Can You Reverse Liver Scarring? Fatty Liver, Fibrosis & Recovery Explained by Aleksander Krag — Transcript

Full transcript

1. 0:00If people did find this early as you're
2. 0:02as you're saying and acted on it,
3. 0:04whether that's through lifestyle or
4. 0:06medications or a combination of both,
5. 0:08how reversible is this steatotic liver
6. 0:12disease generally speaking and what kind
7. 0:14of of complications could people avoid?
8. 0:17>> What we've learned basically is that in
9. 0:20general this reversible up to very
10. 0:22advanced stages.
11. 0:24So when I went to school and I'm not
12. 0:26that [clears throat] old, but then we
13. 0:28had an understanding of fibrosis which
14. 0:30is scarring of the liver as something
15. 0:32that was not steatotic that could not be
16. 0:35reversed. But as many of the other
17. 0:37beliefs we've had
18. 0:38and sort of truths, they turn out to be
19. 0:41wrong. Fibrosis tissue scarring tissue
20. 0:44and many are very active tissue and
21. 0:46active mean that it actually can be
22. 0:48reverted to make so even quite advanced
23. 0:50stages of disease we've seen that with
24. 0:52hepatitis B and hepatitis C, but also
25. 0:55now with steatotic liver disease. So
26. 0:57that's I think is is really the key to
27. 1:00hope. Yes, it's it's basically I'll say
28. 1:02never too late, but the earlier you go
29. 1:05of course the easier it is and then the
30. 1:07distance you needs to walk to get back
31. 1:10to a normal liver is shorter.
32. 1:13And the complications for liver disease
33. 1:15is that the liver is is
34. 1:17in many ways a I don't know. I could
35. 1:19talk about I love the liver. It's a
36. 1:21fascinating organ. It does thousands of
37. 1:23things, but let me not drill into that.
38. 1:25But you know, it's a bit it's a middle
39. 1:26of the bloodstream.
40. 1:28Most of the proteins in the blood are
41. 1:30actually generated by the liver. So many
42. 1:32things that make the whole whole body,
43. 1:34everything work is coming from the
44. 1:37liver. But the liver is also huge organ.
45. 1:39It has a very big regenerative
46. 1:41potential. So you can harm it a lot of
47. 1:44with alcohol, obesity and many other
48. 1:47things and actually regenerate. You
49. 1:49know, sometimes when they do surgery you
50. 1:51cut out a chunk of the liver and if it's
51. 1:53otherwise normal liver, it grows out
52. 1:55again.
53. 1:56It's not happening like that like that a
54. 1:58finger
55. 1:59or if you lose a kidney, it doesn't grow
56. 2:01out. So, the liver is unique in the body
57. 2:03in that sense.
58. 2:04But, also means the liver has a lot of
59. 2:06functions.
60. 2:07So, it affects a lot. Also, some of the
61. 2:09key things you would see is how people
62. 2:12can have symptoms from all over the
63. 2:14body.
64. 2:15I use actually when I have my student
65. 2:17lectures, then I say, "Will you give me
66. 2:19one example of somewhere in the body
67. 2:21where a failing liver cannot be seen?"
68. 2:24And that means you can have symptoms,
69. 2:25yes, from the kidneys, from fluid
70. 2:27accumulation in the stomach, in the
71. 2:29legs.
72. 2:30You can have this what we call portal
73. 2:32hypertension, increased blood pressure
74. 2:34which increases generation of vessels
75. 2:36around the esophagus, and you can have
76. 2:38vomiting. It can remove a change the
77. 2:40cleaning of the blood from the gut, so
78. 2:42the toxins go to your head, and you
79. 2:44become completely strange in your head
80. 2:46what we call it encephalopathy. And
81. 2:49hundreds of other things that are more
82. 2:50subtle, but these are some of the the
83. 2:52dramatic things, and that's what we we
84. 2:55want to ideally prevent as many people
85. 2:58as possible to get to that very advanced
86. 3:00stage where you have these symptoms that
87. 3:02are dramatic. Because at the same time,
88. 3:04you become tired, you become weak.
89. 3:07We can come back to that. It's also like
90. 3:09the the liver is also the metabolic
91. 3:12supercomputer of the body.
92. 3:14So, if all these things about
93. 3:16gluconeogenesis, etc., if the capacity
94. 3:19to all that is lost, the body starts to
95. 3:21digest itself.
96. 3:23You start to lose muscle mass, etc., and
97. 3:25that's what we see at the advanced
98. 3:27stages. Many of these, let's say, with
99. 3:30excess capacity, which is very important
100. 3:32for for our homeostasis or our
101. 3:35biological integrity as a human is sort
102. 3:37of lost with this.
103. 3:38>> So, in addition to everything that you
104. 3:41just mentioned there,
105. 3:43does the liver
106. 3:44does it also play a role or does
107. 3:46steatotic liver disease increase
108. 3:48someone's risk of
109. 3:50more common chronic conditions that
110. 3:52maybe people hear of or have experienced
111. 3:54like having a stroke or a heart attack
112. 3:57or developing neurodegenerative disease.
113. 3:59Are there are there associations there?
114. 4:01>> Yeah, there's strong associations. We we
115. 4:03just have to be cautious because if you
116. 4:05have the alcoholic liver disease, you
117. 4:06have higher risk of cardiovascular
118. 4:08disease including strokes.
119. 4:10But that's again, is it the liver that
120. 4:12causes or because they are both driven,
121. 4:15they are both very tightly linked to
122. 4:16type two diabetes, they are tightly
123. 4:18linked to hypertension, dyslipidemia,
124. 4:22you know, hypercholesterolemia,
125. 4:24and obesity. So, some of these shared
126. 4:26risk factors. So, there we actually have
127. 4:28a bit of a discussion in the field. Is
128. 4:30this on itself an excess risk?
129. 4:33The argument or got many different
130. 4:35arguments, but that the liver when it
131. 4:38has this disease, then it cannot just
132. 4:40have fat in the liver, but it can also
133. 4:42come to inflammation.
134. 4:43And inflammation we know is not good
135. 4:45because then there's a systemic
136. 4:47inflammation. I just working on a
137. 4:49wonderful paper that also affect how it
138. 4:50affects the fat cells. But you know, the
139. 4:52whole thing then sort of become
140. 4:54inflamed, but you have this low-grade
141. 4:56inflammation which we know is also bad
142. 4:58for the whole cardiovascular risk
143. 5:00cascade. So, probably this definitely
144. 5:04doesn't help, but it's really tightly.
145. 5:06And that's also when we should see these
146. 5:08people as from a more holistic approach.
147. 5:11Of course, I'm a liver guy. I love the
148. 5:13liver, but I have to be really cautious
149. 5:15and aware that of all the other organs
150. 5:18that actually share some of the risk
151. 5:20factors with what we see with the
152. 5:21alcoholic liver disease. And also, yeah,
153. 5:23I hope you can bring up a little bit
154. 5:25there with with alcohol because it's a
155. 5:27really important factor. And and and
156. 5:29most people in the world or at least in
157. 5:31in in the United States, Europe, but
158. 5:33also beyond, they drink more of this
159. 5:35alcohol, and that's really important
160. 5:37actually.
161. 5:38>> Quick word on eight sleep. Here's a fact
162. 5:40that I certainly didn't know. Women
163. 5:43weren't required to be included in
164. 5:44federally funded US research until 1993.
165. 5:49So, much of our sleep science was built
166. 5:51around male physiology. Eight Sleep is
167. 5:53one of a few companies that's trying to
168. 5:56fix that. Their women's sleep initiative
169. 5:58has analyzed over 60,000 nights of
170. 6:00pregnancy sleep data across 110 women,
171. 6:04and two features of their Pod 5, their
172. 6:07smart mattress cover, come out of this
173. 6:09research. Pregnancy mode auto adjusts
174. 6:12the temperature week by week through
175. 6:14pregnancy and early postpartum. And hot
176. 6:17flash mode detects a hot flash and
177. 6:19rapidly cools that side of the bed.
178. 6:22Pretty neat, huh? For me, well, I'm not
179. 6:24pregnant, but my sleep is better than
180. 6:26it's ever been. I rarely miss a full
181. 6:29night with good deep and REM sleep. I
182. 6:32must say, the only downside is that when
183. 6:34I travel, I get a quick reminder how
184. 6:36good my sleep is at home. Fortunately,
185. 6:39these days I sleep most of the year in
186. 6:41my own bed.
187. 6:42It's one of those things that's hard to
188. 6:44explain until you've actually tried it.
189. 6:47And then you wonder why you didn't get
190. 6:48started sooner. Individual results vary,
191. 6:51and the Pod tracks your health, but is
192. 6:53not a medical device. Use my code the
193. 6:56proof at eightsleep.com/theproof
194. 7:00for up to $350 off. You get 30 days to
195. 7:03try it at home and return it if you
196. 7:05don't love it. Again, that's code the
197. 7:08proof at eightsleep.com/theproof.
198. 7:14>> [music]