By Nicole Cutler, L.Ac.

When it comes to our health, the liver is an extremely underrated organ. Responsible for manufacturing countless essential body substances and keeping the blood free from toxins, properly functioning liver cells are a requirement for life. To make sure there are a sufficient amount of liver cells capable of performing their duties, those with chronic liver disease are tasked with protecting their liver from harm. To that effect, there is some evidence suggesting that eating spirulina is a strategy capable of shielding liver cells from injury.

Whether the cause of chronic liver disease is viral hepatitis, fat accumulation, alcoholism or some other source, anyone affected must continually strive to protect his or her liver from damage. Toxins in the environment, in our food and our water supply are potentially hazardous to an ailing liver. While a healthy liver can grow new cells after it has sustained minor damage, those with chronic liver disease may be unable to regenerate new cells. The very nature of chronic liver disease means that the liver must contend with an even greater quantity of daily threats, making protecting the liver from harm that much more crucial.

About Spirulina
A blue-green algae that is rich in protein, vitamins, minerals and antioxidants, spirulina is often considered to be one of the most nutritious foods available. More specifically, some of spirulina’s nutrients include:

•    B-complex vitamins
•    Beta-carotene
•    Vitamin E
•    Manganese
•    Zinc
•    Amino acids
•    Copper
•    Selenium
•    Iron
•    Gamma linolenic acid

This blue-green algae is often referred to as a super-food. Believed to boost the immune system, fight infections, foster probiotic growth in the gastrointestinal tract, battle oral cancer and protect the liver from harm, spirulina has inspired a collection of health products.

Spirulina for the Liver
Besides the support it lends the immune system, its potential for protecting the liver from harm is what makes spirulina such an exciting find for people with chronic liver disease. There is evidence that suggests spirulina may help protect against liver damage, cirrhosis and liver failure in those with chronic liver disease.

In an Egyptian study published in a May 2011 edition of the journal Nutrition, researchers investigated how spirulina might protect the liver’s health. They found that spirulina:

•    functioned as an antioxidant
•    helped scavenge cell damaging free radicals
•    chelated harmful metals
•    prevented liver damage induced by a well-known liver toxin (carbon tetrachloride)

Although this was an animal study, it still presents evidence of spirulina’s potential health benefits to someone with chronic liver disease.

A Mexican study published in the March 2010 edition of Lipids in Health and Disease showed that spirulina succeeded in improving the biochemical parameters of liver health in subjects exposed to liver toxins. Although this was also an animal study, the researchers concluded that spirulina has liver protective characteristics associated with the algae’s antioxidant capabilities.

Another Mexican study published in the April 2010 Journal of Medical Case Reports followed three patients who underwent blood tests before and after treatment, were treated with spirulina for three months and then had their liver assessed with ultrasound at the treatment’s conclusion. Based on their observations, the authors concluded that spirulina could be considered as an alternative treatment for patients with non-alcoholic fatty liver disease.

All three of the studies described above are insufficient for concluding spirulina’s effectiveness at protecting the liver. However, there is enough evidence to encourage those with chronic liver disease to consider taking spirulina and to warrant further studies on this topic.

Spirulina Hazards
Despite all of its purported benefits, spirulina is not 100 percent safe. Spirulina flourishes in warm climates and warm alkaline water, which is the same environment that renders it vulnerable to contamination with heavy metals and toxic substances called microcystins. Thus, spirulina should only be purchased from a trusted, reputable company that partakes in product testing.

Another issue for those with liver disease is the iron content of spirulina, since many with liver ailments are advised to avoid supplements or foods containing iron. This could preclude spirulina from their diet. According to a Wolters Kluwer Health article:

•    Spirulina preparations contain iron 300 to 400 ppm (dry weight).

•    Unlike many forms of plant iron, this iron has high bioavailability when ingested by humans.

•    A dosage of 10 g/day can contain 1.5 to 2 mg of absorbable iron, similar to standard ferrous sulfate.

Thus, anyone cautioned against consuming excessive amounts of iron are encouraged to discuss this point with his or her physician.

There is no proof that spirulina interacts with any drugs; however, there is a possibility that blue-green algae might interfere with certain immune-suppressing drugs. As such, spirulina has the potential to reduce the effectiveness of medications like Humira, Imuran, Neoral, Enbrel, Remicade, Arava, Methothrexate, Prednisone and CellCept.
Its allocation as a super-food is no accident; spirulina contains many powerful health properties. As long as those who consume it heed by the cautions associated with blue-green algae and realize that it is not yet a proven liver protector, regular spirulina consumption could contribute to slowing or halting the progression of chronic liver disease.

References:

http://www.drugs.com/npp/spirulina.html, Spirulina, Retrieved June 12, 2011, Wolters Kluwer Health, 2009.

http://www.liversupport.com/wordpress/2010/12/could-curcumin-help-your-liver/, Could Curcumin Help Your Liver, Nicole Cutler, L.Ac., Retreived June 10, 2011, Natural Wellness, 2011.

http://www.ncbi.nlm.nih.gov/pubmed/20353607, Protective effects of Spirulina maxima on hyperlipidemia and oxidative-stress induced by lead acetate in the liver and kidney, Ponce-Canchihuamán JC, et al, Retrieved June 12, 2011, Lipids in Health and Disease, March 2010.

http://www.ncbi.nlm.nih.gov/pubmed/20370930, Hepatoprotective effects of Spirulina maxima in patients with non-alcoholic fatty liver disease: a case series, Ferriera-Hermosillo A, et al, Retrieved June 3, 2011, Journal of Medical Case Reports, April 2010.

http://www.ncbi.nlm.nih.gov/pubmed/20708378, Antioxidant activity and hepatoprotective effects of whey protein and Spirulina in rats, Gad AS, et al, Retrieved June 9, 2011, Nutrition, May 2011.

http://www.nlm.nih.gov/medlineplus/druginfo/natural/923.html, Blue-Green Algae, Retrieved June 9, 2011, US Department of Health and Human Services, 2011.

http://www.umm.edu/altmed/articles/spirulina-000327.htm, Spirulina, Retrieved June 3, 2011, University of Maryland Medical Center, 2011.

By Nicole Cutler, L.Ac.

Experts estimate that a quarter of American adults have fatty liver disease. Whether or not those with this condition have received a diagnosis yet, awareness of fatty liver prevention is growing. The top recommendations for preventing fat accumulation in the liver include eating a healthful, high-fiber, low-fat diet and regular physical activity. Although these two lifestyle choices are extremely important for liver health, they are joined by another popular wellness trend. Typically suggested for individuals who have been inundated with antibiotics or for people with vague gastrointestinal discomfort, probiotics also appear to battle the development of non-alcoholic fatty liver disease (NAFLD).

About NAFLD
Along with the increasing incidence of obesity and diabetes in Western countries, nonalcoholic fatty liver disease has risen steadily. Encompassing two conditions that affect people who drink little or no alcohol, NAFLD can be mild or it can progress to a more severe stage:

1.    Steatosis – A mild condition, steatosis is a simple fatty liver where there is rarely any liver damage.

2.    Nonalcoholic steatohepatitis (NASH) – When the accumulation of fat in the liver is accompanied by inflammation, fatty liver has escalated to NASH. Fibrous tissue can form with NASH, which could progress to cirrhosis or liver cancer.

Although experts still have a lot to learn about NAFLD, it is typically diagnosed in people who are overweight, diabetic or pre-diabetic and who have elevated cholesterol and triglyceride levels. A person is considered to have a fatty liver when the fat makes up at least 10 percent of his or her liver. Especially if addressed during the first stage, steatosis, it is possible to reverse NAFLD. At the very least, instituting lifestyle changes that support a healthy liver can help prevent a fatty liver from getting worse.

About Probiotics
The opposite of antibiotics, probiotics refers to specific digestive bacteria that produce healthy intestinal flora. Examples of probiotics include:

•    Bifidobacteria
•    Lactobacilli
•    Bacteroides
•    Fusobacteria

Probiotics are beneficial bacteria that support the health of the gastrointestinal system by suppressing or destroying harmful bacteria. The regular use of probiotics is believed to re-colonize the digestive tract with enough normal flora to prevent potentially damaging microbes from gaining dominance.

Often advised for a wide range of gastrointestinal issues that could benefit from an influx of beneficial bacteria, probiotics are a part of many peoples’ health routines. While there are a wide range of strengths and strains available, probiotics have traditionally been found as a supplement in pill or powder form. However, our knowledge of probiotics’ value is steadily increasing – a movement that has led to their availability in many foods such as yogurt, kefir, sauerkraut and a growing list of fermented foods.

Evidence that Probiotics Benefit a Fatty Liver
Documentation that improving the gut bacterial balance impacts fat accumulation in the liver has gained significant momentum over the past decade:

•    2003 – Researchers at Johns Hopkins University found that intestinal bacteria play a pathogenic role in hepatic insulin resistance (a marker of pre-diabetes) and NAFLD.

•    2008 – In an animal study, researchers at the Imperial College of London found that probiotic exposure altered fat metabolism in the liver.

•    2009 – Italian researchers found that NAFLD is associated with gut permeability that is related to small intestinal bacterial overgrowth.

•    2011 – Because their effects have proved to be beneficial in NAFLD, researchers from University of Naples described probiotics as an emerging therapeutic strategy for fatty liver disease.

There is no substitute for eating the right foods and getting regular exercise for preventing fat accumulation in the liver. However, adding probiotics to these lifestyle standards increases your lean liver efforts. As we continue to witness how improving the ratio of friendly bacteria to detrimental bacteria in the gastrointestinal tract reduces the incidence of fatty liver disease, more resources will be poured into this healthful strategy.

References:

http://altmedicine.about.com/b/2009/05/23/probiotics-may-protect-your-liver.htm, Probiotics May Protect Your Liver, Retrieved February 7, 2011, About.com, 2011.

http://onlinelibrary.wiley.com/doi/10.1002/hep.22848/abstract, Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease, Luca Miele, et al, Retrieved February 11, 2011, Hepatology, January 2009.

http://www.betterhealthresearch.com/news/probiotics-may-one-day-lower-fat-levels-in-liver-experts-say-800384845/, Probiotics May One Day Lower Fat Levels In Liver, Experts Say, Retrieved February 7, 2011, Better Health Research, 2011.

http://www.liversupport.com/wordpress/2007/03/probiotics-help-support-liver-health/, Probiotics Help Support Liver Health, Nicole Cutler, L.Ac., Retrieved February 7, 2011, Natural Wellness, 2011.

http://www.liversupport.com/wordpress/2006/05/nonalcoholic-fatty-liver-disease-and-insulin-resistance/, How to Prevent a Fatty Liver, Nicole Cutler, L.Ac, Natural Wellness, 2011.

http://www.ncbi.nlm.nih.gov/pubmed/18197175, Probiotic modulation of symbiotic gut microbial-host metabolic interactions in a humanized microbiome mouse model, Martin FP, et al, Retrieved February 11, 2011, Molecular Systems Biology, January 2008.

http://www.ncbi.nlm.nih.gov/pubmed/21292470, Probiotics as an emerging therapeutic strategy to treat NAFLD: focus on molecular and biochemical mechanisms, Iacono A, et al, Retrieved February 11, 2011, The Journal of Nutritional Biochemistry, February 2011.

Ingredients

• 1-2 lbs. of chicken (depending on how much you want to make); you can use thighs, breasts, legs or whole chicken
• 1 bag of fresh or frozen spinach
• 1 large onion – yellow, white or red, finely chopped
• 1 large bulb of garlic,  about 6-8 cloves, finely chopped
• 1 jar of roasted red peppers, or make your own fresh, chopped
• 1 cup of orzo, couscous or brown rice
• 3 tbsp. of lemon juice
• 5-6 cups of water to cover chicken
• 1 large pot

Directions

1. Boil chicken with garlic and onions in large pot.
2. Remove chicken from pot and cool broth, skimming off any fat. Remove skin from chicken. Remove chicken meat from bones. Chop or pull chicken meat into bite size pieces and add back to broth.
3. Add bag of spinach, lemon juice and rice, orzo or couscous, chopped red peppers and bring to a boil again. Then simmer until rice is cooked.
4. This keeps well and can be frozen. You can add bouillon; just watch the salt content.

By Nicole Cutler, L.Ac.

An estimated 25 to 30 percent of Americans have a fatty liver, a condition that can progress to cirrhosis if not detected early enough and managed diligently. A study from the United Kingdom highlights the hazards of cirrhosis, providing even greater incentive to screen for fatty liver disease and prevent this condition from causing cirrhosis of the liver.

About a Fatty Liver
Fatty liver is a condition describing excessive fat accumulation in the liver. Although the exact cause has yet to be determined, the main risk factors for fatty liver are obesity and metabolic syndrome. According to hepatologist and assistant professor of medicine at Mount Sinai, Dr. Charissa Chang says, “Fatty liver is the liver manifestation of metabolic syndrome. So it’s associated with all the other features of metabolic syndrome: high blood pressure, diabetes, high cholesterol and an increased waistline.”

Although those who drink alcohol are notoriously vulnerable to fat accumulating in their liver and are especially likely to suffer from liver problems, non-drinkers are not immune from liver ailments. Describing the accumulation of fat in the liver in people who drink little or no alcohol,non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the United States.

Casually referred to as a fatty liver, NAFLD describes two conditions: steatosis and non-alcoholic steatohepatitis (NASH). Steatosis is a mild condition where fat in the liver is not accompanied by inflammation or damage. NASH is the more severe stage where fat accumulation is accompanied by inflammation. A result of the inflammation, scar tissue can accrue with NASH – a process that can escalate to cirrhosis of the liver.

About Cirrhosis
Cirrhosis is a slowly progressing disease in which healthy liver tissue is replaced with fibrous scar tissue. In the liver, scar tissue has the following repercussions:

•    It blocks the flow of blood, thus hindering blood detoxification.

•    It slows the processing of nutrients, hormones, drugs and naturally produced toxins in the liver.

•    It slows the production of proteins and other crucial substances made by the liver.

Not surprisingly, cirrhosis deteriorates the liver’s ability to function. According to the National Institutes of Health, cirrhosis is the 12th leading cause of death by disease in the U.S. Fatty liver, Hepatitis C and alcohol abuse are the most common causes of liver cirrhosis, but anything that damages the liver can cause cirrhosis.

Cirrhosis Warning from Fatty Liver
As published online in the June 2011 edition of Hepatology, researchers undertook a study to examine and compare the long-term morbidity and mortality of patients with advanced NAFLD and advanced, chronic Hepatitis C. Of the data collected, the researchers happened upon an important discovery for those with fatty liver disease.

Although not much of a surprise, they found that those with fatty liver that had progressed to cirrhosis (stage 4 on the Child-Pugh scale) were in a much worse position than those with a fatty liver that had only progressed to advanced fibrosis (stage 3 on the Child-Pugh scale). More specifically:

•    Those with NAFLD and stage 4 scarring (cirrhosis) had a higher occurrence of liver-related complications, including liver cancer, than those with stage 3 liver scarring.

•    Those with NAFLD and stage 4 scarring (cirrhosis) were associated with liver-related mortality more than those with stage 3 liver scarring.

Preventing Cirrhosis
According to Chang, “Once there is cirrhosis in a patient with NASH, there aren’t a lot of options to reverse the damage.” Obviously, the message from Dr. Chang and this British study is to detect fatty liver disease as soon as possible and implement strategies to prevent its progression to cirrhosis in the first place.

Signs and symptoms of NAFLD before significant liver damage occurs can easily go undetected. Thus, the first step towards preventing a fatty liver from progressing to cirrhosis is to implement routine screening. Early detection of NAFLD can help more people engage in the following steps to prevent cirrhosis:

•    Abstinence – Drinking alcohol is a guaranteed route towards liver cell destruction. While some sources suggest limiting alcohol consumption, those with confirmed NAFLD are advised to completely abstain from drinking alcohol.

•    Minimize Toxin Exposure – Reduce exposure to synthetic chemicals, such as cleaning products and pesticides, because they put an additional burden on functioning liver cells. If you come into contact with chemicals often, wear protective clothing and a facemask.

•    Vaccinate – If not already current, make sure vaccinations against Hepatitis B and Hepatitis A are up-to-date. Becoming ill with one of these preventable viruses while managing NAFLD makes the liver more vulnerable to damage.

•    Nutrition – Eating a nutritious, well-balanced, low-fat diet helps supply the body with the ingredients needed to function optimally. On the other hand, consuming processed, sugary or fatty foods fans the flames of liver inflammation.

•    Protect Liver Cells – Known to strengthen the outer walls of liver cells to prevent against damage, supplementing with milk thistle can stave off further liver injury. Additionally, liver cells can be protected from oxidative damage by loading up on antioxidant-rich foods.

Considering that at least a quarter of American adults are affected (and a majority don’t know it), there is every reason to include fatty liver disease screening into routine health maintenance programs. In addition, those with confirmed NAFLD are advised to discourage its advancement in every way possible. As confirmed by research from the United Kingdom, preventing cirrhosis may play a prominent role in reducing liver complications and death as a result of fatty liver disease.

References:

http://articles.nydailynews.com/2010-10-06/entertainment/27077329_1_liver-disease-metabolic-syndrome-hepatitis, The skinny on fatty liver: Weight and metabolic disorders put millions at risk, Katie Charles, Retrieved July 9, 2011, NY DailyNews.com, 2011.

http://onlinelibrary.wiley.com/doi/10.1002/hep.24491/abstract, The natural history of nonalcoholic fatty liver disease with advanced fibrosis or cirrhosis: An international collaborative study, Neeraj, Bhala, et al, Retrieved July 8, 2011, Hepatology, June 2011.

http://www.doctorslounge.com/index.php/news/pb/21276, Fewer Complications With NAFLD Than Hepatitis C Virus, Retrieved July 8, 2011, HealthDay, 2011.

http://www.webmd.com/digestive-disorders/cirrhosis-liver, Cirrhosis of the Liver, Retrieved July 9, 2011, WebMD, LLC, 2011.

By Nicole Cutler, L.Ac.

The formula upon which SST is derived has a long history of helping conditions related to the liver and gallbladder. Despite the time-tested strength this formula displays in supporting several areas of human health, sales and marketing restrictions rendered it unavailable for a short amount of time. Luckily, the obstacle hindering the sale of SST has been resolved, making this legendary supplement accessible to consumers once again.

Known in Traditional Chinese Medicine as Xiao Chai Hu Tang, the herbal formula known as SST originated during the Eastern Han Dynasty (25 AD – 220 AD). Comprised of seven ingredients, Xiao Chai Hu Tang was traditionally brewed as a tea. Although this potent brew was very effective, the labor involved in its preparation and the pungent, bitter taste dissuaded many potential benefactors from taking it. Comprised of the exact same seven ingredients as Xiao Chai Hu Tang, SST is a compliant-friendly capsule that doesn’t require brewing a tea or tasting the potent herbs.

Xiao Chai Hu Tang is one of the most used formulas in Traditional Chinese Medicine today. This is because the formula is expertly balanced, providing herbs to balance the liver, cool liver heat, dry dampness and harmonize the digestive system while simultaneously strengthening the qi (energy) and the blood. Although these properties might not be familiar to a Western-trained physician, they apply to many common chronic illnesses affecting the liver and gallbladder. As such, healthcare practitioners from all disciplines rely on Xiao Chai Hu Tang (or SST) for supporting liver and gallbladder health.

Unfortunately, SST was unavailable for a while because of disease claims made in the marketing and advertising arena. The Dietary Supplement Health and Education Act of 1994 (DSHEA) established some special regulatory procedures for claims for dietary supplement labels and related marketing materials. According to Food and Drug Administration (FDA) guidelines, labeling or marketing for an herbal formula must not contain references to any known diseases. Likely because of prominent research being conducted with SST on people with Hepatitis C in a well-known U.S. medical facility, and it being the leading prescribed medicine in Japan for hepatitis, the manufacturer felt confident disclosing SST’s use for this common liver infection.

It may seem unfair that an herbal formula’s part in a research study or its use in a different country be concealed in its promotion; however, there is a valuable reason behind this legislation. The FDA aims to protect the public from erroneous claims that any substance (herbal, vitamin or pharmacological) benefits a disease if it has not been tirelessly proven to do so. The purpose of this rule is to prevent propaganda from taking the place of sound medical advice.

For the most part, Americans are lucky that their government protects them from putting their faith in, purchasing and taking ‘snake oil’ remedies for their health problems. However, there are many herbal supplements (especially those that have been studied for decades – or centuries) with clear benefits for specific diseases – that are unable to promote this benefit. Unless the supplement’s manufacturer has funding on par with a pharmaceutical company to finance the process of becoming FDA-authorized for a disease claim, insinuating that a supplement helps a disease is illegal.

Thankfully, this legal matter is in the past and SST’s manufacturer is now in compliance with the DSHEA. As such, it will be a tad more difficult for those who could truly benefit from this seven-herb formula to learn of its value to their liver. Nonetheless, those who are willing to do some extra research on the evidence supporting this formula’s use for chronic liver disease are in luck, because SST is finally back.

References:

http://www.acupuncturetoday.com/mpacms/at/article.php?id=31544, Herbal Monograph for Xiao Chai Hu Tang, John Chen, PhD, PharmD, OMD, Lac, Retrieved April 1, 2012,  Acupuncture Today, July 2007.

http://www.fda.gov/food/labelingnutrition/labelclaims/ucm111447.htm, Claims That Can Be Made for Conventional Foods and Dietary Supplements, Retrieved April 1, 2012, U.S. Food and Drug Administration, 2012.

http://www.mskcc.org/cancer-care/herb/sho-saiko, Sho-saiko-to, Retrieved April 1, 2012, Memorial Sloan-Kettering Cancer Center, 2012.

http://www.travelchinaguide.com/intro/history/han/eastern.htm, Eastern Han Dynasty, Retrieved April 1, 2012, TravelChinaGuide.com, 2012.

Ingredients

Choose amounts of each fruit based on taste preference and what you can find at the local fruit stand or grocery store. It’s that easy!

• Blueberries
• Strawberries
• Fresh Pineapple
• Bananas
• Grapes
• Cantaloupe
• Watermelon
• Fresh Lemons or Limes (this will help the fruit maintain its color)

Directions

1. Slice the strawberries, fresh pineapple and bananas into about 1-inch chunks.
2. To create fun circular or oval shapes, you can use a melon baller (a small spoon-like tool) to scoop out the watermelon and cantaloupe. (Or simply cut the fruit into about 1-inch chunks.)
3. Combine prepared fruit with blueberries and grapes in a large serving bowl. Simply squeeze the juice of one or two lemons or limes (your choice!) over colorful fruit. Mix gently.
4. Optional – Add nutritious nuts such as almonds, pecans or walnuts. Learn more about how nuts can help support liver health.
5. Cover and store in the refrigerator.

By Nicole Cutler, L.Ac.

In today’s society, fatty liver disease is fast becoming a major health menace. Experts estimate that one in every four American adults has a fatty liver – a condition that predisposes people to obesity, diabetes, heart disease, liver cirrhosis, liver failure and liver cancer. Although there is not yet an approved medical treatment for a fatty liver, various lifestyle choices are known to prevent and reverse fatty liver disease. Relatively new research makes a strong case for aerobic exercise as a habit that can protect people from the repercussions of a fatty liver.

About Fatty Liver Disease
Describing the accumulation of fat in the liver, fatty liver disease is characterized by one of two levels of severity. Steatosis, the mild form of a fatty liver, occurs when there is fat accumulation in the liver that is not associated with inflammation. Steatosis typically does not cause liver damage. If recognized before it progresses, lifestyle changes can reverse steatosis.

In those who do not consume alcohol, NASH (non-alcoholic steatohepatitis) is the more severe form of fatty liver disease. Besides fat accumulation in the liver, steatohepatitis means that inflammation is also present. The liver can scar in those with NASH, a problem that may progress to cirrhosis, liver failure or liver cancer.

Easing Fatty Liver Disease
Especially for those who have not yet progressed to the more severe form of fatty liver disease, losing weight, sticking to a regular exercise program and eating a low-fat, high-fiber diet have the potential to reverse steatosis. Health professionals agree that adhering to these lifestyle tenements from the start helps to prevent all kinds of deleterious health conditions – including the development of a fatty liver.

According to a recently presented study, aerobic exercise in particular has a positive impact on fatty liver disease. Everyone knows that frequent physical activity is a means to lose weight and improve overall health. However, research presented at the April 2011 Experimental Biology meeting in Washington, D.C. makes the claim that aerobic exercise protects the liver from fatty liver disease.

About the Study
Led by Jacob M. Haus Ph.D., a research fellow in the Department of Pathobiology, the aforementioned research took place at the Cleveland Clinic. Haus and his collaborators found that those with fatty liver disease who walked on a treadmill at 85 percent of their maximum heart rate for one hour per day for seven consecutive days exhibited several statistically significant fatty liver improvements.

At the conclusion of the study, improvements in the following markers were found:

•    An 84 percent increase in the liver’s polyunsaturated liver index, an indication of an improvement in liver health.

•    An increase in insulin sensitivity, an indication that the body is better able to manage blood sugar – thus reducing fat accumulation.

•    An increase in adiponectin levels, an indication that fat is being better metabolized.

•    A decrease in the production of reactive oxygen species, an indication that less oxidative damage is occurring.

According to Dr. Haus, “Exercise appears to affect the cumulative metabolic risk factors for the progression of nonalcoholic fatty liver disease. We like to think of exercise as medicine.”

About Aerobic Exercise
Aerobic exercise differs from other types of physical activity in that it is typically of longer duration, yet of relatively low intensity. It generally involves rhythmically using the same large muscle group for at least 15 to 20 minutes. Examples of aerobic activities are walking, biking, jogging, rowing, swimming and cross-country skiing. As a rule, you should be able to carry on a short conversation while doing aerobic exercise without gasping for breath.

Besides benefitting the 25 percent of American adults with a fatty liver, there are many more reasons to engage in regular aerobic exercise. Six reasons to get aerobic exercise daily are:

1.    Aerobic exercise activates the immune system, reducing susceptibility to colds and flus.

2.    Aerobic exercise helps keep arteries clear and strengthens the heart.

3.    Aerobic exercise can ease depression, reduce anxiety and promote relaxation.

4.    Aerobic exercise keeps muscles strong, which helps maintain mobility with advancing age.

5.    Aerobic exercise reduces cognitive decline in older adults.

6.    Aerobic exercise enhances stamina and reduces fatigue.

Although running a marathon may not be everybody’s preference, just about anyone can find a way to include aerobic exercise into their lifestyle. By partaking in this kind of physical activity, fatty liver disease can be prevented, steatosis reversed and steatohepatitis progression halted. As demonstrated by the Cleveland Clinic researchers, long and steady physical activity officially wins the race toward a leaner, healthier liver.

References:

http://k2.kirtland.cc.mi.us/~balbachl/aeroprin.htm, What is Aerobic Exercise and Why Should I do it?, Lisa Balbach, Retrieved June 5, 2011, Lisa Balbach, 2011.

http://www.emaxhealth.com/1506/increase-aerobic-exercise-may-slow-progression-non-alcoholic-fatty-liver-disease, Increase in Aerobic Exercise May Slow Progression of Non-Alcoholic Fatty Liver Disease, Denise Reynolds, RD, Retrieved June 1, 2011, eMaxHealth.com, 2011.

http://www.liversupport.com/wordpress/2011/05/newly-revealed-health-risk-linked-to-fatty-liver-disease/, Newly Revealed Health Risk Linked to Fatty Liver Disease, Nicole Cutler, L.Ac., Retrieved June 5, 2011, Natural Wellness, 2011.

http://www.mayoclinic.com/health/aerobic-exercise/EP00002/NSECTIONGROUP=2, Aerobic Exercise: Top 10 Reasons to Get Physical, Retrieved June 5, 2011, Mayo Foundation for Medical Education and Research, 2011.

http://www.ncbi.nlm.nih.gov/pubmed/21569626, Exercise and spirulina control non-alcoholic hepatic steatosis and lipid profile in diabetic Wistar rats, Moura LP, et al, Retrieved June 3, 2011, Lipids in Health and Disease, May 2011.

By Nicole Cutler, L.Ac.

The human body is a complexity, involving countless amazing feats at every moment. Nowhere is this seemingly miraculous series of events more pronounced than in the liver. An organ subjected to repeated abuse, the liver maintains a remarkable ability to regenerate itself upon incurring cellular damage. A new study published in a peer-reviewed journal has found that a hormone known predominantly for its link to emotional well-being also appears to play a role in liver cell regeneration.

Especially in the presence of the Hepatitis B or C virus, alcoholism, a fatty liver or an autoimmune disease, sometimes the balance required to repair liver cells gets disrupted. This disruption impairs the liver’s regenerative abilities so that it can no longer keep up with relentless liver cell injury – and scars form. The propensity to scar more than repair the cellular damage describes the course of chronic liver disease – and British researchers believe that a well-known hormone could be the key to regaining balance.

About Serotonin
A team led by Newcastle University researchers has identified serotonin as playing a healing role in liver tissue regeneration. Also known as 5-hydroxytryptamine, serotonin is a hormone found in many locations, including the brain, the digestive tract and blood platelets. In addition, serotonin is a neurotransmitter – a substance needed to transmit certain nerve impulses.

Serotonin’s wide range of functions partially depends on what type of receptor this hormone attaches to: sometimes serotonin’s binding to a receptor can encourage a physiological function while binding to a different receptor can discourage a physiological function. There are at least seven different types of serotonin receptors, each of which can have many subtypes. For those studying serotonin, the expansive nature of serotonin and its receptors confirms the complexity of human biology.

Often regarded as the ‘happy’ hormone, serotonin exerts a major influence on our overall sense of well-being. Serotonin is instrumental in:

•    Learning
•    Balancing mood
•    Aiding sleep
•    Vasoconstriction [is the narrowing (constriction) of blood vessels by small muscles in their walls.]
•    Regulating aggression, appetite and sexuality
•    Regulating body temperature and metabolism
•    Tempering anxiety
•    Relieving depression
•    Wound healing

Because a deficiency of serotonin levels in the brain typically affects mood, many antidepressant medications function to increase serotonin levels. Selective serotonin reuptake inhibitors (SSRI’s) are one of the most frequently prescribed medications for depression and mood disorders, contributing to the assumption that serotonin is primarily a hormone linked to emotional health. However, serotonin’s clinical applicability extends far beyond the emotions.

Serotonin and the Liver
Of particular interest to those with liver disease, the extent of liver damage depends on the balance between the generation of scar tissue and the regeneration of new liver cells. When scarring of this important organ becomes excessive, the liver’s ability to function is impaired. Also known as fibrosis, extensive liver scarring interferes with the liver’s ability to detoxify the blood and manufacture crucial hormones and clotting factors. Advanced cases of fibrosis can lead to cirrhosis – the permanent hardening and shrinking of the liver – and liver cancer.

As part of the normal healing process, scientists understand that blood platelets secrete serotonin when involved in tissue repair. However, serotonin exerts an undesirable effect on hepatic stellate cells, specialized cells that are the major source of liver damage in chronic liver disease. Researchers from Newcastle University have found serotonin to be involved in the balance between scar tissue formation and healthy liver cell regeneration. More specifically, their research indicated that:

•    when scar-forming cells (hepatic stellate cells) are present, serotonin influences them to increase scar tissue formation and switch off healthy cell production

•    the serotonin receptor 5-HT2B instructs hepatic stellate cells to switch off regeneration

•    substances that bind to 5-HT2B results in less liver scarring and more cellular regeneration

To make sense of this research, a bigger picture of serotonin and its receptors is helpful. Similar to a lock and key unit, serotonin inserts into a receptor to either “lock or unlock” a cell’s function. When serotonin binds with a receptor, there is less of it available in the spaces in between cells. In this case, serotonin binding with 5-HT2B gives hepatic stellate cells instructions to cease cellular regeneration. Blocking serotonin from binding to the 5-HT2B receptor interferes with its ‘cease cellular regeneration instruction’ and results in more serotonin circulating between cells.

Although only observed in an animal study, this research has a dramatic impact on our understanding of the mechanisms that dictate the balance of cellular regeneration and fibrogenesis. In addition, the study’s lead author, Professor Derek Mann indicated that their results suggest that chemicals targeting 5-HT2B (which are currently in clinical trials for mood disorders and pulmonary hypertension) could also help treat chronic liver disease.

Both liver scarring and cellular regeneration are a normal part of the liver’s response to injury. However, influencing the balance to favor cellular regeneration would be very beneficial to people with chronic liver disease.

The new information linking serotonin with liver scarring via the hepatic stellate cells is preliminary, and is insufficient for drawing conclusions. The Newcastle research does not imply that currently available SSRI’s are good or bad for liver health. Instead, their finding is exciting because it reveals that occupying a specific serotonin receptor provides a way to reduce liver scarring and encourage liver cell regeneration. As such, future studies zeroing in on 5-HT2B have the potential to improve the outlook for the millions of people living with chronic liver disease.

Editor’s Note: In response to the confusion posted by several readers, this article has been updated. It seems that the role of serotonin on tissue healing and regeneration is specific to the receptor type and the cell type.

References:

http://www.acnp.org/g4/GN401000039/Ch039.html, Serotonin Receptor Subtypes and Ligands, Richard A. Glennon, et al, Retrieved April 1, 2012, American College of Neuropsychopharmacology, 2012.

http://www.healthcanal.com/medical-breakthroughs/23858-Manipulating-serotonin-can-promote-healthy-repair-chronic-liver-disease.html, Manipulating serotonin can promote healthy repair in chronic liver disease, Retrieved November 28, 2011, HealthCanal.com, 2011.

http://www.medicalnewstoday.com/articles/232248.php, What is Serotonin?, Christian Nordqvist,  Retrieved December 4, 2011, Medical News Today, 2011.

http://www.ncbi.nlm.nih.gov/pubmed/11586470, Hepatic stellate cell behavior during resolution of liver injury, Iredale, JP, Retrieved April 1, 2012, Seminars in Liver Disease, August 2001.

http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.2490.html, Stimulating healthy tissue regeneration by targeting the 5-HT2B receptor in chronic liver disease, Mohammad R Ebrahimkhani, et al, Retrieved November 28, 2011, Nature Medicine, November 2011.

By Nicole Cutler, L.Ac.

Editor’s Note: The information below is for educational purposes only and is not intended to replace, supersede or substitute medical advice.

Whether it is for the flu, a headache, menstrual pain, muscle ache or any other type of discomfort, just about everyone has times when they seek pain relief. Over-the-counter staples for this purpose usually fall into one of three categories: acetaminophen, ibuprofen or aspirin. Unfortunate for those with chronic liver disease, all three of these medicines can be harmful to the liver. Because different doctors will favor different types of painkillers, it can be very confusing for someone with liver concerns to know what his or her best choice is. The preferred painkiller – and dosage – will vary depending on each individual, but understanding why each of these medications may be hazardous can help people make informed decisions.

As a general rule, the more advanced a person’s liver disease is, the greater caution is warranted when considering pain relief medications. Similar to how the food we eat and the beverages we drink must be processed by the liver, so too do most medications. By recognizing that drugs exert some degree of strain on the liver, it is easy to see why a severely damaged liver would have a harder time metabolizing medications. In addition, conditions that often result from liver disease make certain drugs particularly hazardous.

Occasional, restricted use of the over-the-counter painkillers listed below may be safe for those with chronic liver disease. However, since each individual is likely to have a different presentation of liver disease – a person must work with a physician in choosing the drug that is least likely to adversely affect his or her liver.

Acetaminophen
Known commonly as Tylenol, acetaminophen is a common, mild to moderate pain reliever. As published in a 2005 edition of the journal Hepatology, U.S. researchers found that over a six-year time span, more than 40 percent of acute liver failure cases were caused by an acetaminophen overdose. High doses of acetaminophen can cause liver injury, even to a healthy liver, so those with fewer functioning liver cells have an even greater risk of harm. In limited dosages, a physician will generally only suggest acetaminophen to someone whose hepatic metabolism is fully functioning.

Unfortunately, overdosing on acetaminophen is much easier than it should be because this ingredient is found in many types of pain-relieving drugs. Acetaminophen is also in several narcotic painkillers like Tylenol with Codeine, Oxycodone, Vicodin, Lortab and Percocet. Abbreviated on labels as APAP, acetaminophen is also in Anacin 3, Nyquil and thousands of other medicines used to treat headaches, fever and sore throats. If given an okay to take acetaminophen by a physician, make certain to avoid taking more than one acetaminophen-containing drug at a time. Those with liver disease are often advised to restrict the daily amount of acetaminophen to 2,000 mg per day, or even less if severe liver disease is present.

Ibuprofen
A non-steroidal anti-inflammatory drug (NSAID), ibuprofen reduces high body temperature, is an anti-inflammatory and inhibits normal platelet function. Available in products such as Motrin, Advil and Nuprin, ibuprofen is the painkiller of choice for millions of people. However, NSAIDS are known to cause gastrointestinal upset and bleeding. For those prone to portal hypertension (a common liver disease complication), the risk of gastrointestinal bleeding is intensified with NSAIDS. Studies have shown that at certain dosages, ibuprofen can stress the liver and elevate liver enzymes in people with chronic liver disease. As such, ibuprofen must be used with extreme caution (and always taken with food) in the later stages of liver disease.

Aspirin
Sometimes used as a preventative for cardiovascular disease, aspirin reduces fever, relieves pain, is an anti-inflammatory and a blood thinner. Also sold under the brand names Bayer, Anacin and Excedrin, aspirin limits the blood clotting process and prolongs bleeding. In chronic liver disease where the body’s production of clotting factors is naturally decreased, aspirin can increase the risk of bleeding. When taken in high doses (more than 2,000 mg per day) aspirin can cause liver injury.

Besides acetaminophen, ibuprofen and aspirin, there are other pain-relieving options. Especially for those with advanced liver disease, a doctor may suggest a prescription drug to relieve pain that is cleared more by the kidneys than the liver. As those with chronic liver disease do not have any great, totally safe options for pharmaceutical pain relief, make sure to consider non-medication pain treatments such as acupuncture, physical therapy, massage therapy, heat therapy, cold therapy, TENS (transcutaneous electrical nerve stimulation) and biofeedback.

The bottom line for people with liver disease is to consult with their physician before taking any type of pain-relieving pill – no matter how innocuous it may seem. Because the liver is targeted by most drugs, an ailing liver must be prioritized before any pill-popping begins – especially if it’s Tylenol, Advil or Bayer.

References:

http://patients.gi.org/topics/medications-and-the-liver/, Medications and the Liver, Jorge L. Herrera, MD, FACG, Retrieved February 26, 2012, American College of Gastroenterology, 2012.

http://www.everydayhealth.com/health-questions/abdominal-pain/what-can-i-take-for-pain-with-cirrhosis-of-the-liver-4th-stage, What can I take for pain with cirrhosis of the liver (4th stage)?, Sarah Lewis, PharmD, Retrieved February 26, 2012, Everyday Health, Inc., 2012.

http://www.everydayhealth.com/health-questions/pain-management/what-pain-reliever-is-safe-for-the-liver, What Pain Reliever is Safe for the Liver?, Patti Brown, PharmD, Retrieved February 26, 2012, Everyday Health, Inc., 2012.

http://www.hepatitis-central.com/mt/archives/2007/05/is_there_pain_r.html, Pain Relievers and Hepatitis C, Nicole Cutler, L.Ac., Retrieved February 26, 2012, Hepatitis Central, 2012.

http://www.ncbi.nlm.nih.gov/pubmed/16317692, Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study, Larson AM, et al, Retrieved February 26, 2012, Hepatology, December 2005.

http://www.npr.org/blogs/health/2011/01/13/132903273/fda-clamps-down-on-acetaminophen-in-prescription-drugs, FDA Clamps Down On Acetaminophen In Prescription Drugs, Scott Hensley, Retrieved February 26, 2012, NPR, 2012.

http://www.physorg.com/news/2011-01-fda-lowering-pain-reliever-vicodin.html, FDA orders lower doses in prescription painkillers, Matthew Perrone, Retrieved February 26, 2012, The Associated Press, 2012.

http://www.washingtonpost.com/national/fda-moves-to-cut-strength-of-prescription-painkillers-citing-risk-of-liver-damage/2011/01/13/ABt45WR_story.html, FDA moves to Cut Strength of Prescription Painkillers – Citing Risk of Liver Damage, Rob Stein, Retrieved February 26, 2012, The Washington Post, 2012.

By Nicole Cutler, L.Ac.

A majority of Westerners include underarm deodorants or antiperspirants in their daily hygiene routine. Despite the acceptance of this practice, many deodorants and antiperspirants increase the body’s toxic load – putting an additional burden on the organ overseeing most of the body’s detoxification responsibilities: the liver. For individuals with chronic liver disease, any extra toxin to be filtered heightens the level of stress on the liver. Unfortunately, this added level of stress can fan local inflammation, a physiological event that can lead to cellular injury and a worsening of the liver’s condition.

Chronic Liver Disease
According to the American Liver Foundation, chronic liver disease affects an estimated 25 to 30 million Americans; a figure that translates to roughly one in every 11 people. There can be many different causes of chronic liver disease ranging from a hepatitis virus, to excessive alcohol consumption, to fat accumulation in the liver, to autoimmune disease. Regardless of the origin, preventing the progression of liver disease is imperative to prevent the liver from being so damaged that it can no longer sustain life.

Although the liver performs many essential daily functions, one of its most crucial jobs is to filter harmful substances out of the bloodstream. Thus, every toxin that gains entrance into our body is eventually filtered out by the liver. Even though this spectacular organ is designed to detoxify poisons, the toxins can damage the very liver cells intending to eliminate them. Thankfully, a healthy liver can grow new cells after sustaining damage. In the case of chronic liver disease, the destruction of liver cells may surpass this organ’s regenerative ability, causing scars that can become permanent. Thus, reducing the body’s toxin load directly benefits those with chronic liver disease.

Deodorants and Antiperspirants
In order to minimize the quantity of toxins the liver must process, those with chronic liver disease are constantly striving to identify and minimize contact with potentially harmful substances. Regrettably, a staple found in our society’s personal care product aisle appears to pose a threat to an ailing liver. Whether using an antiperspirant that uses chemicals to prevent wetness or non-antiperspirant deodorants that contain chemicals to kill bacteria and odor, the ingredients of these staples are absorbed through the skin, enter the bloodstream and await filtration by the liver. Deodorant absorption is especially rapid in freshly shaved armpits, where tiny breaks in the skin provide a free ride to any substance in direct contact with that area.

Although a respected, published study linking deodorant and/or antiperspirant use with chronic liver disease does not yet exist, numerous studies have examined how these personal care items contribute to breast cancer, Alzheimer’s disease and allergic reactions. Thus far, the data is conflicting – but our understanding that toxins are being swiped under Americans’ armpits is irrefutable.

Known Deodorant Toxins
They may be slightly less effective than mainstream deodorants, but there are all-natural options for minimizing armpit odor available. In fact, the market for more ‘natural’ deodorants appears to be strengthening in accordance with the increasing awareness of how chemicals negatively impact our health. Barring deodorants created to intentionally reduce the body’s contact with harmful chemicals, the following four substances are found in many commercially prepared deodorants/antiperspirants:

1.    Triclosan – An antimicrobial chemical used to kill bacteria on the skin and other surfaces, triclosan is a skin irritant and may contribute to liver damage when absorbed through the skin.

2.    TEA & DEA –Triethanolamine and diethanolamine (TEA and DEA) adjust pH, and can be toxic if absorbed into the body over a long period of time. Both of these chemicals are already restricted in Europe due to their known carcinogenic effects.

3.    Propylene glycol – Originally developed as an anti-freeze, this substance prevents products from drying out. An ingredient in some deodorants and antiperspirants, propylene glycol is a neurotoxin known to cause contact dermatitis, kidney damage and liver damage.

4.    Aluminum – Used to block sweat glands, aluminum-based compounds are the active ingredients in antiperspirants. Many studies have pointed at these aluminum compounds as being responsible for causing changes in estrogen receptors in breast cells – a risk for developing breast cancer. This claim may or not be accurate. However, the simple act of preventing perspiration hinders the body’s natural attempt at eliminating toxins via the skin’s pores.

In this country, pools of wetness or odiferous fumes emanating from the armpits are not socially acceptable. How we look and smell often trumps wellness and, as such, many people put potent and potentially harmful deodorant use above their liver’s health. Indicating a shift in society’s priorities, a growing movement is recognizing the need for personal care products that simultaneously support health and wellness. Until a more natural solution can match the effectiveness of todays commercial deodorants, those with chronic liver disease must find ways to mitigate their reliance on these potentially liver-toxic products.

*Editor’s Note – Because new products continually emerge and existing formulations are subject to change, finding a liver healthy deodorant typically requires reading the label and knowing what to avoid. However, several options that do not contain liver-harmful ingredients at this time are Dr. Hauschka’s deodorant floral, Erbaviva organic deodorant, Aubrey deodorants, Bubble and Bee deodorants, Burt’s Bees herbal deodorant and Terresentials deodorants.

References:

Dadd, Debra, Toxic Free: How to Protect Your Health and Home from the Chemicals that are Making You Sick, Penguin Group, New York, NY, 2011.

http://www.hepquant.com/liver-disease-faq.php, Liver Disease FAQ, Retrieved February 5, 2012, Hepquant, 2012.

http://www.naturalcosmeticnews.com/toxic-products/dangerous-chemicals-in-deodorant-antiperspirant-a-detailed-review-of-the-chemicals-research-avoidance-tips/, Dangerous Chemicals in Deodorant & Antiperspirant: A Detailed Review of the Chemicals, Research & Avoidance Tips, Retrieved January 30, 2012, Natural Cosmetic News, 2012.

http://www.sharecare.com/question/what-scientists-know-deodorant-ingredients, What do Scientists Know About Antiperspirant/Deodorant Ingredients?, Retrieved February 4, 2012, The Mount Sinai Medical Center, 2012.

http://www.webmd.com/healthy-beauty/features/antiperspirant-facts-safety, Antiperspirant Safety: Should You Sweat It?, Stephanie Watson, Retrieved February 4, 2012, WebMD, LLC, 2012.

http://www.wisegeek.com/what-are-the-dangers-of-aluminum-zirconium.htm, What are the Dangers of Aluminum Zirconium?, Retrieved January 31, 2012, Conjecture Corporation, 2012.