Dr.NateNeph said:

ATTAIN trial (survodutide) context for liver and MASH: survodutide, a GLP-1/glucagon dual agonist, showed -18.7% body weight at 46 weeks in the Phase…

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 317 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 15 months: CAP dropped to 230 dB/m (minimal steatosis) and stiffness normalized to 5.3 kPa. Hepatologist says the liver is essentially healing itself as the metabolic stress resolves.

GLP-1 agonists may become first-line NASH therapy. The Phase 3 data on semaglutide for NASH is very promising.

MounjBrad said:

Fatty liver on an incidental scan two years ago and nobody followed it up.

NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy. The Phase 2b data for semaglutide showed 59% NASH resolution (vs 17% placebo) with 43% achieving fibrosis improvement[1].

Mechanism: GLP-1R activation reduces hepatic lipogenesis, increases fatty acid oxidation, reduces hepatic inflammation, and may directly reduce hepatic stellate cell activation (fibrosis pathway).

With resmetirom (thyroid hormone receptor agonist) recently approved for NASH, the field is evolving rapidly. Combination approaches (GLP-1 + resmetirom) are being explored.

NeuroNate said:

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 317 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible…

There is a second half to this that has not been said yet. If two explanations both fit, the useful question is which one predicts something the other does not. That is answerable; arguing about which sounds more plausible is not.

One thing that is still open after JakeSmashed95’s answer:

Did your prescriber agree with that reading, and if not what was their objection?

Reporting back.

Following up because I said I would. I changed one thing, left everything else alone, and waited the full interval before looking. It resolved, and I cannot prove which half of that did it.