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Key Liver Functions

The liver is the body's largest organ, weighing three to five pounds in adults. Optimal nutrition is a function not just of what we eat and digest, but of how well the liver transforms incoming nutrients into the proper biochemical forms your cells need to perform their metabolic functions. Some of the liver's key functions:

  • Converts the thyroid hormone thyroxine (T4) into its more active form, triiodothyronine (T3). Inadequate conversion may lead to hypothyroidism, chronic fatigue, weight gain, poor memory and other debilitating conditions.
  • Creates GTF(Glucose Tolerance Factor) from chromium, niacin and possibly glutathione. GTF is needed for the hormone insulin to properly regulate blood-sugar levels. It also manufactures bile salts, which emulsify fats and the fat-soluble vitamins A, D, E, and K for proper absorption. The liver also removes some fat-soluble toxins from the body.
  • Activates B vitamins into their biologically active coenzyme forms. Virtually every nutrient must be biotransformed by the liver into its proper biochemical form before the nutrient can be stored, transported or used in cellular metabolism.
  • Stores various nutrients, especially A, D, B-12 and iron for release as needed.
  • Manufactures carnitine from lysine and other nutrients. Carnitine is the only known bionutrient which can escort fats into the mitochondria where they are used to generate ATP energy. The mitochondria generates 90% of the ATP energy at the cellular level.
  • Converts lactic acid from a toxic waste to an important storage fuel. Lactic acid is produced when glucose is metabolized through the energy production cycle. When excessive levels accumulate, you experience sore muscles. A healthy liver will extract lactic acid from the bloodstream and convert it into the reserve endurance fuel, glycogen.
  • Serves as the main glucose buffer, preventing high or low extremes of blood sugar. The liver is the key regulator of blood sugar between meals due to its manufacture, storage, and release of glycogen, the starch form of glucose. When blood sugar is low, a healthy liver converts stored glycogen into glucose, releasing it into the bloodstream to raise blood sugar levels. When blood sugar is high, a healthy liver will convert the excess into stored glycogen or fat.
  • Chief regulator of protein metabolism. The liver converts different amino acids into each other as needed.
  • Produces cholesterol and converts it into the various forms needed for blood transport.
  • Converts essential fatty acids such as GLA, EPA, and DHA into the lipoprotein forms necessary to allow transport via the bloodstream to the 50 trillion cells requiring fatty acids.
  • Main poison-detoxifying organ in the body. The liver must break down every substance toxic to the body including metabolic wastes, insecticide and pesticide residues, drugs, alcohol, etc. Failure of this function will usually cause death in 12 to 24 hours.
  • Removes ammonia, a toxic by-product of animal protein metabolism, from the body.
  • Breaks down hormones after they have served their function. i.e., if the liver does not break down insulin fast enough, hypoglycemia results because the circulating insulin continues to lower blood sugar.

The liver is vital to a host of other metabolic functions, but this brief overview should serve to illustrate the central role the liver plays in maintaining good health and the importance of implementing life-style change if necessary.

  • Junk foods, such as french fries, doughnuts, fried chicken and snack foods are cooked in overheated, overused, hydrogenated fats. Fried foods are a major source of liver-toxic lipid peroxides (rancid fats) and trans-fatty acids. Lipid peroxides are immune suppressive and damage liver cell membranes. Trans-fatty acids suppress production of PGE1, an important liver-protecting, anti-inflammatory prostaglandin.
  • Alcohol. The liver converts alcohol into toxic acetaldehyde during its alcohol detoxification process. Acetaldehyde inhibits PGE1, production, is a powerful free radical inducer, and is largely responsible for the liver, brain, heart, kidney, skin, and blood vessel lining damage associated with chronic alcoholism.
  • Coffee. Coffee crops are sprayed with pesticides. Almost all the coffee beans in the U.S. are imported, there is no way to determine which pesticides were used. Carcinogenic hydrocarbons are produced during roasting and the highest levels are found in dark roasts.
  • Smoking. Tobacco smoke contains toxic benzopyrene, polycyclic aromatic hydrocarbons, cyanide, acetaldehyde, tars, etc. As the body's main detoxifying organ, the liver must work overtime to remove this stew of toxins.
  • Fuel exhaust. Auto and diesel exhaust contain dozens of liver damaging poisons such as lead, sulfur and nitrogen oxides, acetaldehyde, cadmium, and peroxyacetylnitrile.
  • Birth-control pills. There have been some cases where as little as two to three weeks of use have been documented to severely reduce the ability of the liver to detoxify naturally produced estrogen. The livers of women on B vitamin/protein deficient diets may have difficulty metabolizing estrogen to nontoxic estriol, leaving it instead in the form of liver-toxic estradiol.
  • Candida. Candida yeast ferments dietary sugars into liver-toxic acetaldehyde in the process of turning sugar into energy. Candida also appears to increase gut and urinary levels of ammonia, another liver toxin.
  • Pesticides such as PDT, Aldrin, chlordane, lindane, 2,4,5-T dioxin, and toxaphene can cause chronic liver damage even at levels measured in parts per billion because they tend to accumulate in body fat over a lifetime.
  • Long-term drug use whether prescribed or illegal are potentially liver-toxic. Potential liver damage is a common warning found in prescription drug descriptions.
  • Anabolic steroids. Liver damage is a major side effect of chronic steroid abuse by athletes.
  • Acetaminophen. Tylenol, Anacin-3, Arthritis Pain Formula Aspirin Free, Datril Liquiprin Elixir, and St. Joseph Aspirin Free Fever Reducer for Children are just a few of the OTC (Over The Counter) products containing acetaminophen. People should be careful not to take too many drugs containing acetaminophen at the same time. Taking more than 15 grams can lead to irreversible liver disease. Whether smaller doses over long periods of time (such as those recommended for relieving arthritis symptoms) harm the liver has not been determined, but prolonged use increases the risk of kidney damage. Additional research is needed, but some reports indicate that fasting (i.e., you stop eating because of a bad cold or influenza) while taking acetaminophen may contribute to liver damage. People who consume large amounts of alcohol are at highest risk of developing liver damage from overuse of acetaminophen.
  • Patient Alert: Acetaminophen was originally introduced in 1955 for children's fever and pain relief. Please note that the 15 grams mentioned above is for an adult;. Read all labels completely before giving your child any medication. It's not uncommon for infant formulas to contain higher amounts of active ingredients than children's formulas.

Hepatitis C:

The Hidden Global Health Crisis

Hepatitis is an inflammation of the liver which can be caused by one or more of the following:

  • Viruses - the viruses identified to date have been named A, B, C, D, E, and G of which A and E are contagious.
  • Toxic agents such as alcohol, drugs or other chemicals.
  • Autoimmune disorders such as lupus, multiple sclerosis, rheumatoid arthritis, scleroderma, thyroiditis, Graves disease, etc.

Hepatitis C is a form of hepatitis caused by an RNA (Ribo Nucleic Acid) virus. The virus was first identified in 1988 and an antibody test became available in 1990, but it was not until 1995 that the virus was actually seen using an electron microscope.

Hepatitis C is considered a blood borne disease. Many people with hepatitis C contracted it either through a blood transfusion or by receiving blood products that were contaminated with the virus. Prior to 1992 blood banks could not screen blood for the virus because there was no reliable test. Today the risk of acquiring hepatitis C from a blood transfusion is under l%.

The Centers for Disease Control suggests that you be tested if you:

  • received a blood transfusion prior to 1992
  • received a blood product for clotting problems before 1987
  • received an organ transplant before July 1992
  • have ever been on long-term kidney dialysis
  • ever had a sexually transmitted disease
  • ever injected illegal drug

Like the HIV virus, the Hepatitis C Virus (HCV) mutates rapidly, making it nearly impossible for the body s own immune system to fight it off. By the time the immune system recognizes the virus and is ready to fight, the virus has changed, so the immune system goes back to "square one." This is the same reason that developing a vaccine has also eluded researchers.

The symptoms of hepatitis C - brief flu-like symptoms or malaise, usually go unnoticed . As the disease progresses, symptoms may include fatigue, muscle weakness, abdominal pain, intermittent nausea, and loss of appetite. In the later stages jaundice and dark urine are common. Underfunding of research seems to be the biggest hurdle in finding a cure for hepatitis C. In terms of numbers, there are 8.5 times more people worldwide with HCV than people infected with HIV (20 million according to the WHO Report in 1996).

In a Fact Sheet published in June 1997, the World Health Organization estimated that "...3% of the world population has been infected with HCV and there are more than 170 million chronic carriers who are at risk of developing liver cirrhosis and/or liver cancer." Four million Americans have been diagnosed with HCV and the rate of new infections is estimated at 30,000 annually.

Hepatitis C turns into a chronic disease in over 70% of the people infected. Some people with chronic hepatitis C will have no significant long-term effects, but most will develop some degree of chronic liver disease. At least 20% will develop cirrhosis, irreversible and progressive destruction of the liver, within 20 years of infection. Once cirrhosis is established, the risk of liver cancer increases 1 to 4 percent per year. Half of those who develop advanced cirrhosis die within five years. HCV causes an estimated 10,000 deaths each year. This number is expected to triple in the next ten to twenty years.

Current treatment options are very limited and have serious side effects such as severe depression, suicidal behavior and birth defects.

  • Alpha-interferon -only if your liver enzymes are abnormal and you don t have cirrhosis
  • Kebetron -a combination of interferon and ribavirin which cannot be used by patients with cardiac disease; and liver transplant - an option open to very few because of availability and cost

The CDC and NIH have been aware of the hepatitis C epidemic for several years, but there has been little media coverage 50 few have paid attention. The time to demand action is now.

Deciphering Liver Function Tests

Different cells have different enzymes inside them, depending on the function of the cell. When cells die or are damaged, the enzymes leak out causing the blood level of these enzymes to rise. The most important thing to remember about liver function tests or "LFTs" is that they do not in fact measure liver function. They have meaning, but they generally cannot be interpreted without clinical information. Also, the numbers do not always detect liver disease. Some patients with severe advanced liver disease will have nearly normal enzyme levels. An added complication in interpretation is that the numbers are not linear, i.e., an AST (see below) of 300 is not twice as bad as 150 (normal is 40) and a reading of 94 and 80 are essentially the same to a liver specialist.

  • ALT - Alanine aminotransferase used to be called SGPT (Serum Glutamate Pyruvate Transaminase). The presence of this enzyme is more Specific for liver disease than AST which is found in more types of cells (i.e., heart, intestine, muscle). The normal range is 5 - 50 IU/L.
  • AST which is found in more types of cells (i.e., heart, intestine, muscle). The normal range is 5- 50 IU/L (International Units per Liter).
  • AST- Aspartate aminotransferase used to be called SGOT (Serum Glutamic Oxaloaceti Transaminase). The normal range is 5-50 IU/L.
  • AP - Alkaline Phosphatase. This enzyme level is elevated in a number of disorders that affect the drainage of bile - gallstone or tumor blocking the common bile duct, alcoholic liver disease, or drug-induced hepatitis. AP is also found in bone, placenta, and intestine 50 the GGT is used as a supplemental test. The normal range is 30-115 IU/L.
  • GGT or GGTP- Gamma Glutamyl Transpeptidase. Elevated levels of this enzyme are specific to liver disorders (GGT levels are not elevated in diseases of bone, placenta or intestine.) The normal level is zero.
  • Bilirubin is the main bile pigment in humans which when elevated, causes the yellow discoloration of the skin and eyes called jaundice. Bilirubin is formed primarily from the breakdown of a substance in red blood cells called "heme." It is taken up from blood processed through the liver and then secreted into the bile by the liver. Healthy persons have only a small amount of bilirubin circulating in their blood - less than 1.2 mg/dl (milligrams per deciliter).
  • Albumin is a major protein produced by the liver. Chronic liver disease causes a decrease in the amount of albumin produced. Serum albumin levels of less than 3.5 mg/dL indicate advanced liver disease. The normal range is 3-5 mg/dL.
  • Prothrombin Time (also called protime or PT) is a test used to assess blood clotting. Blood clotting factors are proteins made by the liver 50 when the liver is significantly injured, the production of proteins is impaired. There is a good correlation between abnormalities in coagulation measured by the PT test and the degree of liver dysfunction. PT is expressed in seconds and compared to a healthy control patient s blood.

The LFTs are used primarily to screen or monitor liver disease. If the markers are present, your physician may order specialized tests to make a precise diagnosis of the underlying cause of liver disease.

There are specific tests that allow the precise diagnosis of hepatitis A, B, C and D.



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