In the First Era, Akatosh gifted Alessia and her followers with his own blood, creating the lineage of the Dragonborn empire that lasted until the end of the Third Era.
While Akatosh is seen as the creator of the world by all races, his first born Alduin is seen as the world destroyer by the Nords. Alduin's quest to consume the world is Skyrim's main storyline.
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