Fatty Liver (MASLD) Care in Chula Vista

Introduction: New Name, Better Clarity—Same Mission: Your Liver Health

Fatty liver disease has a new name—MASLD (metabolic dysfunction-associated steatotic liver disease)—and MASH replaces NASH. The update emphasizes the metabolic roots of the condition and removes stigmatizing language, helping patients get clearer, earlier care.

At Medical Wellness Doc, Dr. Nisha Kuruvadi provides comprehensive MASLD evaluation and treatment for adults in Chula Vista and the South Bay, combining plant-forward nutrition, weight management, and evidence-based medications when appropriate.

Key takeaway: With the right lifestyle plan and modern, non-invasive testing, many patients improve liver health without procedures—and those who need medications now have FDA-approved options.

What Are MASLD and MASH? (New Terms Explained)

• MASLD: The umbrella term for fatty liver linked to metabolic risk (e.g., overweight/obesity, type 2 diabetes, dyslipidemia).

• MASH: The inflammatory form (previously NASH) that can lead to fibrosis, cirrhosis, and liver cancer if untreated.

• The updated framework also recognizes MetALD (overlap with higher alcohol intake).

Who’s at Risk? (Diabetes, Weight, Lipids)

People with type 2 diabetes, obesity, or high cholesterol have substantially higher rates of MASLD/MASH. Addressing insulin resistance with nutrition, activity, and (when indicated) metabolic medications improves liver and cardiometabolic outcomes.

Non-Invasive Fibrosis Assessment (Skip the Biopsy—When You Can)

We follow guideline-based, stepwise testing to stage fibrosis and decide who needs specialty referral:

1. First-line blood score: FIB-4

   • <1.3 → usually low risk; manage in clinic with lifestyle care and periodic re-check.

   • ≥1.3 → do a second-line test.

   • >2.67 → advanced fibrosis likely; confirm and refer.

   • Age caveat: FIB-4 is less reliable <35 or >65; age-adjusted thresholds apply for older adults (commonly a higher low-risk cutoff).

2. Second-line tests (non-invasive):

   • VCTE/FibroScan® (liver stiffness), ELF test, or MR elastography based on access and coverage.

   • Discordant results or red flags → hepatology for advanced evaluation.

Our clinic orders the right labs for FIB-4 (age, AST, ALT, platelets) and coordinates elastography locally when needed.

Lifestyle Protocol (Foundational Care)

Goal-based weight loss and fitness are the backbone of MASH reversal:

• Targets: ~≥5% body-weight loss reduces liver fat; 7–10% improves inflammation; ≥10% can improve fibrosis.

• Nutrition: Plant-forward, high-fiber meals (legumes, vegetables, intact grains), limited added sugars/refined carbs, moderate healthy fats; minimize alcohol.

• Activity: Brisk walking + 2–3×/week resistance training to protect/raise lean mass and insulin sensitivity.

We tailor plans to cultural preferences (e.g., Mexican, Filipino, Middle Eastern cuisines common in South Bay) so changes stick.

Medication Options (Case-by-Case, Evidence-Based)

• Resmetirom (Rezdiffra™): FDA-approved for non-cirrhotic MASH with F2–F3 fibrosis, alongside diet and exercise.

• Semaglutide 2.4 mg (Wegovy®): FDA-approved (accelerated) for MASH with moderate-to-advanced fibrosis; also supports weight loss and metabolic control.

• Other GLP-1–based strategies and incretin therapies can improve metabolic drivers of MASLD; selection depends on A1C, weight, comorbidities, and coverage. 

Coverage varies. We confirm Sharp/Scripps/Medi-Cal/PPO benefits and discuss self-pay options when needed.

When to Refer (or Co-Manage)

Refer/coordinate with hepatology if any of the following:

• FIB-4 >2.67 or elevated elastography suggesting advanced fibrosis

• Persistent ALT elevation, imaging concern, or discordant non-invasive tests

• Cirrhosis complications or suspicion of other liver diseases (viral, autoimmune, hereditary)

• Need for specialty drug initiation/monitoring or HCC surveillance (advanced fibrosis/cirrhosis)

Neighborhoods We Serve

Chula Vista (Eastlake, Otay Ranch), Bonita, National City, Imperial Beach, San Ysidro—and via telehealth across California.

Your First Visit: What to Expect

• Detailed history (weight trends, alcohol, meds, sleep), exam, labs

• FIB-4 calculation; if needed, FibroScan/ELF/MRE

• Personalized nutrition + movement roadmap

• Medication discussion only if indicated

• Clear follow-up schedule and goals

Success Story: “Carlos Turned the Corner in 16 Weeks”

Carlos (57, Bonita) started with FIB-4 1.8 and fatigue. He adopted a plant-forward plan, added walks after meals and resistance bands. With insurance approval, he started semaglutide for metabolic control. At 16 weeks: ✅ 9% weight loss and A1C improved ✅ ALT normalized; non-invasive scores down-risk ✅ More energy; routine is sustainable

FAQs

1) Do I still need a biopsy? Often no. Modern blood scores + elastography can risk-stratify many patients. Biopsy is reserved for uncertain or complex cases.

2) What’s the difference between MASLD and MASH? MASLD is the overall fatty-liver spectrum tied to metabolic risk; MASH is the inflammatory subtype that drives fibrosis.

3) How much weight do I need to lose to help my liver? Rough guide: ≥5% lowers fat, 7–10% improves inflammation, ≥10% can improve fibrosis.

4) Are there medications for MASH now? Yes. Resmetirom (2024) and semaglutide/Wegovy (2025, accelerated) for non-cirrhotic MASH with fibrosis, used with lifestyle care. 

5) Do you accept my insurance? We see Sharp, Scripps, Medi-Cal, and PPO patients and verify coverage before testing or treatment.

Call to Action

Don’t wait for symptoms. Get your liver checked, staged, and supported with a plan that fits your life.

 ➡️ Book your MASLD/MASH evaluation in Chula Vista today.