Liver Health
In The News
March 2013
Meal consumption confounds liver stiffness measurements in
patients with chronic HCV
Feb 2013
Hepatitis C-Moderate, excessive or heavy alcohol consumption:
each is significantly associated with increased mortality
Consumption of coffee associated with reduced risk of
liver cancer: a meta-analysis
Jan 2013
Binge drinking can dramatically amplify damage to the
liver
Abstaining from alcohol in January 'not enough' liver experts say
Ways You Can Take Care of Your Liver
Managing Your Medications
2012
Tips for a healthy liver this holiday season
Detox diets could be harmful for liver disease patients
Effects of coffee consumption in chronic hepatitis C
Hepatitis C - Alcohol effects on liver diseases: good or bad
buddy?
Coffee and Liver – Long Way To Go
Natural Approaches to Hepatitis C and Liver Health
Hepatitis C Review - Acetaminophen -Tylenol
Shark liver oil: hidden dangers
Concurrent Hepatitis C and Chronic Obstructive Pulmonary Disease
Green tea could be secret to healthy old age
Your liver is for life - so treat it well
Hepatitis C - Five Ways You Can Take Care of Your Liver
Hepatitis C and Liver Health-Getting It Right In 2012
2011
Oct 2011Liver Health and Wellness
HCV-Listeria Outbreaks, Tainted wipes; Its Personal
Mythbusters: Learn the Truth about Food Safety in Your Home
Cholesterol Confusions-Does cholesterol in your food really matter?/Aug
Sunday Morning Wellness : Healthy You
Chronic Liver Disease: The Salt Scenario
Hepatitis C Cirrhosis; Vitamin K Deficiencies
Diet and physical activity influence the risk of advanced liver disease in HCV
The hepato-protective effect(s) of three cups of a coffee a day: Relevance for patients with chronic hepatitis C
Hepatitis C; Beta Carotene
Inflammation of the Liver
Hepatitis News;The liver - the body's powerhouse
AASLD ; Monitoring Hepatitis C, NAFLD, Acetaminophen and acute liver failure
Undefined Liver Failure Linked to Acetaminophen
Review of liver injury associated with dietary supplements
Herbal Supplements;Evidence/Safety/Drug interactions
2010 :
HCV/OTHER MEDICAL PROBLEMS
2.5 cups of coffee daily reduced risk of hepatic steatosis in patients with HCV
Liver Health and Household Products.
Olive oil protects liver
Taking Low Dose Aspirin and NSAIDs? Know Your Risk.
Gluten and Your Liver
What Is a Healthy Stool ?
The Liver an amazing degree of diversity
What Are Simple Liver Cysts ?
Liver Abscess: Complications and Causes
Next to your skin, your liver is the largest organ in your body. It’s also one of the hardest working and can even re-grow its own tissue. It can work when a large portion of it is diseased or removed. The things that you eat, drink, breathe and take in through your skin all get filtered through your liver. It’s also where you body stores vitamins, releasing them during the day as you need them. In all, your liver performs hundreds of tasks throughout a day.
Your liver filters alcohol and toxins from your blood. It breaks down many drugs into forms that are easier for your body to use. It changes the food you eat into energy and gives out chemicals that aid your brain and central nervous system. It also helps to maintain your body heat to clot your blood.
Many substances can be toxic to your liver. Alcohol, street drugs, smoke, toxic fumes, some herbs and even some prescription and non-prescription drugs can harm your liver. Infections can harm it as well, such as hepatitis viruses and bacteria. Since the liver performs so many vital jobs, any of these toxins can cause it to not work properly. This, in turn, can hurt almost all of your body’s other systems.
A healthy liver is essential to a healthy life. There are many everyday things that you can do to keep your liver healthy. Not putting yourself at risk for liver diseases can help. Simple changes in your diet can go a long way in helping your liver to work well and recover from illness—especially if you have liver disease. This publication describes these and many other ways to promote a healthy liver.
Other publications are also available from Project Inform. They include Hepatitis A, Hepatitis B, Hepatitis C. and Hepatitis D.
Your liver:
- Stores vitamins, minerals and sugars for energy
- Makes new proteins
- Helps digest food
- Cleans the blood
- Helps your blood to clot
- Controls cholesterol and fats
- Clears alcohol and toxins
- Helps control body heat
- Maintains hormones
- Helps fight infections
Get informed Read up on liver disease and how to prevent it. This publication is a good starting point and reliable sources can be found on the internet. Your doctor or an experienced nutritionist can also advise you on a liver health plan.
Another way to learn about health issues is by talking to others with similar concerns. Consider joining a support group. Online "Ask the Experts" forums and bulletin boards may also help. These can be found through your doctor's office, local health care organization or internet search engine.
Make lifestyle changes Making changes in your diet can go a long way in helping your liver work well. Eating a healthful diet can also help the liver recover from illness, and is sometimes an important part of treatment. Check the US Food Guide Pyramid at www.mypyramid.gov. Alcohol is rather difficult for the liver to process. Some people are more sensitive to it than others. It can be an issue depending upon how much and how often a person drinks. Stopping or cutting back will give your liver a chance to work better. Some experts suggest no more than 1–2 drinks a day, but for people with liver disease, it's recommended to not drink alcohol at all. Consider the alcohol content of the many liquid cold and flu products. As well, drinking alcohol with acetaminophen and other medicines can be toxic to your liver.
What we breathe is also filtered by the liver. Two ways to preserve your liver's health are to avoid smoking and to stay away from toxic fumes and liquids. Smoking may increase the risk of liver cancer. Fumes from everyday items like hair sprays, cleaning products, bug sprays and paint thinners can also damage your liver. Wear a mask or gloves or open windows to air out your living spaces. Also, look around your home or work for any signs of chemicals that may cause liver damage.
Liver damage is common in people who are injection drug users. This can pass viruses and bacteria from person to person. Street drugs are also often impure. Limiting or not using street drugs will help protect your liver, and don't share your works with others. This also holds true for syringes for taking steroids or diabetic meds.
Safer sex and good hygiene can prevent infections that affect the liver. Finding out more about your sex partner's sexual history can also help. (Read Project Inform's publication, Sex and Prevention Concerns for Positive People.) Also, don't share personal items like toothbrushes, razors, manicure tools or other items that may have blood on them.
Get a vaccine Two of the most common infections of the liver are hepatitis A and B. Both are preventable. Your doctor can test you to see if you've been exposed to them before. If you haven't, getting vaccinated can prevent a good deal of harm to your liver. The vaccines are given as 2–3 shots and are available on their own or combined as one.
Keep up with your health care Many people don't know they have liver disease. You can get tested by your doctor to find out if your liver is working properly. Let your doctor know if you have any risk factors for liver disease.
Make sure you get regular check-ups and blood work done. Liver function tests will check for changed levels of chemicals in your body. These will show whether your liver is working well or if there's an infection or other problem that needs to be addressed. It can be useful to keep track of your test results over time as well.
If you have chronic liver disease like hepatitis B or C, specialists such as a hepatologist or gastroenterologist can help you. Infectious disease specialists may also help. Depending upon your level of disease, you may want to consider using a medical team for treatment.
Other conditions you have, like diabetes, may affect how well your liver works. Treating these other conditions properly will help your body in general and also help support your liver to work as well as it can.
Know the symptoms and causes Your liver can continue to do its job even when there's damage being done. So it's important to know the possible symptoms of liver disease. Report them to your doctor as soon as possible. Liver disease can often be corrected if found early.
Symptoms may not appear in everyone. When they're present, they can include fatigue, nausea, loss of appetite, stomach pain, changes in memory or behavior, swelling and itching of the skin. More severe symptoms include yellowish coloring of the skin or eyes (jaundice), dark urine and changes in stool.
Inflammation in the liver, called hepatitis, upsets how well your liver works. It refers to damage caused by viruses, bacteria, alcohol, legal and illegal drugs, among others. Left untreated, hepatitis can lead to liver scarring, cancer, failure, transplant and even death. For these reasons it's important to help prevent disease in the first place.
Eat well and exercise Eat a balanced diet with a range of fresh fruits and vegetables, lean meats, whole grains and foods with fiber. Cut down on fatty foods or foods with a high amount of sugar or salt. Excess fat, sugar and salt can stress your liver, like fried foods, fast food, processed cheeses and meats, and many boxed and frozen processed foods. Eating smaller meals more often can aid your liver to work less.
Drink lots of water and other fluids to flush toxins from your body. Eight glasses of water a day is recommended for most people. Also, get regular exercise and reduce stress in your life. Both help promote a healthy body, which in turn helps your liver do its work.
Getting a proper amount of protein and keeping a normal body weight is essential. Good sources of protein include lean meat, fish, eggs, poultry, beans, nuts and dairy products. However, getting too much protein can stress your liver. Being overweight or having diabetes can put you more at risk for a serious liver disease called non-alcoholic steatohepatitis (NASH).
Fruits, vegetables and meats should be washed well before using. Be careful with any food if you don't know its source. Do not eat raw or undercooked fish or shellfish like sushi, oysters, shrimp or clams if you have a weaker immune system. Someone with an already damaged liver doesn't need to fight an additional battle.
Medicines Tell your doctor about all the medicines you take—both prescription and over-the-counter meds like pain or flu medicines. Make a list of them and take it in during your next check-up. Liver function tests will help monitor your liver health while you take these and other drugs.
If you ever wonder what's in a medicine or product, read the label or ask your doctor or pharmacist. These can help you avoid dangerous side effects and drug interactions.
Some common pain relievers can be hard on the liver if used too often. Some prescription drugs, including HIV meds, can also stress the liver. Acetaminophen can be very toxic, especially when taken with alcohol. If you have liver disease, NSAIDs like Advil (ibuprofen) can also be dangerous to take.
Aspirin can lower a person's platelet count. People with liver disease often experience a swelling of the spleen. This can destroy platelets faster than the body can make them. Taking aspirin will add to this problem.
Vitamins and herbs Tell your doctor, pharmacist or trained nutritionist about all the supplements you take. You could write up a list of them or take them in a bag with the product boxes or labels. Include vitamins, herbal teas and remedies, nutrition supplements, over-the-counter items and other products you take. Many of these can have side effects and interact with each other and many medicines. This could end up hurting your liver.
Some people think taking more vitamins and minerals than necessary will give them better health including those labeled "natural". However, that can actually be harmful. Avoid high doses of vitamins A, D, E and K. As well, taking iron supplements may be hard on your liver. It may be wise to avoid iron-fortified foods or iron-coated cooking utensils.
Virtually no well-done study has proven which herbs help the liver. In fact, studies are not required to show the safety of herbal products as are prescription meds. A few supplements are thought, but not proven, to help the liver. Some of them include artichoke, astragalus, California poppy, chamomile, dandelion, garlic, ginkgo biloba, licorice root, milk thistle, peppermint and soybean.
One herb called milk thistle could alter the blood levels of HIV drugs because it uses a liver protein called p450 which is also used by HIV meds. Another common herb, St. John's Wort, greatly lowers the blood levels of some HIV meds and it's recommended that it not be used with an HIV regimen. In the end, we just don't have proof what kind of reactions will happen with different herbal products.
Several groups of people should avoid using herbs unless OK'd by their doctor. These include infants, pregnant and nursing women, and people with liver disease, organ transplants, serious medical conditions or those scheduled for surgery.
Herbs to avoid (possible liver toxicity)
Blue-green algae
Borage
Bupleurum
Chaparral
Comfrey
Dong Quai
Efedra
Germander
Jin Bu Huan
Kava
Mistletoe
Pennyroyal
Sassafras
Shark Cartilage
Skullcap
Valeriana
http://www.projectinform.org/info/liver/index.shtml
Review Addresses Acetaminophen Use in Cirrhosis Patients
Oct 05 2010
Patients with cirrhosis can safely receive between 2 and 3 grams of
acetaminophen daily for longer than two weeks, and individuals with
and without cirrhosis using alcohol regularly can safely receive
up to 4 grams on a short-term basis, according to Mayo Clinic
researchers (Mayo Clin Proc2010;85:451-458).
Although the authors believe their review should alleviate
concerns regarding the use of this analgesic at any dose in hepatically
compromised patients, one expert told Pain Medicine News that more research on
the topic is needed before definitive recommendations can be made.
I think the published recommendations are reasonable but are really based on
very little evidence, commented Roger Chou, MD, associate professor of
medicine, Oregon Health & Science University, Portland, and director of clinical
guidelines development for the American Pain Society.I would advise
clinicians who follow these recommendations to monitor for signs of ongoing
liver damage, given studies showing that acetaminophen can cause liver
abnormalities at therapeutic doses even in healthy individuals.
To clarify the controversy associated with acetaminophen use in these patients,
senior author Kymberly Watt, MD, associate professor, Division of
Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minn., and a colleague
reviewed the thin body of literature on the topic, including expert opinion,
published reviews and studies catalogued on PubMed or MEDLINE.
They found one study demonstrating that cirrhosis patients do not have depleted
glutathione stores, which, along with altered cytochrome P-450“related
metabolism, is a risk factor for acetaminophen-induced hepatoxicity seen in
regular alcohol consumers (Am J Ther 2005;12:133-141). Results from a
double-blind, crossover study of 20 patients with chronic stable liver disease,
including eight patients with cirrhosis, confirmed the low risk for
acetaminophen-induced hepatoxicity, showing that 13 days of acetaminophen use at
4 grams per day was not associated with adverse events and was well tolerated in
a group of individuals with cirrhosis (Clin Pharmacol Ther 1983;33:95-101).
In individuals without cirrhosis consuming one to three drinks per day, a
randomized, controlled trial of acetaminophen at 4 grams per day for 10 days
found no significant toxicity, but a small increase in liver enzymes did occur,
the authors reported (Ail Pharm Ther 2007;26:283-290). Similarly, a systematic
review of several short-term studies examining the safety of 4 grams per day of
acetaminophen in patients with chronic alcohol use showed the drug did not cause
liver injury. A separate study of 443 non-cirrhotic patients consuming more than
six drinks daily for more than six weeks and undergoing chemical detoxification
found that 4 grams per day of acetaminophen for a three-day period during
detoxification also did not cause liver toxicity (BMC 2007;5:13). Dr. Watt and
her colleagues review yielded no literature examining the safety of long-term
acetaminophen use in individuals consuming alcohol regularly.
Given their findings, the authors believe that long-term acetaminophen use is
safe at a dose of up to 3 grams per day in cirrhotic patients and that
short-term administration of 4 grams per day is safe in both cirrhotic and
non-cirrhotic patients consuming mild to moderate amounts of alcohol regularly.
An important caveat is that the care of patients with cirrhosis must be
individualized and treatment depends on a number of factors, such as nutritional
status, adherence, follow-up and renal and liver function,†the authors
cautioned.
http://www.painmedicinenews.com/index.asp?section_id=82&show=dept&issue_id=661&a\
rticle_id=15838
Oct 05 2010
Patients with cirrhosis can safely receive between 2 and 3 grams of
acetaminophen daily for longer than two weeks, and individuals with
and without cirrhosis using alcohol regularly can safely receive
up to 4 grams on a short-term basis, according to Mayo Clinic
researchers (Mayo Clin Proc2010;85:451-458).
Although the authors believe their review should alleviate
concerns regarding the use of this analgesic at any dose in hepatically
compromised patients, one expert told Pain Medicine News that more research on
the topic is needed before definitive recommendations can be made.
I think the published recommendations are reasonable but are really based on
very little evidence, commented Roger Chou, MD, associate professor of
medicine, Oregon Health & Science University, Portland, and director of clinical
guidelines development for the American Pain Society.I would advise
clinicians who follow these recommendations to monitor for signs of ongoing
liver damage, given studies showing that acetaminophen can cause liver
abnormalities at therapeutic doses even in healthy individuals.
To clarify the controversy associated with acetaminophen use in these patients,
senior author Kymberly Watt, MD, associate professor, Division of
Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minn., and a colleague
reviewed the thin body of literature on the topic, including expert opinion,
published reviews and studies catalogued on PubMed or MEDLINE.
They found one study demonstrating that cirrhosis patients do not have depleted
glutathione stores, which, along with altered cytochrome P-450“related
metabolism, is a risk factor for acetaminophen-induced hepatoxicity seen in
regular alcohol consumers (Am J Ther 2005;12:133-141). Results from a
double-blind, crossover study of 20 patients with chronic stable liver disease,
including eight patients with cirrhosis, confirmed the low risk for
acetaminophen-induced hepatoxicity, showing that 13 days of acetaminophen use at
4 grams per day was not associated with adverse events and was well tolerated in
a group of individuals with cirrhosis (Clin Pharmacol Ther 1983;33:95-101).
In individuals without cirrhosis consuming one to three drinks per day, a
randomized, controlled trial of acetaminophen at 4 grams per day for 10 days
found no significant toxicity, but a small increase in liver enzymes did occur,
the authors reported (Ail Pharm Ther 2007;26:283-290). Similarly, a systematic
review of several short-term studies examining the safety of 4 grams per day of
acetaminophen in patients with chronic alcohol use showed the drug did not cause
liver injury. A separate study of 443 non-cirrhotic patients consuming more than
six drinks daily for more than six weeks and undergoing chemical detoxification
found that 4 grams per day of acetaminophen for a three-day period during
detoxification also did not cause liver toxicity (BMC 2007;5:13). Dr. Watt and
her colleagues review yielded no literature examining the safety of long-term
acetaminophen use in individuals consuming alcohol regularly.
Given their findings, the authors believe that long-term acetaminophen use is
safe at a dose of up to 3 grams per day in cirrhotic patients and that
short-term administration of 4 grams per day is safe in both cirrhotic and
non-cirrhotic patients consuming mild to moderate amounts of alcohol regularly.
An important caveat is that the care of patients with cirrhosis must be
individualized and treatment depends on a number of factors, such as nutritional
status, adherence, follow-up and renal and liver function,†the authors
cautioned.
http://www.painmedicinenews.com/index.asp?section_id=82&show=dept&issue_id=661&a\
rticle_id=15838