After New Year’s Eve has passed, one’s thoughts often turn to making up for the excesses of the holidays. I can’t help you with your credit card debt, and dropping those extra pounds is a subject bigger than this blog can cover, but I can give you some tips on toning up your liver. This is the organ that takes most of the abuse that is caused by dietary indiscretions and excessive alcohol use, and it is a good idea to give it a tune-up once the seasonal celebrations have died down. And for anyone with serious liver problems the material to follow will offer the most scientifically valid approaches to healing and rejuvenating this most important organ.
MEET YOUR LIVER Next to the skin, the liver is the largest organ in your body, and everything ingested by the body (absorbed through the skin, inhaled, or eaten) must be processed by the liver. Over 500 bodily functions are dependent on the liver, including: the creation of bile (for digestion); regulation of blood sugar; filtering the blood; the synthesis and utilization of cholesterol; the production and break down of hormones; and the removal of toxins, both externally-derived and internally-produced. The liver is the workhorse of the body and, in these toxic modern times, has had to work harder than at any time in history.
We cannot live without our liver but a damaged liver can be fairly easily restored. There have been many instances in modern medicine where a mother will donate half of her liver to her child (who has liver malfunction), and both parties will re-grow a fully functioning liver from the half that they each have. Given this ability of the liver to regenerate, it is not surprising that there are many nutrients, nutraceuticals, and herbal extracts that have been scientifically proven to cleanse and/or rebuild damaged livers.
Aside from helping the liver out after too much partying, cleansing and rejuvenating the liver is a necessary treatment for many ailments related to liver malfunction. These include cirrhosis, fatty liver, hepatitis, high cholesterol, hormonal imbalance in both genders, and skin problems (including acne and psoriasis). Supporting the liver is especially important for those who have used drugs, both legal (over-the-counter and prescription) and illegal, and/or alcohol, for long periods of time.
Following is a list of the most important liver-supportive substances, which can be used alone (following label instructions), or combined in liver-support formulas.
HERBS THAT REJUVENATE THE LIVER
Recent scientific experiments with two Traditional Chinese herbs, Astragalus and Schisandra, have revealed a synergistic relationship between them. Together these two herbal extracts create a powerful liver protecting and rejuvenating effect. (1)
Astragalus is used in Traditional Chinese Medicine to build resistance to disease and to increase energy and support immunity. Even before it was adopted by Western herbology, astragalus had been used for centuries by Traditional Chinese Medicine to “tonify the spleen and augment the qi (vital energy)”. It is also traditionally used to tonify the lungs and to treat those with frequent colds. Recent scientific studies, done on animals, have been finding astragalus to be hepatoprotective. One such study showed a clear increase in glutathione, SOD (superoxide dismutase) and total antioxidant levels, after introducing chemical damage to the livers of experimental animals. (2)
Schisandra is used to improve digestion, increase circulation and enhance immune function. Traditional Chinese Medicine uses schisandra to boost physical and mental endurance and encourage detoxification. So powerful is it that schisandra is used in Chinese medicine to treat hepatitis and cirrhosis, as well as to increase bile flow. Schisandra is also used by athletes to increases stamina and physical performance.
Dandelion Root is considered to be nourishing and tonifying in Traditional Chinese Medicine, and is used as a tonic to improve liver function. In Western herbology, dandelion root is used to treat hepatitis and liver congestion because it can stimulate the liver, aiding it in eliminating toxins from the blood. It is also helpful for the gallbladder, spleen, kidneys and pancreas.
Clinical studies on hepoprotective substances are often done on mice that have carbon tetrachloride-induced liver damage, something that mimics chemical damage in humans. The results of one such study “provide scientific evidence to substantiate the traditional use of Taraxacum officinale (dandelion) root in hepatic disorders.” (3)
Milk Thistle is clinically proven to restore optimal liver function and to protect the liver from toxins. Milk thistle is also an antioxidant that can raise glutathione levels in the body by up to 35%, and can help to reduce inflammation in the liver. It has been clinically used to treat cirrhosis, chemical-induced liver damage, fatty liver, inflammation of the bile ducts, and viral hepatitis. The active ingredient in milk thistle is known as silymarin, and clinical studies are mostly done with milk thistle products standardized to 80% silymarin. Milk thistle is so effective that studies have shown it to dramatically improve the quality of life and reverse the biological markers of liver disease in patients with chronic hepatitis C. (4)
Turmeric Extract (including the isolate curcumin) has repeatedly proven itself to be hepatoprotective, protecting the liver from chemical damage, toxins and viruses, as well as strengthening liver function. It is a powerful antioxidant that reduces free radicals, serves anti-inflammatory functions and is anti-carcinogenic. In one study turmeric extract provided protection against chronic alcohol-induced liver disease by alleviating oxidative damage. (5) The best form of turmeric extract is one that contains 95% curcuminoids.
NUTRACEUTICALS THAT PROTECT THE LIVER
Alpha Lipoic Acid is a co-factor in many reactions in our bodies, including energy production. It is an antioxidant that is both fat and water soluble and so can effectively recycle the other antioxidants in the body including vitamin C, vitamin E, COQ10 and glutathione. Most ALA supplements are a mix of the synthetic (S-) and the natural (R+) forms of the nutrient. Studies have shown that the S- form may be of little value and may in fact impede the effectiveness of the R+ form, so when purchasing it is ideal to buy the R+ form.
In one interesting study, mice were fed a diet deficient in methionine and choline to induce non-alcoholic steatohepatitis (NASH), a liver disease that causes fat accumulation, inflammation and fibrosis. The conclusion of the study was that “ALA can be used to prevent the development and progression of non-alcoholic fatty liver disease in patients who have strong risk factors for NASH.” (6)
Calcium D-glucarate is a naturally occurring substance (found in apples, grapefruit and cruciferous vegetables) that is used by the body to detoxify carcinogens and toxins, allowing the liver to easily process these dangerous chemicals. Calcium D-glucarate inhibits an enzyme called “beta-glucuronidase” that can interfere with the detoxification process of glucuronidation, part of what is known as “Phase II liver detoxification.” According to the Alternative Medicine Review, “elevated beta-glucuronidase activity is associated with an increased risk for various cancers, particularly hormone-dependent cancers such as breast, prostate, and colon cancers. Other potential clinical applications of oral Calcium-D-glucarate include regulation of estrogen metabolism, and as a lipid-lowering agent.” (7)
N-Acetyl Cysteine is a sulfur-based amino acid that functions as an antioxidant, and is required by the body to raise glutathione levels. NAC prevents the depletion of glutathione when the body is overloaded with heavy metals and toxins. In Europe NAC is approved as a treatment for liver damage caused by acetaminophen (Tylenol) overdose, and it is also used to treat lung conditions and bronchoplumonary diseases. The study listed below shows that not only will NAC protect the liver against drug induced damage but the oral form works better than the intravenous protocol. (8)
L-Taurine is another sulfur-based amino acid, necessary for functions related to the brain, eyes and, especially, the heart. Taurine is also involved in “Phase II detoxification”, being required for “conjugation” which binds toxic substances and eliminates them through the kidneys and bladder by way of the bile. This detoxification pathway is required to reduce dangerously high hormone levels (including xenoestrogens) in the body. One taurine study observed rats with induced zinc toxicity, a form of heavy metal poisoning. Symptoms of zinc toxicity in rats included loss of body weight, hepatotoxicity, and nephrotoxicity (kidney damage). However, “these toxic effects of zinc were significantly reduced when the rats fed diet with supplement of taurine.” (9)
VITAMINS AND MINERALS THAT PROTECT THE LIVER
Selenium (I prefer Seleno Excell tm) is required by the body in order to produce glutathione peroxidase, the internally-produced antioxidant necessary for the removal of free radicals and toxins. The liver requires selenium to produce enzymes necessary for Phase II detoxification, whereby toxins are bound to substances that escort them out of the body via the kidneys.
Selenium also plays a pivotal role in the restoration of immune functions. Population studies have demonstrated an inverse association between selenium levels and cancer incidence, as well as viral infections. One study was designed to evaluate the concentration of selenium in the blood of patients suffering from hepatitis B and C. The conclusion of the study was that “serum selenium concentration of hepatitis B and C patients is less than serum selenium concentration of healthy individuals. However, serum selenium decline is relative to severity of disease. Based on findings of this study, it is proposed that selenium should be supplemented in such patients in order to get better treatment response.” (10)
VITAMIN D (Reprinted from Newsletter #11) A build up of extra fat on the liver that isn’t caused by alcohol abuse is known as Nonalcoholic Fatty Liver Disease (NAFLD). NAFLD has become the most common form of chronic liver disease in Western countries, and with rates as high as 30%, its prevalence exceeds that of viral hepatitis and alcoholic liver disease. Unfortunately, NAFLD is often a disease that shows no obvious symptoms but, if left undiagnosed, this condition can lead to further complications, including inflamed liver, and cirrhosis. Currently, there is no approved treatment for NAFLD except for a recommendation to follow a healthy diet and exercise regularly.
NAFLD is closely linked to metabolic syndrome (insulin resistance), which is in turn linked to obesity and sedentary lifestyle. Also linked to these three conditions is vitamin D deficiency, so researchers have been looking for a potentially causative relationship between vitamin D deficiency and NAFLD: and they appear to have found it. One study from last year concluded that: “Vitamin D deficiency is commonly associated with NAFLD and has even been correlated with disease severity. The metabolic, anti-inflammatory and anti-fibrotic properties of vitamin D provide plausible mechanisms by which vitamin D may impact on the various steps of disease progression and severity. Cumulatively, this would suggest that vitamin D replacement might be effective in the treatment of NAFLD.” (11)
Choline Bitartrate is a member of the family of B-vitamins. It is found in common foods (especially high in egg yolks), and is required for the production of the neurotransmitter acetylcholine (necessary for learning and memory), and is required to maintain the integrity of cell membranes. Since choline is required to metabolise fat, a deficiency in choline can allow fat to become trapped in the liver, blocking the functions of the liver.
Animals fed a choline-deficient diet will develop kidney and liver disorders, and humans who have a diet deficient in choline develop liver dysfunction and fatty build up on the liver. Knowing that choline is essential for proper liver function, it is used therapeutically in Germany to treat alcohol-induced fatty liver, hepatitis, cirrhosis, and drug-induced liver damage. (12) Studies done at The Feinberg School of Medicine at Northwestern University have shown that fatty liver can be prevented with the addition of choline. (13)
Inositol, another member of the B vitamin family, works together with choline to maintain cell integrity and works, like choline, as a “lipotropic” which moves fat from the liver. Keeping fatty deposits off of the liver is critical because fat and bile build up on and in the liver is linked to many liver problems including the development of cirrhosis. Inositol is used therapeutically to treat depression, diabetes and liver disorders, and is necessary for healthy functioning of the brain, muscles and nerves. (14) It should be noted that drinking more than two cups of coffee per day can deplete the body of inositol.
L-Methionine is a sulfur-based, essential amino acid, required for the body to manufacture choline. Like choline and inositol, it also assists in the digestion of fats, helping to prevent fat build up in the arteries and on the liver. Also like choline and inositol, methionine is a “methyl donor” (as are B-12 and folic acid). Methyl donors provide methyl molecules to other molecules involved in maintaining cell membrane components and producing neurotransmitters. They are also required for energy metabolism, nerve functions, and a healthy immune system.
Methionine serves as an antioxidant in the body, helping to prevent glutathione depletion if the body is overly toxic. It especially protects the liver from damage from toxins, aiding in detoxifying chemicals and heavy metals, and protects against radiation damage. It also promotes the excretion of excessive and/or synthetic estrogens from the body. Research has indicated that in rats and mice, diets deficient in the methyl groups (choline, methionine, betaine, folate) produced fatty liver and that long-term administration of diets deficient in choline and methionine also caused liver cancer. (15)
An easy way to get all three of these lipotropic vitamins – choline, inositol, and methionine – is to consume lecithin in the granular or powdered form – at least 1 tablespoon a day. Lecithin capsules are a waste of time, unless you take about 9 per day, but the concentrated form of lecithin known as phosphatidylcholine is effective in capsule form (at 3 per day).
You can work with these nutrients and herbs to make them more effective at detoxifying and rejuvenating your liver. For the period of time that you are rejuvenating your liver, make every attempt to avoid vices (coffee, tobacco, alcohol, drugs of any kind) and to eat a healthful diet. Try to avoid deep fried foods, fatty foods, excessive animal protein, excess sodium, refined carbohydrates such as flours and sugars, and processed foods containing chemical preservatives, coloring agents and artificial flavors.
Make a point of eating whole fruits and vegetables, especially apples, grapefruit and cooked cruciferous vegetables (kale, broccoli, cabbage, cauliflower, Brussels sprouts), eat whole grains, or yams and sweet potatoes, for carbohydrates, and use vegetable-based, or lean animal proteins. Whey protein is especially helpful, since it raises levels of the antioxidant glutathione in the body. For those who might find this difficult, take the approach of eating well during the week and allowing more indiscretions on the weekends. The substances I have discussed will still work to cleanse and rejuvenate your liver even if your diet is not impeccable, but they will work better if you work with them.
All the substances mentioned can be purchased singly or in formulas that combine many of them. In my experience helping those with severe liver damage, the best approach is to rotate the herbs used so as not to acclimatize to them. So, while the nutrients (including lecithin) can be taken ongoing (skipping weekends), essentially for as long as you like, the herbs should be alternated. For example, you might take milk thistle, or a milk thistle-based formula, for one month, then, the following month take turmeric, or a turmeric-based formula; use dandelion thereafter, and then rotate back to milk thistle.
I have seen this approach work miracles on rebuilding damaged livers. In fact, a cousin of mine had a liver so badly damaged from a virus (picked up from a tropical bird that he purchased as a pet for his kids), that he could no longer get life insurance. After 6 months on a rotating program, based on the liver regenerating herbs, he once again had normal liver function. As you can see from the material covered here, even cirrhosis and hepatitis can be effectively treated with these substances, so be sure to share this information with anyone you know who has any serious liver condition.
- 2009 Sep;16(9):805-13. Epub 2009 Apr 2, “Synergistic hepatoprotective effect of Schisandrae lignans with Astragalus polysaccharides on chronic liver injury in rats”, Yan F, et al. http://www.ncbi.nlm.nih.gov/pubmed?term=synergistic%20hepatroprotective%20effct%20of%20schisandrae
- Fish Physiol Biochem. 2012 Jun;38(3):871-81. Epub 2011 Nov 17, “In vitro and in vivo hepatoprotective and antioxidant effects of Astragalus polysaccharides against carbon tetrachloride-induced hepatocyte damage in common carp (Cyprinus carpio).” Jia R, et al. http://www.ncbi.nlm.nih.gov/pubmed/22089693
- 2010 Aug 9;130(3):569-77. Epub 2010 Jun 2; “Antifibrotic activity of Taraxacum officinale root in carbon tetrachloride-induced liver damage in mice.” Domitrović R, et al. http://www.ncbi.nlm.nih.gov/pubmed/20561925
- J Res Med Sci. 2011 Mar;16(3):287-90. “Effects of silybum marianum on patients with chronic hepatitis C.” Kalantari H, et al.) http://www.ncbi.nlm.nih.gov/pubmed/22091246
- 2012 Apr 15;19(6):545-50. Epub 2012 Mar 23; “Curcumin prevents chronic alcohol-induced liver disease involving decreasing ROS generation and enhancing antioxidative capacity.” Rong S, Zhao Y, et al. http://www.ncbi.nlm.nih.gov/pubmed/22445643
- Life Sci. 2012 Jan 30;90(5-6):200-5. Epub 2011 Dec 1; “Alpha-lipoic acid attenuates methionine choline deficient diet-induced steatohepatitis in C57BL/6 mice.” Min AK, et al. http://www.ncbi.nlm.nih.gov/pubmed/22154902
- Altern Med Rev. 2002 Aug;7(4):336-9; Calcium-D-glucarate. http://www.ncbi.nlm.nih.gov/pubmed/12197785
- J Pharmacol Exp Ther. 2012 Aug;342(2):529-40. Epub 2012 May 16. “An analysis of N-acetylcysteine treatment for acetaminophen overdose using a systems model of drug-induced liver injury.” Woodhead JL, et al. http://www.ncbi.nlm.nih.gov/pubmed/22593093
- J Food Sci. 2011 May;76(4):T90-8. doi: 10.1111/j.1750-3841.2011.02110.x. Epub 2011 Apr 5; “Dietary taurine reduces zinc-induced toxicity in male Wistar rats.” Yeh YH, et al. http://www.ncbi.nlm.nih.gov/pubmed/22417375
- Saudi J Gastroenterol. 2012 Mar-Apr;18(2):106-10; “The possible role of selenium concentration in hepatitis B and C patients.” Khan MS, et al. http://www.ncbi.nlm.nih.gov/pubmed/22421715
- World J Gastroenterol. 2015 Feb 14; 21(6): 1718–1727. “Vitamin D: A new player in non-alcoholic fatty liver disease?” Myrto Eliades and Elias Spyrou. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323447/
- Lieber CS & Rubin E, Alcoholic fatty liver, N. Engl J Med 280, 705-708, 1969
- Annu Rev Nutr. 2008;28:273-93; “Methionine metabolism and liver disease.” Mato JM, et al. http://www.ncbi.nlm.nih.gov/pubmed/18331185