The Aging, Forgotten & Unloved Liver
Few people talk about the liver.
Fewer still about the aging liver.
Fewer yet about the connection between the liver and neuro-muscular-skeletal system.
And what, if anything, we can do to protect the liver.
I recently attended a workshop on the health connection between the liver and the muscle skeletal system. There is a connection. But it’s rather convoluted and probably too difficult for me to explain in depth and still be easily understood.
My challenge here is to translate medical-ease into English and provide us a useful take-away.
When in school I learned an analogy that wasn’t actually mentioned in this workshop, but has always stuck with me. We can think of the liver like the catalytic converter on our car. It works to accelerate chemical reactions and remove toxins (like harmful exhaust in the car), so that the body can function more efficiently.
Indeed, the liver is a human workhorse. It produces bile which carries toxins out of the body such as unwanted hormones and bad cholesterol. It metabolizes (and stores) fat. It assimilates and breaks down drugs and hormones and synthesizes proteins we need.
Liver Conditions and Diseases
Most of us grew up hearing about cirrhosis of the liver (generally assuming an alcohol-consumption connection). Or maybe liver fibrosis. And perhaps we knew someone who had Hepatis C or Hepatis B (both which are inflammation of the liver and both now controllable, unlike when we were young). We didn’t hear much more.
More common today, in far greater numbers than any of the conditions above, is NAFLD (and sub-sets). If you have it, you already know what the letters stand for. NAFLD is Non-Alcoholic Fatty Liver Disease.
NAFLD and NASH
NAFLD, due to the accumulation of excess fat in the liver, is incredibly common these days. Unlike cirrhosis, it’s not connected to heavy alcohol use, and can be seen in those who consume a lot or a little.
About 80% of patients with NAFLD have what is known as “simple fatty liver.” Those with simply fatty liver don’t have as much to worry about.
Technically, simple fatty liver doesn’t cause liver cell damage (at least not obviously). There is controversy about whether it accelerates inflammation or not. Additionally, there are some significant self-benefiting, self-help steps which we’ll cover later.
While the majority of the people who have NAFLD are in this mild-worry zone, others aren’t as lucky. The other 20% suffer from another acronym; NASH, which is a type of NAFLD, but a more serious liver condition. NASH or Non-alcoholic Steatohepatitis arises from storing excess fat in the liver, similar to NAFLD.
[BTW, let’s break down part of this word. “Hepatis as in the second half of Steatohepatitis means liver inflammation. The root word, “hepat” is that for “liver.” You may see other words related to the liver that use this root as well. In medical terms “itis” means inflammation, so together they simply mean liver inflammation. Arcane no more.]
Unlike simply fatty liver, NASH is caused by inflammation and liver cell injury. It can lead to major complications including fibrosis of the liver, liver cancers and permanent liver damage.
Both NAFLD and NASH share some common flashpoints.
Role of Metabolic Syndrome in Liver Health
We can’t have two conditions under the same category without realizing that there’s some commonality. Such is the case here. And that common link (other than the liver itself) is Metabolic Syndrome.
Here is another piece of medical language to dissect. The term “syndrome” is usually meant as a cluster of symptoms happening together, same here. Metabolic Syndrome is a cluster of concomitant (or associated) conditions, sadly exacerbating the others.
In Metabolic Syndrome these buddy-problems can include:
- Increased blood pressure
- Blood sugar imbalances (Hyperglycemia, impaired glucose tolerance, type 2 diabetes mellitus or insulin resistance)
- Excess body fat (that ‘apple’ type they warn you about, fat particularly around the waist and especially if reaches the “abdominal obesity” category)
- Dyslipidemia (abnormal fat particles in the blood, like increased levels of ‘bad’ LDL cholesterol, or triglycerides)
- Arterial plaque buildup and Proinflammatory state (tending toward inflammation)
- Prothrombotic situation (concern for increased risk of thrombus formation, occlusion of blood vessels, and/or infarction – obstruction to blood supply, or localized ischemia – lack of blood oxygen)
Assistance for Metabolic Syndrome
While the list above may seem like a litany of usual-suspect conditions (and admittedly, it is), the symptoms have many consequences not to be ignored. The liver condition is just one.
A person who has a majority of metabolic syndrome symptoms has an 11 times greater risk of developing NAFLD than if they don’t. Why important? According to the Annals of Gastroenterology, hospitalizations due to NAFLD have more than tripled just between the tracked years of 2007-2014. Certain demographic groups and men (who tend toward more comorbidities) fare more poorly in regard to both hospitalizations and progressions to worse conditions or death.
Shockingly, it is estimated that 33% of adults world-wide now have NAFLD. It is THE most common liver disease.
Still, some simple dietary changes (like the Mediterranean Diet, Vegetarian or Pescatarian diet or Intermittent Fasting) can greatly help. [See #7 at Opportunity in Times of Isolation — Aging with Pizzazz regarding intermittent fasting.]
Antioxidants made in Body are very Few – Liver Makes One
There may be various ideas as to the prime causes in the pathology of NAFLD and NASH. Still, it appears that mitochondrial dysfunction and oxidative stress appear to be the most important mechanisms leading from a healthy to a diseased liver. But the body tries to help itself also, like with antioxidants.
Most of the antioxidants we use in the body come from our food. And even those made in the body need food (phytochemicals, a general term for ‘plant chemicals,’ not a specific ingredient). Still, only two antioxidants (possibly a few more depending on definitions) can be synthesized by the body.
ALA or alpha-lipoic acid is produced in the “powerhouse” part of the cell, the mitochondria. It’s a coenzyme necessary for chemical reactions in all our cells and how we produce energy. There is a claim that it protects against the damage to the liver (as well as other organs) but it is not made in the liver. Mitochondrial dysfunction can accelerate liver disease.
Glutathione is the Liver’s big gift, mother of them all. This second body-made antioxidant is perhaps the most powerful, naturally-occurring one.
Glutathione, which is technically categorized as an endogenous antioxidant is a pseudopeptide composed of three amino acids (glycine, cysteine and glutamate). However, it’s less important for its makeup and category as much as its overall function. It helps with detoxification of the liver, overcoming infection, recovery after exercise, helps with inflammation and much more – including oxidative stress.
Glutathione isn’t Magic – and has Helpers
It isn’t magic, and does need some help to function, like the above-mentioned amino acids, sulfur (which acts as a sticky agent to collet free radicals and toxins) and selenium. It needs B-Vitamins, specifically Folate, vitamin B6 and B12, which coincidentally are the major components in balancing homocysteine levels, essential to combat inflammation. [See homocysteine portion at: Advantageous Alternatives for B/P.]
Glutathione is present in almost all cells and is vital in protecting proteins and fats against potential harmful effects of free radicals. After 45, the body slows production of glutathione. Naturopaths often consider this a good time of life to start taking what they sometimes refer to as “reduced” Glutathione supplements.
Zinc is also needed for liver to perform its duties (like protein synthesis). [See Zinc – Necessity or Nauseating?]
Many complimentary-medicine experts recommend Silymarin (aka Milk Thistle) to boost glutathione levels and detoxify the liver. Moderate (non-exhaustive) exercise can also boost glutathione production. 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.
Liver & Neuromuscular Skeletal System. Really?
I want to back-track to an earlier comment and say a couple short things about this connection between the liver and the neuro muscular skeletal system. It all revolves around function.
A well-working liver can decrease pain from muscle tension or Rheumatoid Arthritis or peripheral neuropathy. This is in part because of its work on pro inflammatory conditions.
Working with the neuromuscular skeletal system, a chiropractor may diagnosis a subluxation between T7 and T12 (thoracic area of spine) where nerves are related to the liver. Problems in the skeletal system here (at those bony vertebra) can lead to nerve dysfunction, decreased blood flow and impaired liver function.
Perhaps surprisingly (at least to me), carrying more weight than we should acts on the liver as it might on our joints. If we carry 10 pounds more weight than is recommended, it can translate to an extra 15-50 lbs. on the knee joint. Not all joints (or organs) are affected to the same degree, but the extra weight is not only part of the metabolic syndrome but is also more stress on the structure of the organ itself.
What Normal Behaviors Strain the Liver?
There are a few things in our daily lives, what seem like simple normal habits, that put a lot of strain on the liver. And as we have all come to realize, strain and stress are often stepping-stones to pain and disease. We have a few (perhaps obvious) stepping-stones here.
Alcohol. Decades ago, people often jumped to the conclusion that if someone had liver cirrhosis (or pancreatitis), they were alcoholics. As we saw earlier, the most common liver disease these days need not have an alcohol component at all. Nevertheless, excessive alcohol (even mildly excessive use) can add to liver trauma. Moderation is certainly a key.
Acetaminophen. The use of certain OTC (over-the-counter) drugs can be problematic. Most important to this story is one medication that you probably have in your back pocket right now – acetaminophen (or its most popular brand name, Tylenol). It’s harmful to the liver and rapidly depletes necessary glutathione levels (the powerful antioxidant discussed above). Just as we have learned to think “stomach bleeding” in connection to aspirin, we need to consider liver stress when considering the need for acetaminophen.
Inflammatory Diets. None of us eat only fruits and dark green leafy vegetables all day. (A shame.) Admittedly, that would be dreadfully boring. Still, avoiding a diet that increases inflammation is wise, if I can be allowed that understatement. Inflammation is key to so many diseases, including a component in the TOP 3 causes of death. But how difficult is such an inflammatory-avoidance diet?
ONE WORD. That’s all you really need to remember about ‘food’ that exacerbates inflammation. Granted it’s a word with nuance, yet if you get this one idea under your belt, it will help your belt size and the health of the belly under that belt. The word? I bet you already guessed it. SUGAR.
If when you think ‘Sugar’ you can envision sugary beverages, labels of anything including high-fructose corn syrup and refined carbs (like sweets) you would be better off than 90% of our nation. Okay, I made that percentage up, but I would guess it is about accurate. I might even go as high as 95%. The point being that with this avoidance behavior you can make huge strides in health, and the liver is just one beneficiary.
The fact that three out of five people around the world die
from a disease linked to inflammation
raises serious red flags.
— Harvard Health Publishing (from Harvard Medical School)
TO BE CONTINUED …
This is a dense subject and one that is relevant to many of our lives. You certainly know someone with NAFLD, even if they don’t know they have it. Or it could be you. After editing out as much as I could, I still started to think this may be all we can digest for one sitting.
So that’s all the bad news I’m covering about fatty liver. Conversely, on the good side, in this part we included 3 ways to ease strain on the liver, avoid fatty liver and Metabolic Syndrome. Next time, in Part 2, there’ll be more good news, namely extra self-help tips that help us prevent liver dysfunction or treat conditions we may already have, unknowingly or not. In other words, prevention.
Stayed tuned for Part 2 next time, for a few focused tips on giving the forgotten organ a boost.
Part 2 might not be all lollipops & ice-cream,
but Part 1 was the liver-wurst.
Title Picture credit: drb
Resources will be listed in Part 2