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Silent liver disease (MASLD)

Fat building up in the liver in people whose alcohol intake is not the cause. Early on it rarely makes you feel unwell, which is why it is often called the silent liver disease. The NHS also lists it as non-alcoholic fatty liver disease (NAFLD).

The basics

4 in 5

An estimated 4 in 5 people (80%) with MASH, the more advanced inflammatory form, are undiagnosed. [2]

  • It usually causes no symptoms. It is typically found when tests are done for another reason, and many people have it without realising. [1]
  • It moves through four stages, from simple fatty liver to inflammation, scarring and cirrhosis. Most people only have the first stage. [1]
  • The core treatment the NHS records is healthy lifestyle change: a balanced diet, at least 150 minutes of exercise a week, and losing weight if overweight. [1]
  • It is associated with a higher risk of death at every stage. In a Swedish nationwide study of 10,568 people with biopsy-confirmed disease, followed for a median of 14 years, those with simple fatty liver had around 1.7 times the death rate of matched comparators from the general population, rising to around 3.8 times for those with cirrhosis. [3]

The weight connection

The NHS records that the condition is often linked to being overweight, particularly fat carried around the stomach and waist, or to type 2 diabetes. [1]

What our blood test can see

3 of 10markers we measure are liver enzymes

  • Cardiovascular risk

    • Total cholesterol
    • LDL cholesterol
    • HDL cholesterol
    • Triglycerides

  • Liver function

    • ALT
    • AST
    • GGT

  • Diabetes risk

    • HbA1c
    • Fasting glucose

  • Thyroid function

    • TSH

A blood test alone does not diagnose or stage liver disease, and normal liver blood tests do not rule the condition out: NICE notes that more than 80% of people with MASLD have normal routine liver blood tests. [4] Out-of-range results are a reason to speak to your GP, who may arrange scans and further tests.

HeMed provides clinician-led weight management. We do not diagnose or treat silent liver disease (MASLD). This page is general health information, not medical advice. If you are worried about symptoms, speak to your GP, or use NHS 111.

The blood test Explore How clinician-led weight management works Explore

Related conditions

Sources (4)
  1. NHS, "Non-alcoholic fatty liver disease (NAFLD)", page last reviewed 31 July 2025. nhs.uk/conditions/non-alcoholic-fatty-liver-disease. Accessed 3 September 2026.
  2. Liver UK (formerly the British Liver Trust), "Liver disease in numbers". liveruk.org. Accessed 3 September 2026.
  3. Simon TG, Roelstraete B, Khalili H, Hagström H, Ludvigsson JF. "Mortality in biopsy-confirmed nonalcoholic fatty liver disease: results from a nationwide cohort." Gut 2021;70(7):1375 to 1382. doi.org/10.1136/gutjnl-2020-322786. Accessed 21 September 2026.
  4. National Institute for Health and Care Excellence, guideline NG49, "Metabolic dysfunction-associated steatotic liver disease (MASLD): assessment and management", context section, last updated 31 July 2026: "more than 80% of patients with MASLD have normal routine liver blood tests". nice.org.uk/guidance/ng49. Accessed 21 September 2026.

Numbered markers in the page text link to these entries. Statistics describe populations, not any one person’s results.