The Aging, Forgotten & Unloved Liver–Part 2

Remember Part I?

In the last blog, we covered the ubiquitous NAFLD, or non-alcoholic fatty liver disease, which is shockingly common world-wide (33% of adults). We also addressed the more severe form of this fatty liver disease called NASH. Additionally, you learned about a common precursor to both of them – Metabolic Syndrome.

You may remember that Metabolic Syndrome is a host of different problems that often occur together. They can include Increased blood pressure, blood sugar imbalances, excess abdominal fat, abnormal cholesterol and triglyceride levels, predisposition to thrombus and clots, arterial plaquing and inflammation.

If you didn’t get a chance to scan the previous blog, this may be a good time. You can see it at: https://www.agingwithpizzazz.com/the-aging-forgotten-unloved-liver/. Now we want to figure out the best choices for you to maintain (or regain) a healthy liver.

Tips to Prevent Liver Dysfunction

Funny how all tips seem to start with “exercise and diet.” No exception here; it’s true for the liver too. Don’t forget our inflammatory-avoidance diets mentioned in part one. These included simple dietary changes (like the Mediterranean Diet, Vegetarian, Pescatarian diet or Intermittent Fasting), all which can greatly help inflammation.

However, there are a few extra steps that we can easily take to improve liver function. And some of these can work in a matter of a couple months.

If you are one of those who avoids taking any supplementation, either for the reason that you think you get everything that you need from food or that you ‘don’t trust what’s in them,’ I understand your point of view. Fraud vs. advantage is not crystal clear.

Nevertheless, sometimes the refrigerator needs a bit of help. Meaning food can’t do it all, even more so as we age. Additionally, with a little bit of homework, you can find products that are reliable quality, and which give you a leg up to AgingWithPizzazz. Further, just because we don’t always hear about them, realize that there are tens of thousands of reviewed studies out there showing great success on many of these substances.  I urge you to read Herbs – a Good Investment or a Waste of Money? and for investigative help:  A Magic Elixir for Everlasting Life? — 3 Warning Tips from California Researcher. 

3 Biggies on the Scoreboard for Liver

The literature on each and every one of the supplements I’m about to cover is extensive. One alone has over 19,000 studies. Thus, I am simply going to mention the basics. Additionally, keep in mind that each offers significant benefit on its own, BUT they can used in combination and are not contraindicated for each other.

1. Curcumin

Curcumin (an element in Turmeric) helps decrease oxidative stress and boosts glutathione (indirectly). It stops changes from NAFLD and can slow or stop the progression of fatty liver. Its ability has been demonstrated equal or above certain drugs.

The workshop I attended made a big deal out of saying “turmeric is a food, curcumin more a medicine.” Indeed, Curcumin is the element of successful studies. Here I am sharing a contrarian opinion about which type to use, but believe I will personally stick with a product guaranteeing an adequate amount (see later) of curcumin.

From my blog (January 2019): #9:

Health Advantage of Turmeric over Curcumin

I am a big fan of Turmeric and its ability to fight inflammation. I was reading related studies being reviewed by Michael Greger, MD. One of the studies showed a rather impressive result of curcumin used with pre-diabetic groups, in which 16% + of the controlled group went on to full-fledged diabetes, whereas zero of the experimental group did so.

Dr. Greger referenced another research paper of 3 case studies treating Alzheimer’s patients with Turmeric in which the results were likewise positive – incredibly so. He pondered whether it was just a fluke, especially since a similar study using Curcumin (an element in Turmeric) did NOT show such results.

The jury may remain out, but Dr. Greger mused why there would be a preference to extract and test the one (currently) known active element in Turmeric, from the Turmeric itself. His answer was only a guess, but worth pointing out. Turmeric (as a spice) cannot be patented but a Curcumin product could. Further, as herbalists have frequently noted, there are synergistic effects from compound substances. The ‘active’ ingredient alone may not fully achieve the effects of the complete complex substance.

Dosing. The supplemental range for Curcumin is vast, as different as 70 to 3,000 mg/day. Very large amounts can cause multiple bowel events in a day. So, no matter what a doc might order, it should always be “to bowel tolerance,” not taking so much that your bowels are loose and active more than 1-2 times per day.

One of the typical recommendations is 750 mg (with 500 mg of that from Curcumin) taken 2x/day. The label will spell that out. Those selling for a manufacturer might also encourage products listed as having “absorption boost.”

2. Andrographis

Andrographis is often called “King of the Bitters” and is an adaptogen. [See ADAPTOGENS – Adapt your Attitude to Alternatives with Resistance Herbs .] It’s fantastic for liver protection and protein metabolism. In traditional herbal medicine, it has been used for various liver complaints and fever, as well as an anti-inflammatory and a boost to the immune system (the latter in studies of respiratory infections and HIV). While studies are still not as numerous as would be liked (800 published in PubMed, as opposed to the over 19,000 for curcumin) the results remain positive, as does anecdotal evidence.

One of its actions that benefits the liver so significantly is that it increases glutathione (along with SOD, another antioxidant). Studies have shown it to be as substantial as Silymarin (Milk Thistle) which has noteworthy respect in both the natural / alternative and pharmaceutical industries.

Dosing. A common dosage recommendation is 400 mg Andrographis with a standardization of 80 mg (whether from leaf of stem). I have never taken this product so can’t report anything on a personal level.

Drugs.com lists no particular side effects. WebMD suggested that with high doses, it’s possible to experience “diarrhea, vomiting, rash, headache, runny nose, and fatigue.”

3. Grape Seed Extract (GSE)

We often hear about Grape Seed Extract for its effect on the heart and blood vessel structures, but it also benefits the liver. More recently, it has been used for painful gout, interestingly since 23% of those diagnosed with gout also have NAFLD.

GSE is also helpful for oxidative stress and inflammation (although not as good as curcumin for inflammation). Animal studies have shown it helps balance blood sugar and decreases LDL (bad cholesterol). But animal studies are just the start of determining such benefits (or not).

Some of the literature is categorized as (or limited to) Oligomeric Proanthocyanidins (OPCs) activity (an active substance of GSE). These are a very complex type of flavonoid found in grape skins, apples and pine bark. [Naturopaths may caution to do a little research beyond standardization, since some products can be adulterated– just as pharmaceutical drugs can – with peanut skin, simply for their color.]

OPCs have many claims to their name, aside from those of general GSE studies.  They include protecting against decreased capillary permeability (which will cause tissue swelling), as well as stabilization of both elastin proteins and skin collagen.

Dosing. Recommended dosage levels for GSE vary (no surprise). According to Drugs.com, this daily dose can range from grape seed extract consisting of 50 milligrams to 300 milligrams daily.

They also report that some studies were structured on dosages consisting of 900 milligrams. It depends on the aim. For general antioxidant support, the U of Pittsburgh Medical Center suggested a daily dose of 50 milligrams of OPCs. Whereas the U of Maryland Medical Center suggests 25 to 150 milligrams for antioxidant support and a daily dose of 150 to 300 milligrams for chronic venous insufficiency.

And remember about that important standardization number. It still remains a fact that supplements aren’t as well regulated as pharmaceutical drugs are meant to be. But each – drug or supplement – is supposed to contain a minimum of a primary active component for the therapeutic benefit we seek.

Some sources say look for standardized grape seed extracts that contain at least 40 to 80 percent proanthocyanidins. According to American Botanical Council, my favorite source for standardization information, “in Canada, GSE standardized to 80-85% OPCs is regulated as an active ingredient of licensed natural health products (NHPs), which require pre-marketing authorization from the Natural and Non-prescription Health Products Directorate (NNHPD).”

I have two products, one a low dose and standardized to almost 50%. The second is a much higher dose and standardized to 70% OPCs. Neither is quite what I would like, but reasonable. Also, neither does the math for me, which seems another black mark for an industry already suspected of being less than transparent.

Bonus Reminder

Since part 2 is concentrating on prevention and alternative solutions, let me include a paragraph from part 1 that belongs here as well. This is a special and well-respected treatment.

Many complimentary-medicine experts recommend Silymarin (aka Milk Thistle) to boost glutathione levels and detoxify the liver. …I have long been a fan (and consumer) of silymarin. Further, the Mayo clinic states that silymarin can be used without concern consistently for more than 3 years.

Once again, I urge you to do a bit of investigative reading yourself, but I will include a recommendation here that I’ve garnered from various sources (varying slightly from each other).  As a preventative or maintenance supplement for the liver (or help with disease or damage) – 300 mg/ 3x per day

Additionally, you should look for standardization levels over 70% silymarin. (80% is commonly available and preferred).   Each of these endorsements suggest divided doses of more than one /day, and frequently 2-3 times a day.

FINAL THOUGHT

Our Liver is a workhorse in the body. Yet it gets much less attention than the other organs or systems. Western lifestyles make it difficult for the liver to function with ease, a reason why the non-alcoholic fatty liver disease (NAFLD) is so common. Still, for most of us, even if diagnosed with NAFLD, or showing signs of metabolic syndrome, there are reasonably-easy avenues to reverse this, and never find ourselves on the road to pervasive liver damage.

If I had a favorite organ, I always thought it would be the under-loved liver. I hope that we can all be inspired to take a few extra steps as outlined here to put a little more love in its life. Of course, that will mean a little more life for us to love as well.

I Thought about ending with a joke about liver and onions.
But I then I realized that might be particularly distasteful.

Resources:

Antioxidants in The Body – This Nutrition

Antioxidants: In Depth | NCCIH (nih.gov) National Center for Complimentary and Integrated Health. Paper covers concepts of free radicals, Oxidative Stress and Pros AND Cons of Antioxidant supplementation.

Curcumin and inflammation in non-alcoholic fatty liver disease: a randomized, placebo controlled clinical trial | BMC Gastroenterology | Full Text (biomedcentral.com)

Difference Between NAFLD and NASH | Compare the Difference Between Similar Terms Comparing NAFLD with NASH

Exhaustive physical exercise causes oxidation of glutathione status in blood: prevention by antioxidant administration – PubMed (nih.gov)

Grape Seed – American Botanical Council (herbalgram.org)

Liver: Anatomy and Functions | Johns Hopkins Medicine

Oligomeric Proanthocyanidins (OPCs) | Winchester Hospital

Understanding antioxidants – Harvard Health

Title Picture credit: drb

 

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Originally Published on https://www.agingwithpizzazz.com/

I hit the Second 50 mark a while back, but have my sights on a different goal –much longer, quality living.

While I may have a ‘dr’ in front of my name, the credentials for this blog are the same as yours – I am on a journey to Age with Pizzazz, whether that is body, mind, spirit or just fun and learning.  It is important to me to share related information with others as well.

I currently live in Southern Oregon with my husband, Michael.  I have had the good fortune (well, usually good fortune) to have called several states my home: Vermont, New York (family home with various locations along the way), Massachusetts (a short stint), Georgia, West Virginia, Connecticut, Arizona and most recently (2014) Oregon.

I grew up in upstate New York to a financially-modest family and did most of my schooling there.  My undergraduate work was in education (music and special education).  I did post graduate work in music therapy (and became an RMT – Registered Music Therapist).  My master’s degree from The New School in New York was in Hospital and Health Care Administration – and also convinced me that along with wonderful advancements, much is wrong with our traditional American medical and health care system (at least at that point).  There was a year more of pre-med courses in the southeast and then a doctorate degree in chiropractic (an industry that also has its many up and down sides).

I often joke that I have had as many professions or jobs as I do fingers.  To live up to that claim, I will name some: waitress, low-level banker, music and special Ed teacher, music therapist, mental health professional, gig performer, real estate agent (for which I had a shot at being the worst ever), probation officer, chiropractor, author and consultant.

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