Liver Fibrosis Leader
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Cogent Family Healthcare
Stephen J Sims, MD
Family Medicine located in Mountain View, CA
Liver fibrosis caused by excess fats accumulating in liver cells, even without any alcohol is a serious disease often causing heart attacks, liver cancer and cirrhosis which can require a liver transplant. Fatty liver (steatosis), which can lead to liver fibrosis is present but un-diagnosed in 80 to 100 million Americans including 70% of those with diabetes, 35% of South Asians and 25% of the world‘s population, more often with prediabetes, alcohol use, obesity, high blood pressure and heart disease. It is very important that you find out whether you might have fatty liver or liver fibrosis by entering your standard blood tests in a calculator (see below) and need to have the definitive Fibroscan liver ultrasound recommended in guidelines, provided in Dr. Sims' office.
Liver Fibrosis Testing
Find out whether you have fatty liver or liver fibrosis using the most highly recommended test - the Fibroscan liver ultrasound. FibroScan® is widely recognized as the clinical benchmark for non-invasive liver assessment (see the liver fibrosis page). AASLD and AACE guidelines support the use of FibroScan® in primary care settings to assess liver fibrosis in at-risk patients. We are one of the first primary care offices in Northern California to provide in-office Fibroscan for your convenience.
The 2025 American Diabetes Association guideline on screening for liver fibrosis recommends most highly the FIB-4 plus Fibroscan sequence that we use. The confirmatory Fibroscan is inexpensive, non-invasive (harmless sound waves lightly tapping on the right side of your chest for 7 to 15 minutes) and convenient in our office. Fibroscan is covered by commercial and Medicare insurance when risk factors are present and always zero out-of-pocket cost with commercial insurance due to out of pocket deductible reimbursement availability. Medicare out-of-pocket deductible max $140.
Risk factors for liver fibrosis are obesity (BMI 30+), diabetes, prediabetes, alcohol use, insulin resistance, abnormal cholesterol or triglycerides, high ALT or AST lab result, lack of exercise, age over 40 and hypertension (high blood pressure).
If your FIB-4 score is over 1.3 and you have the above risk factors, Dr. Sims recommends a Fibroscan*. Check your FIB-4 score here https://www.mdcalc.com/calc/2200/fibrosis-4-fib-4-index-liver-fibrosis.
To learn more please see the Liver Fibrosis page on this website.
