Deliverance for Your Liver
Julian Whitaker, MD
When Jim was 55, he went to his doctor for a checkup. It had been a few years since he’d had a physical exam, and although he had no significant problems, he was a little tired and he knew he needed to lose the 30 pounds that had crept up around his belly. When Jim sat down with his doctor to go over his lab results, he was told that he had mild diabetes, borderline hypertension, and liver disease.
The first two things he could understand, but liver disease? He drank little alcohol, and only an occasional beer or glass of wine. He had never engaged in anything that increased risk of hepatitis such as unprotected sex, IV drug use, or foreign travel. And he’d never even heard of the disease he was diagnosed with: nonalcoholic fatty liver disease (NAFLD).
Beyond Belly Fat
Jim isn’t alone. Contrary to popular belief, the leading liver problem in this country is not alcoholic cirrhosis or hepatitis, but NAFLD. Afflicting roughly one in four Americans, it is not caused by alcohol or a virus but by obesity and insulin resistance, which made Jim a prime candidate. At least half of all type-2 diabetics are affected by this condition, as are up to three-quarters of obese people and 90 percent of the morbidly obese. Although NAFLD usually develops in people over age 50, it is becoming increasingly common in children as obesity rates skyrocket in our younger age groups.
NAFLD is a progressive disease with three distinct stages. Simple fatty liver, or steatosis, is characterized by elevations in liver enzymes and fatty deposits in the liver (at least 10 percent of the liver cells are replaced by fat). If the disease is arrested in this stage, it remains relatively benign. Unfortunately, for one in five patients, it progresses to nonalcoholic steatohepatitis, involving inflammation of the liver. From there, half develop cirrhosis, marked by advanced and irreversible scarring, fibrosis, and loss of liver function.
The most significant risk factors for progression include a body mass index greater than 30, type-2 diabetes, and metabolic syndrome. The unifying link here, common to all these conditions, is insulin resistance. When the cells resist insulin’s signals to let glucose in, the pancreas secretes higher and higher levels of insulin to get the job done. Elevated concentrations of insulin in the blood create metabolic imbalances that drive up blood levels of free fatty acids. This influx of fatty acids overwhelms the liver’s ability to handle them, and they are converted into triglycerides and stored in the organ, setting up a vicious cycle of free radical damage, inflammation, and liver cell injury.
SOS for NAFLD
The best treatment for preventing and treating NAFLD is weight loss. Losing just 10 percent of body weight lowers fatty deposits and improves liver enzymes. Slow, gradual loss of a pound or two a week is most desirable, for rapid weight loss may actually worsen the condition. Getting diabetes and other manifestations of insulin resistance under control are also helpful and, in fact, metformin (Glucophage) a diabetes drug that increases insulin sensitivity, has been shown to decrease fatty deposits, inflammation, and fibrosis.
Natural therapies that improve insulin sensitivity include exercise, vanadyl sulfate, cinnamon, chromium, and magnesium. Because oxidative stress contributes to liver damage, antioxidant therapy is also useful. The best-studied antioxidant for fatty liver is vitamin E, with doses ranging from 300-1,200 IU per day resulting in reductions in fatty liver infiltration.
Give Your Liver Some TLC
In addition to therapies that specifically address NAFLD, there are other things you can do to enhance the health of your liver. One is to avoid known liver toxins. Go easy on alcohol, especially if you’re obese—the combination of excess alcohol and obesity is especially damaging to the liver. Also, do your best to stay away from certain drugs, or at least monitor liver enzymes if you must take them. These include cholesterol-lowering statin drugs, NSAIDs, acetaminophen, glitazone diabetic drugs, triglyceride-lowering fibrates, some anticonvulsants, Strattera (for ADHD), steroids, synthetic estrogen, tamoxifen, and methotrexate.
You can also support your liver by supplementing with nutrients that enhance liver function. Your liver is a major organ of detoxification, but rather than physically screening out toxins as many people believe, it converts them into compounds that can be eliminated from the body. It accomplishes this through a complex two-part process called phase I and phase II detoxification.
During phase I, enzymes collectively known as cytochrome P450 neutralize some toxins and ready others for phase II. Phase II involves a number of conjugation reactions that transform toxins into safe, water-soluble compounds that can be excreted in the urine and bile. A number of nutrients are required for each of these phases. Not the least of these are antioxidants such as lipoic acid, silymarin (from milk thistle), and selenium to protect the liver against the free radicals generated during phase I. Calcium-d-glucarate, N-Acetyl-Cysteine, ellagic acid (found in pomegranates and raspberries), and trimethylglycine all support various conjugation reactions that occur in phase II detoxification.
When You Need Extra Help
Unlike other organs, the damaged liver has the unique ability to regenerate itself, provided that it gets a little help. We’ve had a lot of success at the clinic helping people who have chronic liver disease with intravenous (IV) alpha lipoic acid, vitamin C, and glutathione, along with an intensive supplement regiment.
If you’ve been diagnosed with advanced liver disease, don’t despair—come and see us.
- To protect against fatty liver, maintain a healthy weight and do what you can to improve insulin sensitivity. Suggested doses of recommended nutrients are 100 mg vanadyl sulfate, one-half teaspoon cinnamon, 200–400 mcg chromium, and 500 mg magnesium.
- For general liver support, look for a combination formula in your health food store containing the following nutrients: 100 mg lipoic acid, 420 mg silymarin, 70 mg selenium, 200 mg calcium-d-glucarate, 600 mg N-Acetyl-Cysteine, 50 mg ellagic acid, and 300 mg trimethylglycine. To order the products we use at the Whitaker Wellness Institute, call (800) 810-6655.
- To schedule an appointment at Whitaker Wellness, call (866) 944-8253.
- Nonalcoholic steatohepatitis. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/nash/.
- Burgianesi, E et al. A randomized controlled trial of metformin versus vitamin E or prescriptive diet in nonalcoholic fatty liver disease. Am J Gastroenterol. 2005 May;100(5):1082-90.
- Patrick, L. Nonalcoholic fatty liver disease: relationship to insulin sensitivity and oxidative stress. Treatment approaches using vitamin E, magnesium, and betaine. Altern Med Rev. 2002;7(4):276-291.
From Health & Healing with permission from Healthy Directions, LLC. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.