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The progression looks like this: excess substrate (carbs, calories, alcohol) leads to increased hepatic triglyceride synthesis, liver exports fat as VLDL (visible as high VLDL and triglycerides in bloodwork), eventually the liver cant keep up and fat accumulates (fatty liver develops), fatty liver causes inflammation and insulin resistance, worsening insulin resistance further increases VLDL production, and the cycle accelerates toward metabolic dysfunction, cirrhosis, and liver failure if unchecked

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The trials happened in many places in 33 countries, such as the United States, Mexico, Canada, India, Japan, and many European countries

This article covers why nausea happens, when it gets better, and exactly what to do about it