Liver Disorder Alternative Treatment:

Common Liver Function Tests

A series of special blood tests can often determine whether or not the liver is functioning properly. These tests can also distinguish between acute and chronic liver disorders and between hepatitis and cholestasis.

The Most Commonly Performed Blood Tests Include:

More than 25 million people in the United States suffer from liver and gallbladder diseases, according to the American Liver Foundation. And, more than 43,000 die of a liver disease each year.

The liver is the largest internal organ in the human body. It is also one of the most important ones. The biliary system -- consisting of the bile ducts and the gallbladder -- and the pancreas are all closely associated with the functioning of the liver.

Some liver, biliary, and pancreatic disorders are congenital. Others can be prevented. In any case, whether these diseases are congenital, injury-related, viral-induced, or alcohol-induced, they can be devastating to a person's health and require professional care. See Below:

There are 5 main types of the hepatitis virus that have been identified.

Hepatitis A - This type of hepatitis is usually spread by fecal-oral contact, including:

Preliminary studies in animals show that milk thistle may help protect the liver from injury by a variety of toxins ("poisons" such as drugs, viruses, alcohol, radiation, and poisonous mushrooms) and limit the damage from them. To date, the most reliable, and also quite preliminary, studies on people show that milk thistle does not cure liver disease, but that it may improve the way the liver works in patients with cirrhosis. However, there is no current evidence to indicate that milk thistle directly affects HCV.

In Germany, where many herbs are regulated and prescribed like drugs, health authorities have approved milk thistle as a complementary treatment (given in addition to conventional drugs) for cirrhosis, hepatitis, and similar liver conditions. But a great deal of research still is needed before this alternative therapy could be considered a standard treatment option in the United States.


For Information On Cancer Of The Liver, See The Listing Under Liver Cancer


Understanding The Liver And Cholesterol
Date: 12/21/2009
By: Jon Barron

And now we come to the liver, one of my favorite organs. Certainly the heart, the brain, and the immune system get more play in the popular imagination than the liver, but that's only because the liver is so misunderstood. Next to the skin, the liver is the largest organ in the body. In many ways, it is the most important organ, and the last to be considered when it comes to health. In addition to being large, the liver is also a complicated organ involved in at least 200 separate functions. Generally speaking, the liver performs a vital role in regulating, synthesizing, storing, secreting, transforming, and breaking down many different substances in the body. In this issue, we explore the anatomy and physiology of the liver in detail from a natural health perspective, and conclude with a discussion of how the body regulates cholesterol and why statin drugs may not be all that doctors promote.

Physical Facts About The liver

As I mentioned above, the liver is the heaviest and largest gland inside the body, weighing in at about 3 pounds. Only your skin (also a single functioning organ) is larger. Your liver occupies almost the entire right upper quadrant of the abdominal cavity. (Remember that in virtually all medical diagrams, right and left are reversed.) It nestles up against the diaphragm on the top and against the ribs on the right -- stretching across the body, almost touching ribs on the left. Thus, barring extreme trauma such as bullet wounds and automobile accidents (or if it is not enlarged), it is fully protected -- a testament to how important the body considers the organ.

Physically, it is divided into four lobes, a large right and a small left lobe. Nestled between those two lobes are two less easily visible lobes, the quadrate lobe sitting on top and the caudate lobe sitting just underneath and extending to the bottom of the liver.

Obviously, a three pound organ cannot just "hang" in the abdominal cavity. It needs to be secured. And in fact, it is suspended from the back of the diaphragm by two ligaments, the falciform and the suspensory ligaments. The falciform ligament in particular runs up through the entire liver, dividing the left and right lobes before attaching to the diaphragm. There is one other interesting note about the falciform ligament. The umbilical vein, when you are inside the womb, runs from the umbilical cord up between the left and right lobes of the liver. Within a week of birth, that vein is completely obliterated and replaced by the fibrous cord known as the falciform ligament.

The liver has a reserve capacity of some 50-80%. That means you can destroy up to 80 percent (and in some cases possibly even more) of the Liver's function and have no demonstrable negative symptoms. And as amazing as that is, it's not the most amazing part. As I have mentioned frequently over the years when talking about detoxing the liver, the liver is one of the few human organs that can regenerate itself. It can actually regenerate (in a matter of weeks) up to an 80% loss of tissue. Once regenerated, it will fill the same space it occupied before, and will take roughly the same shape as before. And when it's done regenerating, it stops! Though it grows faster than any cancer known to man, its regeneration does not become malignant, and the liver will stop growth at approximately its normal size. This is particularly useful after trauma such as an automobile accident that has damaged part of the liver. The damaged or diseased tissue can be removed by the surgeon with no loss of liver function, and in a matter of a few weeks, the liver will have regenerated all of its lost tissue. You've gotta love this stuff!

Your Liver's Blood Supply

Before we begin discussing the Liver's blood supply, which is unique in the body, it should be noted that everything in the liver begins with the three letters "hep", as in hepatic or hepatitis.

Your Liver's Vascular System

The right lobe of the liver is served by the right branch of the hepatic artery (a branch of the celiac trunk). The left branch serves the left lobe. Venous drainage occurs through the inferior vena cava, which cuts across the liver from top to bottom and receives venous drainage from the hepatic veins.

So far, nothing very interesting. But dig a little deeper and we find that the liver is unique in the entire body. In fact, the liver has an entirely separate circulation system to accommodate its special needs and functions. This is called the portal system.

Hepatic Portal Circulation

As it turns out, all the physiology and pathology of the liver depend on this specialized circulation system. Functionally, the hepatic system is a venous system, ultimately returning used blood to the heart for reoxygenation. But unlike every other part of the venous system, it serves a second, even more important function. The portal system actually takes all of the veins that drain the organs of digestion and instead of returning their blood directly to the heart passes it through the liver.

Why?

Effectively, the portal venous system is responsible for directing blood from parts of the intestinal tract to the liver. All of the substances that you process and absorb in your small intestine must first travel to the liver for a final processing before continuing to the heart. In addition to the small intestine, the portal system also includes venous drainage from the spleen and pancreas.

So what is being processed in the liver?

Ultimately, we are talking about all of the protein, fat, and sugar molecules broken down in your digestive tract -- and all of the vitamins and antioxidants. Every nutrient you consume flows from the intestinal tract, through the portal system, and into the liver for processing and extraction. The liver thus plays a primary role in the digestive process. Specifically, the portal vein drains the inferior mesenteric vein, the superior mesenteric vein, the splenic vein, the gastric veins, and the esophageal veins. As you can see from the diagram, all of these veins dump into one vein, the inferior vena cava, just before it enters the lower part of the liver. From there it splits into many progressively smaller veins that ultimately reach every single cell of the liver before reversing the flow and reassembling, once again, as the inferior vena cava that exits through the top of the liver on its way back to the heart.

As a side note, many drugs that are absorbed through the intestinal tract are substantially metabolized by the liver before being parceled out for general circulation. This is the primary reason that so many drugs list liver damage as a notable side effect. On the flip side of the coin, processing by the liver "inactivates" some drugs, thus they cannot be taken orally. Nitroglycerin, for example, cannot be swallowed as it would be neutralized by the liver. Thus, it is taken under the tongue and absorbed sublingually, totally bypassing the portal system and the liver. Other drugs are administered through skin patches so they can be absorbed transdermally, once again bypassing the portal system and the liver.

As mentioned above, and as befits the special function of the portal system, the inferior vena cava does not continue as an uninterrupted thoroughfare through the liver. In fact, the portal system divides into a capillary bed of ever smaller venous capillaries in the liver sinusoids (see diagram below) formed by the cells of liver. It re-forms on the other side of the sinusoids as the hepatic capillaries and veins, which drain into the vena cava. Effectively, it is a venous-capillary-to venous-capillary system.

What Happens Inside The Liver

Okay, we've laid out the location of the liver and the unique blood supply that supports it. Now let's talk about the structures inside the liver that do the actual work.

Liver Lobules

The hepatic lobule is the structural unit of the liver. It consists of a roughly hexagonal arrangement of plates of liver cells radiating outward from a central vein in the center. Each lobule is approximately one to two millimeters in diameter, with tens of thousands of lobules per liver. At the vertices of the lobule are regularly distributed "portal triads," containing a bile duct and a terminal branch of the hepatic artery and portal vein.

The lobule is composed of multiple smaller units, called acini (which are just the grouping of cells at the end of each sinusoid) and is artificially defined into three zones, with Zone I closest to the portal vein and Zone 3 closest to the hepatic venule in the center of the lobule. Organization of the functional parts of the liver into lobules and acini between the portal vein and the hepatic vein allows for an easy exchange between the blood and the liver cells and a gradual filtration of blood as it moves through the sinusoids from Zone I to Zone 3. Contrary to blood flow, bile flows in the exact opposite direction, from Zone 3 to Zone I via a separate route to the portal bile ducts.

To summarize, nutrient-rich blood enters the liver via the hepatic artery and portal vein (remember, portal venous blood is rich in nutrients.) The blood from these two sources merges as it enters the sinusoids. Blood reaches the hepatocytes by detouring through capillaries at the sinusoids, where exchanges take place. The exchanges are made as the liver requires according to what zone the blood is in -- nutrients in, waste out, alcohol removed, etc. Blood then exits the lobule via the central hepatic vein, ultimately reentering circulation through the inferior vena cava that exits through the top of the liver. Note: the depleted blood returning from the legs and lower body is not involved in this exchange. It does not enter the liver. It is not altered in any way. Only the rich venous blood from the portal system is involved with the liver exchange before returning to the heart.

Sinusoids

Sinusoids are vascular channels lined by hepatocytes. As blood flows out of the hepatic arteries and portal veins, it flows through the sinusoids for "processing" by hepatocytes before it ultimately empties out through the central vein of each lobule, the hepatic venule, from where it ultimately makes its way to the heart. In addition to normal processing by hepatocytes, liver sinusoids are equipped with Kupffer cells that literally devour foreign pathogens such as bacteria that enter the sinusoids. As a side note, Kupffer cells are particularly vulnerable to damage from alcohol.

Hepatocytes - Liver Cells

Liver cells do the primary work in the liver -- everything from extracting oxygen and blood, to synthesizing cholesterol, to breaking down fats and sugars, to neutralizing toxins. That said, it's a little more complicated than that. In fact, although virtually all liver cells are fundamentally similar, their function varies according to their location in the liver lobule. Zone 1 cells, for example, are located near the blood vessels that bring oxygen rich blood and nutrients into the lobule and are adept at oxidative liver functions such as cholesterol synthesis, the oxidation of fatty acids, glycolysis (the process that breaks down sugar for energy), gluconeogenesis (the formation of glucose), and lipogenesis. Zone 3 cells, on the other hand, specialize in detoxification.

What The Liver Cells Actually Do

The liver actually performs several hundred functions in the body. I can't cover them all in detail in this newsletter, but to summarize:

Cholesterol Defined

Cholesterol is a fat soluble steroid, In fact, it is the most abundant steroid in the body. Far from being harmful, when properly regulated, it is a critically important molecule, essential in the formation of a number of key compounds, including:

It is also essential in the formation of every cell membrane in your body, not to mention the fact that your brain is mostly made up of cholesterol -- much of it in the myelin sheaths that insulate nerve cells and in the synapses that transmit nerve impulses.

As a fat soluble molecule, cholesterol cannot easily be carried in the blood -- a water based medium. Therefore, the body converts cholesterol into water-soluble molecules known as lipoproteins so it can be transported. Lipoproteins are composed of an outer shell made from a phospholipid which renders the particle soluble in water, a core of fats (lipids) including cholesterol, and a surface protein molecule (apolipoprotein) that allows tissues to recognize and take up the particle. Lipoproteins are characterized by their density: high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL).

In simple terms, HDL lipoproteins are good for you. LDL lipoproteins "theoretically" promote arterial build up and are bad for you.

Where Cholesterol Comes From

Diet accounts for about 25% of the cholesterol levels in your body. Your liver synthesizes about the same amount, and the rest is synthesized in organs such as the intestines, the adrenals, and the reproductive organs. Obviously, trying to control cholesterol levels by solely changing diet will be effective only if levels are slightly out of whack. Although keep in mind, controlling diet is not just a question of regulating the cholesterol or fats that you eat; it is also a question of the soluble fiber (such as oat bran and psyllium husks) that you eat and which absorbs cholesterol and carries it out with your feces so that it never enters your bloodstream.

Unlike dietary changes, statin drugs seek to stop cholesterol formation in the liver by inhibiting a biochemical called 3-hydroxy-3-methylglutaryl coenzyme A reductase, which is required for cholesterol synthesis. Unfortunately, the reason for high cholesterol levels is only rarely due to over production in the liver; it is primarily the result of inadequate removal from the body. That means that statin drugs are not going to be the cause of the problem, but are addressing a symptom by artificially suppressing a properly functioning mechanism in the body. In scientific terms: that can't be good. We'll talk more about that later. But for now, let's talk about how your body actually regulates cholesterol levels.

As it turns out, your liver not only manufactures and secretes LDL cholesterol into the bloodstream; it also "down regulates" or removes LDL cholesterol from the bloodstream. In general terms, your liver oxidizes the cholesterol into a variety of bile acids which are then "pulled into the liver," carried into the bile ducts, and then on out through the intestines. As a side note, if the cholesterol becomes too concentrated in the bile and sits too long in the gallbladder, it can crystallize and form gallstones. (We'll talk more about gallstones in the next issue of the newsletter.) In any case, that's the general description of the cholesterol removal process. To understand exactly what's going on here, we need to examine it in a little more detail.

As it turns out, a healthy liver has a large number of active LDL receptor sites sitting on the surface of all the liver cells. When present and functioning properly, these receptor sites are associated with the rapid removal of LDL cholesterol from the blood -- and consequentially low blood LDL cholesterol levels. So why do these sites sometimes not perform as advertised?

How many of each are we talking about? The genetic condition affects maybe one in 500 people. For everybody else, we're talking about a self inflicted condition. In other words, the vast majority of cases of high LDL cholesterol are caused by a dietary inflicted blockage of the Liver's LDL clearing mechanism. In fact, blockage occurs in two distinct places in the liver. First, fatty deposits can build up in the sinusoids, which prevents the bile from entering the bile ducts and physically clearing the liver -- essentially clogging the liver. Second, and more importantly, excess dietary fats can actually cause ingested cholesterol to build up in the membranes of liver cells, thus crushing the ability of those cells to process Sterol Regulatory Binding Protein (SREBP), which as its name implies, activates the gene in the LDL receptor site to tell it to take up cholesterol from the bloodstream. This literally stops the receptor sites from functioning as receptors -- totally shutting down the flow of cholesterol through the liver and on out through the bile ducts and colon. Depending on how many liver cells are blocked, this can lead to anything from a minor rise in cholesterol levels on up to a "your doctor is screaming at you" level. In any case, the use of statin drugs does nothing to change this underlying problem. They merely force your body to work around it.

Fortunately, there are options. If you can flush the excess fats and cholesterol that are unnaturally stored in the liver, your body's mechanism for regulating excess LDL cholesterol in the bloodstream will once again function properly -- automatically lowering your cholesterol levels. This is actually not that hard to do, although medical doctors have no idea how to accomplish it. it's called a liver detox/flush, and we will explore it in detail in the next newsletter.

Conclusion

Before we go, a couple of notes on statin drugs. I'm not very big of them for a number of reasons, including the fact that they have all kinds of side effects. But more to the point, they do nothing to address the underlying cause of high cholesterol levels for the vast majority of people who have the problem -- the clogging of your body's self regulating mechanism. Oh, and as a minor point, the connection between cholesterol and heart disease is not necessarily as automatic as you have been led to believe. But most significantly of all, one of the side effects of statin drugs is liver failure. Now, given the understanding you now have of what has caused the problem in the first place, how much sense does it make to take a drug that potentially destroys the one mechanism in your body that actually down-regulates cholesterol?

Absolutely none! The bottom line is that unless you are one of the 1 in 500 who has a genetic problem, statin drugs should only be used as a last resort. Far better to address the source of the problem -- which we will do next issue. Specifically, we will cover:


Healing The Liver And Gallbladder
Date: 01/11/2010
By: Jon Barron

In the last issue of the newsletter, we explored the anatomy and physiology of the liver from a natural health perspective. In this issue, we get to reap the reward for our diligence. We cover what can go wrong with the liver, how doctors test for it, and what you can do about it -- again from a natural health perspective. In addition, we will spend some time on the gallbladder and biliary tree, the bile ductwork that ties everything together. Considering that gallbladder removal (cholecystectomy) is now one of the most common surgeries in the world, with over a half million performed each year in the U.S. alone, that should be of interest to a number of people. In fact, roughly 20 million Americans suffer from gallstones, and 750,000 of them undergo cholecystectomies each year. There are 800,000 hospitalizations and $2 billion spent annually on gallbladder disease in the U.S. The bottom line is that gallbladder surgery pays for many boats for many doctors every year -- and there are far better, less expensive ways to deal with the problem.

What Can Go Wrong With The Liver

As we learned in the last issue of this health newsletter series, the liver is amazingly resilient and, at the macroscopic level, not much goes wrong with it. Because it is so well protected, it is rarely affected by trauma, but when it is (automobile accidents, war, etc.), it is often fatal because of the large blood supply that serves it. Likewise, although primary liver cell cancer is common in Africa and Asia (related to a very specific combination of "insults" to the Liver's cells), it is very rare in the United States and the rest of the developed world where those insults tend not to exist. Although hepatitis (particularly hepatitis B) and cirrhosis can be contributing factors, the primary cause of hepatocellular carcinoma is aflatoxin B1.

Liver Cancer

Aflatoxin B1 is the most potent liver cancer-forming chemical known. It is a product of a mold called Aspergillus flavus, which is found in food that has been stored in a hot and humid environment (common storage conditions in much of the third world, especially Southern China and Sub-Saharan Africa). This mold is found in such foods as peanuts, rice, soybeans, corn, and wheat (all staples in the third world). It is thought to cause cancer by producing changes (mutations) in the p53 gene. These mutations work by interfering with the gene's important tumor suppressing (inhibiting) functions. Generally, both hepatitis B and aflatoxin B1 are required for hepatocellular cancer.

That said, metastatic cancer, which is carried to the liver from other organs (think back on how the portal system feeds blood from the intestinal tract, pancreas, and spleen through the liver)is very common.

Hepatitis A

Hepatitis A is a viral disease that affects the liver. Transmission can occur through:

The symptoms of hepatitis A are fever, lack of appetite, nausea, and fatigue, and then jaundice. Jaundice is a yellow or orange tint to the skin or whites of the eyes. Some persons with hepatitis A will have no symptoms at all -- especially children. The symptoms of hepatitis A, if you have them, usually last about one or two weeks, and, in most cases, no specific treatment is required in order to get better. Infected persons shed the virus in their stools from a week or two before symptoms begin until a few days after jaundice begins. Because of this, persons who are ill with hepatitis A should not work in restaurants, child care centers, or nursing homes until their symptoms have resolved.

The hepatitis A IgM test is used to screen for early detection of infection and is used to diagnose the disease in patients with evidence of acute hepatitis. Hepatitis A IgM is the first antibody produced by the body when it is exposed to hepatitis A. On the other hand, hepatitis A IgG antibodies develop later and remain present for many years, usually for life, and protect you against further infection by the same virus. There is no test specifically for hepatitis A IgG antibodies, although a total antibody test (which detects both IgM and IgG antibodies) detects both current and former infection with hepatitis A and will remain positive even after receiving the hepatitis A vaccine.

Hepatitis B

The hepatitis B virus results from exposure to infectious blood or body fluids containing infected blood. Possible forms of transmission include (but are not limited to) unprotected sexual contact, blood transfusions, re-use of contaminated needles & syringes (which explains why the incidence of hepatitis B among drug users is so high), and transmission from mother to child during childbirth. It should also be noted that if you are into the latest fashion trends centered around body piercing and tattooing, you have to be extremely careful with the equipment that is used on you. Make sure the equipment is totally sterile. Using non-sterile equipment can transfer the hepatitis B virus or other blood born diseases to your body.

Also, be careful when eating out. Eating uncooked, raw food or eating from outside vendors can infect you with hepatitis B. This is of particular note when visiting third world countries, but can still be a problem in any developed country.

Symptoms of hepatitis B include:

The danger of hepatitis B is that it can become acute, and then chronic -- ultimately leading to severe liver damage. Unfortunately, there is no treatment that can prevent acute HBV infection from becoming chronic once you get it. The degree of liver damage is related to the amount of active, replicating (multiplying) virus in the blood and liver. Antiviral agents, the medical treatment of choice for chronic hepatitis B, do not work in all individuals with the disease, and may not even be required as in many cases the infection may resolve itself over time.

Although, it's difficult to prevent hepatitis B from progressing if you get it, it is possible to protect yourself from getting it in the first place through immunization. The primary test for hepatitis B is for HBsAg (the hepatitis B surface antigen). Its presence indicates either acute or chronic hepatitis B infection.

Hepatitis C

Hepatitis C (HCV) is the most dangerous of the hepatitis viral infections, and it is the most common cause of chronic liver disease in North America. It is difficult for the human immune system to eliminate the virus from the body once infected, and infection with HCV usually becomes chronic. Over time (often decades), hepatitis C damages the liver and can lead to liver failure. As mentioned, it is difficult for the immune system to clear the virus -- with up to 85% of newly infected people failing to clear it -- and thus most people become chronically infected. It is estimated that in the U.S. alone more than three million people are chronically infected with hepatitis C, with between 8,000 to 10,000 people dying each year. In the U.S., hepatitis C is the leading cause of liver transplant surgery.

Treatment usually involves a combination of an antiviral (most often ribavirin) and alpha interferon. Alpha interferon is an antiviral protein normally made in the body in response to viral infections. The alpha interferon used in treating hepatitis C, however, is not natural. It is a recombinant form that usually involves the addition of a large molecule of polyethylene glycol to "improve" uptake, distribution, and excretion of the interferon, not to mention prolonging shelf life -- and of course, increasing profits for the companies holding patents.

Peginterferon (owned by Roche), the current alpha interferon of choice, can be given once weekly and provides a constant level of interferon in the blood, whereas standard interferon must be given several times weekly and provides intermittent and fluctuating levels. In addition, peginterferon is more active than standard interferon in inhibiting HCV and yields higher sustained response rates with similar side effects. Because of its ease of administration and better efficacy, peginterferon has replaced standard interferon both when used alone and as part of a combination therapy for hepatitis C.

Combination therapy can indeed lead to rapid improvements in up to 70 percent of patients, but it often doesn't last. Long-term improvement only occurs in 35-55 percent of patients. And unfortunately, there are side effects, which frequently include profound fatigue, headache, fever, muscle pain and chills. In fact, that's just the tip of the iceberg.

Fortunately, there are natural alternatives. Ten years ago, I was introduced to someone who had hepatitis C and who reacted badly (extremely so) to his interferon treatments. By the time I met him, he had reached the point that he had stopped his interferon treatments, as death was preferable to the side effects associated with his treatment. As I said, those side effects can be profound. Fortunately, using a different approach, which we'll talk more about at the end of this report, he was able to drop his numbers to undetectable levels -- and maintain those for years. When I last spoke to him about two years ago, he was still symptom free after eight years -- and that's despite never giving up many bad habits including heavy, daily cigarette smoking. Since then, I have personally seen that experience duplicated several more times with other HCV patients.

Testing for hepatitis C, usually involves a series of five tests -- each filling in a piece of the puzzle.

Cirrhosis Of The Liver

Cirrhosis is a degenerative disease of the liver that is often caused by alcoholism, but also may result from hepatitis and even parasites. It is characterized by formation of fibrous tissue, nodules, and scarring, which interfere with liver cell function and blood circulation and can often lead to blood backflow. Symptoms include weakness, weight loss, fatigue, abdominal swelling due to fluid accumulation, clotting defects, jaundice, and tenderness and enlargement of the liver. Tests for cirrhosis include prolonged prothrombin time and decreased albumin. Cirrhosis is untreatable and when advanced ends in portal hypertension, liver failure, hepatic coma, and death. As already mentioned, the primary tests for cirrhosis include prothrombin time (a test that measures how long it takes blood to clot) and decreased albumin. As discussed in the last newsletter, the liver makes all prothrombin and fibrinogen (clotting factors) for the blood, as well as albumin, the major blood protein. Thus, tests indicating low levels of these proteins would be indicative of liver problems.

Liver Enzyme Tests

A simple liver blood enzyme test is often your doctor's first step in determining liver problems. The test is simple. Under normal circumstances, liver enzymes reside exclusively within the cells of the liver, but if the liver is injured for any reason, these enzymes spill out into the blood stream. Thus, if tests reveal them in the bloodstream, it's an "indication" of problems. Specifically, your doctor is looking for the two aminotransferase enzymes: aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). Again, if these enzymes are found in the bloodstream, they are indicative of liver problems. They are not, however, conclusive.

Higher-than-normal levels of these liver enzymes do not automatically mean that you have liver problems. For example, high levels of these enzymes can be caused by muscle damage -- such as that produced by intense exercise. Moderate alcohol intake can also raise levels, as can aspirin. Also, even if the levels are raised as a result of real liver problems, the actual levels are not indicative of the extent of liver damage. For example, patients with hepatitis A may demonstrate very high levels for one to weeks before the condition, as mentioned earlier, totally resolves itself and goes away. On the other hand, patients with chronic hepatitis C infection typically show very little elevation. Again, liver enzyme tests merely indicate a potential problem.

Bilirubin Test

In addition to the liver enzyme test, the prothrombin time test, and the albumin test mentioned above, a complete liver panel will usually include one more test, the bilirubin test. Again as we discussed in the last newsletter, the liver excretes bilirubin, the broken-down pigments from dead red blood cells, by metabolizing it with bile salts and excreting it through the feces. Bilirubin is what makes our feces brown. If for some reason, bilirubin is not excreted (as in obstructive jaundice) the feces will turn clay-colored. Likewise, if bilirubin is found in the bloodstream, it's indicative that something is amiss in the liver and that bilirubin is flowing in the wrong direction -- out into the bloodstream.

Gallstones And The Biliary System

As we discussed last issue, gallstones don't start in the gallbladder; they are related to cholesterol metabolic defects originating in the liver itself. They also happen to be associated with obesity and pregnancy. Essentially, if the cholesterol produced in your liver is too thick and becomes too concentrated in the bile and sits too long in the gallbladder, it can crystallize and form gallstones. It is estimated that gallstones result in some 600,000 hospitalizations and more than 500,000 operations each year in the United States alone. Bottom line: it's one of the most prevalent digestive disorders known.

The usual treatment is laparoscopic surgery to remove the gallbladder. The surgery itself has now become so routine that it can be completed in about an hour and the patient leaves the same day -- back to work the next day.

However, because it does not address the underlying cause of the problem (metabolic issues in the liver), gallbladder surgery often does not resolve the patient's discomfort. And because it eliminates the body's regulating mechanism for the release of bile when needed, it often creates new digestive problems of its own. In fact, after gallbladder removal, some 13% of patients report persistent pain. Another 17% report chronic diarrhea, and another 20% report intermittent digestive problems and pain. The bottom line is that although surgeons will report an almost 100% success rate for the surgery, patients will report a 50 % failure rate. it's all a matter of perspective. The surgeon considers the surgery successful if the patient survives, there are no immediate problems, and she collects her fee without a lawsuit. The patient, unfortunately, has to live with the long term results.

The Biliary Tree

The biliary tree is the anatomical term for the treelike path by which bile is secreted from the liver on its way to the duodenum.

It is referred to as a tree because it begins with a multitude of small branches coming from the thousands of liver lobules which empty into the common bile duct, which is sometimes referred to as the trunk of the biliary tree. Hanging off the trunk, tucked up into the liver is the gallbladder. It is a secondary outpouching, if you will -- an outpouching of the bile duct coming from the liver, which is itself an outpouching of the digestive tract. The gallbladder lies in a groove under the liver, between the two lobes, and is a soft, thin-walled sac, shaped like a fat carrot, with its narrow end pointing toward the bile ducts.

Liver Duct System

Bile drains from the ultra small bile ducts (ductiles) that service each of the Liver's tens of thousands of lobules into progressively larger ducts, culminating in the common bile duct. The right and left hepatic ducts join just outside the liver to form the common hepatic duct.

Bile passing through the common bile duct exits and enters the gallbladder through the cystic duct. Most physicians refer to the gallbladder as a vestigial organ (as they do the appendix) -- meaning that it's lost most of its original function and now pretty much "gets in the way." To them, this explains why the gallbladder does not usually empty completely, which allows gallstones to form -- leading to pain, infection, inflammation, and even cancer. This also explains why they remove upwards of half a million gallbladders a year in the United States alone.

They are wrong!

The gallbladder serves a definite function. It is not vestigial. It regulates the flow of bile so that it can "push out" into the digestive tract in bursts as needed to assist in the digestion of fats. In fact, the gallbladder will contract to squeeze out stored bile when stimulated by a fatty meal. Without the gallbladder, bile merely dribbles out in a constant flow, thus being present when not required and insufficiently present when needed. This can lead to a whole series of digestive problems including poor digestion, intestinal distress, diarrhea, and an inability to fully break down fats. In fact, many people, as they age, need to take an ox bile supplement (available at all health food stores) with their meals to compensate for insufficient bile in their digestive tracts. If you have digestive problems after eating fatty meals, it's one of the first things you (and your doctor) should look at. Incidentally, the issue here isn't one of good fats versus bad fats, but of how much fat. That's one of the reasons fast foods present such a problem -- their fat content is so high, particularly when you combine items such as burgers and fries.

It is important to understand that problems with the gallbladder rarely stem from the gallbladder itself. They stem from the liver, which if not functioning properly will manufacture bile that is prone to "stoning." Thus removing the gallbladder does not eliminate the problem; it merely eliminates ONE place problems can manifest. Where else can problems manifest? If you follow the biliary tree down past the gallbladder, you will find that the common bile duct joins the pancreatic duct before entering the duodenum through the ampulla of Vater. And there's the problem. Although stones and sludge formed in the liver can no longer get trapped in the gallbladder (if it's been removed), they can still quite easily get lodged in the pancreatic duct and ampulla of Vater. This causes the digestive juices secreted by the pancreas to back up into the pancreas itself and start inflaming and digesting pancreatic tissue. This is called pancreatitis.

In other words, by merely removing the gallbladder and not addressing the underlying problem of "bad bile" being formed in the liver, you may potentially merely be moving symptoms from the gallbladder to the pancreas. Fortunately, there are natural health alternatives. Dietary changes will often help. But the best way to optimize the health of your liver, gallbladder, and pancreas is to regularly cleanse and flush the liver and gallbladder.

The Liver Gallbladder Flush

Of all the things I talk about in my books and newsletters, the one that medical doctors have the hardest time with is detoxes and flushes. In fact, the "scientific" community will regularly speak out against the concept. But most of that hostility comes from confusion, misunderstanding, and prejudice. Yes, it's true that there is a great deal of "noise" that contributes to that confusion. A search on the internet shows that the word detox has been associated with everything from shampoos to footpads. On the other hand, it's not that hard to separate the wheat from the chaff -- if one wants to. Certainly there's a whole lot of chaff in the medical community that must be ignored: hormone replacement therapy, angioplasties, and Tamiflu to name just a few.

That said, the principle of the liver/gallbladder cleanse is simple. You deprive the body of all fats and oils for a period of time to allow bile and cholesterol to build up in the liver and gallbladder. You then consume a drink containing a large amount of olive oil, which requires the liver and gallbladder to purge all of their bile in an attempt to digest this sudden intake of fat. This produces a figurative "wringing" action on both the liver and gallbladder causing them to empty. In addition to the purging of bile and cholesterol, a good gallbladder cleanse and liver detox will also help the liver purge accumulated fats and toxins. Note: there are several cautions when doing a liver/gallbladder cleanse.

One Day Versus Five Day Liver Cleanses

If you search under liver detox/flushes on the net, you will find two programs recommended -- a five day program and a one day program. The principles of both programs are the same. The one day program is essentially the same as the last day of the five day program. I prefer the five day program for a number of reasons.

What You Can Expect On The Liver Detox

If you are so inclined (and you should be), you should examine what you deposit in the toilet during the liver/gallbladder flush. Check for "stones" which may or may not be visible. The bile from the liver gives some stones their typical green color, but also look for black, red, and brown stones, as well as stones with blood inside them. During the course of the liver detox, some people will pass many. Be glad, because the more you pass, the healthier you become. You may also find untold numbers of tiny white cholesterol "crystals" mixed in with the waste. But do not be fooled. Oftentimes, the olive oil is converted into little "soap beads" in the intestinal tract, and many people confuse these little beads with actual stones. Also, keep in mind that if you are softening your stones before doing the flush, they will develop the consistency of toothpaste -- thus they will be significantly elongated when "squeezed" out and not look very beadlike at all. And if you are taking psyllium during the program (which I recommend), most of the waste will be encased by the psyllium and not be visible at all.

If you don't notice anything, though, it doesn't mean the flush is not working. Also, many people don't have gallstones. But they do have toxins and accumulated fat in the liver, and those are being purged. In the end, though, it's not what you see, it's how you feel. Wait for a few days after the liver detox and then evaluate. Did you lose weight? Do you feel lighter and cleaner? Did your senses come alive? Does food taste better? Are colors brighter? Is your breathing a little easier, less congested? These are the true evaluations of the liver detox.

Go To The Liver Detox Site

I am not going to go into the details of how to do a liver detox in this newsletter. it's too involved to cover in a single newsletter, and we've covered it in great detail at the Baseline of Health Foundation website. Everything you need to know is there including things like:

Check it out at: Baseline of Health Foundation Liver Detox and Blood Cleansing


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Liver Disorder Information: Jon Barron 11/22/2004 - Detoxifying Your Liver

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