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Cleaning up the world, one person at a time
Dr Fi Dann Ray MSc Applied Toxicology, MSc Chiropractic.
September 2018
The liver is amazing, it’s our own personal clean-up crew, nutrient maker, waste processing plant, energy storage and retrieval, metabolism controller and surveillance unit all rolled into one.
It can have a hard time when subjected to the challenges of modern life, with its stresses, fast food, pollution, lack of nutrients and recreational substances.
The Chinese say the liver, in TCM is related to anger and the free flow of emotion, depression is regarded as anger turned inward.
Taking care of your liver can help energy, mood and health.
So here are a few ways:
pH is a measure of the acid or alkali levels in the body. We need to be eliminating waste products of metabolism, many of them acids through the urine. If we are not getting enough acids out, the saliva pH will drop, we use up our alkali reserve (bicarbonate, minerals) too fast, are more prone to inflammation and metabolic stress. See the pH management article for more info.
This one is vital. Ideally we should be having a bowel movement for each meal eaten, but a minimum of 1-2 poos a day. If you don’t poo then the waste stored in the colon can ferment, we reabsorb more toxins and create more stress on the liver. Consider adding more fruit and veg to your diet, more soluble fibre sources (oats, psyllium husks), doing more exercise and walking more (the movement helps move poo along the colon). Dried fruit such as dates and figs help too. Laxatives only for short term use.
Alcohol is a direct liver toxin. Drinking a large amount of alcohol in one go causes stress and damage to many organs including the liver. Too much alcohol in a short space of time overwhelms the ability of the body to detoxify it and leads to a build up of acetaldehyde which is highly reactive, can damage DNA, proteins and fats in the body. In the liver it causes damage to the mitochondria (energy producing units in the cell), damage to liver cells, activation of repair mechanisms such as fibrogenesis (important in liver cirrhosis) inflammation and accumulation of fat around the liver[i].
Many people drink on a daily basis, and while one drink is unlikely to be problematic, for many people it’s half a bottle of wine, or a few beers. Particularly if you are already dealing with a health issue, daily drinking is an extra liver stress you do not need. Two or three alcohol free days a week can really help.
Not all sugars are metabolised in the same way. Increasingly we are seeing prepared foods and soft drinks sweetened with high fructose corn syrup, or it’s newer name, glucose-fructose syrup. Fructose in its free form (different to being in fruit) is very stressful to the liver. It is metabolised in the liver and is transformed into fatty acids in the liver. These can build up to an abnormal level and lead to Non-alcoholic fatty liver disease, dyslipdaemia (high blood lipids) and insulin resistance[ii]. Excess free fructose in the gut, whether from high fructose corn syrup/ glucose fructose syrup, fruit juice or fruit drinks, has been linked to increased rates of arthritis in young adults[iii], asthma in children[iv].
Some fruit juice is good – a rich source of antioxidants[v] and nutrients. Too much leads to an increased intake of fructose, can damage the teeth and may be linked to obesity.
Naturopaths have long maintained that freshly squeezed lemon juice had a beneficial effect on the liver and acted as an alkaliser on the body. There is certainly evidence that polyphenols/ flavanoids in lemon juice have a beneficial effect in liver homeostasis and disease[vi]. The lemon juice must be freshly squeezed from a lemon freshly cut open to have the best effect. This can be done a few times a week, or daily.
Another old –time liver remedy. Apple cider vinegar with honey in warm water as a drink, or added to foods has been used to support the liver and alkalise the body. People with inflammation such as those with osteo-arthritis have found apple cider vinegar useful. From a scientific point of view, ACV has been found to lower cholesterol levels and have a protective effect on liver, kidney and red blood cells[vii]. This can be done a few times a week or daily.
In Chinese medicine terms, the liver is associated with anger. Too much anger, or anger felt for too long can unbalance the liver[viii]. The other side to this of course is that liver issues can fuel anger. Free flow of emotions, not bottling them up or turning them inward is beneficial for the liver. Many techniques and personal development courses help with this. Mindfulness, EFT, Cognitive Behavioural Therapy and Heartspeak are all good, find a technique and practitioner that you gel well with.
For those experiencing chronic stress, the substances our body’s produce –cortisol and other glucocorticoids, lead to increased liver inflammation and increase the risk of liver cancer[ix]. Reducing the level of chronic psychological stress and finding better stress management techniques is very useful.
Most toxins are dealt with in a two-step process in the liver. Phase 1 processes make the toxin more reactive so it joins to a linking molecule in phase 2 enabling it to be safely excreted. People who do phase 1 well but not phase 2 are known as ‘pathological detoxifiers’ as they can make a toxin more toxic. Hence discussing phase 2 before phase 1. If you have phase 2 sorted first it’s much safer! The supplements listed below are all useful. Take MSM and NAC at recommended dose unless advised otherwise.
One of the greatest threats to health is our lack of movement. We spend hours sitting, and not enough time walking and moving. Gentle to moderate exercise is very beneficial to the liver. From the speeding up of the movement of food through the intestine to reduce constipation to the improvement in insulin sensitivity, blood lipid level reduction and reduction of fatty liver disease[xi], exercise greatly improves liver health. Even when exercise does not result in weight loss, there is still great improvement in non-alcoholic fatty liver disease[xii] .
Even a 10 minute burst of activity that gets you our of breath per day, or 30 minutes of walking help. Taking stairs instead of lifts, parking a little further away. Small changes can really add up. Finding a form of exercise that is fun for you, or doing it with people who you enjoy being with is important as it helps you to keep doing it long term.
Many prescription drugs put extra stress and burden on the liver.
The 10 worst are said to be[xiii] :
For many people they are on a complex mixture of different drugs, and the cumulative effect can be increased stress on the liver. This issue, known as polypharmacy is most common in the elderly who may be on 8 or more medications. It is good to talk to your doctor and a pharmacist to see what could be interacting with what, and to see if any of the drugs can be discontinued, or to find out what lifestyle changes would remove the need for the drug.
It’s not just the recreational drug, it’s whatever it was cut or mixed with. This is usually a complete unknown and can be a complex and draining task for the liver to detoxify.
Heroin, inhalants and steroids are particularly known for liver damage[xiv].
Best advice of course is to reduce or stop drug usage, otherwise to get support and advice, and to be sure of your source.
There are several issues with fast food:
Limit your intake of fast/junk food as much as possible. Pre-prepared food from home, a bag of healthy snacks available, or altering your choices as regards the food you order. More fruit and veg content, less frying. If you do enjoy a late night kebab and chips, then bear that in mind in your food choices over the next day or two to include more fruits, veggies, good oils and antioxidants, a more Mediterranean diet for instance.
There can be a high degree of leakage from the packaging to the food[xvii]. Phthalate and bisphenol type chemicals, including bisphenol A are common culprits[xviii]. Plastic wrapped food and canned food are common culprits. Reducing your intake of these foods, not buying dented cans, not wrapping fatty foods such as cheese in clingfilm/ plastic wrap, getting your take out coffee in your metal travel coffee mug instead of the paper cup (plastic lined) and getting some glass storage containers for the fridge all help.
It is when the body does its rest, repair and housekeeping activities to the greatest extent. Shorter sleep periods than you need lead to reduced cell repair and regeneration (in common with all other body tissues). Tired people also tend to eat more unhealthy food, which is also a liver stress.
A good 7-9 hours sleep, in a dark room with no electrical devices near the bed, phone on airplane mode, wifi off really helps.
Many modern diets can be deficient in the nutrients we need to process toxins and wastes in the liver. The nutrients listed below are the main ones involved in the first phase of processing in the liver. It is best to supplement with some of the phase 2 nutrients before the phase one nutrients to avoid pathological detoxification. Food state vitamins and minerals are best, as supplements and as a varied diet with plenty of nuts, fruit, veg, eggs and seeds.
Organ meats are fantastically nutritious, and liver is a rich source of nutrients such as bioavailable iron, selenium, zinc, polyunsaturated fatty acids, amino acids and glutathione[xix]. Vitamins A, B12 and other B vitamins, Co Q10, folic acid and purines are also rich in liver. The Weston Price Foundation class liver as the most important sacred food, and give many recipes and nutritional information on this organ meat at https://www.westonaprice.org/health-topics/food-features/the-liver-files/
This fantastic herb acts as an antioxidant on the liver, and has a beneficial effect on non-alcoholic steatohepatitis (fatty liver), is helpful in reducing insulin resistance and diabetes induced hyperglycaemia (high blood sugar)[xx]. Take as tablet or tincture.
Dandelion has anti-inflammatory effects, decreases insulin resistance, is an antioxidant and useful in treating metabolic syndrome[xxi], of which liver dysfunction (fatty liver) is a part. It aids detoxification, stimulates the digestive system and is useful in cases of high blood pressure, high cholesterol and unstable blood sugar levels[xxii]. Take as tablet or tincture. Young dandelion leaves are also good in salad.
Turmeric is one of the most useful spices there is. It is an antioxidant, anti-inflammatory (hence it’s use in people with arthritis), anti-hepatotoxic (reduces the effect of toxins on the liver) and has anti-cancer properties[xxiii]. It is not the most easily used spice by the body though. Taking turmeric as a tablet, you need one that has been formulated to increase absorption. Look for information that show the difference between the levels of curcuma the supplement gets into the blood vs normal curcuma. Some supplements add piperine (black pepper) which aids absorption, as does taking it with oil. Adding turmeric to food, along side some black pepper is useful, as are turmeric latte recipes, an example here[xxiv]. Essentially use any milk of your choice, as long as it’s not fat free. Add turmeric, black pepper and your choice of spice (cinnamon/ ginger/ cardamom pods/ vanilla/ clove (a little goes a long way) /nutmeg / allspice). Heat for 5-10 mins. Pour into cup, use a strainer to catch any larger pieces of spice. Sweeten as needed (honey/ maple syrup/stevia) and enjoy.
The globe artichoke has been used medicinally as an anti-microbial, anti-inflammatory, and as a liver protective food[xxv]. It also has cholesterol lowering, glucose level lowering and lipid (fat) lowering effects. You can eat artichokes, or for those who don’t know how, or don’t like them, then as tablets.
Known to be useful in diabetes, high blood pressure and inflammation, reduces blood sugar cholesterol and uric acid[xxvi]. Olive leaf has antioxidant properties, anti-microbial actions and cardio-protective effects. Take as tincture or tablet.
Cranberry is another useful food for the liver. It can reduce liver inflammation and non-alcoholic fatty liver disease (common in obese people)[xxvii]. Drinking proper cranberry juice (not the usual tetra-pak of cranberry juice with water and sugar, adding 100% cranberry juice to your smoothies, juices or other beverages (it is very sour), making your own cranberry juice (natural sweetener, not white sugar) or a cranberry powder capsule are all good ways to include more cranberries.
Green tea extract is a powerful antioxidant, and can help negate some of the effects on the liver of autoimmune disease, acting as a normaliser[xxviii].
It can also help prevent liver fibrosis (the mechanism that drives liver cirrhosis).
Body weight is a big issue for the liver. Obesity is a high risk factor for non-alcoholic fatty liver disease (NAFLD). NAFLD runs the spectrum from Non-Alcoholic Fatty Liver (NAFL) which is the build up of fats in the liver, to Non-Alcoholic Steatohepatitis (NASH) which is the fatty build up in the liver with inflammation. It’s really common, with 25-35% of the general population of the western world having some degree of NAFLD. The majority of these will be obese or have type 2 diabetes. Of those with NAFL, about 20-35% will progress to NASH – so have liver inflammation, and be at risk for cirrhosis and liver cancer[xxix]. The very best treatment is to lose weight and increase exercise. Plus a lot of the liver supportive measures listed here of course.
After years of coffee-bashing, the evidence is that it is quite good for the liver. Obviously not in excess of course but a few brews a day is pretty good. Coffee seems to lower the amount of fibrosis seem due to liver injury in hepatitis, and coffee drinkers have lower levels of enzymes indicating liver damage than non-coffee drinkers. There is evidence that coffee drinkers have a lower risk of various cancers, type 2 diabetes and metabolic syndrome. It also may lower the risk of neurodegenerative diseases such as Parkinson’s and Alzheimer’s disease[xxx]. We’re great fans of the cold brew method of making coffee as even better for health.
For example –Aspartame. Linked to hyperglycaemia (high blood sugar) neurological and behavioural disturbance and liver lesions. These are thought to be due to the way aspartame is processed in the body, with 10% of it becoming methanol (toxic), which is then converted to formaldehyde[xxxi]. Aspartame can deplete glutathione levels in the liver. Glutathione is a major antioxidant, cell protector and phase 2 detox agent.
Liver damage was seen at an aspartame intake equal to two 330ml cans of diet drink a day. Best to avoid artificial sweeteners in general.
We are exposed to various toxic metals from our food, water, dental fillings (silver amalgam), medical interventions (vaccinations) environmental pollution, occupational exposure and in utero from our mothers. These metals, mercury, arsenic, aluminium, lead to name but a few can have a negative effect on the liver.
People with lower levels of mercury in their urine, so those less good at excreting mercury, had higher levels of liver enzymes in their blood, signifying more liver damage[xxxii]. Higher levels of blood mercury were also linked to increased liver damage.
Arsenic – found in soils, in high levels in the Indian subcontinent, drinking water and rice grown in high arsenic areas (Indian subcontinent). Raises the risk of liver cancer, and increased risk of diabetes[xxxiii].
Lead – increases inflammation.
A good detox to remove toxic metals from the body is helpful.
Flame retardants, BPA and Phthalates from plastic, diesel particulate, Volatile organic compounds from household cleaners, fuel emissions, dry cleaning, fabric conditioners and paints can cause liver dysfunction[xxxiv]. Phthalates (from plastics) can exceed safety limits for children easily and affect the hormone balance in children, as well as increase risk for obesity, inflammation, diabetes and oxidative stress[xxxv].
Avoid the use of bottles marked PET – soft drinks and bottled water are usually in this type of plastic. Don’t use perfumed household cleaners and if you use chemical or spray household cleaners, air the house out afterward. Always air out dry cleaning before putting away.
Using a hairbrush with rounded bristles, hit your legs up and down the insides of your thighs and calves, starting at the ankles, for about five minutes. This gently stimulates your Liver meridian, allowing your qi to flow more freely and relaxing your Liver.
You can also do Acupressure for the liver. Rub the acupressure point called “Taichong” (Liver 3) which stimulates a key point on the Liver channel. This can be sore but means you’re in the right place. Rubbing here helps to unblock Liver Qi. Try to rub this area every day. It’s located on top of your foot where the big toe bone meets the second toe bone (about an inch back from the skin between these toes). Using your thumb, press and massage this spot on both feet (the meridians are on both sides of your body). You can also rub with your thumb moving forward along the inside of the big toe. (from TCM world)[xxxvi]
Assists with flushing toxins out via the kidneys, reducing liver workload somewhat. Assists with flushing toxins out of the liver. Assists bowel function and reduces constipation, also removing stress from the liver. The amount of water recommended varies a lot, 2 litres is fairly standard. It is however best sipped through the day, not a large glass guzzled down every so often. Avoid bottled water in PET bottles. Ideally, find a good filter system for your house or a table top unit.
Chewing is a major body process that has effects way past the mouth. The main way we react to stress hormonally is called the hypothalamic (at the base of the brain), Pituitary (next to hypothalamus) Adrenal (on top of the kidney) Axis, known as the HPA axis[xxxvii]. Chewing supresses this stress response – which may explain why you see football managers chewing gum during matches, and reduces the amount of stress hormones circulating. Also chewing your food spares the digestive enzymes as less are needed for breaking down the food, so they can do their other job of breaking down scar tissue in the body. Chewing also improves the ability of stomach acid to start breaking down proteins as the surface area of the food is increased. All of this leads to more efficient digestion and less stress on the liver.
Take the time to chew each mouthful of food at least 20x before swallowing. For the gobblers amongst you, work your way up from 10 chews per mouthful. Many people find they eat less as they are more satisfied.
Following on from the point above, stomach acid is a major body defence against gut parasites and also for maintaining the correct bacteria balance in the small intestine. Low stomach acid is usually a result of age (levels reduce past the age of 35-40), drinking alcohol on an empty stomach or to excess (damages the acid producing cells at the base of the stomach), stomach/gut infections (can turn off acid production) or stress. Often a mix of the above factors. Indications of low stomach acid can include Heartburn and indigestion (I know it sounds strange but it is the case), burping after meals, slow stomach emptying and Small Intestine Bacterial Overgrowth (SIBO), often mistaken for Candida. SIBO causes liver stress.
To test for low stomach acid levels at home, you can do the Bicarbonate test, the VEGF test or the Betain test. See the reference for details[xxxviii].
Chronic infections in the liver lead to inflammation, scarring and if untreated cirrhosis and cancer. If a chronic infection (hepatitis) is present it needs treating and medical management asap. Anyone with a history of injected drug abuse or unsafe sex is potentially at risk and should be tested.
These include worms such as hookworm, pinworm, roundworm and tapeworm, also Flukes, Protozoan species such as Giardia Cryptosporidium and Amoebas[xxxix]. Bacteria such as Salmonella and others associated with food poisoning. They tend to be spread by ingestion of infected food, water and exposure to infected faecal matter. People bring back parasites from their travels abroad, from exposure to pets and farm animals, eating at restaurants where hygiene is not as good as it could have been, from family members, festival campsites and exposure to contaminated water from floods or in the sea near a sewage outlet.
Some parasites can directly affect and infect the liver, other just put more strain on the liver as the level of exotoxins released from the parasites needs dealing with in the liver.
A good parasite cleanse repeated on an annual or semi-annual basis, that involves the whole household including pets is recommended.
As a general body and liver support, to reduce the level of toxins in the digestive system, we recommend eating organic/ chemical free where possible. The US based Environmental working group (EWG) found those who often or always ate organic had a 65% lower level of pesticide residues compared to those who did not eat organic[xl].
The foods with highest residues tend to be GMO grains (roundup/glyphosate resistant) farmed salmon and the following fruits and vegetables.
In descending order,
Strawberries.
Spinach.
Nectarines.
Apples.
Grapes.
Peaches.
Cherries .
Pears.
Tomatoes.
Celery.
Potatoes.
Peppers.
These should always be brought organic.
The cleanest fruit and veg, with no or little residue detected were:
Avocados.
Sweetcorn.
Pineapple.
Cabbage.
Onion.
Papaya.
Asparagus.
Mango.
Eggplant/ Aubergine.
Honeydew Melon.
Kiwi.
Cantaloupe melon.
Cauliflower.
Broccoli.
So these are safer to buy non-organic if you are having to watch your budget.
So buy your fruit and veg organic where you can, particularly for the ones most likely to have high levels of residues, buy organic grain products (bread, pasta, flour etc.) Avoid conventional farmed salmon.
Last but certainly not least. Giving up smoking will be a tremendous help to the liver. Tobacco smoke has direct and indirect toxic effects on the liver, increasing the risk of liver damage, cancer and fibrosis[xli]. It worsens the outcome of treatment for liver disease.
References.
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Detoxicology 