The Liver Part I
LOOMIS
ORGAN
By
Howard F. Loomis
Jr., DC
I have described in this series of articles the specific physiological steps the body uses in response to any stress, be it structural, visceral, or emotional. This month I look at the wonders of the liver. Describing all of its multiple functions would fill this article. Instead, I would like to write about how we, as clinicians, can help our patients understand the liver and help identify when the liver is unable to fulfill all its responsibilities for maintaining homeostasis before liver disease can be identified.
The problem is liver dysfunction can be silent for a very long time. As many as half of the people who have it don�t have any symptoms at all. If you do have warning signs, they�re often vague, like being tired and having aching muscles. You may also have itchy skin, swelling in your abdomen, and dark urine, but these symptoms can be signs of problems with other organs. Since yellowing of the eyes or skin is a late sign, you will need to see a panel of blood tests to identify liver problems, and then in the absence of a pathological process, how do you proceed with a treatment plan?
Here are a few things to look for when taking a case history
Does your patient use liver detoxification diets? This is a common procedure often recommended to be done routinely every month in many alternative healthcare offices. The claim is that limiting a patient�s diet to certain juices or foods will wash away toxins from the liver. There is no scientific proof that these detox diets work, but that begs the question of what is being measured. A healthy diet will give your liver the nutrients it needs to do its many jobs if digestion is adequate. So why wouldn�t detoxification be beneficial?
Inquire about alcohol and expect your patient to deny overuse
I think it might be useful to develop this discussion with patients if they use alcohol to any extent. First, why is alcohol bad for your liver? They already know that it can damage liver cells, but they probably don�t know that the liver must stop most of its functions to break down (detoxify) the alcohol before it can metabolize nutrients. Drinking more alcohol than your liver can process is what causes damage. Therefore, drinking less alcohol for some patients can help prevent liver problems. Other useful information to pass on is to consider being tested to see if they have hepatitis C. The CDC suggests baby boomers get tested if they ever used IV drugs or had a blood transfusion before 1992. For the record, baby boomers were born between 1944 and 1964. They are currently between 55 to 75 years old, and there are presently 76 million in the U.S.
Do cirrhosis and heavy drinking always go together?
Cirrhosis, or scarring of the liver, is the most serious type of liver disease. Patients need to know that liver damage from cirrhosis cannot be reversed. Though alcohol can contribute to cirrhosis, it can also result from hepatitis B or C, among many other causes.
Review your patients� medications
Taking too much acetaminophen (Tylenol) can cause serious liver damage. Don�t forget that it can be found in more than 600 medications, including prescription drugs and many over-the-counter remedies for pain, colds, and coughs. For adults, the daily limit of acetaminophen is equal to six extra-strength Tylenol tablets from all sources combined. Ask them to read the ingredients carefully.
Has a statin drug been prescribed? The most common side effects of statin drugs are muscle aches, tenderness or weakness (myalgia), headaches, difficulty sleeping, flushing of the skin, and drowsiness, among others. Next month, I will point out that involuntary muscle contraction below the right costal arch always precedes the onset of myositis by a considerable length of time.
Now let�s describe what causes the skin and eyes to yellow
We said it is a late sign of problems and is caused when there�s too much indirect bilirubin in the blood. Indirect bilirubin is a yellow pigment your body makes when it breaks down red blood cells. The death of red blood cells and destruction of hemoglobin by the reticuloendothelial system yields bilirubin and heme.
• The heme (iron-containing) molecule is either used to make more hemoglobin or is stored.
• The bilirubin is linked to plasma proteins and taken to the liver. In the liver, it is conjugated to diglucuronide (and is now called direct bilirubin) and excreted in the bile. Direct bilirubin may back up into the blood and accumulate in the plasma when the rate of hemolysis increases, biliary obstruction is present, or liver insufficiency exists.
• Rarely, abnormalities of enzyme systems involved in bilirubin metabolism in the liver result in abnormal bilirubin concentrations.
I should note that hepatitis A is one example of an illness that results in jaundice. Also, newborns often have jaundice because their livers are still developing, and they have trouble filtering the bilirubin. There is a vaccine for hepatitis A used to stimulate the body to produce antibodies (proteins) that will fight and kill the virus. Concerning hepatitis B and C
There is a vaccine for hepatitis B, but not for hepatitis C. In the U.S., the hepatitis B vaccine is given to all babies and children, as well as most adults. It�s given as a series of three shots over six months. My clinical experience has indicated that it affects the flow of bile, and its symptoms mimic gallbladder dysfunction and interference with digestion.
There is not a vaccine for hepatitis C, which is usually spread by blood, such as through either a hospital needle-stick accident or sharing needles when injecting drugs. It can be spread by an infected mom to her baby during birth. It can sometimes be spread during sex. The rule of thumb is that if you�re at risk for an STD, then you�re also at risk for hepatitis.
Conclusion
This has been the first of two parts in our series of the many faces of stress. I have emphasized that signs of early liver involvement are very difficult to identify. Next month, I will continue our discussion of stress and the liver and discuss in more detail the use of blood tests for screening.
Howard F. Loomis, Jr., DC, has an extensive background in enzymes and enzyme supplements. He is the founder and president of the Food Enzyme Institute™. His extensive knowledge of physiology, biochemistry, and enzymology has made him a sought-after speaker and a prolific writer. Dr. Loomis published ENZYMES: The Key to Health in 1999, as well as The Enzyme Advantage: For Healthcare Providers and People Who Care About Their Health, in 2015. Contact info: 6421 Enterprise Lane, Madison, Wl 53719, [email protected], 800-662-2630.
