The secrets of the liver ft. the Liver Doctor

Brut India

What’s so special about the liver and how do we keep it healthy? The Liver Doctor explains.   : BeerBiceps

Transcript

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.

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