Monthly Archives: September 2015

Liver Lesson #3: Storage [Show Notes]

 in Podcasts  tagged eating / glucose / intestines / Liver / sleeping / storage / Vitamins by

Recap

Digestion – bile breaks down fat to be absorbed by intestines

Metabolism – breaking down food into useful pieces

Your liver helps you store those energy sources until you need them – like times when you’re not eating.

Your body does lots of processes for you while you’re sleeping.

Storage

Glucose is a main source of energy for your body.

Insulin tells your cells to let glucose in the door so it can be used immediately.  It also tells the liver to put extra glucose in long chains called Glycogen to store for future use.

Another energy source is fat or fatty acids.  When the liver doesn’t have enough space for fat, it sends it to other areas of the body.

Certain vitamins (A, D, E, K) like to hang out in fat more than water, so it goes with the fat wherever it goes.

The liver stores Vitamin B12.  B12 is usually promoted for energy boosting.  A vitamin B12 deficiency can lead to a certain type of anemia (pernicious anemia). This means not enough red blood cells are being made, thus not enough oxygen is being delivered to all the parts of your body.  Therefore your body doesn’t have the resources to utilize and create energy.  End result: you feel tired.

Iron and copper are also stored by your liver until you need them.  Low iron is another culprit of anemia.

Interesting fact:  This is why liver tastes more metallic than other red meats.

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Liver Lesson #2: Metabolism [Show Notes]

 in Podcasts  tagged athletes / Cholesterol / Diabetes / fat / gallbladder / glucose / intestines / Liver / metabolism / protein / sugar by

Review

Liver – have one.

Lobule – yep!

A colored sketch of a liver lobule with labeled parts.

Liver makes bile, helps digest fat in the intestines. Gallbladder? Holds bile until your intestines need bile.

3 main energy sources:  Carbohydrates, Fats, Proteins

Intestines absorb them into the blood and send them to the liver.

Basics of Metabolism

Metabolism = change

This type of change happens for 2 reasons:

  1. To make something useful
  2. To make something safe

What’s water got to do with it?

  • Your blood is made of water
  • Liver preforms hydrolysis on carbohydrates (using water to dissolve it into tiny bits of sugar = glucose)

Carbohydrate Metabolism

Glucose is the main form of sugar that your body uses for energy.

Sugars are the easiest to turn into energy so that gets used first.  So low carb diets force the body to go after fats, which are the next easiest.  If you’re eating low fat as well, then the body will burn the fat deposits on the body.  Weight loss!

Fat Metabolism

The liver breaks down the fatty acids to make cholesterol (which is not always bad).  Cholesterol is used in your cells walls to keep them fluid and slippery.  Cholesterol is also used to make bile (think “like dissolves like”).  If there’s any extra fatty acids the liver performs gluconeogenesis (gluco = glucose, neo = new, genesis = creation). It basically creating glucose out of anything that contains Carbon.

This is why fats are bad for Type 2 Diabetics as well as sugar.

Protein Metabolism

Protein is the hardest, but can still provide energy.  Proteins are made up of amino acids.  Amino = Nitrogen, acid = carbon.  The nitrogen is relatively useless, so the liver turns it into urea, that gets sent out and filtered by the kidneys.  The part with the carbon can be turned into glucose (gluconeogenesis again).

One of the intermediate steps of the urea production is ammonia.  There is actually a blood test that can be done to test the ammonia-urea balance (BUN = Blood Urea Nitrogen), and if this is out of balance, it indicates a problem.  This test may indicate that your body is metabolizing your own muscles.  This can also be a sign of starvation or other nutritional imbalance.  You need your muscles, you don’t want to metabolize your muscles.

Your body generally needs fully intact amino acids to build, rebuild, and heal muscles.  Proteins and amino acids have a life span, so your body is constantly rebuilding and replacing with fresh supply.  Athletes require higher protein diets than most because of this process.

Take Away

Glucose and fats aren’t inherently bad, it’s more about the amounts of each that get consumed and float around your body.

Your liver can be very efficient and metabolizing the foods you eat.

Your body gets fat deposits because the body is saturated with enough fatty acids that it needs, so any extra gets packed up and shipped around the body to be stored until later.

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Liver Lesson #1: Digestion [Show Notes]

 in Podcasts  tagged bile / Cholesterol / digestion / gallbladder / hepatocyte / intestines / Liver by

Review

Liver shaped like a triangle – check!

Lobule, hepatocytes, vessels – check!  Hundreds of thousands – got it! 

A colored sketch of a liver lobule with labeled parts.

Bile Basics

Hepatocytes make bile.

It’s colors green due to red blood cell waste (bilirubin).

Bile consists of water, salt, cholesterol, bilirubin.

Bile moves from hepatocytes in liver to the gallbladder.

When you eat fats, the intestines triggers the gallbladder to send bile to help digest fat.

The fats are used in the energy-making process.

Bilirubin makes bile green.  It also makes the skin yellow in jaundice.  Makes poop brown.

For babies, it’s because baby hangs on to extra red blood cells from mommy after birth, and the liver has to learn what to do with all of them after they die (RBC’s only liver 120 days!).  For adults with hepatitis, it’s because their liver is damaged and can’t work as efficiently as it used to.  If your poop is the wrong color, it can indicate there is a major liver problem.

If you are gallbladderless, there is no where for the bile to be stored.  So, it gets send to the intestines continuously.  Also, if you have a meal heavy in fats, the intestines will just dump the food it can’t process faster towards the exit.

High levels of bilirubin in infants can lead to cerebral palsy.  If the liver can’t handle all the bilirubin in a timely manner, the only other way to get it to breakdown is UV light. 

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How to Hear Your Liver [Show Notes]

 in Podcasts  tagged detoxification / digestion / immunity / Liver / metabolism / percussing by

Liver Basics

Your liver is shaped like a lumpy triangle.  

It is part of the digestive system, so having it close to the organs that carry your food means that blood doesn’t have to travel very far to get things to and from this organ.

During a physical exam, your doctor finds its location and size by percussing (aka tapping on it – just like a percussion instrument).  Here is a video demonstrating the technique.

Microscopic Level

Hepatocytes (liver cells) build together into Lobules.  Lobules build together into Lobes.

A colored sketch of a liver lobule with labeled parts.

6 Functions

  1. Digestion
  2. Metabolism
  3. Storage
  4. Detoxification
  5. Production
  6. Immunity

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APAP vs NSAIDs

 in Blog  tagged advil / APAP / Aspirin / fever / headache / inflammation / naproxen / NSAIDs / OTC / pain / tylenol by

FAQ

What’s the difference between acetaminophen (Tylenol) and ibuprofen (Advil/Motrin)?

APAP

Acetaminophen (A-SEET-a-men-o-fin, APAP) is in a class all by itself and science isn’t 100% sure how it works. There is a suspicion that there is an enzyme in the inflammation cascade that is only found in the central nervous system, and that enzyme is inhibited by APAP. But because it’s central, this is why APAP works on pain and fever but not swelling. APAP is metabolized by the liver, and that metabolism pathway produces a very toxic by-product if it gets into a traffic jam. This is why APAP dosing limits have been adjusted, and APAP overdoses are so dangerous, even if one does not have liver disease or consume alcohol.
Podcast Episode: Too Much Acetaminophen

NSAIDs

Ibuprofen is in a class many call NSAIDs (non-steroidal anti-inflammatory drugs – because the other medications used to treat inflammation are steroids). NSAIDs, including ibuprofen work on a specific enzyme step in the inflammation process that result in pain, swelling, and fever. That is why joint and muscle injuries respond well to NSAIDs. It is also why the inflammatory response due to viral or bacterial infections are subdued easily by NSAIDs. NSAIDs are metabolized and processed through the kidneys. An overdose can lead to kidney damage, as well as kidney disease can be worsened if these medications are used.  Aspirin is also a NSAID, as well as naproxen.

Bottom Line

In my personal experience, APAP works well on fever and overall body aches (think the flu). Ibuprofen and naproxen work well on injured joints and muscles, as well as sore throat symptoms due to viral infections.  Aspirin doesn’t get recommended for the same things as NSAIDs, mostly because it has such a big reputation as a blood thinner.