibrosis) scores—to help identify patients with F3 fibrosis, who are at higher risk for rapid progression to cirrhosis and hepatocellular carcinoma (HCC). She encourages early referral to transplant hepatology to avoid delays in care, especially given long wait times and the value of multidisciplinary support teams at transplant centers. For clinicians without access to FibroScan, Christy shares practical alternatives such as ordering reflex testing to ELF via major labs and leveraging easy-to-use digital tools like MDCalc for FIB-4 calculation. This episode is a valuable resource for GI providers looking to optimize liver care pathways and prevent late-stage complications in MASLD and MASH patients.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this video, Jonathan Yeh, PA, answers three of the most frequently asked questions about MASH—Metabolic Dysfunction–Associated Steatohepatitis—and offers practical advice for understanding and managing this progressive form of fatty liver disease. He begins by explaining what MASH is: an inflammatory, more advanced stage of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease), driven by abnormal fat accumulation in the liver due to impaired fat transport. Jonathan then breaks down the treatment approach, emphasizing the importance of lifestyle modification—particularly diet and exercise. He highlights the benefits of a green Mediterranean diet, regular physical activity, and sustainable weight loss, which can improve or even reverse MASH in many patients. For individuals with more advanced fibrosis, pharmacologic treatment with resmetirom (Rezdiffra) may be indicated. This concise FAQ offers helpful guidance for patients and providers alike on tackling MASH with evidence-based strategies.
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Common Questions From Patients About MASH
July 2025
In this practical and patient-focused discussion from the GHAPP MASLD/MASH Community Network, we address some of the most frequently asked questions by patients newly diagnosed with MASLD (Metabolic dysfunction-associated steatotic liver disease). Many patients wonder how they can have liver disease if they don’t drink alcohol. This video explains the evolution from NAFLD to MASLD, emphasizing that MASLD is rooted in metabolic risk factors—not alcohol use—and commonly affects individuals with diabetes, obesity, and hypertension. Viewers will also learn about evidence-based lifestyle interventions, including the benefits of a hypocaloric diet, the recommended Mediterranean-style eating pattern, and 150 minutes of weekly physical activity. Finally, we tackle the question “Is MASLD curable?” with empowering guidance on how weight loss and exercise can help reverse liver damage and reduce liver fat. This is a must-watch for clinicians, care teams, and patients seeking clarity and confidence in managing this increasingly common 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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Common Questions from Patients About MASH
July 2025
In this focused episode, Suzanne Robertazzi, NP at the Washington DC VA, shares expert insights on how to prevent recurrence of MASH (Metabolic-associated steatohepatitis) and MASLD (Metabolic dysfunction-associated steatotic liver disease) in liver transplant recipients. Drawing on her experience caring for post-transplant veterans, Suzanne explains that MASH can return even after liver transplantation, making ongoing metabolic management essential. She outlines key strategies including tight blood sugar and blood pressure control, especially since transplant medications can contribute to hypertension. Suzanne also emphasizes the importance of introducing regular physical activity post-recovery and adopting a Mediterranean-style diet—while tailoring nutrition guidance to meet the needs of patients in urban settings with limited access to fresh foods. This video is a must-watch for transplant teams, hepatology providers, and patients seeking to extend the life and health of their new liver through evidence-based lifestyle and clinical interventions.
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Common Questions from Primary Care Providers About MASH
July 2025
In this FAQ session, Brian Lam, PA-C, breaks down a common question he receives from primary care providers, endocrinologists, and even other GI specialists: Which patients with fatty liver should be referred to hepatology or GI for further evaluation? Using a clear and practical approach, Brian explains how to apply FIB-4, a simple lab-based non-invasive test, to guide referrals. He emphasizes that patients with metabolic syndrome—especially those with diabetes—are at significantly higher risk for MASH (Metabolic dysfunction-associated steatohepatitis), with roughly 1 in 3 diabetic patients affected. If the FIB-4 is greater than 1.3, or greater than 2.0 in adults over 65, it's time to refer. Brian also highlights the utility of FIB-4 with reflex to ELF, now available through major labs like LabCorp and Quest, as an efficient two-step method to detect advanced fibrosis and at-risk MASH. This video is perfect for busy clinicians looking for a referral-friendly workflow to catch MASH early and improve liver health outcomes in high-risk populations.
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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, 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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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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Common Questions From Primary Care Providers About MASH
July 2025
In this concise and practical discussion, Lindsay Pratt, PA-C from the University of Colorado’s Department of Hepatology and Liver Transplant, shares expert guidance on screening and managing patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). Speaking directly to the common questions she receives from primary care providers, Lindsay outlines when to screen for MASLD/MASH—emphasizing the importance of evaluating patients with elevated liver enzymes, hepatic steatosis on imaging, and cardiometabolic risk factors like diabetes, hypertension, hyperlipidemia, and sleep apnea. She breaks down the utility of FIB-4 as a first-line non-invasive test, when to use FibroScan®, and clears up a common misconception about statin use in liver disease—encouraging providers to continue or initiate statins when indicated. This session is ideal for clinicians managing metabolic syndrome and its liver manifestations and offers simple, evidence-based tools to identify at-risk patients early.
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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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