Our Liver - Let's Look After It
To know more what our liver does, the following by Dr. Sandra Cabot is great reading
Liver Disease
The liver has everything to do with how we live, that’s why it is called the liver. The state of your liver will have a huge bearing upon how well you live, how long you will live and how you will look and feel.
In today's world, the liver has to work harder than ever before, and all over the world we find that liver problems are increasing. Globally, one in every ten persons suffers with some type of liver, bile duct or gall bladder disease. Liver cancer is one of the most common cancers in men and has a poor outlook.
350 million people worldwide suffer from hepatitis B which kills more than 2 million annually. Hepatitis C is the most rapidly spreading infectious disease in many countries and is a time bomb waiting to explode. These problems are increasing, and thousands of people are waiting anxiously for liver transplants that many of them will never be lucky enough to receive. There are 25 million Americans with liver disease with thousands waiting for liver transplants. Unfortunately there are not nearly enough donor livers to meet the ever-increasing demand and so more than ever the message is that we need to take care of our livers from an early age. Thankfully nutritional medicine has been able to give many people with liver disease, from hepatitis B and C, to auto-immune disease, a healthy normally functioning liver. It is never too late as the liver has remarkable powers of healing and regeneration.
A number of diseases can affect the liver such as acute and chronic hepatitis, cirrhosis and tumors. The underlying causes of these disease states include viral infections like hepatitis A, B and C alcohol, drugs, metabolic disorders and immunological factors. Chronic liver disease passes through a long period of minimal vague symptoms until the final stages of jaundice and mental confusion appear.
Liver Dysfunction
This is different to liver disease in that the liver has not yet sustained permanent or sufficient damage to cause gross impairment of its vital functions. In those with a dysfunctional liver, the routine blood tests of liver function are generally normal. A dysfunctional liver is not working efficiently, and is overloaded, toxic or sluggish. Liver dysfunction is much more common than liver disease, and may be a forerunner to liver disease. In my experience of over 20 years of clinical medicine, I have found that approximately one in every three persons has a dysfunctional liver. Even if the level of dysfunction is only slight, it will still have a negative impact on your immune system and energy levels.
Many people suffer with the symptoms and signs of a dysfunctional liver for years, and yet the treating doctor or naturopath does not recognize the significance of these symptoms. The result is that the symptoms get treated while the underlying problem of an overloaded, toxic and inefficient liver is ignored or only partially treated. Inevitably, the patient’s symptoms deteriorate, and increasing doses of drugs such as antibiotics, anti-inflammatory medication, immune-suppressants, pain killers, cholesterol lowering drugs etc, are needed.
The full range of symptoms indicative of “dysfunctional liver syndrome” can only be defined after a study of Eastern and Western medical disciplines. Chinese doctors have long considered the liver to be the most important organ in the body and indeed they call the liver, the “General of the Army” of the body. I consider the liver to be the most strategic organ in the body, because by improving its function we are able to help many other body systems.
Common causes are incorrect diet, excessive alcohol intake, adverse reactions to drugs and toxic chemicals, and viral hepatitis. Dr. Cabot believes it is because modern-day medicine has become sidetracked into treating the symptoms of diseases and not the causes. Excess weight is a symptom of liver dysfunction and not solely due to the number of calories you consume.
We have been attacking the symptoms of weight excess with fad diets, obsessional high impact aerobics, stomach stapling and toxic drugs, such as appetite suppressants, laxatives and diuretics. We have failed to consider the underlying cause of LIVER DYSFUNCTION and indeed we have virtually ignored the hardest-working organ in the body, with dire consequences.
Dr. Sandra Cabot's books on the liver show us these consequences - not just weight problems, but a higher incidence of cardiovascular and degenerative diseases that are the leading causes of death in modern affluent societies.
I received an E-mail from a reader of my books and websites, who was alarmed by the large number of hormone implants being inserted into beef animals where she worked in a stock and station agency. Steers are implanted with Hormonal Growth Promotants (HGP) which is justified by corporate statements, that tests have shown that a non-pregnant woman produces 54,000 times the amount of estrogen found in a 500 gram steak and that only a fraction of the amount used in human hormone replacement therapy is used in the implants that are put into animals. This is all very well, however, it is still increasing the workload of the liver, which over a long period of time may cause hormonal imbalances in those who eat beef regularly. We must ask ourselves why is the incidence of breast cancer so high, particularly in relatively young women? Surely it is better to eat meat from animals that roam free and happy in fresh green pastures that are not injected with potent hormones or fed concentrated stock feed to rush their growth?
The use of drugs to control and treat animal disease and to promote faster, more efficient growth of livestock is a common practice. An estimated 80 percent of U.S. livestock and poultry receive some animal drugs during their lifetime. Improper use of animal drugs may cause residues in the edible tissues of slaughtered animals that could be hazardous to consumers.
Most countries will have set MRL or Maximum Residue Limits. This is the amount of pesticide residue, heavy metals, hormone residues and natural toxins that the food ( eggs, meat or milk) are allowed to have and still be sold to the public for consumption. The MRL in Australia are set by the National Registration Authority for Agricultural and Veterinary Chemicals. In the USA they are set by authorities under the Food and Drug Administration. The key point is, just because a food substance complies in relation to the MRL , does not mean that the food is free from ALL contamination - just that it is at, or under, the level set by the particular authority deemed to be safe. MRLs are often set on a national basis to meet the requirements of a particular country. However, pests and pest pressure can vary between countries, as can chemicals used and agronomic practices. The lists of MRL values applying in different countries can therefore be quite different.
There is also the point that despite the existence of these laws, it does not guarantee that all farmers and growers comply 100% . Principle causes of excessive drug residues are failure to observe drug label withdrawal periods before slaughter or processing, or failure to withhold milk after dosing of herds with drugs such as the treatment of bovine mastitis with large doses of penicillin which requires a withholding period before the residues in milk are reduced to acceptable levels. Other causes may include failure to follow other drug label directions, poor feed manufacturing practices, and human negligence.
There are many chemicals (e.g., trace metals, industrial chemicals, and mycotoxins) that may be inadvertently present in animal tissues yet have no established safe concentrations. This of course does not mean that these substances are not harmful.
It is a fact of life that pesticides, herbicides and hormones are used in food production. Although the regulatory levels set by authorities provide some control over residues - it is not the 'be all and end all'. The liver is again highlighted as vital, as it is the organ that metabolizes these substances and excretes them from the body.
The liver is the gateway to the body and in this chemical age its detoxification systems are easily overloaded. Thousands of chemicals are added to food and over 700 have been identified in drinking water. Plants are sprayed with toxic chemicals, animals are injected with potent hormones and antibiotics and a significant amount of our food is genetically engineered, processed, refined, frozen and cooked. All this can lead to destruction of delicate vitamins and minerals, which are needed for the detoxification pathways in the liver. The liver must try to cope with every toxic chemical in our environment, as well as damaged fats that are present in processed and fried foods.
The Liver Filter
The liver is the cleanser and filter of the blood stream and is of vital importance. It is the largest organ in the body and has an enormous amount of blood flowing through it every minute of our lives. It is between 21 - 22.5 cm in its greatest diameter, 15 - 17.5cm in its greatest height and 10 - 12.5 cm in its depth, weighing around 1200 - 1600 gms
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| A Normal Healthy Liver |
What are the functions of the liver?
• It is responsible for the production of bile which is stored in the gallbladder and released when required for the digestion of fats.
• The liver stores glucose in the form of glycogen which is converted back to glucose again when needed for energy.
• It also plays an important role in the metabolism of protein and fats. It stores the vitamins A, D, K, B12 and folate and synthesizes blood clotting factors.
• Another important role is as a detoxifier, breaking down or transforming substances like ammonia, metabolic waste, drugs, alcohol and chemicals, so that they can be excreted. These may also be referred to as "xenobiotic" chemicals. If we examine the liver under a microscope, we will see rows of liver cells separated by spaces which act like a filter or sieve, through which the blood stream flows. The liver filter is designed to remove toxic matter such as dead cells, microorganisms, chemicals, drugs and particulate debris from the blood stream. The liver filter is called the sinusoidal system, and contains specialized cells known as Kupffer cells which ingest and breakdown toxic matter.
The liver filter can remove a wide range of microorganisms such as bacteria, fungi, viruses and parasites from the blood stream, which is highly desirable, as we certainly do not want these dangerous things building up in the blood stream and invading the deeper parts of the body. Infections with parasites often come from the contaminated water supplies found in large cities, and indeed other dangerous organisms may find their way into your gut and blood stream from these sources. This can cause chronic infections and poor health, so it is important to protect your liver from overload with these microorganisms. The safest thing to do is boil your water for at least 5 minutes, or drink only bottled water that has been filtered and sterilized. High loads of unhealthy microorganisms can also come from eating foods that are prepared in conditions of poor hygiene by persons who are carrying bacteria, viruses or parasites on their skin. Foods, especially meats that are not fresh or are preserved, also contain a higher bacterial load, which will overwork the liver filter if they are eaten regularly.
Recently, it has become very fashionable for people to detoxify their bodies by various means, such as fasting or cleansing the bowels with fiber mixtures. Fasting can by its extreme nature, only be a temporary method of cleansing the body of waste products, and for many people causes an excessively rapid release of toxins which can cause unpleasant, acute symptoms. The liver filter, like any filter, needs to be cleansed regularly, and it is much easier and safer to do it everyday. This is easily and pleasantly achieved by adopting a daily eating pattern that maintains the liver filter in a healthy clean state. By following the methods and guidelines on this site, you will be able to keep the liver filter healthy and clean. Although it is important to keep the intestines moving regularly and to sweep their walls with high fiber and living foods, it is important to remember that the bowels are really a channel of elimination and not a cleansing organ per se. In other words the bowels cannot cleanse, filter or remove toxic wastes from the blood stream.
It is only the liver that can purify the blood stream and we only have one liver.
Inside the liver cells there are sophisticated mechanisms that have evolved over millions of years to break down toxic substances. Every drug, artificial chemical, pesticide and hormone, is broken down (metabolized) by enzyme pathways inside the liver cells. Many of the toxic chemicals that enter the body are fat-soluble, which means they dissolve only in fatty or oily solutions and not in water. This makes them difficult for the body to excrete. Fat soluble chemicals have a high affinity for fat tissues and cell membranes, which are made of fatty substances. In these fatty parts of the body, toxins may be stored for years, being released during times of exercise, stress or fasting. During the release of these toxins, symptoms such as headaches, poor memory, stomach pain, nausea, fatigue, dizziness and palpitations may occur.
The body's primary defense against metabolic poisoning is carried out by the liver. The liver has two mechanisms designed to convert fat-soluble chemicals into water soluble chemicals so that they may then be easily excreted from the body via watery fluids such as bile and urine.
How the Liver Detoxifies Harmful Substances
Basically there are TWO major detoxification pathways inside the liver cells, which are called the Phase 1 and Phase 2 detoxification pathways.
Toxin list: metabolic end products, micro organisms, contaminants/pollutants, insecticides, pesticides, food additives, drugs, alcohol.
Phase One - Detoxification Pathway
An example of the phase one pathway is the Cytochrome P-450 mixed function oxidase enzyme pathway. These enzymes reside on the membrane system of the liver cells (called Hepatocytes).
Human liver cells possess the genetic code for many isoenzymes of P-450 whose synthesis can be induced upon exposure to specific chemicals. This provides a mechanism of protection from a wide variety of toxic chemicals.
To put it simply, this pathway converts a toxic chemical into a less harmful chemical. This is achieved by various chemical reactions (such as oxidation, reduction and hydrolysis), and during this process free radicals are produced which, if excessive, can damage the liver cells. Antioxidants (such as vitamin C and E and natural carotenoids) reduce the damage caused by these free radicals. If antioxidants are lacking and toxin exposure is high, toxic chemicals become far more dangerous. Some may be converted from relatively harmless substances into potentially carcinogenic substances.
Excessive amounts of toxic chemicals such as pesticides can disrupt the P-450 enzyme system by causing over activity or what is called 'induction' of this pathway. This will result in high levels of damaging free radicals being produced.
Substances that may cause overactivity (or induction) of the P- 450 enzymes:
Caffeine, Alcohol, Dioxin, Saturated fats, Organophosphorus pesticides, Paint fumes, Sulfonamides, Exhaust fumes, Barbiturates
The family of P-450 enzyme systems is quite diverse, with specific enzyme systems being inducible by particular drugs, toxins or metabolites. It is this characteristic that has allowed the development of special tests to check the function of the various pathways - see liver tests. The substrate is the substance that is acted upon by the enzyme.
| Substrates of cytochrome P-450 enzymes: |
Theophylline, caffeine, phenacetin, acetaminophen, Lidocaine, erythromycin, cyclosporin, ketoconazole, testosterone, estradiol, cortisone, Alprenolol, bopindolol, carvedilol, metoprolol, propranolol , Amitriptyline, clomipramine, desipramine, nortriptyline , Codeine, dextrometh- orphan, ethylmorphine, 4-methoxyamphetamin Family Phenytoin, ibuprofen, naproxen, oxicam drugs, S-warfarin, Diazepam, hexobarbitone, imipramine, omeprazole, alcohol, chlorzoxazone, enflurane. |
Phase Two - Detoxification Pathway
This is called the conjugation pathway, whereby the liver cells add another substance (eg. cysteine, glycine or a sulphur molecule) to a toxic chemical or drug, to render it less harmful. This makes the toxin or drug water-soluble, so it can then be excreted from the body via watery fluids such as bile or urine.
Major Phase II pathways include glutathione, sulfate, glycine, and glucuronide conjugations. Individual xenobiotics and metabolites usually follow one or two distinct pathways. Again, this makes testing of the various pathways possible by challenging with known substances.
The conjugation molecules are acted upon by specific enzymes to catalyse the reaction step. Through conjugation, the liver is able to turn drugs, hormones and various toxins into excretable substances. For efficient phase two detoxification, the liver cells require sulphur-containing amino acids such as taurine and cysteine. The nutrients glycine, glutamine, choline and inositol are also required for efficient phase two detoxification. Eggs and cruciferous vegetables (eg. broccoli, cabbage, Brussels sprouts, cauliflower), and raw garlic, onions, leeks and shallots are all good sources of natural sulphur compounds to enhance phase two detoxification. Thus, these foods can be considered to have a cleansing action. The phase two enzyme systems include both UDP-glucuronyl transferase (GT) and glutathione-S-transferase (GSH-T). Glutathione is the most powerful internal antioxidant and liver protector. It can be depleted by large amounts of toxins and/or drugs passing through the liver, as well as starvation or fasting. Phase II reactions may follow Phase I for some molecules or act directly on the toxin or metabolite.
Substrates of the glycine pathway
Salicylates and benzoate are detoxified primarily through glycination. Benzoate is present in many food substances and is widely used as a food preservative. Many other substances are detoxified as well via the glycine conjugation pathway. Patients suffering from xenobiotic overloads and environmental toxicity may not have sufficient amounts of glycine to cope with the amount of toxins they are carrying.
Substrates of the sulfation pathways
Neurotransmitters, steroid hormones, certain drugs such as Acetaminophen (also known as paracetamol) ,and many xenobiotic and phenolic compounds.
Substrates of glucuronidation
Polycyclic aromatic hydrocarbons, steroid hormones, some nitrosamines, heterocyclic amines, some fungal toxins, and aromatic amines. It also removes "used" hormones, such as estrogen and T4 (thyroid hormone) that are produced naturally by the body.
Toxic Overload
If the phase one and two detoxification pathways become overloaded, there will be a build up of toxins in the body. Many of these toxins are fat soluble and incorporate themselves into fatty parts of the body where they may stay for years, if not for a lifetime. The brain and the endocrine (hormonal) glands are fatty organs, and are common sites for fat-soluble toxins to accumulate. This may result in symptoms of brain dysfunction and hormonal imbalances, such as infertility, breast pain, menstrual disturbances, adrenal gland exhaustion and early menopause. Many of these chemicals (eg. pesticides, petrochemicals) are carcinogenic and have been implicated in the rising incidence of many cancers.
Most people would be unaware of the concept of the action of everyday chemicals as 'endocrine disruptors'. Our body reacts to them as if they were hormones produced in us or intentionally taken. They are hormonally active substances which means they can cross placental barriers and may have profound effects on the offspring of animals which ingest them. The types of chemicals that mimic hormones are as diverse as pesticides, herbicides, fertilizers, plastics, solvents, and more.
Richard M. Sharpe, research physiologist with the Medical Research Council in Edinburgh, hypothesized that estrogens in the environment can disrupt the body's hormonal balance, possibly explaining phenomena such as earlier puberty, lowered sperm counts, and other reproductive anomalies exhibited by late 20th century females and males of many species. "Of all the hormones we know, the estrogens are the most potent. You can get biological effects from estrogen at levels so low you cannot measure them by any analytical method," Sharpe has found through his research. Other environmentalists and scientists postulate effects ranging from behavioral changes to motor, intellectual, and immune system impairment.
Ingestion or exposure to these substances can have dramatic effects on our state of health and the development of disease.
From The journal of complementary medicine march/april 2003 Vol2 no2:
In estrogen sensitive breast tumors it is important to regulate estrogen metabolites. There are 2 pathways which estrogen may be metabolized to oestrone. Altering the ratio of these two pathways has a dramatic effect on the long term survival of the patient. One pathway (C16) that is influenced by xenoestrogens eg: DDT and other pesticides and herbicides, provides markers for the increased risk of breast cancer. The other pathway (C2) is associated with a decreased risk of malignancy and is stimulated by the brassica family. (cabbage, cauliflower, Brussels sprouts, broccoli).
Pesticides
Pesticide is a term encompassing a wide variety of substances used in food production to control undesirable plant, insect, and other animal populations. These may include Chlorinated hydrocarbon pesticides, organophosphates, plus others on an "as needed" basis Many factors influence the persistence of pesticide residues in or on food. Residues may vary depending on the time between application and harvest, exposure to wind, rain, or sunlight, and the amount removed during processing (washing, peeling or cooking). Residues of pesticides can be found in many foods including breast-milk. Particular care in assessing the safety of exposure to pesticide residues needs to be exercised for pesticides which could be transferred from food into breast milk and result in a relatively high exposure level to babies, and also to those which leave residues in foods which may be consumed in relatively higher amounts by children.
Antiparasitics
Certain antiparasitics are fat soluble and will therefore persist in the fat component of foods containing animal fats such as dairy products and the fatty parts of meat. This means that foods such as fatty meats, cheese, butter and other dairy products should be avoided when trying to lower the workload for the liver. Similarly, it is these fat soluble toxins that may be tucked away in our fatty deposits.
Hormones
Hormones may be used to accelerate the growth rate of animals so that they can reach market earlier. They may also be used to improve or manage breeding programs. Natural and synthetic hormones are used. In some countries inadequate monitoring and education of the users of these hormones resulted in meat (both beef and chicken) and eggs to contain high levels of hormonal residues. This caused health concerns in the population consuming these foods including early puberty, cessation of puberty, breast development and ovarian cysts in young girls. Some scientists believe that the potential for hormones in food to cause metabolic and reproductive problems in humans needs further evaluation.
Hormonal Growth Promotants (HGP) are in implants designed to slowly release small quantities of hormones from the ear of cattle to the tissues. The hormone is similar to natural hormone found in animal species and humans or they mimic the effects of natural hormones. They can also act as hormone replacements for castrated animals (steers, spayed heifers) HGPs increase weight gain and the efficiency of food conversion in cattle.
Use of Hormones and Growth Promotants in Australia
Some HGP have been approved for use in Australia since 1979. The levels of these hormones in meat, milk etc are tested for in the Commonwealth Government’s National Residue Survey program.
Australian authorities state that no growth promoting hormones are used in the rearing of chickens. Estrogens were once administered to young male chickens as a hormonal alternative to castration to produce sterile roosters, however this practice was banned in Australia in the early 1960s. Some antibiotics are used therapeutically if a chicken has some sort of disease that can't be cured by normal methods. These are used under veterinary prescription. But antibiotics are used in products called digestion enhancers also known as growth promotants. What these antibiotics do is adjust the gut in the chicken so it gets rid of the unwanted bacteria, so the bacteria that aid the digestion of the chicken's food can proliferate. They are used specifically for growth promotion.
Use of hormones in USA
Most of the beef raised in the United States today is produced with the use of hormones of some kind and have been used for more than 40 years. Low levels of hormones, delivered through pellets placed in animal's ears, are commonly used as growth enhancers. The arguments for using hormones in meat production are mostly economic. With hormones, conversion of feed into meat is more efficient, thus theoretically lowering producer's costs. In the United States, there are six FDA-approved hormones: three naturally occurring hormones (estradiol, progesterone, and testosterone) and their synthetic surrogates (zeranol, melengestrol acetate and trenbolone acetate). There is an ongoing dispute on the subject of hormones used in cattle. The US government and beef growers associations maintain that the use of hormones as growth promoters is safe and has no adverse effect on human health. However In 1988, the EU (European Union) prohibited of the use of oestradiol 17 , testosterone, progesterone, zeranol, trenbolone acetate and melengestrol acetate (MGA) for growth promotion in farm animals. This prohibition applies to Member States and imports from third countries alike. This had major implications for trade and has caused an ongoing dispute. As a result the United States has opposed the EU prohibition on the use of these hormones since its implementation.
Use of hormones in dairy cattle in the US
BGH stands for Bovine Growth Hormone, a substance naturally produced by the pituitary gland of the cows. It is otherwise known as Bovine Somatotropin (BST). The actual hormone injected into cattle is rBGH. R stands for recombinant and means that it is a synthetic version of the natural hormone. This hormone is marketed under the brand name "Posilac" Monsanto is the only company that markets this hormone to the dairy industry. U.S. Food and Drug Administration approved Posilac in 1993. The hormone is used to increase milk yields from the cow - however it can cause serious health concerns for the animal which can then affect its milk supply in other ways - namely increased udder infections leading to higher levels of pus and infective matter in the milk.
Monsanto prints the following on the warning label on each package of the hormone: "Cows injected with Posliac are at an increased risk of clinical mastitis (which results in visibly abnormal milk). The number of cows effected with clinical mastitis and the number of cases per cow may increase. In addition, the risk of sub-clinical mastitis (milk not visibly abnormal) is increased. In some herds, use of Posilac has been associated with increases in somatic cell counts…Use of Posilac is associated with increased frequency of use of medication in cows for mastitis and other health problems.…"
Since 1993, there has been a National Drug Residue Milk Monitoring Program to test raw milk for the presence of antibiotics—but only for antibiotics in the penicillin (betalactum) family. Only about four times a year do federal officials spot check samples of pre-processed raw milk from any given state, looking for residues of an antibiotic outside the penicillin family of drugs.
Hormone use in dairy cattle in Australia
A number of hormonal products are commercially available for use in the improvement of reproductive performance of dairy cattle.
Prostaglandin
This hormone is injected into the cow. Use: synchronization - to bring a group of heifers all into 'season' at once. Improving fertility, Retained foetal membranes, ovarian cysts in the cow, treatment of non-cycling cows, infections of uterus and induced abortion.
Progesterone
Vaginal implants (CIDR®) and a system of ear implant and intramuscular injection (CRESTAR) are used in Australia. Only CIDR is registered in Australia for use in lactating dairy cows.
Use: Synchronization of cows to all be on heat at once, improved conceptions rates, stimulating the breeding state in non-cycling heifers and cows.
Gonadotrophin Releasing Hormone (GnRH)
Use: Improving conception rates, Ovarian cysts. Commercially available GnRH products are either identical to the naturally occurring hormone or synthetic.
Oestrogen
Used for preventing conception.
Corticosteroids
Use : Inducing calving, aborting calves, ovarian cysts - Corticosteroids may be used in cases of cystic ovaries that do not respond to other treatments.
Bovine somatotrophin (also called rBGH)
Bovine somatotrophin is NOT used in Australia but is approved for use in dairy cattle in the US (see above) and several other countries for increasing milk production.
From Research Notes " Hormone treatments for better reproductive performance" Dairy Research and Development Corporation.
Antibiotics
This is a group of drugs approved for use in animal led to stimulate growth and improve feed efficiency (so that less feed is required for growth) and also to reduce infection and stock loss. There is no doubt that antibiotics are used widely in the Australian livestock industry. The continuous in-feed use of antibiotics began in agriculture in the early 1950s, especially in the pig, poultry, cattle and aquaculture industries. They are administered to the animal via coating of feed grains, drenching, injection or addition to water.
The use of antibiotics in food animals has been a human health concern since the 1970s when American FDA first called for restrictions on antibiotics used in animal feed.
Resistance of dangerous bacteria is proportional to use therefore overuse of antibiotics in animals, especially as growth promoters, poses unnecessary dangers to human health via the food chain. Resistance to antibiotics is not harmful in itself, but it may create health hazards if humans become infected with a strain of micro-organism that cannot be controlled by available antibiotics. In other words, antibiotics not working against bacteria that they've managed to kill before.
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