Liver Health

The Life-Line of Youth

There is not a single health problem that the liver is not aware of and cannot assist in resolving. Since the liver is responsible for detoxification of blood, it is able to detect toxic accumulations coming from different areas of the body. The liver plays a crucial role in detoxifying the body of harmful substances and invading pathogens. When ailments plague the body, it is likely that the liver is working to relieve the issue. In order to enhance liver functioning, and ultimately encourage overall health, you may wish to explore liver cleansing. Cleansing and detoxifying your liver is one of the most powerful procedures you can do to enhance your body's performance. It can significantly improve digestion, regularity, transit time, and energy levels, which is the basis of your health.

Somewhere between 90 and 125,000 people die each year because of simple liver disease and cirrhosis. There is no reason for this to be happening because the liver is the only organ in the body capable of regeneration. The liver is able to regenerate itself when toxic accumulations destroy parts of it. Liver disease occurs only when the liver becomes so overwhelmed that regeneration cannot occur successfully.

The liver is a fantastic and complex organ that performs the true miracle of converting food into the elements for sustaining life. The human system is a scientific marvel often compared to a machine, e.g. the steadfast pump of the heart, the remarkable bio-computer brain, the electrical system of the nerves. So subtle and versatile is the liver that it defies a machine-like analogy, but rather might be compared to an entire city, for the variety of its activities. It is one of the body's most vital organs. Many researchers claim it is our second brain and the lab of the human body. The more you understand this organ the better your life will be.

The largest of the internal organs, the liver, "weighs in" at 2.5 to 5 pounds. It is suspended behind the ribs on the upper right side of the abdomen and spans almost the entire width of the body over to the heart. It has two separate lobes that operate independently of each other (in case one side stops functioning). Even after a loss of liver, up to 75% due to injury or surgery, the remaining liver can grow back and be restored to normal size within several months.

The liver receives blood directly from the stomach, pancreas and intestines via the portal vein. The liver, with its intricate labyrinth of special cells, veins, and ducts, receives nutrient rich blood and filters out the nutrients, taking them into its own cells to be processed. The liver also receives freshly oxygenated blood via a different artery, from which it takes its oxygen supply. It filters out wastes and other poisons and converts them into substances that can be safely carried out of the body. The liver filters more than a quart of blood each minute.

The liver is the organ that is responsible for processing, converting, distributing and maintaining the body's fuel (energy) supply. It converts the complex foods we eat (carbohydrates fats, and proteins) into simple glucose (blood sugar) for energy or it can store this fuel as glycogen. It breaks down and converts fats for distribution and storage. The liver is responsible for dismantling proteins into amino acids, assembling proteins, and making new amino acids for use throughout the body. It breaks down old blood cells and recycles the iron.

The liver also makes bile, a yellowish-green alkaline liquid that is stored in the gall bladder, and secreted into the small intestines to help break down fats. Bile contains the pigments that give color to urine and feces. When the bile ducts are obstructed, it is the bile pigments that can cause the body to turn jaundice or yellow. Add to the list of liver functions, the production of many different hormones and proteins, which affect the way the body grows and heals. Many vitamins and other nutrients, like iron, are stored in the liver and released when needed. Poisons such as alcohol and drugs are detoxified in the liver.

As we can see, this organ is vital for many reasons. No one has ever devised an artificial liver because it is so complex. Second only to the brain in complexity, the liver is the home of many of the mysteries of life. As powerful as this organ is, it can become overwhelmed and may fall prey to disease. The following paragraphs will briefly describe some of the common diseases of the liver.

Hepatitis literally means an inflammation of the liver. It can be caused by alcohol, viruses, drugs and blood exchange. One type of viral hepatitis, hepatitis A (also called infectious hepatitis) is transmitted usually through food and is more common where sanitation and hygiene are poor. The other type, hepatitis B, is a virus spread via exchange of blood (it is also known as serum hepatitis). Today's blood supplies are thoroughly checked for the hepatitis B virus. Hepatitis C is a type involved in blood exchange or I.V. drug use. This type of hepatitis seems to be the most troublesome of all. For many there are no symptoms for 15 to 20 years. This type of hepatitis can turn into cirrhosis or even liver cancer. Many people in the United States are receiving liver transplants for this type of hepatitis. Others have found natural ways to get his type of hepatitis under control and treated.

Alcohol can damage the liver, even in moderate quantities. Alcohol is a concentrated sugar that causes fat to be deposited in the liver. For those who drink only occasionally, the damage is temporary and the liver can usually 'bounce back' to normal after several days of rest and clean living. Those who drink more often don't give the liver a chance to recuperate from the alcohol poisoning. In some cases alcohol abuse can lead to alcoholic hepatitis or cirrhosis. As mentioned before, the liver is one organ that has the amazing ability to regenerate itself. Cirrhosis is a condition in which a liver, damaged by disease, alcohol or drugs doesn't grow back 'good as new.' In cirrhosis, the liver forms fibrous scar tissue and lumpy irregular nodules as it regenerates. In advanced cases the liver becomes so badly scarred by cirrhosis that it can no longer do its work, and the afflicted person dies of liver failure.

Liver Functions

• Filtering Blood
• Purifying and Clearing Waste Products, Toxins, and Drugs
• Regulating and Secreting Substances Important in Maintaining Your Body's Functions and Health
• Storing Important Nutrients (such as glycogen, glucose, vitamins, and minerals)
• Metabolizing Fats, Proteins, and Carbohydrates
• Creating Bile
• Metabolizing Hormones, Internally-Produced Wastes, and Foreign Chemicals
• Forming Urea
• Assimilating and Storing Fat-Soluble Vitamins
• Synthesizing Blood Proteins

As we know it today, the liver has well over 500 known functions and is believed to have well over 2500 functions. These functions are growing at a rate of no less than 25 new functions each year. For a more comprehnsive list, check out the Liver Functions article.

Causes of Elevated Liver Enzymes

A wide range of health problems can lead to elevated liver enzymes. Some common causes include:

• Adrenal Insufficiency (inadequate levels of hormones released by the adrenal gland)
• Alcohol Abuse
• Alpha-L-Antitrypsin Deficiency (a disorder caused by defective production of the glycoprotein alpha-1-antitrypsin)
• Autoimmune Disorders of the Liver and Bile Ducts (such as autoimmune hepatitis and celiac disease)
• Diabetes Elevated Triglycerides (fat tissues)
• Excessive Use of Certain Herbal Supplements (such as comfrey, kava, pennyroyal, and skullcap)
• Hepatic Steatosis and Steatohepatitis, and Non-Alcoholic Steatohepatitis (NASH)
• Infections (such as Viral Hepatitis and Mononucleosis)
• Medications (including certain nonsteroidal anti-inflammatory drugs, cholesterol-lowering medications, antibiotics, anti-seizure medications, and acetaminophen)
• Metabolic Liver Disease (such as hemochromatosis and Wilson's disease)
• Muscle Disorders
• Obesity
• Thyroid Disorders
• Tumors of the Liver or Bile Ducts

Liver disease risk factors are things that can no longer be avoided. Every year researchers find another airborne chemical that weakens our liver functions. If it's not the air then it's the water. The only air we can improve on is the air we breathe at home and at work. There are inexpensive ways to correct both of these areas to take the load off of our liver. For information regarding common toxins that contribute to liver disease, check out our Liver Disease Risk Factors Article.

The liver is the most responsive and considerate organ in the body. It clearly sends out signals to us when things are not going well or when it simply does not like something. These warning signs should not be ignored with the hope that they just go away. The liver is not a fragile organ and will not complain unless it is totally necessary. Know the warning signs and when you see them find out what you can do about them. Most drug side effects can be avoided just by doing a few simple things each day. Check out our Liver Toxicity and Weakness health article for more information.

Deciphering Liver Function Tests

Different cells have different enzymes inside them, depending on the function of the cell. When cells die or are damaged, the enzymes leak out causing the blood level of these enzymes to rise. The most important thing to remember about liver function tests or "LFTs" is that they do not in fact measure liver function. They have meaning, but they generally cannot be interpreted without clinical information. Also, the numbers do not always detect liver disease. Some patients with severe advanced liver disease will have nearly normal enzyme levels. An added complication in interpretation is that the numbers are not linear, i.e., an AST (see below) of 300 is not twice as bad as 150 (normal is 40) and a reading of 94 and 80 are essentially the same to a liver specialist.

• ALT - Alanine aminotransferase used to be called SGPT (Serum Glutamate Pyruvate Transaminase). The presence of this enzyme is more Specific for liver disease than AST which is found in more types of cells (i.e., heart, intestine, muscle). The normal range is 5 - 50 IU/L.
• Albumin is a major protein produced by the liver. Chronic liver disease causes a decrease in the amount of albumin produced. Serum albumin levels of less than 3.5 mg/dL indicate advanced liver disease. The normal range is 3-5 mg/dL.
• Alpha-fetoprotein Alpha-fetoprotein (a specific blood protein) is produced by fetal tissue and by tumors. This test may be performed to monitor the effectiveness of therapy in certain cancers, such as hepatomas.
• AST which is found in more types of cells (i.e., heart, intestine, muscle). The normal range is 5- 50 IU/L (International Units per Liter). AST - Aspartate aminotransferase used to be called SGOT (Serum Glutamic Oxaloaceti Transaminase). The normal range is 5-50 IU/L.
• AP - Alkaline Phosphatase: This enzyme level is elevated in a number of disorders that affect the drainage of bile - gallstone or tumor blocking the common bile duct, alcoholic liver disease, or drug-induced hepatitis. AP is also found in bone, placenta, and intestine 50 the GGT is used as a supplemental test. The normal range is 30-115 IU/L.
• Bilirubin, Total is the main bile pigment in humans which when elevated, causes the yellow discoloration of the skin and eyes called jaundice. Bilirubin is formed primarily from the breakdown of a substance in red blood cells called "heme." It is taken up from blood processed through the liver and then secreted into the bile by the liver. Healthy persons have only a small amount of bilirubin circulating in their blood - less than 1.2 mg/dl (milligrams per deciliter).
• Bilirubin, Direct The diagnosis narrows down further the Total bilirubin. If direct (i.e. conjugated) bilirubin is normal, then the problem is an excess of unconjugated bilirubin, and the location of the problem is upstream of bilirubin excretion. Hemolysis, viral hepatitis, or cirrhosis can be suspected. If direct bilirubin is elevated, then the liver is conjugating bilirubin normally, but is not able to excrete it. Bile duct obstruction by gallstones or cancer should be suspected.
• Blood Ammonia Measurement of the blood ammonia concentration is not always useful in patients with known or suspected hepatic encephalopathy. Ammonia contributes to hepatic encephalopathy; however, ammonia concentrations are much higher in the brain than in the blood and therefore do not correlate well. Furthermore, ammonia is not the only waste product responsible for encephalopathy. Thus, blood ammonia concentrations show only a mediocre correlation with the level of mental status in patients with liver disease. It is not unusual for the blood ammonia concentration to be normal in a patient who is in a coma from hepatic encephalopathy. Blood ammonia levels are best measured in arterial blood because venous concentrations can be elevated as a result of muscle metabolism of amino acids. Blood ammonia concentrations are most useful in evaluating patients with stupor or coma of unknown origin. It is not necessary to evaluate blood ammonia levels routinely in patients with known chronic liver disease who are responding to therapy as expected.
• Coagulation Tests (e.g. INR) The liver is responsible for the production of coagulation factors. The international normalized ratio (INR) measures the speed of a particular pathway of coagulation, comparing it to normal. If the INR is increased, it means it is taking longer than usual for blood to clot. The INR will only be increased if the liver is so damaged that synthesis of vitamin K-dependent coagulation factors has been impaired: it is not a sensitive measure of liver function.
  It is very important to normalize the INR before operating on people with liver problems (usually by transfusion with blood plasma containing the deficient factors) as they could bleed excessively.
• GGT or GGTP- Gamma Glutamyl Transpeptidase or gamma-glutamyltransferase. Elevated levels of this enzyme are specific to liver disorders (GGT levels are not elevated in diseases of bone, placenta or intestine.) The normal level is zero. Levels are often elevated in persons who have three or more alcoholic drinks per day; thus, it is a useful marker for immoderate alcohol intake.
• Lactate Dehydrogenase (LDH): - An enzyme found in blood and body tissues, LDH is involved in energy production in cells. Elevated levels of LDH may indicate liver damage.
• Mitochondrial Antibodies The presence of these antibodies can indicate primary biliary cirrhosis, chronic active hepatitis, and certain other autoimmune disorders.
• Platelet Count Platelets are the smallest of the blood cells (actually fragments of larger cells known as megakaryocytes) that are involved in clotting. In some individuals with liver disease, the spleen becomes enlarged as blood flow through the liver is impeded. This can lead to platelets being sequestered in the enlarged spleen. In chronic liver diseases, the platelet count usually falls only after cirrhosis has developed. The platelet count can be abnormal in many conditions other than liver diseases.
• Prothrombin Time (also called protime or PT) is a test used to assess blood clotting. Blood clotting factors are proteins made by the liver 50 when the liver is significantly injured, the production of proteins is impaired. There is a good correlation between abnormalities in coagulation measured by the PT test and the degree of liver dysfunction. PT is expressed in seconds and compared to a healthy control patients blood.
• Serum Protein Electrophoresis In this test, the major proteins in the serum are separated in an electric field and their concentrations determined. The four major types of serum proteins whose concentrations are measured in this test are albumin, alpha-globulins, beta-globulins and gamma-globulins. Serum protein electrophoresis is a useful test in patients with liver diseases as it can provide clues to several diagnostic possibilities. In cirrhosis, the albumin may be decreased (see above) and the gamma-globulin elevated. Gamma-globulin can be significantly elevated in some types of autoimmune hepatitis. The alpha-globulins can be low in alpha-1-antitrypsin deficiency.
• 5'-Nucleotidase (5'NTD) This test measures the levels of 5'- nucleotidase (an enzyme specific to the liver). The 5'- nucleotidase level is elevated in persons with liver diseases, especially those diseases associated with cholestasis (disruption in the formation of, or obstruction in the flow of bile). 5' nucleotidase is another test specific for cholestasis or damage to the intra or extrahepatic biliary system, and in some laboratories, is used as a substitute for GGT for ascertaining whether an elevated ALP is of biliary or extra-biliary origin.
• Cytochrome P450 or Porphyria This test is one of the most important liver function tests that show the real function of the liver. This tests show the real details on the health of your liver. Most doctors do not even know about this tests and many HMO refuse to perform them. You won't believe the reasons why. This test has a random and 24 hour urine screening. It is best to ask for both but the 24 hour is most important.

Elevated Liver Enzymes Further Testing

Having elevated liver enzymes isn't an indication of a specific liver disease. And while it is not uncommon to have elevated liver enzymes, in order to determine the underlying cause, additional tests, including a physical examination, ultrasound, a CAT scan (computed axial tomography), an MRI (magnetic resonance imaging), a biopsy, and liver blood tests, are usually necessary. It is best to save the biopsy for last and try to entirely avoid.

The LFTs are used primarily to screen or monitor liver disease. If the markers are present, your physician may order specialized tests to make a precise diagnosis of the underlying cause of liver disease. There are specific tests that allow the precise diagnosis of hepatitis A, B, C, D and E.

Unfortunately blood testing has no real way of telling us the health of our liver or our biological age. But we have discovered that by the time you have reached the age of 30 your liver is probably functioning at 75% of its ability at best.

The health and vitality of all body systems depend, to a large extent, on the health and vitality of the liver. Because we are constantly bombarded by toxins in our air, water and food, it is a good idea once or twice a year to renew the health of a clogged and overworked liver with a detoxification regimen. Also if you have been using prescription drugs (antibiotics and or tranquilizers) for any length of time, your immune system may be exhausted, and it's essential to rejuvenate and flush your liver to release stored toxins.

As you learn more about your body, always remember how vital your liver is to maintaining good health. It's not something we think about all the time, but the common problems of an abused or toxic liver will speak to you with many symptoms. You know your body better than anyone else. Listen to it.

• Liver - Cytochrome P-450
• Liver - What You Need To Know!
• Liver Products
• Liver Toxicity