Hampered detoxification processes can result in a condition labeled by many naturopathic and nutrition-oriented physicians as the "congested" or "sluggish" liver, or the more recently coined "impaired hepatic detoxification". Standard liver enzyme blood tests may or may not be elevated in such cases.
The capacity of the liver to detoxify any given compound is determined not only by the inherent toxicity of the compound but also by the available supply of nutrients and endogenous molecules required for Phase I and II reactions, by any pre-existing liver disease which may be present and by the total load of all toxins to which it is exposed.
Impaired liver function can result from intrahepatic problems caused by exposure to food additives, solvents (cleaning materials, formaldehyde, toluene, benzene, etc.), pesticides, herbicides, heavy metals (lead, mercury, cadmium, arsenic, nickel, and aluminum), and other toxins. Other causes include viral infections of the liver, some inherited disorders such as Gilbert's syndrome, alcohol-induced fatty deposits, the use of anabolic steroids/estrogens/oral contraceptives and hyperthyroidism. Bile flow can be restricted also by extrahepatic means such as gallstones, pregnancy, or other physical causes such as tumors.
The congested or sluggish liver is characterized by a diminished bile flow, a condition known in medical terms as cholestasis, while impaired hepatic detoxification refers to decreased phase I and/or phase II enzyme activity. Phase I detoxification rates that are in excess of Phase II activity will also cause toxicity problems due to excessive accumulation of activated intermediates.
The activity of Phase I detoxification enzymes decreases in old age. Aging also decreases blood flow through the liver, further aggravating the problem. Lack of the physical activity necessary for good circulation, combined with the poor nutrition commonly seen in the elderly, add up to a significant impairment of detoxification capacity, which is typically found in aging individuals. This helps to explain why toxic reactions to drugs are seen so commonly in the elderly.
The presence of chronic fatigue is a frequent symptom. Among the other symptoms, people with a sluggish liver may complain of depression, general malaise, headaches, digestive disturbances, allergies and chemical sensitivities, premenstrual syndrome, and constipation. Not surprisingly, these are the same types of symptoms people exposed to toxic chemicals often complain of. Many toxic chemicals (especially solvents) and heavy metals have an affinity for nervous tissue, giving rise to a variety of psychological and neurological symptoms such as depression, headaches, mental confusion, mental illness, tingling in extremities, abnormal nerve reflexes, and other signs of impaired nervous system function.
Although there are more sensitive tests to determine the functional activity of the liver, such as a serum bile acid assay and various clearance tests, clinical judgment based on medical history remains the major diagnostic tool for the sluggish liver.
Clearance tests using saliva, urine, and/or blood after chemical challenge by caffeine, aspirin, and acetaminophen can be useful in detecting Phase I and II imbalances.
General treatments include:
Protection against toxic substances
Bile creation enhancement (cholerectics) often lowers cholesterol
Bile movement enhancement (cholagogues)
Fatty Infiltration reduction
Protection from free radical damage
No one really is allergic to smoke. Many people insist that they are allergic to smoke created by cigarettes or cigars, but the truth is that they have having an allergy-like reaction due to other health complications.
An inability to digest onion or garlic may indicate compromised liver function.
If the liver is too congested, blood may not flow easily back to the liver through the hemorrhoidal veins and this might cause swelling of a weakened vein.
Reduced night vision can be linked to a variety of conditions caused by impaired liver function which in turn reduces vitamin A metabolism.
Impaired liver function can result in excess circulating estrogens and a worsening of breast tenderness.
In one evaluation of 200 Chronic Fatigue and Fibromyalgia patients it was found that 80% had a significant impairment of liver detoxification function.
Patients suffering from toxic burdens may experience a wide range of symptoms, among them fatigue and poor tolerance for exercise. These processes have been postulated to be a central factor in the development of CFS. Oxidative damage to mitochondria and the detoxification process itself is being considered as a fundamental mechanism in the development of CFS. [1 Bland JS, HealthComm Inc., 1997; Int Clin Nutr Rev 1988;8(4): pp.173-5]
A 'sluggish liver' often contributes to headaches.
Acetaldehyde is a toxic substance produced in the body from alcohol and is one of the impurities found in cheap wine and 'moonshine' spirits. Some researchers believe that an acetaldehyde buildup is the cause of hangovers. If the liver's detoxification pathways are impaired, aldehydes can, instead of being converted to the next intermediate product, build up to harmful levels and cause damage since they are often more toxic than the original substances from which they are derived.
It is probably the metabolism of methanol to formaldehyde and formic acid that causes hangover symptoms. Quick methanol metabolizers suffer more. This is reinforced by the fact that the types of drinks associated with more severe hangovers contain higher levels of methanol. [Hangovers: Not The Ethanol, Perhaps The Methanol, British Medical Journal, January 4, 1997;14: pp.2-3]
All types of alcoholic drinks contain some methanol, a substance blamed for the worst hangovers. Whiskey, cheap red wine, fruit brandy and other dark spirits contain the most methanol, sometimes as much as 2% by volume. Vodka and other clear drinks contain the least. In the liver, methanol takes 10 times longer than ethanol to break down.
Magnesium deficiency has been found to be more common in patients with diabetes, liver disease or malabsorption problems.
Correcting abnormal liver function is of great benefit in the treatment of psoriasis. The connection between the liver and psoriasis relates to one of the liver's basic tasks (filtering and detoxifying the blood). Psoriasis has been linked to the presence of several microbial byproducts in the blood. If the liver is overwhelmed by excessive levels of these toxins in the bowel, or if there is a decrease in the liver's detoxification ability, the toxin level in the blood will increase and the psoriasis will get worse.
The liver is responsible for breaking down hormones. If it is not fully functioning, estrogen can build up in the body and increase the risk of breast cysts.
High protein intakes may cause extra metabolic stress to be placed on the liver and kidneys.
Long-term exposure to environmental pollutants and continued assaults on the detoxifying systems may lead to oxidative stress, high levels of phase 1 activity in the liver, and reduced phase 2 detoxification.
The liver is responsible for breaking down hormones. If it is not fully functioning, estrogen can build up in the body and increase the risk of breast cysts.
If the liver is too congested, blood may not flow easily back to the liver through the hemorrhoidal veins and this might cause swelling of a weakened vein.
Four herbs that can promote liver health include milk thistle, dandelion root, globe artichoke and turmeric.
Castor oil packs are commonly placed over the liver.
The coffee enema causes the liver to produce more bile (which contains processed toxins) and moves bile out towards the small intestine for elimination. This frees up the liver to process more incoming toxic materials that have accumulated in the organs, tissues and bloodstream. Coffee contains some alkaloids that also stimulate the production of glutathione-S-transferase, an enzyme used by the liver to make the detox pathways run. It is pivotal in the formation of more glutathione, one of the main conjugation chemicals, enabling toxins to be eliminated via bile into the small intestine. So in other words, a coffee enema speeds up the detoxification process and minimizes the backlog of yet-to-be-detoxified substances.
Fasting has a powerful effect on improving liver function, an effect which continues after the fast. However, fasting should be avoided in cases of severe liver disease or failure.
Acetaldehyde, a metabolic breakdown product of alcohol, is said to destroy vitamins B1, B6 and C. Even though supplements of these nutrients, together with the amino acid cysteine, may help the liver detoxify acetaldehyde, it would be wiser to avoid alcohol, its primary source.
Alpha-lipoic acid has been used very successfully as a therapeutic agent in a number of conditions relating to liver disease, including alcohol-induced damage, mushroom poisoning, metal intoxification and carbon tetrachloride poisoning.
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