Several causes: I'm going to trust that alcohol isn't a factor, that you've been checked for hepatitis c, and that there's nothing to suggest one of the uncommon inborn errors of metabolism that can cause this. You first task -- if it's agreeable to your physician -- is to change how you think about diet and exercise and adopt a fitness-focused, aerobic intensive lifestyle. You'll be very glad even short-term.
Answered 8/15/2013
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