Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition (89 page)

The liver is the most complex organ in the body. Unlike the heart, which has one major function—to beat—the liver has a multitude of functions that include regulation of blood sugar levels, making 13,000 different enzymes, humanizing food by acting as a filter, breaking down toxins, manufacturing cholesterol and bile, breaking down hormones, and more. Because of its complexity and the 10,000 pounds of substances it must filter over a lifetime, the liver can easily become overwhelmed. Often the first sign of liver disease is elevated liver enzymes, AST (aspartate amino-transferase) and ALT (alanine aminotransferase).

Common liver conditions include hepatitis, cirrhosis, hemochromatosis, and, more rarely, liver cancer. Jaundice, a yellowing of your skin, is a sign that something is wrong with your liver.

Love your liver once in a while by helping facilitate detoxification. Read
Chapter 18
for information on detoxification programs.

Fatty liver disease is just that, your liver is accumulating fat. It’s not an actual disease but can lead to cirrhosis and liver failure. It’s also called nonalcoholic fatty liver disease (NAFLD) and it affects 20 percent of Americans. At this stage, it’s completely reversible with changes in diet, exercise, and liver support. You probably
will have
no
symptoms. If you do, you may be tired, have pain in your liver area (below your ribs to the right), or be losing weight for no reason. It’s detected when your liver enzymes, ALT and AST, are elevated in a blood chemistry panel. It can also lead to metabolic syndrome, which increases risk for diabetes and cardiovascular diseases.

Recently a study of children in San Diego found fatty liver disease in 13 percent of children who died from natural causes and were autopsied. The highest rates were in obese children; 38 percent had fatty liver. High fructose corn syrup has been linked to fatty liver disease in several studies, and there is some evidence that artificially sweetened soft drinks are worse instigators of fatty liver than even the drinks sweetened with high fructose corn syrup. The average American adult consumes 18.6 percent of calories from refined sugars; teens consume on average 20 percent. That’s 34 teaspoons (544 calories) for boys and 24 teaspoons (384 calories) for girls. Most of this comes from soft drinks sweetened with high fructose corn syrup. Environmental toxins, junk food, and high-fat diets also contribute to fatty liver. A recent rat study asked the question, will pregnant moms who eat junk food predispose their children to obesity and fatty liver disease? The answer was yes. The alarming part was that much of this was irreversible, even when the baby rats were given a healthy diet to eat.

Diet and lifestyle:
Changes in diet and lifestyle are the current medical recommendations for people with fatty liver. Lose weight if you are overweight. Exercise if you aren’t exercising. Eat a whole-foods diet, filled with fruits and vegetables. Avoid refined sugars and soft drinks. Stop drinking alcoholic bever-rages. Take an antioxidant supplement. Take milk thistle and lipoic acid supplements (see Healing Options under Hepatitis for dosages). Check your labs every four to six months. If your ALT and AST levels aren’t responding, be more aggressive.

Try southern ginseng:
Gynostemma pentaphyllum is known as southern ginseng because it has similar therapeutic properties to ginseng and grows in southern China. A study that combined diet, exercise, and southern ginseng reported additional effects in weight loss, liver enzyme reduction, insulin levels, and HOMA levels. Take 500 mg three times daily.

Try keishibukuryogan:
There is a formula used in Japanese medicine called keishibukuryogan (KBG TJ-25). This was found to be of benefit when added to exercise, diet, and weight loss.

The eight types of hepatitis are A, B, C, D, E, autoimmune, alcoholic, and nonalcoholic steatohepatitis (NASH). Types A through E are caused by a blood-borne viral infection that causes inflammation in the liver. Autoimmune hepatitis, alcoholic hepatitis, and NASH are not caused by infection.

Hepatitis A can occur in isolated cases or spread among large groups of people. You can catch it from close personal contact with a person who has it or from food or water that has been contaminated. It is usually a self-limiting illness with flu-like symptoms. Once you’ve had hepatitis A, you cannot get it again. It may take several months to recover fully. A vaccine for people over the age of two is available for lifelong protection against hepatitis A.

Hepatitis B is the most common serious liver infection in the world and is more serious than hepatitis A. It can lead to cirrhosis, liver cancer, or liver failure. In most people, it is a self-limiting illness. However, 90 percent of infected babies, 30 to 50 percent of infected children, and 5 to 10 percent of infected adults will also develop a chronic infection. A vaccine is available to help prevent hepatitis B infection. It is currently recommended by the CDC that all babies be vaccinated.

Each year 100,000 Americans contract hepatitis B and 5,000 to 6,000 Americans will die from it. It is estimated that 1.25 million Americans have chronic hepatitis B. Worldwide, it affects 400 million people and there are 1 million deaths per year. It is passed directly through blood. Since 1992, blood collected for transfusions is carefully screened for hepatitis B (and C). Prior to that time, infection through blood transfusion was common.

You can get hepatitis B from having unprotected sex with someone who has it, by sharing needles for drug use or tattooing, or by an accidental needle poke with an infected needle. During childbirth, a mother could pass it to her child.

Hepatitis C accounts for about 15 percent of acute viral hepatitis, 60 to 70 percent of chronic hepatitis, and up to 50 percent of cirrhosis, end-stage liver disease, and liver cancer. In the United States, four million people, or 18 percent of our population, have been diagnosed with antibodies to the disease. This indicates that they currently
have an infection or previously were exposed to the virus. There are 10,000 to 12,000 deaths each year because of hepatitis C. Seventy-five percent of people with acute hepatitis C will ultimately develop chronic hepatitis. Millions more of us may be infected but have not been diagnosed.

Many people with hepatitis C are asymptomatic and may not know they have the disease. In those who do have symptoms, they are generally mild and include fatigue, liver discomfort or tenderness, nausea, muscle and joint pains, and a poor appetite.

The course of this disease varies radically. No symptoms might occur for up to 20 years and liver enzymes might not be elevated. If a liver biopsy is performed and the injury is mild, the outcome is usually good. On the other hand, if severe symptoms occur and liver enzymes are elevated, many people will ultimately develop cirrhosis and end-stage liver disease. Or the illness may be characterized by elevated liver enzymes with few symptoms, with an uncertain outcome. It is estimated that 20 percent of those with chronic hepatitis C will develop cirrhosis within 10 to 20 years. After that time, a small group will develop liver cancer. Hepatitis C is the most common reason for liver transplants.

Hepatitis C is passed via blood. The hepatitis C virus was only isolated in 1988, so many people were infected by blood transfusion prior to that time. Since 1992, blood has been routinely screened for hepatitis. You can get hepatitis C from having unprotected sex with someone who has it, by sharing needles for drug use or tattooing, or by an accidental needle poke with an infected needle. During childbirth, a mother could pass it to her child. In 10 percent of cases, the source of the infection is unknown.

Standard treatment for hepatitis C is interferon and antiviral medications. Their success rate is only 30 percent and the side effects can be severe. This is why so many people with chronic hepatitis are looking at alternative therapies. Patients on interferon therapy have found Saint-John’s-wort and ginger help with side effects of treatment.

You can get hepatitis D only if you already have hepatitis B. It exists as a coinfection. You contract it the same way you contract hepatitis B and C.

Hepatitis E spreads by consuming contaminated drinking water and food. At this point in time, the only Americans who contract this form of hepatitis get it outside of the country, probably in a developing nation. For best prevention, drink bottled
water when traveling, and use only ice made with bottled water. Don’t eat raw shell-fish, and avoid uncooked fruits and vegetables that are not peeled by you personally.

Autoimmune hepatitis occurs when your body’s immune system attacks your own liver cells, and it is probably due to a genetic defect. About 70 percent of people with this illness are women, and it’s usually diagnosed between the ages of 15 and 40. It is a long-term illness and if left untreated can lead to cirrhosis and eventual liver failure. With treatment, about 70 percent of people with autoimmune hepatitis go into remission or experience a decrease in symptoms. It is usually treated with prednisone and azathioprine, both of which have unwanted side effects. About half of the people who are affected also have another autoimmune illness, such as Hashimoto’s thyroiditis, Grave’s disease, Sjögren’s syndrome, ulcerative colitis, or autoimmune anemia. The most common symptoms are fatigue, enlarged liver, jaundice, itching, skin rashes, joint pain, lack of menstrual periods in women, and abdominal discomfort.

Alcoholic hepatitis is a self-inflicted, progressive liver disease caused by the toxicity of alcohol. Unlike hepatitis A, B, C, and D, it is not an infectious disease. It is also known as alcoholic steatohepatitis, acute hepatic insufficiency of patients with chronic alcoholism, florid alcoholic cirrhosis, subacute alcoholic cirrhosis, and fatty liver with hepatic failure.

Alcoholic liver disease causes symptoms in more than two million people (1 percent of our population) but affects many more people who remain completely asymptomatic. It is the fourth leading cause of death in urban adult men ages 24 to 65. It is estimated that up to 35 percent of heavy drinkers have alcoholic hepatitis. This is often undetected until the disease has progressed. Women and nonwhite males are more susceptible to alcoholic liver damage with smaller amounts of alcoholic consumption. On average, it is estimated that men develop cirrhosis taking in about two ounces daily of ethanol, and women with less than one ounce daily. This is an illness that can kill you. Overall, the one-year survival rate after hospitalization for alcoholic hepatitis is about 40 percent.