I have NASH. I believe KNOW that it was originally caused by niapan. My doctor did not take me off the med. My liver enzymes were slightly above normal. she said that was ok. year later I now have NASH-50 percent inflammation. 5 years ago my ultra sound was normal but I had the liver damage symptom. My gastroenterologist is saying the medication had nothing to do with it. The symptoms were RUQ abd pain nausea, broken blood vessels, high B/P, swollen ankle neuropathy. I still have all the symptoms, sometimes worse tha n others.