How can stage 4 liver fibrosis be managed?

Q. Will losing weight help in treating stage 4 liver fibrosis?

Answered by
Dr. Goswami Parth Rajendragiri
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Nov 28, 2019 and last reviewed on: Mar 22, 2023

Hello doctor,

Two years back, after a routine blood test I was diagnosed with fatty liver due to raised liver enzymes ALT 53 ALP 66 and GGT188. I later underwent a liver scan and the conclusion was Child A Cirrhosis-possibly secondary to NASH. Advised to lose weight with no medication prescribed. Yesterday, I underwent a FibroTouch scan and result showed liver stiffness of 19.9 kPa and UAP(dB/m) of 279. Meanwhile, for the past one year I have been taking daily supplements of Milk Thistle, Gluthathione and lately Magnesium Bisglycinate, (for cramps and muscle weakness), and Vitamin E. I was also once told that I may have high inflammation due to autoimmune-related problem possibly due to a weak gut (leaky gut). All not really validated through any test.

Apart from deciding to go aggressive with my weight loss initiative and eating more plant based food, I am at a loss as to what to do to reverse the stage 4 fibrosis from worsening. I am going plant based because of the testimonies of those who adopted the diet lifestyle and had a change for the better in their conditions. My family is worried that I may not have the chance to live long. I am almost 62 now. What do you advice that I should do to recover from this?



Welcome to

You have investigated by fibroscan report (attachment removed to protect patient identity). The 19 kpa is suggestive of grade 4 fibrosis in liver. The fibrosis can from due to chronic inflammation. The NASH is form of hepatitis due to overweight. So, fibrosis can develop in NASH as well and so liver can be more stiff. However, your high kpa and UAP are suggestive of early cirrhosis change. So, you need to lose weight first.

The Ursodeoxycholic acid can be prescribed for your condition. You need to be monitored regularly by gastroenterologist. No further aggressive treatment needed just now. I suggest you consult gastroenterologist for detailed evaluation and do regular follow up.

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