This letter will help significantly improve your health. The key is to use and apply it in practice. Just use it.

NAFLD is a cunning disease, as it progresses without clear symptoms.

In the past, NAFDL(non-alcoholic fatty liver disease) was not the primary consideration among potential liver obesity causes. However, it has now taken the lead. Presently, non-alcoholic fatty liver is more prevalent than its alcoholic counterpart, and it occurs even more frequently than certain types of hepatitis that also result in fat accumulation in the liver tissue.

What is meant by NAFLD ? Essentially, it refers to the buildup of fat within the organ. Even in a completely healthy liver, there is always some level of fat present. When this surpasses 5%, it is classified as obesity. Liver obesity specifically denotes an accumulation of triglycerides within liver tissue exceeding the 5% threshold. This fat percentage can vary, reaching levels like 10%, 15%, 30%, 45%, and so on. The distribution of fat in the liver can be localised – appearing as small focal points, or it can pervade the entire organ.

By the way, if a person has an issue with the lipid profile in blood tests, instead of looking at total cholesterol, they should first pay attention to triglycerides. If they are elevated (ideally, triglycerides < 1 / (100) depending on the measurements), then address the liver health issue promptly, as the liver is involved in triglyceride production. Also, in metabolically unhealthy people, an unhealthy liver produces more of the LDL 'bad cholesterol’. This was a footnote, but more information on this will be covered in other letters.

Different Stages of NAFLD

Steatosis

The first stage of the disease is a fatty liver, also known as steatosis.

In this stage, the liver collects fat but doesn't get rid of it. It happens when the liver either doesn't export enough fat or produces too much internally, but can't use it for energy or release it into the bloodstream. In simple terms, it means the liver is filled with fat. Steatosis is the most common type of non-alcoholic fatty liver disease. Every patient diagnosed with this disease has this stage. If this stage is not present, the whole condition is not there.

Steatosis + Inflammation == Steatohepatitis

The second stage is non-alcoholic steatohepatitis (NASH). At this point, the liver is visibly affected. Now, there's not only excess fat but also inflammation of liver cells. It's hard to be sure that during the steatosis stage, the liver only filled with fat without inflammation. In reality, the excessive fat accumulation in liver cells could already be a result of their damage. Therefore, it's impossible to rule out that inflammation and fat accumulation may start simultaneously because all of this is closely connected with increased oxidative stress in the liver.

Liver Fibrosis

Fibrosis begins after steatohepatitis. It can occur with or without inflammation, meaning it can go directly from steatosis to damaged tissue—fibrosis. This happens very quickly. In the stage of steatohepatitis, there is inflammation, but we also have a chance to control this inflammation. However, if fibrosis occurs (scar tissue formation), the tissue (adipocytes are fat cells) loses its functional properties. That's when liver insufficiency sets in. The intensity of inflammation and fibrosis can vary.

Liver Cirrhosis

The final (fourth) stage of non-alcoholic fatty liver disease is liver cirrhosis. If during the fibrosis stage, the liver develops connective tissue due to the inability to regenerate liver cells, cirrhosis is the stage where scar tissue forms on the liver. Areas of the liver that were not regenerated in time turn into scars. Liver functions sharply deteriorate, and they exceed 400! The liver performs numerous biochemical reactions, all occurring within it. It produces hormones, regulates blood sugar, stores glycogen, produces bile, and much more.

Cirrhosis and fibrosis, especially cirrhosis, are irreversible! If cirrhosis has developed, there is a high likelihood that a liver transplant will be needed. A liver donor will be required, from whom at least a piece of the liver will be transplanted. Liver fibrosis is also considered irreversible, although some part of the liver can still recover. However, some portion of the liver may likely remain as a 'scar.

Re-cap

"Fatty Liver — Steatosis (liver saturated with fat) — First Stage"

"Non-Alcoholic Steatohepatitis — Inflammation begins — Second Stage"

"Non-Alcoholic Steatohepatitis + Fibrosis (depends on how it progresses)"

"Cirrhosis — Final Stage (Liver deteriorates its functions — 400 functions of the liver, including hormone production, bile synthesis, etc.)"

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