Protect Your Liver

[David Baxter PhD]

Best Ways to Protect Your Liver
Berkeley Wellness
September 13, 2018

Your liver is the consummate multitasker. It helps digest food, regulates cholesterol and fat metabolism, and plays a key role in the processing and removal of metabolic waste products and most ingested drugs, to name only several of its 500 or so essential functions. Here's what you can do to protect this vital organ.

• Avoid heavy alcohol use, a major cause of cirrhosis and other liver damage. Death rates from alcohol-related liver disease have risen sharply in the U.S. since 2009, especially in younger adults.
• Heed dosing directions for medications—in particular, for acetaminophen (Tylenol or generics). The maximum dose for acetaminophen is 4 grams (8 extra-strength tablets) in 24 hours. Because acetaminophen is an ingredient in hundreds of OTC and prescription medications, such as cold remedies, it’s easy to consume too much. To help prevent liver damage, avoid consuming alcohol if you take the drug regularly. If you need a pain reliever on a regular basis, consult your doctor. Here's good information about the safe use of acetaminophen and other pain relievers.
• Avoid obesity. Obesity increases the risk of nonalcoholic fatty liver disease and liver cancer. The obesity epidemic helps explain why liver cancer has become the sixth leading cause of U.S. cancer deaths, according to a CDC report in 2018.
• If you work with toxic chemicals, such as some cleaning solutions, paints, and pesticides, ventilate the room and take other precautions.
• Be wary of dietary supplements. Many are potentially toxic to the liver, especially when taken long term or in high doses. The proportion of all drug-related liver injuries that could be attributed to supplements rose from 7 percent in 2004 to about 20 percent in 2014, according to a review based on reports to the NIH's Drug-Induced Liver Injury Network, published in Hepatology in 2016. Body-building formulas (notably those spiked with illegal anabolic steroids) and weight-loss products (notably those containing green tea extract) accounted for about half of the cases of liver damage linked to supplements. Other herbal products known to harm the liver include chaparral, comfrey, kava, skullcap, and yohimbe. Many of the supplements contain multiple ingredients, so it’s often impossible to identify the cause of liver damage. In some cases, impurities and adulterants are introduced during processing of the products. Don't count on supplements promoted specifically to protect the liver.
• Talk to your doctor about getting vaccinated against hepatitis A and hepatitis B and about being tested for hepatitis C. Though there is no vaccine against hepatitis C, you should get tested for it if you were born between 1945 and 1965, ever injected drugs or used un-sterile needles, have HIV, have been on long-term dialysis for kidney disease, received clotting factor that was produced before 1987, or had a blood transfusion before 1992. The CDC has a good website.

 

[David Baxter PhD]

Be Wary of Liver Supplements

Be Wary of Liver Supplements
Berkeley Wellness
September 13, 2018

Your liver is the consummate multi-tasker. It helps digest food, regulates cholesterol and fat metabolism, and plays a key role in the processing and removal of metabolic waste products and most ingested drugs, to name only several of its 500 or so essential functions.

It’s no wonder then that there are dozens of dietary supplements—pills, powders, and tonics—touted to protect this vital organ. LiverCare, Liverite, Liver Plus, and Liver-Rx are but a few that claim to “neutralize toxins” and repair and regenerate the liver. Some products even claim to alleviate chronic fatigue, food allergies, PMS, and immune problems, as well as increase energy, lower cholesterol, and help you lose weight.

Let’s filter out these claims.

A thorn in the thistle?
Of all ingredients commonly found in these products, the herb milk thistle (Silybum marianum) is one of the more researched. Reports of its use date back to the ancient Greek physician Dioscorides, who used this white-veined plant to treat serpent bites. In Europe, milk thistle has been a popular folk remedy for liver disease and is sometimes given as an intravenous drug to treat liver damage from mushroom poisoning.

Lab studies suggest that silymarin, a group of compounds extracted from the plant’s seeds, may protect the liver against damage from toxins and disease by acting as an antioxidant, immune-stimulant, and anti-inflammatory agent. It may also help stabilize membranes so toxins can’t bind and help regenerate liver cells, among other mechanisms.

While this all sounds promising, studies in people have been flawed, and results have been inconsistent or inconclusive. In a 2007 review of 13 clinical trials, the independent Cochrane Collaboration questioned the use of milk thistle for alcoholic liver disease and hepatitis B and C because of the poor quality of the research.

Perhaps the best clinical trial on milk thistle extract was published in the Journal of the American Medical Association in 2012 and involved 154 people who had chronic hepatitis C and were not responding well to interferon antiviral therapy. It found that a standardized silymarin extract (Legalon 140, approved as a prescription drug to treat liver diseases in several European and Asian countries) taken for six months did no better than a placebo in reducing blood levels of ALT, an enzyme that’s a marker for liver injury.

Moreover, nearly all studies have looked at milk thistle or silymarin in chronic liver disease.There’s little if any evidence the herb can “detoxify” or protect a healthy liver, though this is what these supplements are typically marketed for. And no matter how convenient it would be, milk thistle is not an antidote for a night of heavy drinking or for smoking, as some supplement makers suggest.

Do these ingredients deliver?
Other common “liver herbs” include licorice root extract, Phyllanthus.Various mixtures (often proprietary) of herbs used in Ayurvedic (Indian) or traditional Chinese medicine are widely available as well. As with milk thistle, lab studies suggest these herbs may have some liver-protective properties. But there are no good human studies.

The same goes for the other herbs (such as dandelion, artichoke, and sea buckthorn), amino acids, vitamins (such as B[SUB]12[/SUB] and E), and other substances (such as choline, inositol, and chlorophyll) that may be found in liver supplements. Some ingredients may have dangerous side effects. For example, unless licorice is specially processed to remove a particular compound(glycyrrhizin), it can raise blood pressure.

Bottom line: Avoid “liver support” supplements. Just because a healthy liver helps detoxify your body, that doesn’t mean it needs to be detoxified itself. It is not like a clogged filter. And a healthy liver has a remarkable ability to restore itself when damaged. If you have liver disease, consult your doctor before taking any supplement or medication.

 

[Daniel E.]

And those Amazon reviews can be so deceiving due to the placebo effect, etc.

 

[GaryQ]

Re: Be Wary of Liver Supplements

Be Wary of Liver Supplements

Just because a healthy liver helps detoxify your body, that doesn’t mean it needs to be detoxified itself. It is not like a clogged filter.

:lol: I loved that clogged filter comment

 

[Daniel E.]

Aspirin for Patients with Nonalcoholic Fatty Liver Disease
Atif Zaman, MD, MPH reviewing Simon TG et al.
Clin Gastroenterol Hepatol
2019 May 8

Daily aspirin use reduced risk for fibrosis progression.

One of the key predictors of increased liver-related morbidity and mortality in patients with nonalcoholic fatty liver disease (NAFLD) is the development and progression of liver fibrosis. Recent studies have shown that aspirin may have antifibrotic effects in NAFLD. In murine models, aspirin limits hepatic stellate cell activation by inhibiting the cyclooxygenase-2 (COX-2) enzyme, and antagonism of COX-2 seems to improve nonalcoholic steatohepatitis (NASH)–related fibrosis. In humans, much of the literature has been limited to cross-sectional studies.

Now, investigators have conducted a prospective cohort study involving 361 adults with biopsy-proven NAFLD, 151 of whom were daily aspirin users. Participants underwent evaluation every 3 to 12 months for development of fibrosis, using serum fibrosis markers.

At baseline, daily aspirin users versus nonregular users had lower odds of having NASH (adjusted odds ratio, 0.68) or fibrosis (aOR, 0.54). During a median of 3692 person-years, daily aspirin users had lower rates of advanced fibrosis (adjusted hazard ratio, 0.63), with the greatest benefit occurring in those taking daily aspirin for ≥4 years (Ptrend=0.026). Nonaspirin NSAID use did not affect fibrosis rates.

Comment

This is the first prospective study to evaluate the potential benefits of daily aspirin use in NAFLD patients. Although this is not a randomized study, the duration-dependent relationship of aspirin to NAFLD-related fibrosis, coupled with the biologic plausibility of the antifibrotic effects of aspirin in NAFLD patients, makes the results compelling. Given the growing body of literature around the association of NAFLD and cardiovascular disease, the use of aspirin in NAFLD patients seems appropriate to consider in clinical practice.

 

[Daniel E.]

Liver Disease Diets: Fatty Liver Diet and More

Explore our selection of liver healthy foods and liver disease diets for people suffering from fatty liver, hepatitis, cirrhosis, and others.

liverfoundation.org

Some general food tips for a healthy or healthier liver:

• What to avoid: Don’t eat foods high in fat, sugar and salt. Stay away from a lot of fried foods including fast food restaurant meals. Raw or undercooked shellfish such as oysters and clams are a definite no-no.
  
  
• Talk to your doctor about alcohol and your liver health: Depending on the state of your liver, you should avoid alcohol. If you’re allowed alcohol, limit it to no more than one drink a day if you’re a woman and two drinks a day if you’re a man.
  
  
• Eat a balanced diet: Select foods from all food groups: Grains, fruits, vegetables, meat and beans, milk, and oil.
  
  
• Eat food with fiber: Fiber helps your liver work at an optimal level. Fruits, vegetables, whole grain breads, rice and cereals can take care of your body’s fiber needs.
  
  
• Drink lots of water: It prevents dehydration and it helps your liver to function better.