What’s so special about the liver and how do we keep it healthy? The Liver Doctor explains.
📹: BeerBiceps
📹: BeerBiceps
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00:00If you cut a healthy liver, 90% of it and just cut it off from the body, the rest 10%
00:06can actually become a whole liver, which is about 1.2 kg to 1.5 kg in 4 to 6 weeks.
00:17So the liver is by weight, it's the second largest organ in the body.
00:24So in adults, it weighs about 1.2 kg in women and about 1.5 kg in men.
00:30What is the heaviest?
00:31The heaviest is skin.
00:34So if you take the whole skin out and weigh it, it becomes like 4 kg.
00:40So the heaviest organ is skin, the second heaviest is liver, third heaviest is the brain.
00:46So it's the second heaviest organ.
00:48Now the liver is very special, which is why I also chose hepatology as one of my professional
00:54career practices.
00:55It's very special because, one you said, it's one of the most powerfully regenerating organ
01:01ever, which is why we have that Greek mythology where Prometheus, who stole the fire from
01:07gods, was punished by the gods and he was chained on a rock and every night an eagle
01:14would come and feast on his liver.
01:16But the eagle would not kill him, it'll just eat out of the liver and then go away.
01:21And his liver would regenerate the next day for that eagle to come back and again eat
01:25the same parts.
01:26So this was like an eternal punishment.
01:28So unless somebody actually kills the eagle or somebody kills Prometheus, this punishment
01:34is going to go on for life.
01:36So that is how the whole aspect of liver generation was first discussed in mythology.
01:42Now if you cut a healthy liver, 90% of it, just cut it off from the body, the rest 10%
01:48can actually become a whole liver, which is about 1.2 kg to 1.5 kg in 4 to 6 weeks.
01:55That is how fast it regenerates.
01:58Even in a slightly older person?
02:00So as you get older, your regeneration capacity is still the same, but then it is affected
02:06by a lot of other things.
02:07For example, you have fatty livers, you have other chronic illnesses in you and also your
02:15regeneration potential or the potential for the liver to actually respond to a stressor
02:24actually becomes lesser.
02:25So the commonest stressor that we see in India is alcohol.
02:31The second commonest that is now still coming up is exactly what we discussed, that is lifestyle
02:36change related and metabolic diseases.
02:38So metabolic disease, there is something known as metabolic syndrome.
02:41So metabolic syndrome has different components in it.
02:43So there is diabetes mellitus, that is your high sugar levels.
02:47You have hypertension, which is high blood pressure.
02:49You have dyslipidemia, which is high cholesterol and lipid triglycerides.
02:54You have hypothyroidism, which is a low functioning thyroid.
02:57You have high uric acid, which is hyperuricemia.
03:00All of this is seeming like it's bad diet related.
03:02Yeah.
03:03So it can be genetic also.
03:04It has a lot of familial.
03:05It can be within the families also.
03:07And it can be acquired also, through sedentary life, lack of physical activity.
03:12Obviously, taking a lot of carb rich foods or calorie rich, calorie dense foods, all
03:17of this can contribute to it.
03:19So it's never one of these stressors that is happening.
03:21It's maybe in people, multiple stressors.
03:23So there is a guy who's drinking alcohol and who's obese.
03:26That guy has double stressors on the liver.
03:28So these are the common stressors from a metabolic health point of view.
03:31Let's talk about fatty liver.
03:32Why do they call it fatty liver?
03:33Is it just because the liver is getting damaged?
03:37Or is there a layer of fat deposited on the liver?
03:39Why does the word fatty even come?
03:42So there are different causes for fat to get deposited inside the liver.
03:47So when I mean inside the liver, it's actually inside the liver cell.
03:51So the liver is made up of different types of cells.
03:53So this is always something very interesting because there are no organs as complex as
03:57the liver.
03:58So I mean, if I ask somebody, which is the most complex organ that you can think of?
04:02They'll say the brain.
04:03Because brain is so complex, right?
04:05But brain has only two types of cells.
04:07That's it.
04:08Two types of cells make up the whole brain.
04:10Look at the heart.
04:11Four types of cells make up the whole heart.
04:13But look at the liver.
04:15Five types of cells make up the liver.
04:17And those are primary types.
04:18And there are so many different types of it.
04:21And all in all, there are like 30 billion cells in the liver.
04:2530 billion cells that make up 1.5 kilogram.
04:28So the liver is so complex.
04:30And the most common cell that you find in the liver is known as a hepatocyte, which
04:33is the liver cell.
04:34What we call as liver cell.
04:36Now when you say fatty liver, it's basically lipids in droplet forms getting deposited
04:41inside the liver cell, you know, around the nucleus within the cell.
04:45So that's a fatty liver.
04:46And when that happens, and more than about, you know, 5% of these liver cells are affected
04:53by this droplet deposition, then we call it as a fatty liver, because we see that on ultrasound.
04:59So when you do a simple scan, you can actually see the liver is grade 1, grade 2, grade 3
05:03fatty.
05:04Those are patterns of deposition.
05:05Patterns of damage?
05:06Patterns of deposition of the fat.
05:08But does that mean also damage?
05:10No, it doesn't mean.
05:11So for us to call it damage, that lipid should cause inflammation within the liver cell.
05:18So that is known as fatty liver disease.
05:20Now the inflammation does something else in between.
05:22Now this is the most important part.
05:24Because just the inflammation is to some extent fine, easily reversible.
05:29But sometimes the inflammation actually damages the liver cell.
05:32So that the liver cells actually die.
05:35And in that position, you get scars.
05:38So you have scarring where the liver cell was damaged.
05:40So that is known as fibrosis.
05:42So the scarring is considered as F0, where there is no scarring, that is no fibrosis.
05:46F1, which is an F2, which is early fibrosis, F3, which is advanced fibrosis, F4, which
05:52is what we call as cirrhosis.
05:54So that range of scarring is also important.
05:58So it goes above F2, that becomes significant scarring and you have a high chance of developing
06:01cirrhosis.
06:03So this much is there to fatty liver.