Frequently Asked Questions about Liver
What is the function of the liver?
All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood and breaks down, balances, and creates the nutrients and also metabolizes drugs into forms that are easier to use for the rest of the body or that are nontoxic.
The liver performs many functions, including
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Digestion
The liver produces bile, which helps break down fats and remove waste during digestion
Blood purification
The liver filters toxins and waste products from the blood
Blood clotting
The liver produces substances that help blood clot after an injury
Blood sugar regulation
The liver maintains healthy blood sugar levels by storing and releasing glucose
Immune response
The liver produces immune factors and removes bacteria from the blood
Nutrient processing
The liver absorbs nutrients from food and converts them into energy
Vitamin and mineral storage
The liver stores vitamins, fat, sugars, and minerals
Protein production
The liver produces proteins for blood plasma, including albumin, which carries hormones, drugs, and fatty acids
Hormone production
The liver produces hormones that regulate sexual desire and function
Bilirubin clearance
The liver removes bilirubin, a substance produced by the breakdown of red blood cells. Too much bilirubin can cause jaundice, which is a yellowing of the skin and eyes
Ammonia conversion
The liver converts ammonia, a poisonous substance, into urea, which is excreted in urine
What is a fatty liver?
A fatty liver, also known as fatty liver disease or steatosis, is a condition where too much fat builds up in the liver. Fat in the liver builds up duo to malfunctioning of nutrients, sugar, fat and proteins processing in the liver cell. Such malfunctioning happens due to 1) burnout of cell machinery from stress caused by overconsumption inadequate proportion (unbalanced) of nutrients, 2) inherent (genetic) defects in cellular nutrients biochemical processing systems.
Lastly, it could result from combination of these two factors. Simultaneously, such patients may also develop DM, obesity, hypertension, hyperlipidemia or dyslipidemia. These manifestations of abnormal nutrient metabolism are collectively called as “Metabolic Dysfunctions” or “Metabolic Syndrome”. Thus new terminology (published in 2023) classify fatty (Steatotic) liver disease based upon underlying dysfunctions into following major categories
1. Alcohol related fatty liver disease (ALD)
(ALD)
2. Metabolic dysfunctions associated with Steatotic (fatty) liver disease
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3. Hereditary monogenic metabolic diseases
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4. Drug induced fatty liver disease (DIFLD)
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How does the fat accumulation in the liver damages liver?
When fat accumulates in the liver, it can damage the organ by causing inflammation within the liver cells, which can lead to cell death, scarring (fibrosis), and eventually progress to a serious condition called cirrhosis, where the liver loses its ability to function properly due to extensive scarring; this process happens when the liver becomes overloaded with fat, causing stress on the cells and triggering a cascade of inflammatory responses.
Key points about fat accumulation in the liver and liver damage
Cell stress
As fat builds up within liver cells, it can disrupt normal cellular functions, leading to stress and damage to the cell membranes
Inflammation
This stress response triggers the release of inflammatory chemicals, causing inflammation within the liver tissue
Cell death
If the inflammation is persistent, it can lead to liver cell death
Fibrosis
When damaged liver cells die, the body attempts to repair the tissue by forming scar tissue (fibrosis)
Cirrhosis
In advanced stages, extensive fibrosis can lead to cirrhosis, a condition where the liver is severely scarred and can no longer function properly.
Important factors to consider
Severity of fat accumulation
Not everyone with fat buildup in the liver will experience significant damage
Underlying causes
Conditions like obesity, diabetes, high cholesterol, and excessive alcohol consumption can contribute to fat accumulation in the liver
Progression of disease
Fatty liver disease can progress from a mild condition with minimal symptoms to a more severe stage with significant liver damage
What are the symptoms and symptoms of fatty?
Fatty liver disease, also known as steatotic liver disease (SLD), often has no symptoms. When symptoms do occur, they can include:
Abdominal pain
Pain or discomfort in the upper right abdomen
Fatigue
Feeling tired or generally unwell
Is fatty liver one disease?
Fatty liver disease is a general term for a group of conditions that involve excess fat in the liver. The two main types of fatty liver disease are nonalcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease. Nonalcoholic fatty liver disease (NAFLD)
Nonalcoholic fatty liver disease (NAFLD)
· The most common chronic liver disease in the United States
· The most common chronic liver disease in the United States
· Fat builds up in the liver, but there's no or little inflammation or scarring
· Also known as metabolic dysfunction-associated steatotic liver disease (MASLD)
· Risk factors include obesity, diabetes, high cholesterol, and metabolic syndrome
· Usually asymptomatic, but symptoms may include fatigue, weakness, and abdominal pain .
Nonalcoholic steatohepatitis (NASH)
Alcoholic fatty liver disease Caused by heavy alcohol use and Also known as alcohol-associated liver disease.
· Fat builds up in the liver along with inflammation and varying amounts of scarring
· Also known as metabolic dysfunction-associated steatohepatitis (MASH)
Fatty liver disease can be diagnosed with blood tests, imaging studies, and liver biopsy. Treatment focuses on making healthy lifestyle choices to prevent the condition from worsening
What are the types of fatty liver?
The two main types of fatty liver disease are alcoholic fatty liver disease (AFLD) and nonalcoholic fatty liver disease (NAFLD)
Alcoholic fatty liver disease (AFLD)
· Caused by heavy drinking
· The liver breaks down alcohol, but if you drink more than it can process, it can become damaged
Nonalcoholic fatty liver disease (NAFLD)
· Not caused by heavy drinking
· The most common chronic liver disease in the United States
· More common in people who are overweight, have diabetes, or have high levels of cholesterol and triglycerides
· Can lead to nonalcoholic steatohepatitis (NASH), a more severe form of NAFLD
Stages of fatty liver disease
· Grade 1: Mild fat accumulation
· Grade 2: Moderate fat accumulation
· Grade 3: Severe fat accumulation, which can lead to liver damage, scarring, and cirrhosis
What is alcohol fatty liver?
Alcoholic fatty liver disease (AFLD) is a condition where fat builds up in the liver due to excessive alcohol consumption. It's the first stage of alcohol-related liver disease (ALD).
Causes
· The liver breaks down alcohol, releasing a toxin that damages liver cells
· The chemical reaction of breaking down alcohol creates higher levels of NADH, which tells the cell to produce more fatty acids
What metabolic syndrome fatty liver?
Metabolic syndrome fatty liver" refers to a condition where excess fat accumulates in the liver, often associated with other metabolic abnormalities like high blood pressure, high cholesterol, and high blood sugar, which collectively form what is known as "metabolic syndrome"; essentially, fatty liver is considered a key component of metabolic syndrome, and the presence of one often indicates a higher risk of the other.
Key points about metabolic syndrome fatty liver:
· Medical term:
This condition is often called "non-alcoholic fatty liver disease (NAFLD)" as it is not caused by excessive alcohol consumption.
· Mechanism:
When someone has metabolic syndrome, their body becomes insulin resistant, leading to increased fat storage in the liver, contributing to fatty liver development.
Can fat related liver damage progress to cirrhosis?
Yes, fat-related liver damage, specifically when it progresses to a stage called non-alcoholic steatohepatitis (NASH), can indeed progress to cirrhosis, which is a serious condition characterized by extensive liver scarring and potential liver failure; meaning that untreated fatty liver disease can lead to cirrhosis in some cases.
Key points
· Stages of progression:
Fatty liver disease can progress from a simple fat buildup to NASH, where inflammation and liver cell damage occur, and then further to fibrosis (scarring) which, if severe, becomes cirrhosis.
· Risk factors:
Obesity, high cholesterol, diabetes, and high blood pressure are major risk factors for developing NASH and progressing to cirrhosis.
· Early detection is crucial:
Since fatty liver disease often has no symptoms in early stages, regular check-ups and monitoring liver
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Is it important to stop drinking alcohol to get liver fat free?
· Fatty liver disease
Fatty liver disease is a condition where fat builds up in the liver. It's the first stage of alcohol-related liver disease (ARLD).
· Reversing damage
If you stop drinking alcohol, the damage caused by fatty liver disease can usually be reversed. This can take months or years.
· Other benefits
Cutting down on alcohol can also improve other health conditions, such as high blood pressure, depression, and skin conditions.
Other tips for liver health Eat a healthy diet, Limit simple sugars and portion sizes, Maintain a healthy weight, and Exercise regularly.
Explanation
Yes, it's important to stop drinking alcohol to get liver fat free if you have fatty liver disease. Fatty liver disease is reversible, and stopping drinking can help your liver return to normal.
What is there a role of liver cleansing agents?
Liver cleansing agents, often marketed as "detox" products, claim to help remove toxins from the body by supporting the liver's natural detoxification process, but most scientific evidence does not support their effectiveness and some can even be harmful; the liver is already highly efficient at filtering toxins on its own, making dedicated "cleansing" agents largely unnecessary and potentially dangerous.
Key points about liver cleansing agents:
· Limited scientific backing:
While some ingredients like milk thistle or artichoke leaf may have potential benefits for liver health, there is not enough robust research to prove that they significantly enhance liver detoxification in healthy individuals.
· Potential risks:
Some liver cleansing products can contain ingredients with harmful side effects, especially when used in large doses or by people with pre-existing liver conditions.
· Focus on healthy lifestyle:
The best way to support liver health is to maintain a balanced diet, limit alcohol consumption, and engage in regular physical activity.
How the liver naturally detoxifies:
· Enzymes:
The liver produces specialized enzymes that break down toxins into harmless substances that can be eliminated from the body through urine and bile.
· Bile production:
Bile helps to digest fats and also carries toxins away from the liver into the digestive tract.
· Kupffer cells:
These cells within the liver act as phagocytes, engulfing and destroying harmful particles in the blood.
Is Milk Thistle beneficial for fatty liver?
No, evidence does not support recovery or reversibility of liver damage
Can drugs cause fatty liver?
Yes, certain drugs can cause fatty liver disease. This is called drug-induced fatty liver disease (DISLD or DIFLD)
Drugs that can cause fatty liver
· Steroid hormones: Can make the mechanisms that lead to NASH worse
· Tamoxifen, cisplatin, and irenotecan: Can cause latent fatty liver
· Methotrexate: Can cause fatty liver disease or liver scarring, especially in people who are already at risk
Can androgen including testosterone intake cause fatty liver disease?
Yes, androgens like testosterone can contribute to fatty liver disease, also known as non-alcoholic fatty liver disease (NAFLD). However, the relationship between androgens and NAFLD is complex and depends on sex and other factors.
In men
- Low testosterone levels can be a marker of NAFLD.
In women
- High androgen levels can promote NAFLD in pre-menopausal women.
- Low testosterone levels can be a risk factor for NAFLD in post-menopausal women.
Overall
- Androgens can promote hepatic fibrosis and hepatocellular carcinoma in both sexes.Yes, certain drugs can cause fatty liver disease. This is called drug-induced fatty liver disease (DISLD or DIFLD)
Drugs that can cause fatty liver
· Steroid hormones: Can make the mechanisms that lead to NASH worse
· Tamoxifen, cisplatin, and irenotecan: Can cause latent fatty liver
· Methotrexate: Can cause fatty liver disease or liver scarring, especially in people who are already at risk
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