Estimated reading time: 7 minutes
Among the most vital organs in the human body are: the brain, kidneys, heart, liver and lungs. Most people are aware of what these organs do! The brain is our computer, the heart the engine, the lungs keep us breathing, and the kidneys filter our blood. The liver, being a vital organ, is also one of the most important organs in the human body. It plays a big role in keeping us alive and healthy by processing nutrients, filtering out toxins, and making important substances for digestion and metabolism. Even though it works quietly behind the scenes, the liver actually performs over 500 vital functions.
For people living with metabolic dysfunction-associated steatohepatitis (MASH), the liver is everything. MASH is characterized by fat building up in the liver, causing inflammation and scarring. This scarring, over time, will make the liver less and less effective. Without treatment it will eventually shut down. Here, PatientsLikeMe will detail what the liver is, its important functions, and how MASH can interfere with its operation.
Where Is the Liver and What Does It Look Like?
Your liver is found in the upper right-hand part of your abdomen, just under your ribcage. It sits underneath your diaphragm, which is the muscle that helps you breathe, and on top of the stomach, right kidney, and intestines. A healthy liver is a dark reddish-brown and weighs about three pounds in adults. It is shaped like a flattened football or a cone and is made up of two main lobes, aptly named the right lobe and the left lobe.
The liver gets a unique blood supply from two different sources. The hepatic artery brings oxygen-rich blood from the heart. The hepatic portal vein brings nutrient-rich blood from the stomach and intestines. This lets the liver process and store nutrients from the food we eat. At any point in time, the liver actually holds about 13% of the body’s total blood supply, making it one of the most blood-rich organs in the body.
What Are the Functions of the Liver?
As we mentioned, the liver does hundreds of essential functions. Here are six of its most important jobs.
Bile for Digestion
It might not be the most appealing thing in the world, but we all need bile! Bile is a yellow-green fluid made by the liver that helps digest fats in the small intestine. It is made up of about 95% water, but also has salts, cholesterol, bilirubin and some metals in it. The liver sends the bile to the gallbladder, which stores and releases it into the digestive system when needed.
Storing and Releasing Energy
Did you know the liver does a lot for your metabolism? It acts as a regulator, storing extra glucose in the form of glycogen when there is too much sugar in the blood and converting it back into glucose when you need energy. It can then distribute this blood sugar to different parts of your body.
Filtering Toxins and Waste
Your liver is also a filter. All the blood leaving the stomach and intestines passes through the liver, where it removes toxins like alcohol, drugs, and chemicals. It converts ammonia, which is a byproduct of protein metabolism, into urea. This is later excreted in urine. The liver also clears out a waste product called bilirubin, which is made when old red blood cells break down. If bilirubin builds up in the blood, it can cause jaundice, a condition that turns the skin and eyes yellow.
Making Proteins for the Blood
The liver makes most of the proteins found in your blood, between 85-90%! These are proteins that help with:
- Blood clotting.
- Carrying fats through the bloodstream.
- Supporting the immune system to fight infections.
Albumin is one of the major proteins made by the liver. Albumin helps regulate blood volume and the distribution of fluids in the body. The liver also makes ferritin, a protein used to store iron in the body.
Storing Important Nutrients
In addition to iron, the liver stores and releases other important vitamins and minerals. Iron and copper are two minerals the liver stores, but it also helps with storing Vitamins A, D, E, K, and B12. All of these play vital roles in the body's natural processes, from creating new red blood cells to the production of DNA and RNA itself.
Supporting the Immune System
The liver is an immune active organ, meaning it does play a role in fighting infections. It has the largest concentration of phagocytic cells in the human body! Phagocytes are a type of white blood cell that help protect the body by getting rid of foreign particles, bacteria and dying cells.
What Happens When the Liver Gets Damaged?
The liver is very resilient and can repair itself. Chronic damage over time can cause scarring, also known as fibrosis. If too much scar tissue builds up, the liver cannot work as it is supposed to. Over time this leads to cirrhosis, a serious and often irreversible condition. One of the most common causes of chronic liver damage is MASH.
What Is MASH and How Does It Affect the Liver?
MASH is a severe form of fatty liver disease. It happens when too much fat builds up in the liver, leading to inflammation and damage. There are a few stages to MASH, each with its own level of impact on the liver.
- Fatty Liver (Steatosis): Here, too much fat builds up in the liver, but there is little to no inflammation. Often people do not even know they have any damage as there are commonly no symptoms.
- MASH (Steatohepatitis): In this stage the liver is inflamed and damaged, leading to scarring. This scarring, called fibrosis, reduces the liver's ability to perform its necessary functions for the body.
- Cirrhosis: Cirrhosis is a more severe form of fibrosis. With cirrhosis, scarring actually stops the liver from functioning properly. This scarring cannot heal, and the damage is permanent. If left untreated, it can lead to liver failure.
- Liver Cancer or Liver Failure: In the most severe cases, MASH can lead to liver cancer or end-stage liver disease. At this point people may need a liver transplant as a treatment option.
If MASH progresses to cirrhosis or liver failure, the liver can no longer perform its vital functions. As the liver stops filtering your blood, a toxin called bilirubin can leak into your skin and eyes, making them turn yellow. Other toxins can cause confusion or memory loss. A condition called hepatic encephalopathy, or brain fog, can affect speech, mood, and behavior. People often feel fatigued, as the liver cannot store or release nutrients properly. A side effect called ascites is common, when fluid builds up in the abdomen. This happens to about 50% of people with cirrhosis. Reduced liver function also puts you at a higher risk of infections.
Can MASH Be Reversed?
Fortunately, yes! If found early, MASH can be slowed down or even reversed with lifestyle changes. Eating a healthy diet is a key part of treatment. It is important to reduce the amount of processed foods, sugar and unhealthy fats. Regular exercise lowers the amount of fat in the liver. Excess weight plays a big role in the development of MASH. A 5-10% weight loss can help a huge amount. Controlling any underlying conditions, like diabetes, will help with both blood sugar and cholesterol levels.
The liver is one of the most important organs in your body, responsible for a whole host of functions. It silently works away on hundreds of things every day, keeping you healthy. MASH is a serious condition that can damage the liver over time. However, early intervention with healthy lifestyle choices can stop or even reverse liver damage. By taking care of your liver through diet, exercise, and regular check-ups, you can protect this organ and live a long, healthy life.
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