by Dr. Scott Saunders, M.D.
When I was a medical student at UCLA, I happened to be on the liver transplant team. In those days, there were only a couple of surgeons who could transplant a liver so we would fly all over California to remove livers from bodies on life support. We would then fly back to UCLA and put the livers into needy recipients. It struck me as funny that the wonder of our noble cause was diminished when we wrapped the livers in saline-soaked cloths, and put them on ice in an Igloo ice chest for transportation. They even let me, the lowest man on the team, carry the precious cargo!
Those who received the livers were so grateful for the gift of life. To date, we have no way to replace the function of the liver, so those in failure were slowly dying. It was sad to see so many people who were barely hanging on to life because of liver failure.
Your liver is vital to so many aspects of your health. For example, everything you ingest has to go through the liver before it gets into the body. In this way, the liver is the primary protection for your body from toxins.
The liver is the second largest organ in the body (the skin is the largest). It is the only organ able to regenerate itself. We can lose 50% of our liver and within 2 weeks, we would have another complete liver.
The liver is an amazing organ that is essential for our body to function. Most liver specialists believe there are over 500 different functions of the liver. Besides detoxifying the things we eat, the liver also is necessary for:
- Storing nutrients
- Detoxifying and recycling waste
- Regulating and storing energy
- Regulating hormones
- Digestion of fats
- Making proteins
- Making cholesterol
- Regulating blood sugar
The primary function of the liver is detoxification. Without this vital organ, we become overloaded with toxins and die.
It’s the liver’s job to cope with chemicals as they travel from the environment via food or drink into your body. The liver acts like a filter through which the blood flows. It removes toxic substances from the bloodstream. Some of these toxins include:
- Bilirubin from the turnover of red blood cells from the spleen
- Ammonia from all the proteins in the body
- Drugs and medications
- Toxins from the intestines such as pesticides, food additives, and bacterial toxins
The most common cause of acute liver failure from toxicity is ACETAMINOPHEN (Tylenol). The medication itself is not toxic, but the liver makes it into another chemical, NAPQI, which causes immediate death of liver cells. Thankfully, we don’t collapse and die every time we take Tylenol because the liver has a way to detox the NAPQI by combining it with GLUTATHIONE. Glutathione is one of the most important anti-oxidants in the body. As long as we maintain enough glutathione we will be protected from acetaminophen toxicity, but ingesting more than the liver can handle causes liver damage, and death.
Fatty Liver Disease
Besides acetaminophen, alcohol, and food additives, the liver must break down nutrients from regular food. Some foods are very toxic and damage your liver. In fact, the most common cause of liver damage is not alcohol or acetaminophen, as one of my patients, Daniel, found out.
Daniel came in to my office because his liver enzymes were slightly elevated and his life insurance company refused to give him a policy. Elevated liver enzymes means that inflamed or injured liver cells are leaking certain enzymes, into the bloodstream. Higher enzyme levels indicate more liver cells are dying. Since his disease was mild, Daniel had none of the symptoms of liver disease:
- Enlargement of the liver
- Changes in stool
- Turning yellow (jaundice)
We needed to find out why he had so many dying liver cells. There are several things that can cause elevated enzymes, including toxins and infections. Tests showed Daniel to have “fatty liver,” a condition created by dying liver cells.
Until recently, alcohol was the primary cause of fatty liver disease because every drop of alcohol damages the liver. One drink can cause the enzymes to be elevated on a blood test. However, because liver cells regenerate quickly, limited alcohol intake doesn’t create any permanent damage. Only people that have a slow detoxification system are more likely to get cirrhosis, or scaring of the liver, with alcohol. Less common causes include protein malnutrition, hypertension, cell toxins, and anoxia (lack of oxygen) including sleep apnea. However, now alcohol has been surpassed by a more insidious toxin.
The Worst Liver Toxin
One of the most common substances we eat has become the primary liver toxin. We give it to children, adults, old people, and even sick people. Most people don’t even know they are eating liver toxins, but what was once completely unknown has become an epidemic today. It’s sugar!
Daniel was a victim of this epidemic. Over the years, he didn’t know that sugar was building up in his liver cells. Sugar is naturally stored in the liver for use when there is no food. However, eating it every day causes sugar to fill up the cells until they can contain no more. When the cells are overloaded with sugar, they start to die, and the excess sugar is made into fat. Over time, the liver becomes riddled with fat, which is known as fatty liver disease.
The insurance company didn’t care what caused Daniel’s liver to fill with fat, whatever the toxin is, they know that fatty liver is a sign of damage, which can be deadly, so they wouldn’t insure him.
Viral Hepatitis Infections
Toxins are just one way that the liver can be damaged. When I was on the transplant team, we transplanted livers into people with all sorts of liver disease. Some of these were toxic problems, but many had infectious diseases. There are a number of infections that can damage the liver. Most of these are viruses that will only grow in liver cells.
Viral hepatitis is inflammation of the liver caused by viruses that attack liver cells. Sometimes these are very mild infections that people hardly even know they have, but other times they can cause a great deal of damage. There are several different viruses that do this, the most common being Hepatitis A, B, and C.
Hepatitis B – is everywhere. But in some places, such as Southeast Asia, it is more common. It is transmitted by direct contact with blood or bodily fluids of a carrier. About half of the cases have an unknown cause because no risk factors are found. It can cause chronic hepatitis and lead to cirrhosis and liver cancer. Hepatitis B also has a vaccine.
Hepatitis C – is the most common blood-born illness in the United States. There is no vaccine against it, and it is transmitted in the same way as hepatitis B. It also leads to liver failure and cancer.
The most wonderful thing about the liver is that it is very forgiving. If damaged, the liver regenerates itself – that is, until it gets scarred (cirrhosis). For example, people who abuse their livers with alcohol can quit drinking and return to normal, as long as there is no cirrhosis. Those that get infected with a virus can take antibiotics to clear the infection, and often return to normal as well. By decreasing inflammation and improving the immune system, liver damage can be minimal.