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What is NASH? A deep dive into non-alcoholic steatohepatitis


Olivia Ustariz

Date Published

12 December 2023


The liver is one of the most resilient and multi-functional organs in the body. It performs nearly 500 functions to keep us alive, including breaking down harmful substances, regulating most chemical levels in the blood, and storing essential vitamins and minerals. 

The liver is also highly resilient and can even regenerate itself provided at least 25% of its tissue remains intact. In saying that, the liver is not invincible, and it can fall foul of over 100 types of liver disease, including non-alcoholic fatty liver disease (NAFLD). 

In this blog post, we will take a closer look at non-alcoholic steatohepatitis (NASH), a severe form of NAFLD. We will also provide the details of an upcoming clinical trial investigating a potential new treatment for NASH. Your participation could potentially help advance medical breakthroughs in the treatment of liver disease!

What is NASH?

As we touched on earlier, non-alcoholic steatohepatitis (NASH) is a severe form of non-alcoholic fatty liver disease (NAFLD), a range of conditions caused by a build-up of fat in the liver. In its initial stages, NAFLD is largely benign and generally only diagnosed during tests for unrelated reasons. As it progresses to NASH, however, the liver becomes inflamed.


Researchers are still not entirely sure why some people accumulate excessive fat deposits in the liver, nor why some cases of NAFLD develop into NASH. In saying that, research indicates the following conditions may increase your likelihood of developing NAFLD and NASH:

  • Overweight or obesity, especially if you have excess body fat around the waist.
  • Type 2 diabetes and other conditions that affect how your body uses insulin.
  • High blood pressure.
  • High levels of triglycerides and bad cholesterol in your blood.
  • Metabolic syndrome, a cluster of conditions that occur together and can increase your risk of cardiovascular disease and Type 2 diabetes.
  • Genes.
A patient receiving test results

Over time, the inflammation caused by NASH can develop into scar tissue. This scar tissue can, in turn, begin to replace healthy tissue and prevent the liver from functioning properly. This is called cirrhosis, a serious condition that can progress to end-stage liver failure.


In its early stages, NAFLD generally does not have any symptoms. However, people with NASH or fibrosis may experience: 

  • A dull or aching pain in the top right of the tummy.
  • Extreme tiredness.
  • Unexplained weight loss.
  • Weakness. 

In addition to the symptoms listed above, early-stage cirrhosis can be characterised by: 

  • Itchy skin. 
  • Poor appetite. 
  • Nausea and vomiting.
It is important to note, many types of liver disease are asymptomatic (do not have symptoms) during their initial stages, and symptoms can sometimes appear only after your liver has sustained irreversible damage. As such, you should visit your GP regularly if you are at risk of developing NASH. 

There are currently no approved medicines to treat NASH. Rather, NASH patients are generally encouraged to maintain a healthy diet, exercise regularly, and potentially lose weight, as these lifestyle changes can help reduce fat and inflammation in the liver as well as address contributing health conditions like diabetes. 

However, making these lifestyle changes and losing weight in the real world can be difficult due to: 

  • Lack of motivation, as the prospect of changing long-term patterns of behaviour can be overwhelming and ultimately stifling.
  • Lack of support from family, friends, and/or healthcare providers. Studies show perceived stigmatisation is common among NAFLD patients, which can subsequently cause feelings of shame and social isolation.
  • Lack of knowledge on how to make positive lifestyle changes.
  • Mental health issues, as research indicates depression and anxiety disorder are frequently seen in NASH patients, both of which can sap energy levels, foster a sense of hopelessness, and ultimately make it challenging to practise self-care.
  • Physical limitations.
Clinical research

As you can see, there is a significant need for a standard treatment that can help NASH patients reclaim command of their liver health and enhance their overall well-being. To that end, we are so excited to be helping Novo Nordisk,  a world leader in chronic disease research, recruit participants for their upcoming clinical trial investigating a potential new treatment for NASH. 

The purpose of this clinical trial is to evaluate whether the investigational medication, which has previously been prescribed at a lower dose to treat Type 2 diabetes, can slow or reverse NASH to a less severe stage. By participating in this clinical trial, you will not only benefit from free study-related medical care, but you will also have the opportunity to: 

  • Meet new people who understand your challenges. 
  • Play an active role in your healthcare journey. 
  • Contribute to medical advancements.

To find out more about this study and to register your interest, head to our website.

Final thoughts

NASH (non-alcoholic steatohepatitis) is a severe form of NAFLD (non-alcoholic fatty liver disease) characterised by high levels of fat and inflammation in the liver. Without treatment, NASH can cause permanent scar tissue and prevent the liver from functioning properly. Currently, the first line of treatment to reduce fat and inflammation in the liver is to make healthy lifestyle changes and lose weight, both of which can be difficult in the real world.

As such, clinical trials present an exciting avenue to develop a standard treatment that can help NASH patients on their healthcare journey. Consequently, we have partnered with Novo Nordisk to help recruit participants for their upcoming trial evaluating the effectiveness of a potential new treatment for NASH. For more information on the study and to register your interest, visit our website.

To find out more about this study, and other studies for which we are currently recruiting, head to the Active Trials page on our website.