TrialTracker_MD said:

The mechanism that matters here is not stomach emptying, it is central.

Agreed, and ALT falling is not the same as fibrosis improving. Enzymes are a crude proxy; FIB-4 or elastography is what tells you about the thing that matters.

TrialTracker_MD said:

The mechanism that matters here is not stomach emptying, it is central.

Genuinely useful, thank you. I had the facts and not the framework.

Clinical perspective, offered as context rather than as advice. Worth answering the question that was asked rather than the one behind it. The narrow version usually has an answer; the broad version usually does not, and answering the broad one is how a thread stops being useful.

pat_auckland said:

Worth answering the question that was asked rather than the one behind it.

Mine went the same way, slower. I had assumed I was the exception until I read this.

pat_auckland said:

Worth answering the question that was asked rather than the one behind it.

There is a second half to this that has not been said yet. Take it one variable at a time. Almost every unanswerable question in these threads is unanswerable because three things changed in the same fortnight, and no amount of subsequent argument can untangle them after the fact.

Worth separating that from liver and MASH, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.