Jeremiah Farias (00:00.086)
Liver health and blood sugar metabolism go hand in hand. In this video, we’ll discuss how an unhealthy liver can drive blood sugar dysregulation. We’ll talk about what things can harm liver health and what we can do instead to optimize the health of our livers. Hi, my name is Jeremiah Farias. I’m a functional registered dietitian and I help adults suffering from blood sugar dysregulation issues, conditions like type 2 diabetes, pre -diabetes, and even low energy levels.

I hope you enjoyed today’s video. The liver is an incredible organ. Here’s a short list of some of the physiological processes that it’s responsible for. First, macronutrient metabolism. Another thing it’s responsible for is blood volume regulation, lipid and cholesterol homeostasis. It’s responsible for detoxification of xenobiotics, medications, excess hormones, and more. It supports the immune system. It processes partitions.

and it’s part of the metabolism of the macronutrients, protein, carbs, and fats that provide us with energy. And it also is responsible for thyroid hormone conversion and much, much more. Let’s discuss how a disease or unhealthy liver can impact blood sugar control or blood sugar metabolism. So first, insulin resistance, which is a hallmark of type two diabetes, is going to increase a process called de novo lipogenesis. And increasing de novo lipogenesis rates is

actually going to increase the risk of one then developing fatty liver disease. So both an insulin resistant liver and a fatty liver are going to negatively impact how the liver functions. This is going to lead to a slew of health problems for an individual, especially when you consider all the roles that the liver plays in our body, thyroid hormone conversion, macronutrient partitioning, detoxification, and even more. However, the focus of this video is to discuss how a dysfunctional liver is going to impact.

blood sugar control and blood sugar metabolism. In the setting of an insulin resistant liver, you’re gonna start to see elevated blood sugar levels and often poor sleep. Let’s start with discussing why we start to see elevations in blood sugar when the liver is insulin resistant. As a reminder, insulin is a hormone that is released in response to carbohydrate consumption. Insulin is released from the beta cells of the pancreas and the purpose of it being released is it is then sent to the liver.

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and it binds to the receptor, insulin receptor on the liver to tell the liver, hey, all is well. There is fuel. There is energy on board. We do not need any glucose from you in this case. Now that’s how normal physiology works. In the state of insulin resistance, the insulin hormone, insulin, it goes to the liver as it’s supposed to. However, because the liver is insulin resistant, it is not responding.

to the insulin, it can no longer bind and signal to the liver that energy is present and plentiful. So instead, the liver believes that we don’t have enough energy. Therefore, let’s start to release glucose, either from stored glycogen, or if we need to do a process called gluconeogenesis, where we’re turning fats and proteins into glucose and continue to release them in the bloodstream. There’s also a role of glucagon in this whole process.

because insulin, in addition to signaling to the liver that feel as plentiful, there are cells called alpha cells on the pancreas. Now, insulin is also supposed to signal the alpha cells that, hey, I’m being released, we’re good, but the alpha cells can often become insulin resistant as well. And so they try to signal to the pancreas, the alpha cell to the pancreas, don’t worry, but they don’t receive that signal. So.

pancreas also releases from its alpha cells, glucagon further encourages the liver to release more and more glucose, produce more and more glucose via glycogenolysis where we’re releasing glycogen but also gluconeogenesis and this is why you see those with type 2 diabetes have higher and higher blood sugar levels because the liver is continuing to churn out more and more. Now I have a previous video that goes into what is insulin resistance.

And so I’ll link to it above if you want to check that out. Let’s dive into how sleep is impacted by poor liver health. When the body is insulin resistant, the liver specifically again is insulin resistant. You’re going to have decreased activity of an enzyme called glycogen synthase. Decreased activity of glycogen synthase is going to impair the liver’s ability to store glycogen. Glycogen as a reminder is stored glucose, stored carbohydrate, and it’s there to be used.

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in the liver when it needs to or release to balance blood sugar levels and more. When we sleep, the liver’s responsibility is to maintain glucose levels as we’re sleeping to give sufficient energy to various tissues, organs, cells, namely the brain. Brain energy requirements are nearly as high while we’re asleep compared to when we’re awake. I have another previous video that talks about how lower blood sugar levels can be the reason why someone is experiencing poor sleep.

Again, I’ll link to that above. Now, because the liver cannot store sufficient glycogen, blood sugar levels begin to dip as blood sugars begin to dip past a certain amount, let’s say around 70 milligrams per deciliter, counter regulatory hormones are released, cortisol, adrenaline, when those are released to help increase blood sugar levels, you wake up. And so having an unhealthy liver, having a liver that is insulin resistant,

is going to negatively impact your sleep and likely increase the amount of times that you’re waking up due to low blood sugar levels. So we’ve discussed how the liver is connected with blood sugar metabolism and our overall health. In a moment, we’ll also review what things can negatively impact the health of our liver. Of the many functions that the liver performs in the body, I’m curious, which ones were you aware of before this video and which ones are you surprised the most with? Let me know down in the comments.

If you’re enjoying this video, getting value from it, please be sure to hit that like button. If you’re looking for practical steps that you can begin implementing today to begin improving your blood sugar metabolism, be sure to download my free guide, Five Steps to Improving Your Blood Sugar Metabolism. The link will be below. Now let’s jump into what things can be negatively impacting the health of our liver and as a result, also negatively impacting our blood sugar metabolism. The five things that we’ll briefly discuss are first, alcohol, two, endotoxin,

three, stress or glucocorticoids, four, polyunsaturated fats, and last, we’re gonna look at micronutrient or nutrient deficiencies and all of their contribution to poor liver health or liver dysfunction. Let’s start with alcohol. The reality is alcohol is a toxin. It’s not to say that one cannot consume alcohol and enjoy it because there is going to be an optimal dose for each individual that’s not gonna result in health.

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issues and liver damage. So the reason alcohol is problematic for the liver is the enzymes that are required to detoxify alcohol are the same enzymes required to activate a vitamin called vitamin A or retinol. And vitamin A or retinol is extremely important for optimal liver health. So not being able to convert vitamin A into its active form that is required by the liver,

is going to impair the overall health of our liver. Second, with alcohol, is alcohol is going to increase oxidative stress. And so it’s going to put potential damage or damage some of the cells of the liver known as hepatocytes, which if you put stress or damage on these cells, it overall is going to impact how the liver functions. Second is endotoxin. Endotoxin is a major component of gram -negative bacteria cell wall.

Now, when a gram -negative bacteria’s membrane is ruptured or goes through a process called lysis, endotoxin is released. Endotoxin can cause something called intestinal permeability. Another term is leaky gut. This allows contents that are in the intestinal tract to escape the gut, enter circulation. And so when endotoxin causes this intestinal permeability, endotoxin is able to enter circulation.

It will go to various parts of the body, but namely it goes to the liver and can actually cause insulin resistance in the liver. Endotoxin is uniquely toxic to the liver. It’s required, the liver’s responsible for detoxifying endotoxin. Endotoxin is also implicated in the development of NAFLD, which stands for non -alcoholic fatty liver disease. This also overall highlights the importance of eating a diet that is optimizing the health of our gut.

We don’t want to be consuming hard to digest foods that result in a variety or a lot of gastrointestinal symptoms. Third, let’s talk about cortisol and its impact on liver health. Elevated cortisol levels have been implicated in the development of NAFLD, that non -alcoholic fatty liver disease. Now cortisol and elevations or increasing cortisol can be a result of mental emotional stress, which we do want to be supporting and addressing. But cortisol can also be a result of what’s called physiological stress.

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These can be from following certain dietary patterns. If one is fasting for extended periods of time, time -restricted eating or intermittent fasting, that has been shown in the research to also increase baseline cortisol levels. Restricting carbohydrates following low carbohydrates, very low or ketogenic diets has also been shown to increase baseline of cortisol levels. And this is normal physiology. We do want this to occur because…

When one is not consuming enough overall calories, enough carbohydrates, the body needs to produce glucose one way or another through that process I’ve discussed before, gluconeogenesis. I’ve recorded a previous video that reviews whether or not one should skip breakfast or do intermittent fasting if they’re looking to improve their blood sugar metabolism or diabetes. I’ll link to that above. Fourth is polyunsaturated fats, specifically excessive amounts of polyunsaturated fats.

Polyunsaturated fats are one of primarily three fatty acids. You have saturated fats, monounsaturated fats, and polyunsaturated fats. I’ve covered in a previous video how excessive amounts of polyunsaturated fats can impair energy production and negatively impact blood sugar metabolism. I’ll link to that video above so you can check it out. So when it comes to polyunsaturated fats and liver health, the oxidation and metabolites of polyunsaturated fats, or PUFAs for short, are

implicated in the formation of NAFLD, that non -alcoholic fatty liver disease. And interestingly, in studies where they inhibit the enzyme lipo -oxygenase or LOX for short, the formation of NAFLD was prevented. What does this mean? So with the lipo -oxygenase being inhibited, you did not see…

the peroxidation of polyunsaturated fats like arachidonic acid and linoleic acid. So by preventing their peroxidation or their oxidation, you then prevented NAFLD from forming. This highlights that polyunsaturated fats and the oxidation of them are required for the formation of liver disease or fatty liver disease. And lastly, other animal models find that PUFA rich oils can induce hepatic or liver oxidative stress and scarring.

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when compared to more monounsaturated rich oils or fats. So the fifth and final thing that can negatively impact liver health is a nutrient deficiency in choline. Choline is a B -like vitamin and choline is found in foods like egg yolks and liver. And a deficiency in choline can actually cause fatty liver disease or result in the formation of fatty liver disease.

So, choline is required to produce phosphatidylcholine. Phosphatidylcholine is a component of very low density lipoproteins known as VLDL particles. So, without enough choline, you’re gonna have an issue creating enough VLDL particles. Without enough VLDL particles, you’re gonna have issues exporting fat out of the liver, which can then contribute to the accumulation of fat, therefore fatty liver. So, by reviewing these five factors that can negatively impact liver health,

We can use this to guide us on how to actually optimize the health of our livers. This means being mindful of our alcohol intake, not consuming too much, avoiding hard to digest foods, any foods that might cause gastrointestinal symptoms or distress. This can mean properly preparing grains, legumes, and nuts and seeds if and when we are consuming them, and eat foods that nourish the gut to limit endotoxin. We want to manage our stress, but also not overstress our bodies.

by over -exercising, fasting, restricting carbohydrates or calories, prioritize saturated fats and monounsaturated fats over polyunsaturated fats, and finally, eat nutrient -dense foods like egg yolks and liver that provide choline and other beneficial nutrients for optimal liver health. If you have diabetes, pleasure -gutus regulation, or even fatty liver, and you’re overwhelmed and confused as to where to start,

You can schedule a free 30 minute discovery call that I offer. In this, you can learn how you can work with me and how I can help you accomplish your health goals. I am credentialed with a variety of insurance companies. You can check the link below to assess whether or not I accept your insurance. One nutrient I didn’t mention but is also crucial for optimizing liver health is sufficient high quality protein. You need enough protein because of the amino acids that they provide to optimize liver detoxification among other roles.

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And if you’re interested, you can check out a previous video that I recorded that goes over how much protein should you be consuming to optimize not only blood sugar metabolism, but your overall health. I hope you have a wonderful day. See you next week.