The liver acts as a chemical storage factory; it manufacturers bile from cholesterol and secretes it via the gall bladder into the small intestines.

The liver is the second largest organ in the body (the skin is the largest) and the largest gland. All together, the liver performs more than 500 separate jobs, including converting fats, amino acids, vitamins and minerals, and making cell structures such as soluble cholesterol, phospholipids, and fat-soluble vitamins (A,E,K,D). The liver’s diverse functions connect the digestive system to the immune, cardiovascular, nervous, and endocrine systems. Some of the liver’s functions include metabolizing carbohydrates, fats and proteins; filtering and detoxifying the blood; storing iron and vitamins; and forming substances for blood coagulation and indigestion. Bile is discharged from the liver and contains biochemically transformed blood cells, various drugs, toxins, and unused hormones generated from emotional and physiological processes. Waste products are broken down and excreted through urination.

When optimizing health, it is critical to support and vitalize the liver, especially for metabolic diseases such as arthritis, diabetes, obesity, and thyroid dysfunction. The P450 liver enzyme works to detoxify the body. When combined with increased vitamin C, this enzyme converts cholesterol to bile and HDL, which may lower total cholesterol by 2%.

Diet

The most important factor in maintaining better integrity of the liver is to eat a diet that is low in protein, especially animal protein. In addition, a low-fat diet is encouraged. Both the liver and the pancreas are responsible for the secretion of important digestive enzymes that are vital for the breakdown of nutrients from food.

A diet rich in green vegetables (especially broccoli, Brussels sprouts and cabbage) and high-sulfur foods (onions, garlic and eggs) is necessary to sustain liver integrity. Green foods (wheat grass juice, chlorella, blue-green algae, and spirulina) are high in fiber and contain high levels of vitamins A and K—the clotting vitamin. Fiber is also found in fruits, vegetables, oat bran, and whole grains. Fruits rich in vitamin C, because of their natural acidity, are closely associated with the regenerative function of the liver. Individuals with liver disease should drink six glasses of filtered water daily and avoid saturated fats, refined sugar and caffeine.

Liver toxins include chemical exposure, alcohol, nicotine, pesticides, and drugs, especially NSAIDS, acetaminophen, chemo-drugs, steroids, and heavy antibiotic use. Smoking and harmful chemicals should be avoided. In addition, hepatotoxicity is also consistent with multiple interactions between concomitant use of alcohol and either the retinol or the beta-carotene form of vitamin A.

Risks & Characteristics

The most serious risks involved with liver disease include anemia (low red blood cells), leukopenia (low white blood cells), and thrombocytopenia (decreased number of platelets). Other complications include low blood pressure, increased heart rate, the development of spider-like blood vessels, red palms, itching, jaundice and enlarged liver. In women, liver problems can cause the cessation of periods and decreased fertility. Impotence can be a problem in men. Intractable diseases such as chronic PMS, allergies, obesity, herpes, digestive problems, constipation, heart and circulatory problems, and cancer usually have an unbalanced liver as an underlying cause.

The liver is the major organ dealing with toxins in the body. Basically, there are two kinds of toxins: exogenous toxins that enter the body as by-products of food, water, chemical and air pollution, and endogenous toxins that are caused by stress. Exogenous toxins pollute the body which can cause a hormone imbalance, thus putting an extra burden on the liver as it tries to regulate them. The transforming, filtering, and discharging ability of the liver is responsible for dealing with both kinds of toxins. An excess of toxins is a primary cause of liver chi (energy) congestion. The process of regulating energy and moods is connected to the liver’s storage of glycogen and its release into the bloodstream in the form of glucose. This process is controlled by the adrenal glands which, when over stimulated, give signals for the release of insulin from the pancreas which may then burn off the available glucose.

Liver function is also the regulator of the nervous system and should be based on the lab-test levels of SGOT, SGGT, SGPT, AP, LDH, cholesterol, triglycerides, and bilirubin.

Liver Imbalance

Three or more of the following conditions definitely indicate a liver imbalance:

Feelings of tightness and constriction of the chest and upper abdomen
Eye disorders
Nausea, dizziness, vertigo, headaches, dark urine and night blindness
A thick yellow- or white-coated tongue
Easy bruising and web-like red spots on the skin (blemishes and poor complexion)
Discomfort in the right abdomen
Allergies and chemical sensitivities
Intolerance to eating fatty foods
Intolerance to alcohol

Supplement Protocol

DETOXIFICATION
A liver detoxification via various herbs, fiber, and nutrients can be an important component of liver cleansing. Choose a quality detoxification program with a qualified practitioner.
MILK THISTLE (SILYMARIN)
Milk Thistle is one of the most potent liver protectors ever discovered and is effectively used in liver disorders due to disease, alcohol, cirrhosis, and liver disease secondary to diabetes. Milk thistle fruit consists of the ripe liberated fruit of Silybum marianum. The active ingredient in the fruit, seeds, and leaves of the milk thistle is called silymarin. As an antioxidant, milk thistle is many times more potent than vitamin E, and prevents the depletion of glutathione. The ability of milk thistle to prevent against liver destruction and enhance liver function derives primarily from the inhibition of hepato-destructive factors. Milk thistle protects against cellular damage, increases intracellular anti-oxidant activity against free-radicals and xenobiotic agents (environmental synthetic antibiotics), and regenerates damaged or injured liver cells by promoting protein synthesis. In addition, milk thistle may totally or partially ameliorate the toxic effects of the commonly prescribed cancer drug Cisplatin. Dosage: 100-600 mg a day.
CHOLAGOGUES (agents that increase the flow of bile)
DANDELION has a long folk history as a medicine for liver and bile problems. It can stimulate production of bile up to 4 times the normal amount. ARTICHOKE lowers cholesterol by decreasing its production in the liver, increases bile flow to the liver, protects liver cells against injury, and helps with digestive disturbances. CURCUMIN (turmeric) increases bile flow and protects the liver’s metabolic/detoxification system. Tumeric has long bee used in Chinese medicine to support liver function and as an anti-inflammatory. Dosage: As directed.
AYURVEDIC PRODUCTS (liver extracts)
There are many Ayurvedic products that traditionally provide an internal cleanser that maintains the vitality and health of the liver. Traditional Indian medicines (LIV-52 or Liver care from Himalaya Healthcare are a few examples). Some unique ingredients include SCHISANDRA BERRY, an extract that has been a classic component of traditional Chinese medicine for centuries. It has antioxidant and anti-stress properties and protects the liver against chemical damage. PICRORHIZA is a small perennial herb that grows in northwest India. It has been shown to protect liver cells from a wide variety of toxins. It may be of value in viral hepatitis. Others include yarrow, arjuna, wild chicory and capers.
ANTIOXIDANTS
Antioxidants decrease free radicals, reduce the body’s susceptibility to toxins, and enhance blood flow properties. The most necessary antioxidant vitamins include VITAMIN C (with QUERCETIN), SELENIUM, CO-ENZYME Q10, VITAMIN E, and VITAMIN A. Vitamin C, because of its natural acidity, is a vitamin closely associated with the regenerative functions of the liver.
N ACETYL L CYSTEINE and GLUTATHIONE
N-Acetyl L-Cysteine (NAC) is an amino acid that is manufactured in the liver. NAC helps protect the liver from free radicals, is the nutritional precursor to the body’s own vital glutathione, and it acts as a detoxifier. NAC has been successfully utilized in treatment of acetaminophen-induced liver toxicity. Glutathione is an important antioxidant tri-peptide that helps rid the liver of several potential toxins. Glutathione is an important water-phase antioxidant and an essential cofactor that protects the mitochondria of the cell against damage. Depletion of this important water-soluble antioxidant and essential cofactor for antioxidant enzymes is a contributing factor to liver injury and morbidity related to liver hypo-function. Dosage: See a qualified practitioner.
PHOSPHATIDYLCHOLINE (PC) and CHOLINE
PC has been shown to increase liver-cell membrane fluidity, enhance transport activity, improve liver metabolism, increase the synthesis of RNA and protein, slow membrane damage, and protect against free-radical damage. Further evidence indicates that PC supports liver cells against attacks by various toxic agents (e.g. xenobiotics, xenoestrogens, radiation exposure, natural plant toxins, drugs and chemicals). PC also provides protection against alcohol-induced septal fibrosis and cirrhosis. Choline deficiency is a well-documented cause of fatty liver. Choline emulsifies fats and provides the substrate for PS biosynthesis, that promotes maintenance and repair of damaged liver cells. Dosage: 1,000-4,600 mg daily.
SAMe (S-ADENOSYL-L-METHIONINE)
SAMe is depleted in liver-diseased patients, especially in patients with ethanol-induced liver injury like cirrhosis. In some studies, SAMe was effective in decreasing bilirubin levels. SAMe combines with L-METHIONINE, an essential amino acid, and is very beneficial in preventing cholestasis and promoting bile flow. Dosage: 200 mg 2-4 times a day.
GARLIC
Garlic works with the body’s detoxification pathway and may act as an anti-carcinogenic agent in liver cancer. Dosage: 4 grams daily or 2-4 cloves.
ZINC
Zinc is a necessary supplement for patients with chronic liver disease as their levels of zinc are usually low, especially in those with cirrhosis. Zinc supplementation may improve glucose tolerance and glucose metabolism. Dosage: 30 mg daily; do not exceed 90 mg per day.
ALPHA-LIPOIC ACID (ALA)
ALA is a sulphur-containing substance necessary for the production of cellular energy. An effective antioxidant, ALA protects the liver from free-radical damage and also helps to promote detoxification. ALA’s physiological actions are a key to overcoming liver failure and may benefit alcoholic liver disease. Dosage: 200-900 mg daily, as directed by a qualified practitioner.
CARMINATIVE HERBS
Carminative herbs can help to regulate liver chi (energy) and promote good blood circulation through the liver. These herbs include OREGON GRAPE ROOT, GREEN CITRUS PEEL, FENNEL SEED, GINGER ROOT, ANGELICA ROOT, and CHINESE WOLFBERRIES.
L- GLUTAMINE
A precursor of N-ACETYL CYSTINE, glutamine is a protein amino acid found in proteins of all forms. L-glutamine has come to be regarded as one of the most important of the amino acids when the body is subjected to stress, trauma and cancer. It has an anti-oxidant effect and allows the kidney and liver to excrete an acid load, protecting the body against acidosis. Dosage: 500 mg once or twice daily.
B-COMPLEX
B-complex vitamins, along with vitamin C, enhance P450 liver enzymes. B-complex is extremely important for liver health. Patients with cirrhosis should supplement with higher doses of folic acid (1600 mg/daily) and pyridoxine B6 (200 mg). Vitamin B6 is an essential cofactor in hundreds of chemical reactions, many of which take place in the liver. Vitamin B6, provided in its active form, pyridoxal 5’-phosphate is a better absorbed form. Avoid excess niacin (vitamin B3). Dosage: 50-100 mg daily.
BETAINE
Betaine, a form a plant hydrochlolic acid, is a valuable hepatoprotective agent because it safeguards the liver against damage from excess homocysteine and generates molecules of SAMe. SAMe is effective in treating cirrhosis of the liver. Dosage: As directed.
ACETYL–L-CARNITINE and L-ARGININE
Acetyl-L-carnitine is an amino acid occurring naturally in animal products. It has demonstrated some efficacy as a neuroprotective agent in the liver. Dosage: 1,000-2,000 mg daily. L-ARGININE is an amino acid that may help regenerate the liver and help lower blood levels of toxic ammonia. Dosage: 5-10 grams daily.
GREEN BARLEY, CHLORELLA, SPIRULINA, GREEN FOODS
These organic greens are some of the most nutritiously-rich life forms that are a powerhouse of essential nutrients. In addition to adding energy to the body, these superfoods also are potent antioxidants that protect the liver and stabilize liver enzymes.
SELENIUM
Selenium levels appear to be significantly depleted in individuals suffering from hepatitis and liver diseases. Low selenium levels were also correlated with increased total serum cholesterol levels. Dosage: 200 mcg daily.
GOJI JUICE
Goji juice is rich in antioxidants and has been shown to decrease oxidative stress and protect red blood cells. It has been used in Traditional Chinese Medicine for many uses including diabetes. Goji juice may have liver protection properties comparable to milk thistle. Dosage: As directed on bottle.
MAGNESIUM
Magnesium is essential in hundreds of biochemical reactions, many of which take place in the liver. Dosage: 400-800 mg daily.
WILD YAM ROOT
Wild yam root aids in detoxifying the liver and in calming tension and internal spasms.
ASTRAGALUS
Astragalus is an immunostimulant herb that is used in treating viral infections and hepatitis. Cases of chronic hepatitis have shown an 86% positive response rate (improved liver function) after astragalus injections. Orally astragalus is an adaptogen with potent anti-cancer activity. Dosage: As directed.

Selected Drugs That Can Cause Liver Toxicity

The predominant presentation of liver toxicity is acute hepatitis or cholestatic liver disease, but toxicity can mimic all forms of acute or chronic liver problems. An acute hepatitis reaction is characterized by symptoms of jaundice, markedly elevated serum transaminase levels, and in severe cases, coagulation disorders and encephalopathy that indicate acute liver failure. Cholestatic disease is not life-threatening, but it has symptoms of jaundice, increased serum alkaline phosphatase levels, and itching.

Drugs that can cause liver toxicity include acetaminophen (Tylenol), allopurinol, amiodarone, amoxicillin, carbamazepine, cyclosporin, diclofenac, erythromycin, flutamide, gemfibrozil, itraconazole, ketoconazole, abetalol, lovastatin, methotrexate, methyldopa, minocycline, niacin/nicotinic acid, nitrofurantoin, pravastatin, phenytoin, protease inhibitors, ranitidine, rifampin, simvastatin, sulfonamides, sulindac, tamoxifen, tetracycline, trazodone, valproic acid, and vitamin A.

Selected Herbs That Are Reported To Cause Liver Toxicity

Herbs that are toxic to the liver include chaparral, comfrey, germander, kava kava, pennyroyal, red yeast, and valerian.

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