Hormonal

Dysbiosis in NASH, specifically decreased abundance of Clostridium leptum and Bacteroidetes, is associated with altered bile acid homeostasis, leading to higher levels of unconjugated primary bile acids.

Your gut bacteria play a direct role in liver health. In NASH, specific beneficial bacteria (like C. leptum) are depleted, which leads to higher levels of potentially toxic primary bile acids in the gut. This suggests that gut health interventions should target these specific microbial deficits to help normalize bile acid metabolism.