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  Liver Detoxification / Support Requirement  
 
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Hampered detoxification processes can result in a condition labeled by many naturopathic and nutrition-oriented physicians as the "congested" or "sluggish" liver, or the more recently coined "impaired hepatic detoxification". Standard liver enzyme blood tests may or may not be elevated in such cases. The congested or sluggish liver is characterized by a diminished bile flow, a condition known in medical terms as cholestasis, while impaired hepatic detoxification refers to decreased phase I and/or phase II enzyme activity. Phase I detoxification rates that are in excess of phase II activity will also cause toxicity problems due to excessive accumulation of activated intermediates. Although there are more sensitive tests to determine the functional activity of the liver, such as a serum bile acid assay and various clearance tests, clinical judgment based on medical history remains the major diagnostic tool for the sluggish liver. The presence of chronic fatigue is a frequent symptom. Clearance tests using saliva, urine, and/or blood after chemical challenge by caffeine, aspirin, and acetaminophen can be useful in detecting Phase I and II imbalances.

Impaired liver function can result from intrahepatic problems caused by exposure to food additives, solvents (cleaning materials, formaldehyde, toluene, benzene, etc.), pesticides, herbicides, heavy metals (lead, mercury, cadmium, arsenic, nickel, and aluminum), and other toxins. Other causes include viral infections of the liver, some inherited disorders such as Gilbert's syndrome, alcohol induced fatty deposits, the use of anabolic steroids/estrogens/oral contraceptives and hyperthyroidism. Bile flow can be restricted also by extrahepatic means such as gallstones, pregnancy, or other physical causes such as tumors.

Among the other symptoms, people with a sluggish liver may complain of depression, general malaise, headaches, digestive disturbances, allergies and chemical sensitivities, premenstrual syndrome, and constipation. Not surprisingly, these are the same types of symptoms people exposed to toxic chemicals often complain of. Many toxic chemicals (especially solvents) and heavy metals have an affinity for nervous tissue, giving rise to a variety of psychological and neurological symptoms such as depression, headaches, mental confusion, mental illness, tingling in extremities, abnormal nerve reflexes, and other signs of impaired nervous system function.

The capacity of the liver to detoxify any given compound is determined not only by the inherent toxicity of the compound but also by the available supply of nutrients and endogenous molecules required for Phase I and II reactions, by any pre-existing liver disease which may be present and by the total load of all toxins to which it is exposed.
 

 
 

Signs, symptoms & indicators of Liver Detoxification / Support Requirement:
 
 
Supplements and Medications  Positive results from coffee enemas

Counter-indicators:
  Coffee enemas do not help

Symptoms - Bowel Movements

  Undigested fat in stools
  Greasy/shiny stools
  Pale stools

Symptoms - Environment

  (High) cigarette smoke sensitivity
  (High) chemical sensitivity

Symptoms - Food - Beverages

  No desire/inability to recover from alcoholism or being a recovering alcoholic
  Sickness caused by wine
  Negative reaction to coffee

Symptoms - Food - General

  Greasy food intolerance

Symptoms - Gas-Int - General

  Unexplained nausea

Symptoms - Head - Eyes/Ocular

  Dark areas under eyes
  Bags under eyes
 Some health care providers believe that dark circles under the eyes indicate toxicity and a need for detoxification.

Symptoms - Head - Mouth/Oral

  Metallic taste in mouth
  Bitter taste in mouth

Symptoms - Head - Nose

  Allergic rhinitis

Symptoms - Liver / Gall Bladder

  Liver/gallbladder cleanses help
  (Severe) pain under right side of ribs

Counter-indicators:
  Liver/gallbladder cleanses no help

Symptoms - Metabolic

  Foot odor/sweating

Counter-indicators:
  Absence of foot odor/sweating

Symptoms - Mind - General

  A 'foggy' mind

Symptoms - Muscular

  Pain between shoulder blades

Symptoms - Reproductive - Female Cycle

  Breast soreness during cycle

Symptoms - Skeletal

  Joint pain/swelling/stiffness

Symptoms - Skin - General

  Itchy skin
  Diminished perspiration

Symptoms - Sleep

  Bizarre/vivid/nightmarish/no bad dreams
  Forgetting dreams

Symptoms - Urinary

  Strong-smelling urine

Counter-indicators:
  Absence of urine odor
 
 

Conditions that suggest Liver Detoxification / Support Requirement:
 
 
Circulation  Varicose Veins
  Bruising Susceptibility

Digestion

  Hemorrhoids

Hormones

  Low Progesterone or Estrogen Dominance
  Elevated SHBG
 The liver is responsible for removing excess estrogen and SHBG, so any compromise in liver function (such as that caused by heavy alcohol consumption, for example) can exacerbate hormonal imbalances.

Immunity

  Chronic Fatigue / Fibromyalgia Syndrome
 In one evaluation of 200 Chronic Fatigue and Fibromyalgia patients it was found that 80% had a significant impairment of liver detoxification function.

Patients suffering from toxic burdens may experience a wide range of symptoms, among them fatigue and poor tolerance for exercise. These processes have been postulated to be a central factor in the development of CFS. Oxidative damage to mitochondria and the detoxification process itself is being considered as a fundamental mechanism in the development of CFS. [1 Bland JS, HealthComm Inc., 1997; Int Clin Nutr Rev 1988;8(4): pp.173-5]

Infections

  Yeast / Candida

Metabolic

  Headaches, Migraine/Tension
 A 'sluggish liver' often contributes to headaches.

  Hangovers
 Acetaldehyde is a toxic substance produced in the body from alcohol and is one of the impurities found in cheap wine and 'moonshine' spirits. Some researchers believe that an acetaldehyde buildup is the cause of hangovers. If the liver's detoxification pathways are impaired, aldehydes can, instead of being converted to the next intermediate product, build up to harmful levels and cause damage since they are often more toxic than the original substances from which they are derived.

It is probably the metabolism of methanol to formaldehyde and formic acid that caused the symptoms of the hangover. Quick methanol metabolizers suffer more. This is reinforced by the fact that the types of drinks associated with more severe hangovers contain higher levels of methanol. [Hangovers: Not The Ethanol, Perhaps The Methanol, British Medical Journal, January 4, 1997;14: pp.2-3]

All types of alcoholic drinks contain some methanol, a substance blamed for the worst hangovers. Whiskey, cheap red wine, fruit brandy and other dark spirits contain the most methanol, sometimes as much as 2% by volume. Vodka and other clear drinks contain the least. In the liver, methanol takes 10 times longer than ethanol to break down.

  Jaundice
  Intoxication Susceptibility
  Edema (Water Retention)
  Bulimic Tendency

Nutrients

  Magnesium Requirement
 Magnesium deficiency has been found to be more common in patients with diabetes, liver disease or malabsorption problems.

Organ Health

  Gallbladder Disease
  Consequences of Gallbladder Surgery
  Night Blindness
 Reduced night vision can be linked to a variety of conditions caused by impaired liver function which in turn reduces vitamin A metabolism.

Skin-Hair-Nails

  Psoriasis
 Correcting abnormal liver function is of great benefit in the treatment of psoriasis. The connection between the liver and psoriasis relates to one of the liver's basic tasks (filtering and detoxifying the blood). Psoriasis has been linked to the presence of several microbial byproducts in the blood. If the liver is overwhelmed by excessive levels of these toxins in the bowel, or if there is a decrease in the liver's detoxification ability, the toxin level in the blood will increase and the psoriasis will get worse.

  Body Odor
  Dandruff
  Night Sweats
  Pruritus Ani

Tumors, Benign

  Ovarian Cysts

Uro-Genital

  Fibrocystic Breasts
 Impaired liver function can result in excess circulating estrogens and a worsening of breast tenderness.
 
 

Risk factors for Liver Detoxification / Support Requirement:
 
 
Diet  Excess Protein Consumption
 High protein intakes may cause extra metabolic stress to be placed on the liver and kidneys.

Environment / Toxicity

  Cigarette Smoke Damage

Lab Values - Chemistries

  (History of) elevated liver enzymes

Counter-indicators:
  Normal liver enzyme levels

Supplements and Medications

  Pain medication use
  Antibiotic use
  Tetracycline use

Counter-indicators:
  Taking typical/taking low/taking high dose silymarin

Symptoms - Environment

  (High) solvent exposure
 Long term exposure to environmental pollutants and continued affronts to the detoxifying systems may lead to oxidative stress, high levels of phase 1 activity in the liver, and reduced phase 2 detoxification.

  Severe/significant/mild diesel exhaust exposure

Symptoms - Food - Beverages

  Moderate/low/high alcohol consumption

Symptoms - Gas-Int - Conditions

  History of hemorrhoids

Symptoms - Gas-Int - General

  History of unexplained nausea

Symptoms - Liver / Gall Bladder

  History of gallbladder attacks

Symptoms - Reproductive - General

  History of ovarian cysts

Uro-Genital

  Consequences of Vasectomy
 
 

Liver Detoxification / Support Requirement suggests the following may be present:
 
 
Cell Salts  Cell Salt, Nat Sulf Need

Environment / Toxicity

  Cigarette Smoke Damage

Laboratory Test Needed

  Liver Function That Should Be Checked
 
 

Liver Detoxification / Support Requirement can lead to:
 
 
Immunity  Chronic Fatigue / Fibromyalgia Syndrome
 In one evaluation of 200 Chronic Fatigue and Fibromyalgia patients it was found that 80% had a significant impairment of liver detoxification function.

Patients suffering from toxic burdens may experience a wide range of symptoms, among them fatigue and poor tolerance for exercise. These processes have been postulated to be a central factor in the development of CFS. Oxidative damage to mitochondria and the detoxification process itself is being considered as a fundamental mechanism in the development of CFS. [1 Bland JS, HealthComm Inc., 1997; Int Clin Nutr Rev 1988;8(4): pp.173-5]

Skin-Hair-Nails

  Psoriasis
 Correcting abnormal liver function is of great benefit in the treatment of psoriasis. The connection between the liver and psoriasis relates to one of the liver's basic tasks (filtering and detoxifying the blood). Psoriasis has been linked to the presence of several microbial byproducts in the blood. If the liver is overwhelmed by excessive levels of these toxins in the bowel, or if there is a decrease in the liver's detoxification ability, the toxin level in the blood will increase and the psoriasis will get worse.
 
 

Recommendations for Liver Detoxification / Support Requirement:
 
 
Botanical  Silymarin/Milk Thistle (Silybum marianum)
  Coffee Enema
 The coffee enema causes the liver to produce more bile (which contains processed toxins) and moves bile out towards the small intestine for elimination. This frees up the liver to process more incoming toxic materials that have accumulated in the organs, tissues and bloodstream. Coffee contains some alkaloids that also stimulate the production of glutathione-S-transferase, an enzyme used by the liver to make the detox pathways run. It is pivotal in the formation of more glutathione, one of the main conjugation chemicals, enabling toxins to be eliminated via bile into the small intestine. So in other words, a coffee enema speeds up the detoxification process and minimizes the backlog of yet-to-be-detoxified substances.

  Dandelion Root (Taraxicum officinale)
  Herbal Combinations
 Some of the scientific research and practical experience of people using Triphala down through the ages has demonstrated that it is an effective blood purifier that stimulates bile secretion as it detoxifies the liver, helps digestion and assimilation, and significantly reduces serum cholesterol and lipid levels throughout body. As a result, it is regarded as a kind of universal panacea and is the most commonly prescribed herbal formula.

Many Indian people believe that triphala is able to care for the internal organs of the body as a mother cares for her children. Each of the three herbal fruits of Triphala takes care of the body by gently promoting internal cleansing of all conditions of stagnation and excess while at the same time it improves digestion and assimilation.

  Garlic
  Chinese Thoroughwax (Bupleurum falcatum)
 Bupleurum has a unique reputation for deeply cleansing an overburdened liver.

  Castor Oil
 Castor oil packs are commonly placed over the liver.

  Turmeric Extract, Curcumin
 Turmeric helps increase bile flow making it a liver cleanser that can rejuvenate your liver cells and recharge their capability to break down toxins.

Detoxification

  Liver/Gall Bladder Flush
  Liver Detoxification Support

Diet

  Therapeutic Fasting
 Fasting has a powerful effect on improving liver function, an effect which continues after the fast. However, fasting should be avoided in cases of severe liver disease or failure.

  Alcohol Avoidance
 Acetaldehyde, a metabolic breakdown product of alcohol, is said to destroy vitamins B1, B6 and C. Even though supplements of these nutrients, together with the amino acid cysteine, may help the liver detoxify acetaldehyde, it would be wiser to avoid alcohol, it's primary source.

Lab Tests/Rule-Outs

  Test/Monitor Liver Function
  Test Liver Detoxification Profile

Nutrient

  TMG (Tri-methyl-glycine) / SAMe
  Alpha Lipoic Acid
 Alpha-lipoic acid has been used very successfully as a therapeutic agent in a number of conditions relating to liver disease, including alcohol-induced damage, mushroom poisoning, metal intoxification and carbon tetrachloride poisoning.
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Weakly counter-indicative
Strongly counter-indicative
Very strongly or absolutely counter-indicative
May do some good
Likely to help
Highly recommended







GLOSSARY

Allergy:  Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Anabolic:  Anabolic compounds: Allow the conversion of nutritive material into complex living matter in the constructive metabolism.

Bile:  A bitter, yellow-green secretion of the liver. Bile is stored in the gallbladder and is released when fat enters the first part of the small intestine (duodenum) in order to aid digestion.

Cholestasis:  Cessation or suppression of bile flow.

Chronic Fatigue Syndrome:  CFS (Chronic Fatigue Syndrome) is a disorder of unknown cause that lasts for prolonged periods and causes extreme and debilitating exhaustion as well as a wide range of other symptoms such as fever, headache, muscle ache and joint pain, often resembling flu and other viral infections. Also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), Chronic Epstein-Barr Virus (CEBV), Myalgic Encephalomyelitis (ME), "Yuppy Flu" and other names, it is frequently misdiagnosed as hypochondria, psychosomatic illness, or depression, because routine medical tests do not detect any problems.

Constipation:  Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.

Diabetes Mellitus:  A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Enzymes:  Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

Estrogen:  One of the female sex hormones produced by the ovaries.

Fibromyalgia:  (FMS): Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.

Gallstone:  (Biliary Calculus): Stone-like objects in either the gallbladder or bile ducts, composed mainly of cholesterol and occasionally mixed with calcium. Most gallstones do not cause problems until they become larger or they begin obstructing bile ducts, at which point gallbladder "attacks" begin to occur. Symptoms usually occur after a fatty meal and at night. The following are the most common ones: steady, severe pain in the middle-upper abdomen or below the ribs on the right; pain in the back between the shoulder blades; pain under the right shoulder; nausea; vomiting; fever; chills; jaundice; abdominal bloating; intolerance of fatty foods; belching or gas; indigestion.

Hyperthyroidism:  An abnormal condition of the thyroid gland resulting in excessive secretion of thyroid hormones characterized by an increased metabolism and weight loss.

Magnesium:  An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.

Malaise:  A vague feeling of bodily discomfort, as at the beginning of an illness. A general sense of depression or unease.

Metabolism:  The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Mitochondrion:  Structure inside a cell that is the location of the cell's energy production machinery. (Plural: Mitochondria)

Naturopathy:  Medical practice using herbs and other various methods to produce a healthy body state by stimulating innate defenses without the use of drugs.

Nervous System:  A system in the body that is comprised of the brain, spinal cord, nerves, ganglia and parts of the receptor organs that receive and interpret stimuli and transmit impulses to effector organs.

Premenstrual Syndrome:  PMS consists of various physical and/or emotional symptoms that occur in the second half of the menstrual cycle, after ovulation. The symptoms begin about midcycle, are generally the most intense during the last seven days before menstruation and include: acne; backache; bloating; fatigue; headache; sore breasts; changes in sexual desire; depression; difficulty concentrating; difficulty handling stress; irritability; tearfulness.

Protein:  Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

Psoriasis:  An inherited skin disorder in which there are red patches with thick, dry silvery scales. It is caused by the body making too-many skin cells. Sores may be anywhere on the body but are more common on the arms, scalp, ears, and the pubic area. A swelling of small joints may go along with the skin disease.

Serum:  The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Steroid:  Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.

Vitamin A:  A fat-soluble vitamin essential to one's health. Plays an important part in the growth and repair of body tissue, protects epithelial tissue, helps maintain the skin and is necessary for night vision. It is also necessary for normal growth and formation of bones and teeth. For Vitamin A only, 1mg translates to 833 IU.