“The liver is a very special organ: even if more than fifty percent of its overall mass is damaged…it can regenerate itself completely. This amazing ability is essential. The liver is the body’s most important metabolic organ…”
~ “Understanding the Mechanisms of Liver Regeneration Through Computer Simulation,” Science News, Science Daily (June 9, 2010)
“Most people think liver disease is caused by excess alcohol or hepatitis viruses. The reality is that the leading cause of liver disease today is excess weight. This form of liver degeneration associated with obesity and high blood sugar is called nonalcoholic fatty liver disease (NAFLD)…With no approved pharmacological treatments, lifestyle and dietary therapies remain the only hope for stemming the tide of NAFLD…Physicians rarely focus on liver health except in advanced cases.”
~ “The Silent Epidemic of Liver Disease,” lifeextension.com/magazine (April 2015)
Most people don’t give much thought to the health of their liver unless they drink alcohol excessively. Even then, they tend not to attend to it until they have symptoms and learn from blood tests that their liver enzymes are high, an indication of inflammation or injury. This article aims to increase your awareness of the critical importance of liver function in order to help you prevent liver disease. Once you have disease symptoms, such as jaundice, abdominal pain and swelling, leg and ankle swelling, dark urine color, itchy skin, nausea/loss of appetite, chronic fatigue, or easy bruising, damage reversal may prove extremely challenging.
The Role of the Liver & How It Works
The liver has three key functions. First, it assures the metabolism of carbohydrates, fats, and proteins. Second, it stores glycogen, which the body uses for energy, and vitamins A, B12, D, E, and K. Third, the liver is one of the main excretory organs that ensure ongoing removal of the body’s waste and toxins. The liver detoxifies by (1) filtering blood, (2) producing and secreting bile, a critical element of fat digestion and fat-soluble vitamin absorption that also carries toxins to the intestines for excretion in fiber, and (3) neutralizing harmful chemicals through a two-phase enzymatic process.
In Phase I detoxification, enzymes either neutralize various unwanted chemicals, or convert them to intermediate forms that are then processed by Phase II enzymes. Genetics, level of exposure, and nutritional status determine the activity of the group of enzymes called cytochrome P450, which detoxify most hazardous chemicals. Phase I enzymes typically neutralize many prescription and OTC drugs, caffeine, histamine, hormones, and pesticides.
In Phase II detoxification, through six different pathways, a process called conjugation either neutralizes toxins or renders it easier for the body to excrete them in urine or bile. Absence of the nutrients and energy required for proper functioning of these enzymatic processes results in dangerous toxic buildup.
A properly functioning liver is especially crucial to cancer prevention. Failure of the body to remove environmental carcinogens, with deficiencies of nutrients needed for proper detoxification and immunity, is thought to cause up to 90% of all cancers. In addition to the symptoms noted above, liver malfunction can also cause weight loss, disorientation, spleen enlargement, and kidney failure.
Types of Liver Disease
Unlike acute liver failure, chronic liver disease can develop slowly over time without causing any symptoms. Threats to overall liver function include toxins in food and the environment, several viruses and general immune system malfunction, genetic abnormalities, and drug overuse/combination, and weight gain.
Nonalcoholic fatty liver disease (NAFLD), the world’s most common form, is generally associated with various other liver-compromising chronic conditions, including obesity, type 2 diabetes/insulin resistance, dyslipidemia (excess blood levels of triglycerides, cholesterol and/or fat phospholipids), and metabolic syndrome. The inflammation and oxidative stress from these conditions can cause excess accumulation of fat in the liver. Certain medications can also cause NAFLD, including corticosteroids, Methotrexate, Tamoxifen, and Tetracycline. NAFLD can progress to NASH (nonalcoholic steatohepatitis, or liver inflammation), liver fibrosis (scarring), cirrhosis (cell degeneration, inflammation, and fibrous thickening of tissue; typically results from alcoholism or hepatitis), liver cancer, and liver failure/premature death. Even worse, NAFLD is the precursor to many chronic diseases, including heart disease, dementia, autoimmune disorders, hypothyroidism, and sleep and skin problems. In most cases of NAFLD, improved insulin sensitivity is the main goal, and weight loss is its most effective treatment. The balance of this article primarily addresses measures that promote the flow of fat and bile to and from the liver, which can benefit all NAFLD patients, whether or not overweight.
A Liver-Supportive Diet & Lifestyle
Due to the connection of NAFLD to inflammation, oxidative stress, and obesity, it can be highly responsive to diet and lifestyle changes. Dietary changes generally include: (1) eliminating high-glycemic/high-sugar (refined carbohydrates) and high-salt foods; (2) adopting an organic, low-iron (absent anemia), plant-based, high fiber diet focused on high-sulfur foods (garlic, onions, whey protein, and eggs) and cruciferous vegetables (broccoli, Brussels sprouts, beet greens, cabbage); (3) consuming healthy fats (omega 3; monounsaturated); (4) drinking at least eight, 8-oz glasses of non-city/filtered/high pH water, up to one-half of one’s body weight in water daily; and (5) avoiding pro-inflammatory foods such as dairy, gluten, excess alcohol, and processed meats.
Lifestyle considerations to support a fatty liver include reducing exposure to food additives/colors, heavy metals, and pesticides and other airborne toxins, exercising 20-30 minutes per day, and daily detoxing (organic lemon and water; green and other detox teas).
Some Important Liver-Supportive Dietary Supplements
Given that no medication exists to treat or cure liver disease adequately, and the liver’s enormous capacity to regenerate, it makes sense to consider dietary supplements that are proven to promote ongoing liver health. Scientific studies support the use of the nutrients below, among others, to increase the liver’s capacity to function effectively and detoxify.
1. Amino Acids: Aging decreases the sulfur-containing, liver detoxifying amino acids L-cysteine and
L-methionine. Their levels greatly dictate how much the body produces free radical-fighting cellular glutathione, considered the “master antioxidant.” Research has established that N-acetyl cysteine (NAC) supplementation reduces heavy metal and drug toxicity and can improve liver function in NAFLD patients.
L-carnitine is an essential nutrient that converts fat to energy in the liver’s powerhouses, and thus is critical to their function. Deficiencies can increase susceptibility to NAFLD, and studies have established that L-carnitine supplementation improves liver damage.
SAM-e (S-adenosyl methionine), crucial to the methylation pathway in Phase II detoxification, is made in the body from L-methionine and vitamin B12 , folic acid, and choline. SAM-e deficiency is associated with impaired detoxification and can exacerbate liver injury. Supplementation with SAMe at the correct dosage has been shown to support liver function, but may have only limited value in treating certain chronic liver diseases.
2. Dandelion: Various holistic practitioners recommend the leaves and root extract of this herb for liver, gallbladder, and bile duct conditions, due to its antioxidant, anti-inflammatory, anti-carcinogenic, anti-lipidemic, and anti-fibrotic properties. Dandelion’s use has been shown to lower AST and ALT, marker enzymes of liver toxicity. Those allergic to ragweed, chrysanthemums, marigolds, and daisies, should avoid consuming it.
3. Green Tea Extract (GTE): This nutrient is widely viewed as beneficial in the prevention and treatment of NAFLD. In one 2016 randomized, double-blind, placebo controlled, 90-day study of 80 NAFLD patients, researchers concluded that 500mg/day of GTE lowered AST and ALT liver enzymes, such that GTE can generally be considered a valid treatment to improve serum levels of liver enzymes in NAFLD patients.
4. Milk Thistle/Silymarin. As milk thistles’ main flavonoid antioxidant, silymarin (with silybin, one of its three active components) protects the liver both by preventing depletion of its glutathione levels, and enhancing its detoxification capacity by reducing the oxidative stress resulting from toxin metabolism. For over two decades, Michael Dworkin, PD, CCN, the founder of the Manchester Parkade Health Shoppe, regularly prescribed this herb in his clinical practice for various liver conditions. Though controversial, according to Michael Murray, ND, human studies have proven milk thistle’s effectiveness against NAFLD, alcoholic liver disease, hepatitis C, liver cirrhosis, and cancer.
Healthy lifestyle choices, including a healthy diet, with the proper combination and dosages of dietary supplements, can greatly promote optimal liver health. Ideally, a practitioner should be consulted before using these methods to address any acute or chronic health condition.
The statements in this article have not been evaluated by the Food and Drug Administration, are for educational purposes only and are not intended to take the place of a physician’s advice.
Submitted by Erika Dworkin, Board Certified in Holistic Nutrition®, Owner of the Manchester Parkade Health Shoppe (860.646.8178), 378 Middle Turnpike West, Manchester, CT, www.cthealthshop.com, nutrition specialists trusted since 1956. Erika is available to speak to groups.
All statements in this article are practice or scientific evidence-based and references are available upon request.