EVERYTHING ABOUT

liver health

Every week I am posting about  everything you need to know about hormones. This weeks topic is about liver health.

Did you know …

  • The human liver is a very vital organ.
  • The Chines call the liver the general
  • It is so important that we cannot survive if it stops functioning for just one single day.
  • It is underappreciated, hardworking and one of the least thought about organs
  • Largest glandular organ of the human body and the second largest organ besides our skin.
  • A reddish brown organ with 2 lobes
  • Weighs about the same as a small Chihuahua, roughly 3 pounds and is about the size of a football.
  • Looks and feels much like calf liver, in fact every animal has one
  • It’s located just beneath your right rib cage.
  • Multifunctional simultaneously performing over 100’s of important jobs, such as fighting infection, manufacturing proteins and hormones, and clotting blood.
  • Its main job is to filter the blood that comes from the digestive tract, before it hits the rest of your body
  • Filtering approx. 1.5 litres per minute.
  • At its fullest, the liver holds approximately 10 percent of the blood in your body
  • It stocks iron and other vitamins and nutrients from the food we eat keeping them for when we need them.
  • The liver is the major detoxifier of internal and external molecules such as hormones, alcohol, drugs etc.
  • The liver is a major regulator of blood glucose and ammonia levels
  • The liver produces bile essential for fat digestion and excretion of by-products from liver detoxification
  • Your body needs about 1gram / .03 ounces of liver for every kilogram / 35 ounces of body weight in order to effectively do its job, so if you are overweight your liver may not be able to keep up
  • The liver produces blood during foetal development and acts as a blood recycler during adulthood.
  • 10% of the liver is made up of fat more than this you have fatty liver – alcoholic or non-alcoholic makes no difference – fat is fat
  • The liver has the amazing ability to regenerate itself, making liver transplant possible.
  • When people donate half their liver, the remaining part of the liver regenerates the section that was removed.
  • The liver is fully regenerated in 2 weeks
  • The first human liver transplant was performed by Dr. Thomas E. Starzl in 1963
  • Every day, over 40 people die from liver disease in the UK.
  • Liver disease and liver cancer together caused 2.5% of deaths in England in 2018
  • Liver disease is the third leading cause of premature death in the UK
  • 90% of liver disease is preventable
  • Diagnosed is often too late due to few if any symptoms, often too late for lifestyle changes or intervention
  • Since 1970, deaths due to liver disease have increased by 400%.
  • In comparison death due to heart disease and cancer have either remained stable or decreased.

Meet Sally and get to know all about liver health

Intro liver health

What does the liver detoxify?

What does the liver detoxify?

Tell-tale signs of poor liver function

Liver jobs 101

What is bad for the liver apart from alcohol

Listen to Sallys radioshow about liver health

Liver 101

The liver controls most chemicals in the body.

Liver cells known as hepatocytes, filter blood coming from the gut acting as little sorting centres, determining:

  • which nutrients should be processed
  • what should be stored
  • what should be eliminated via the stool and or urine
  • what should go back to the blood

Other jobs

  • stores fat-soluble vitamins
  • stores vitamin B12
  • stores the minerals copper and iron
  • releasing the above when the body needs them
  • produces an estimated 800 to 1,000 ml of bile each day for the breakdown an absorption of fats in the gut
  • produces proteins, such as
  • plasma proteins eg. CRP
  • blood clotting proteins, called coagulation factor, such as factor V111
  • carrier proteins eg. SHBG that carries sex hormones specifically estrogen and testosterone
  • hormones eg. FGF21, a protein hormone that induces mitochondrial oxidation of fatty acids, hepatic gluconeogenesis, and ketogenesis in response to fasting
  • prohormones eg. Angiotensinogen, when converted to angiotensin causes vasoconstriction and release of aldosterone, in effect increasing blood pressure
  • apolipoproteins, which create the LDL and HDL cholesterol ‘busses’
  • breaks down proteins creating ammonia
  • turns ammonia and urea for excretion through the kidneys as urine
  • removes alcohol from the blood
  • converts glycogen to glucose
  • stores extra glucose as glycogen or fat
  • removing potential toxins from the bloodstream, such as alcohol, medication, pesticides, used hormones, neurotransmitters, etc
  • makes internal and external toxins less harmful to the body and
  • when harmful substances are broken down into bile, they are incorporated into the stool and leave the body.
  • when harmful substances are broken down and the waste products enter the bloodstream, they are filtered in the kidneys and leave the body in the urine,.
  • creates immune system factors that can fight against infection
  • breaks down old and damaged red blood cells
  • breaking down saturated fat produces and breaks down cholesterol

Tell-tale Signs of a Poor Liver Function

  • Little to no appetite.
  • Disturbed sleep
  • Poor memory.
  • Tired all the time.
  • Itchy skin.
  • Yellowing of the eyes or skin – jaundice
  • Sudden weight gain.
  • Sudden weight loss
  • Palms of the hands turn red.
  • Enlarged breast
  • Changes in your personality.
  • Bruise easily
  • Swelling of your legs or ankles.
  • Easily confused
  • Trouble focusing
  • More aches and pains than usual
  • Abdominal pain and swelling / bloating
  • Urine is a darker than usual
  • Regularly get the chill
  • Eyes and or mouth are dry
  • Pale stool colour
  • Nausea and or vomiting
  • Diarrhoea
  • Vomiting blood
  • Blood in the stool
  • Changes in mental status
  • Musty or sweet breath odor
  • Movement problems
  • General feeling of being unwell

 

The Chinese Interpretation of the Liver

  • The liver is “the general of the army”.
  • Is one of the yin organs
  • Partner with the yang organ the Gallbladder
  • Function is regarded to be strongest between 1–3 am.
  • Spring is regarded as liver time
  • Governs “unclogging and deflation” of qì / energy and emotions.
  • The free flow of qì in turn will ensure the free flow of blood, digestion, and water, where stagnation of that flow will cause pain.
  • Associated with anger, depression, resentment, frustration, irritability, bitterness, and “flying off the handle”
  • Positive emotions associated with the liver are generosity and kindness. This is why people say you can often tell that someone is a kind person by simply looking into their eyes.
  • Stores blood
  • Opens into the eyes
  • Governs the tendons, ensuring they are properly nourished and not too tense or gristly
  • Reflects in the nails
  • Houses the hún the “Ethereal Soul”
  • Is associated with tears or watery eyes
  • Its blood is responsible for the repetitive cycles of human life, for example menstruation
  • Governs a woman’s health more than any other organ.

Detoxification in a Nutshell

  • When it comes to detoxification, the liver is king (or general as the Chinese say)
  • The liver basically decides which substances remain in the body and which are excreted.
  • Enormous amounts of blood flow through the liver every single minute.
  • The liver filter is designed to remove toxins such as dead cells, chemicals, drug residues and other fat soluble molecules such as hormones from the blood as well as microorganisms such as bacteria, fungi, viruses, and parasites.
  • Some of these substances are a common part of the body’s biochemistry, which are produced continuously, such as hormones, transmitter substances, etc. others are absorbed in the gut from the diet, inhaled through our breathing or absorbed through the skin
  • Detoxification takes place in two phases, the purpose of which is to convert fat-soluble substances to water soluble substances, which can easily be excreted via the bile, then through the stools or via the kidneys, as urine.
  • Phase 1 is responsible overall for converting the fat-soluble substances into an oxidized version, which is passed on to phase 2, which is responsible for adding a variety of nutrients that neutralize oxidation and make the molecules water-soluble.
  • In short, the conversion of “toxic, old, used, fat-soluble substances” into inactive, water-soluble substances ready for excretion.
  • However, with imbalances and deficiencies, the intermediate oxidized molecules can create symptoms and disease, and end up being stored.

Phase 1

  • Internal and External fat-soluble substances are oxidized
  • Oxidation creates free radicals, which may be more toxic than the parent molecule.
  • These new substances are called “metabolites” which must be made water-soluble, otherwise they come back into circulation.
  • Phase 1 uses various oxidising enzymes

What Controls Phase 1?

  • Genetics, which can both increase or decrease the enzyme activity
  • Increased enzymes activity may lead to increased amounts of phase I metabolites
  • Decreased enzyme activity leads poor clearance of the original molecules, called substrates, such as medications which can then work longer in the body, which may increase the toxicity and or effect of a medication. Grapefruit can slow phase 1 and should not be ingested with certain medications – as stated on the referral note of many medications
  • Phase 1 activity decreases with age, just as blood circulation through the liver decreases with aging, which means that liver detoxification becomes less effective which is the cause of many symptoms and diseases, such as breast cancer.

Phase 1 enzymes

  • At least 10 families of Phase I enzymes have been identified in humans.
  • Cytochrome P450 enzymes involved in metabolism of medication, xenobiotics, and endogenous molecules, such as steroid hormones, fat soluble vitamins, and much more
  • Humans have 57 genes, 18 families of cytochrome P450 genes and 43 subfamilies, such as
  • CYP1A2

– Appox. 15% of the enzymes in phase 1

– Breaks down of several types of drugs, Estradiol/E2 and Estrone/E1 to their hydroxy forms 2-OH-E1 and 2-OH-E2, which are regarded to be the least carcinogenic if at all.

– Inhibited by inflammation, grapefruit juice, Berberine, Resveratrol, Alcohol, Artemisia/wormwood, antifungals, calcium channel blockers, beta blockers and PPI/stomach acid blockers.

– Promoted by Environmental substances/xenobiotics, such as PAHs, PCBs, phthalates, BPA.s, xenoestrogens, smoking, charred food, St. John’s Wort

  • CYP1B1

– Responsible for the degradation of several types of drugs, as well as Estradiol/E2 and Estrone/E1 to their hydroxy forms 4-OH-E1 and 4-OH-E2, which are regarded the most carcinogenic

– Inhibited by DIM, Quercitin, Grapefruit juice, Berberine, Resveratrol, Artemisia/wormwood, antifungals, calcium channel blockers, beta blockers and PPI/stomach acid blockers

– Promoted by Environmental substances/xenobiotics, such as PAHs, PCBs, phthalates, BPA.s, xenoestrogens, smoking, charred food, St. John’s Wort

  • CYP3A4

– metabolises approx. 60% of all prescription drugs, is the most commonly used phase 1 pathway, also breaks down Estrone/E1 to 16-OH-E1 and Estradiol/E2 to 16-OH-E2/Estriol/E3 Estrogens

– Inhibited by inflammation, grapefruit juice, Berberine, Resveratrol, Artemisia/wormwood, antifungals, calcium channel blockers, beta blockers and PPI/stomach acid blockers

– Promoted by Alcohol, Caffeine in soda, but not in coffee, Environmental substances (xenobiotics), such as PAHs, PCBs, phthalates, BPA.s, xenoestrogens, smoking, charred food, St. John’s Wort

Testing Phase 1 function

Urine Test

  • DUTCH complete gives an indication of some phase 1 activity 
  • Organix Comprehensive tests various phase 1 markers

Gene test

  • DNA Health tests various phase 1 enzymes
Find DUTCH Complete test here
Find Organix Comprehensive test here
Find DNA Health test here

Phase 2

  • Conjugation can be described as ‘packing or wrapping’ the different oxidised metabolites, where different enzymes and nutrients are used as the ‘wrapping paper’
  • Making new water soluble molecules ready for excretion through the urine or stools
  • Through conjugation, it is possible for the liver to convert drugs, hormones and other fat-soluble substances into water-soluble substances.
  • Phase 2 enzymes play an essential role in the metabolism of hundreds of foreign substances, as well as regulating the metabolism of the various endogenous/internal biologically active substances and thus maintaining homeostasis.

What Controls Phase 2?

  • Genetics, which can both increase or decrease the enzyme activity
  • Decreased enzyme activity leads to the inability to make the oxidised molecules water soluble, which will be recycled
  • Nutrient deficiency can also lead to poor conjugation
  • Poor conjugation increases the risk for cancer
  • Phase 2 activity decreases with age, just as blood circulation through the liver decreases with aging, which means that liver detoxification becomes less effective which is the cause of many symptoms and diseases, such as breast cancer.

Phase 2 enzymes

  • Glucuronidation with Enzyme UDP-glucuronosyltransferase (UGT)

– wrapping in glucuronic acid

– most commonly used conjugation pathway

– inhibited by NSAID

– Jerusalem artichokes contain large amounts of glucuronic acid

  • Sulfation with Enzyme Sulfotransferases (SULTs)

– Wrapping in sulphur

– Eggs, Cruciferous vegetables (broccoli, cabbage, cauliflower, Brussels sprouts), garlic, onions, leeks and Brazil nuts contain sulphur

  • Glutathione conjugation with Enzyme Glutathione S-transferases (GST)

– Wrapping in Glutathione, the body’s most powerful internal antioxidant

– Excess toxins and longer periods of hunger/fasting can deplete Glutathione depots

Cabbage, broccoli, spinach, avocado, Brussels sprouts, asparagus contain glutathione

– Be careful cooking can reduce the amount of Glutathione by 30-60%, and canned vegetables contain no Glutathione

– Supplement with Essential PRO Liposomal Glutathione. 

AND/OR

– Broccolox® Capsules

  • Acetylation with Enzyme N-acetyltransferase (NAT1 and NAT2)

– Wrapping in acetyl aka vinegar

– Add vinegar to salad dressings

– Drink apple cider vinegar

  • Methylation

– Wrapping in methyl

– There are several methyl enzymes

– Liver and other organ meats, eggs, seafood, beet, mushrooms, nuts support methylation

– Green tea may inhibit

  • Amino acids conjugation with Cysteine, Glycine and Taurine

– Wrapping in cysteine, glycine or taurine

– Poultry, especially the skin, eggs, beef, seafood, dairy products ,whole grains, legumes gelatine powder or bone-broth contain cysteine, glycine and taurine

– Buy Bone broth.

 

Testing Phase 2 function

Urine Test

Gene test

 

 

Detox Speed

The two detoxification phases should preferably be in harmony.

Fast phase 1 and a Slow phase 2

  • Leads to the build-up of oxidised intermediate molecules which increases oxidative stress.

Slow phase 1 and slow phase 2

  • Slow phase 1 leads to an increase of the original fat-soluble substances, such as medications, hormones and other toxins, still in circulation. Resulting in increased activity and effect of the medication, hormone etc. The sluggish phase 2 leads to more oxidised molecules coming back in circulation.

Toxic Overload

  • If phase 1 or 2 detoxification processes become overloaded, the toxins can accumulate in the body.
  • The brain and endocrine glands are commonly used for storage, which can lead to dysfunction of the brain and nervous system and hormonal imbalances, such as infertility, chest pain, menstrual disorders, adrenal fatigue and early menopause.
  • Many of these substances (eg. pesticides, petrochemicals) are known to be carcinogenic and are implicated in the increasing incidence of the many cancers.

The Liver Detoxes what?

Externals Sources

  • External / foreign substances called xenobiotics
  • Insecticides and pesticides
  • Food preservatives, additives, textiles, creams, etc.
  • Hormone residues in food
  • Medication
  • Alcohol
  • Fats via diet
  • Fats via creams and lotions

 

Internal sources

  • Hormones
  • Ammonia
  • End products of energy production
  • Cholesterol
  • Fat soluble vitamins A, D, E, K
  • Melatonin
  • Polyunsaturated fatty acids – Omega 3 and 6 fatty acids

Supplements that Support Liver Detox

Sulforaphane

  • Is a natural plant substance found in many cruciferous vegetables, such as broccoli (especially sprouts), cabbage, cauliflower, and kale.
  • Sulforaphane acts as a ‘pro-oxidant activating activates NrF2 – (Nuclear Core factor erythroid 2-related factor), which activates the genes involved in oxidative stress, inflammation, immune response, energy production, liver detoxification and methylation, and thus considered ‘the master switch’ and a multi-body protector.
  • When choosing sulforaphane supplements, it is important that they contain both glucoraphanin and myrosinase and NOT sulforaphane. 
  • Sulforaphane is produced when glucoraphanin comes in contact with water which activates myrosinase.
  • Sulforaphane is active for approx. 25 minutes.
  • Optimal levels approx. 10 -20 gm sulforaphane per day.
  • This product produces 10gm per capsule.

Artichoke

  • Cynera scolymus, is a diuretic and laxative, and can reduce the loss of Glutathione

Dandelion

  • Taraxacum officinalis, especially the root (radix) is anti-inflammatory, anti-rheumatic, cleanses the blood and rebuilds a low blood percentage, immune-boosting, base-forming, promotes bile influx to digestion, rich in vitamins and minerals eg. A, C, iron, silica and potassium

Turmeric

  • Curcuma longa improves liver function as an powerful antioxidant which may stop liver damage by toxins.

Milk thistle

  • Silibum marianum, is anti-inflammatory and an antioxidant, protects against chemotherapy and increases glutathione.

Sulphur

  • MSM supplement

Stinging nettle

  • liver-strengthening, anti-inflammatory, alkaline, anti-rheumatic.

Schizandra

  • increases the synthesis of glutathione and protects liver cells against free radicals and increases the liver’s detoxification capacity, eg. by activating both the phase 1 and 2 enzymes. Also acts as an adaptogen (this last property can be beneficial in connection with liver cleansing, as the symptom of a stressed liver is often tiredness).

Golden rice

  • Solidago virgaurea, works as a diuretic and kidney tonic. Increases the excretion of toxins through the kidneys.

Ginger

  • Zingiber officinalis, promotes the tone and peristalsis of the intestinal tract and the passage time through the gastrointestinal tract. In addition, ginger promotes the absorption of other herbs and or protects them from degradation in the liver.

Greater burdock

  • Arctium lappa, has a strong detoxifying effect and is very useful in connection with imbalances that cause the accumulation of waste substances. The herb probably has a blood-purifying effect by stimulating the body’s excretory organs.

Supplements

The following supplements are excellent detoxification support:

Love your Liver

Love your Liver

  • Eat liver
  • Maintaining a healthy weight
  • Quit smoking
  • Regular movement & exercise
  • Avoid excess sugar, especially fructose
  • Avoid excess omega 6 fatty acids, plant and seed oils and margarines
  • Avoid processed food, they often contain excess omega 6 and high fructose corn syrup
  • Drink coffee – 2-3 cups a day can protect your liver from damage caused by too much alcohol or an unhealthy diet. Some research suggests it may lower your risk of liver cancer.
  • Sunlight aka Vitamin D low levels are bad for liver disease
  • Check your liver genetics and liver blood numbers for specific supplement support
  • Green tea may protect against liver cancer
  • Water – the solution to pollution is dilution
  • Vitamin E for antioxidant protection
  • Herbs like Rosemary

 

Liver Function Test

Liver Function Tests

Measures specific enzymes and proteins in your blood, urine and DNA.

Blood test

Alanine transaminase (ALT)

  • Alanine transaminase (ALT) is used by your body to metabolize protein.
  • If the liver is damaged or not functioning properly, ALT can be released into the blood. T
  • his causes ALT levels to increase.
  • A higher result than what’s typical on this test can be a sign of liver damage.
  • A higher result than typical on this test can be a sign of liver damage
  • Very high levels are most often caused by viral hepatitis, ischemic hepatitis, or injury from drugs or other chemicals.
  • It’s estimated that about 10 percent of people in the US have elevated ALT levels.

Aspartate aminotransferase (AST) test

  • Aspartate aminotransferase (AST) is an enzyme found in several parts of your body, including your:
  • Heart
  • Brain
  • Pancreas
  • Liver
  • muscles
  • When the liver is damaged, AST can be released into the bloodstream.
  • A high result on an AST test might indicate a problem with the liver or muscles.
  • Elevated AST without elevated ALT may indicate heart or muscle disease.
  • Since AST levels aren’t as specific of a marker for liver damage as ALT, it’s usually measured together with ALT to check for liver problems.
  • For example, a high AST:ALT ratio may indicate alcoholic liver disease.
  • If ALT, bilirubin, and ALP are also elevated, it may indicate liver damage.

Alkaline phosphatase (ALP) test

  • Alkaline phosphatase (ALP) is an enzyme found in your bones, bile ducts, and liver.
  • An ALP test is typically ordered in combination with several other tests.
  • An ALP test can be used to evaluate the bile duct system of the liver.
  • High levels of ALP may indicate liver inflammation, blockage of the bile ducts, or bone disease.

Gamma-glutamyl transferase (GGT) test

  • The GGT test is currently the most sensitive enzymatic indicator of liver damage and disease.
  • Experts don’t fully understand the role GGT plays, but it seems to have something to do with breaking down, changing, and moving proteins and other molecules in the body.
  • GGT is an enzyme found throughout the body, but it is mostly found in the liver.
  • When the liver is damaged, GGT may leak into the bloodstream.
  • High levels of GGT in the blood may be a sign of
  • liver disease
  • damage to the bile ducts
  • CV problems
  • fatty liver

Albumin test

  • Albumin is the main protein made by your liver.
  • It performs many important bodily functions, such as
  • nourishes your tissues
  • transports hormones, vitamins, and other substances throughout your body.
  • An albumin test measures how well your liver is making this particular protein.
  • High and low can levels indicate disease
  • Low levels can indicate cirrhosis, malnutrition, and cancer.

Bilirubin test

  • Bilirubin is a waste product from the breakdown of red blood cells.
  • It’s ordinarily processed by the liver.
  • It passes through the liver before being excreted through your stool.
  • A damaged liver can’t properly process bilirubin.
  • This leads to an atypically high level of bilirubin in the blood.
  • Certain inherited diseases can raise bilirubin levels, even when liver function works as expected.
  • Elevated bilirubin levels with elevated ALT or AST may suggest cirrhosis or hepatitis.

Total protein

  • measures the total amount of protein in the blood where high levels can indicate chronic infection or inflammation

Lactate dehydrogenase (LT) test

  • enzyme registering cellular damage by disease or injury.

Prothrombin time (PT) test

  • the time it takes for the blood to clot.

Other tests

  • Ultrasound
  • CT scan
  • Liver biopsy to evaluate fibrosis, fatty liver disease, or other liver conditions.

Urine testing

DNA testing

 

 

What is bad for your Liver besides Alcohol

  • Excess glucose and fructose
  • High-fructose corn syrup (soft drinks and sodas)
  • Excess Omega 6 fatty acids – plant and seed oils and margarines and trans fats
  • Excess herbal supplements – Herbs and all-natural therapy are processed by the liver in the same way as medications
  • Carrying excess kilos
  • Excess Vitamin A – such as acne medication
  • Excess acetaminophen / paracetamol
  • Contaminated – if you are injecting yourself make sure the needles are sterile

Alcohol 101

  • Alcohol, ethanol or ethyl alcohol is the ingredient found in beer, wine and spirits that causes drunkenness.
  • Is formed when yeast ferments the sugars in different food.
  • For example

– wine is made from the sugar in grapes

– beer from the sugar in malted barley (a type of grain),

cider from the sugar in apples

vodka from the sugar in potatoes, beets or other plants

  • Alcohol is classed as a ‘sedative hypnotic’ drug

– At high doses it depresses the central nervous system.

– At lower doses it can act as a stimulant,

– Can create feelings of euphoria and talkativeness

– Drinking too much alcohol at one session can lead to drowsiness, respiratory depression / breathing becomes slow, shallow or stops entirely, coma or even death

  • After an alcoholic drink is swallowed, the alcohol is rapidly absorbed into the blood
  • 20% absorbed through the stomach and 80% through the small intestine
  • Effects are felt within 5 to 10 minutes of drinking.
  • Peaks in the blood after 30-90 minutes
  • Carried to all the organs of the body.
  • 90% of alcohol metabolism / break down is performed by the liver creating water and carbon dioxide
  • The rest excreted

– through the lungs (allowing alcohol breath tests)

– through the kidneys (into urine)

– and in sweat.

  • The liver can only break down a certain amount of alcohol per hour, which for an average person is around one standard drink.
  • When alcohol is drunk faster than the liver can break it down blood alcohol rises, and the feeling of drunkenness occurs,
  • However blood alcohol doesn’t necessarily correlate with symptoms of drunkenness and different people have different symptoms even after drinking the same amount of alcohol.

Effect on overall health, well-being

  • Consuming alcohol can significantly affect your health, as well as your overall well-being and safety.
  • Alcohol is the third-leading preventable cause of death in the U.S., with 95,000 people dying each year from alcohol-related causes.
  • During the COVID-19 pandemic, national alcohol sales have increased 54%.

Between 2011 and 2015, the leading causes of death due to alcohol-related chronic conditions were:

  • Liver disease, including cirrhosis and cancer
  • Heart disease, abnormal heart rhythms, hypertension and stroke
  • Oral and upper digestive tract cancers
  • Breast cancer

Alcohol-impaired driving fatalities accounted for one-third of all driving fatalities

Alcohol and Liver Disease

  • Alcohol is regarded as a poison
  • The liver breaks down most of the alcohol to remove it from the body
  • This creates substances, called metabolites that are even more harmful than alcohol.
  • These substances can damage liver cells and cause serious liver disease.
  • Alcohol causes 4 out of 5 deaths from liver disease.

Liver disease caused by alcohol

Fatty liver (steatosis)

  • The most common type of alcoholic liver disease.
  • Almost all heavy drinkers develop fatty liver, which is the earliest stage of alcohol-related liver disease.
  • Fat builds up in the liver
  • This stops the liver from working properly.
  • Most people with fatty liver don’t have symptoms, although they can have an enlarged liver or mild discomfort in the upper right side of the abdomen.
  • This is a preventable disease, and it’s reversible if treated early.
  • The best treatment is for the patient to stop drinking

Inflammation of the liver (hepatitis)

  • About 1/3 of people with fatty liver will develop a mild or moderate inflammation of the liver.
  • Called alcoholic hepatitis.
  • The liver becomes inflamed and swollen
  • Liver cells are destroyed.
  • Hepatitis may not cause any symptoms at first, so you may not realise that you have it.
  • Depending on severity may give symptoms such as

– Jaundice

– Fever

– Nausea

– Vomiting

– Abdominal pain.

  • Can last for years and lead to more liver damage, unless the patient stops drinking.

Acute alcoholic hepatitis

  • Severe alcoholic hepatitis occurs suddenly, usually after binge drinking, and it can be life-threatening.
  • More serious and life-threatening inflammation of the liver can cause:

– a loss of appetite

– sickness

– tummy pain

– jaundice (yellow skin)

– liver failure

death

  • Around 1 in 3 people who develop severe alcoholic hepatitis will die.
  • The only way to possibly prevent this hepatitis from worsening and improving life expectancy is to stop drinking.

Scarring of the liver (cirrhosis)

  • Around 1 in 5 heavy drinkers have scarring of their liver (cirrhosis).
  • Usually develops after 10 or more years of drinking.
  • Scar tissue builds up and replaces most of the liver cells, it’s irreversible.
  • Early stages cirrhosis may not give any symptoms and the condition tends to progress and significantly damage the liver before it’s detected.
  • Over time, patients develop:

– Loss of appetite

– Fatigue

– Weakness

– Muscle wasting

– Muscle cramping

– Increased pressure in the liver

– Accumulation of fluids in the abdomen and legs

– Bleeding from veins of the oesophagus

Confusion, decreased concentration and changes in behaviour

– Enlarged spleen

  • Cirrhosis can lead to fatal liver failure or liver cancer. At this point, some patients may benefit from a liver transplant if they meet the criteria.
  • Most people who develop cirrhosis and liver failure don’t notice symptoms until it’s too late
  • There is no cure for cirrhosis. But cutting out alcohol completely gives a much better chance of survival.
  • You can live for decades with cirrhosis but complete abstinence from alcohol use is essential.

What Affects the Alcohol Effect

  • The ability of the liver to metabolise alcohol – genetics and nutrition play a role
  • The presence or absence of food in the stomach – food dilutes the alcohol and dramatically slowing its absorption into the bloodstream by preventing it from passing quickly into the small intestine
  • The concentration of alcohol in the beverage – goes without saying
  • How quickly alcohol is consumed – goes without saying
  • Body type – heavier and more muscular people have more fat and muscle to absorb the alcohol
  • Age sex, ethnicity – women have a higher blood alcohol after drinking the same amount of alcohol than men – due to differences in metabolism and absorption – some ethnic groups have different levels of a liver enzyme responsible for the break-down of alcohol
  • How frequently a person drinks alcohol – someone who drinks often can tolerate the sedating effects of alcohol more than someone who only drinks occasionally

Is there a Safe Level of Drinking

  • Reaction to the adverse effects of alcohol varies depending on age, gender, genetic background and other medical issues.
  • Women tend to develop liver disease faster than men, despite consuming the same amount of alcohol (or less) over the same length of time.
  • Beer and wine are not safer than spirits. Alcohol is alcohol,
  • One standard drink is equivalent to

– 12 ounces / 285 mL of full strength or 425 mL of low strength beer.

– 5 ounces / 100ml of wine

– 5 ounces / 30ml. of spirits.

– All have the same amount of alcohol.

How much

  • 2 drinks per day for men
  • 1 drink per day for women
  • Higher-risk drinking is

– 3 or more drinks per day for men

– 2 or more drinks per day for women.

  • Binge drinking is defined as consumption of

– 5 or more drinks within 2 hours for males

– 4 or more drinks within 2 hours for women.

Questions? Please don't hesitate to contact me