Karin & David Henderson

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Maple Ridge, B.C.

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Your Liver: Understanding Its Functions And Your Role In Maintaining Its Health


As you know, we get many emails and phone calls from people with Meniereís Disease, but we also get a lot of visitors to our website who have only one of the classic Meniereís symptoms. (tinnitus, hearing fluctuation, dizziness and vertigo, and inner ear pressure.)  Information about tinnitus is the most common request followed by dizziness and vertigo: a close second. It led me to research those individual symptoms and what an eye-opener that proved to be! I found this frequent reference to liver toxicity, which of course has severe health consequences. Someone had also sent me a very long list of drugs that had tinnitus listed as a possible side effect. But what really caught my attention was some correspondence about Methotrexate, which incidentally is also on this list. Methotrexate is one of the common treatments for Meniereís symptoms. Please read the article and check out your drugs. If you havenít received the list of possible triggers or havenít read them for a while, let me send it to you. The list continues to grow.


In the last few weeks I have been involved with several searches on drug interactions. Many people haven't any idea that your liver is very closely involved. Your body is like a laboratory. You are consciously or unconsciously creating "mixes" that you may not choose to do. So I thought it would be helpful to discuss the liver as a "body part" and then, talk a little about tests that can be done to detect possible problems. I'll
discuss some of the more common unhealthy conditions. I'll touch a little on how to detoxify or clean your liver.

Lastly, I'll also include some "common sense" ideas that help you to find ways to maintain a healthy liver. I am not definitely not an expert, but your liver is a "body part" that needs a lot more discussion and understanding. When you feel the urge to learn more, please check out the links that are included throughout this article. It is your body and your health, and ultimately, your lifestyle that is under surveillance. I'll also share examples of correspondence I continue to be involved in. You might then think about your own situation and the need for awareness of possible side effects when using drugs. As always, please do not use this information for your own diagnosis, or treatment. My purpose is to help you understand your body's needs. This is not meant to be a medical textbook.

Your liver is somewhat larger than the size of a football and weighing about 2-3 pounds. The liver is the largest organ in your body. Please remember that even if people are not the same size, their livers will be relatively equal in size.  It is a vital organ. In medical terminology that means "to pertain to or contribute to life forces". So while we think or feel it is vital for our lives, it really IS vital for life. You can't live without it. Hence liver
transplants. No other part of your body can replace your liver's function.

It is located in the upper right-hand side of the abdomen. If you look down at your chest right now, it is located on the right side under your ribs, tucked below the lungs. You body is three dimensional. There is lots of room inside your torso. Your lungs are located in your "thoracic" cavity. This is a sac-like area. The abdominal cavity is directly below it, but in a different "sac". It's like two different rooms in your home: each is used for a different purpose. (Actually one sac requires positive pressure in it
and the other requires negative pressure.) Both sacs are in front of the spine. So the liver is tucked in just near the lungs and partially protected by the lower part of the rib cage, but in the abdominal cavity. In front of it sits the gallbladder. You will see the reason for this shortly.

The liver is made up of many, many lobes of different sizes. Think of it as the workings of a Swiss clock. Many processes are constantly working harmoniously together in small "factories"".

Generally we talk about the liver as "liver", but we are really describing its activities or functions. Research has discovered that it participates in over 500 functions! They can be grouped together as metabolism, storage, filtration or excretion. We won't go into great detail with these, but serious students should get reputable books and learn more.

Some of these "broad" functions include:

  1. converting nutrients derived from food into essential blood components.

  2. Storing vitamins and minerals.

  3. Regulating blood clotting.

  4. Producing proteins and enzymes. 

  5. Maintaining hormone balances.

  6. Metabolizing and detoxifying substances that would otherwise be harmful to the body.

  7. Makes factors that help the human immune system fight infection.

  8. Removes bacteria from the blood.

  9. Makes bile which is essential for digestion.

In other words, it stores nutrients, sugars, fats, and vitamins that you body needs to function. It removes or neutralizes toxins or poisons from the blood such as alcohol and other poisons. It produces immune agents to control infection and removes germs and bacteria from the blood. It makes proteins that regulate blood clotting and produces bile to help absorb fats and fat-soluble vitamins. Again, you cannot live without a functioning liver. If you study this list carefully, you will see a tremendous workload
for a relatively small part of your body.

So in working backwards as to what the liver does, and thinking about the things that WON'T get done if the liver is damaged or not functioning properly, you can see that many body systems are going to be in serious trouble.

Let's examine French Fries. In eating some, you ingest the food including the fat involved in the cooking process. The potato itself offers very little in the way of food value, but the chip does offer fat. Your liver creates this fluid and it is stored in the gallbladder (which sits just in front of it). The gallbladder releases bile to help digest fat. If it doesn't metabolize it or use all of it, the fat runs in your blood stream and
finds a home in less desirable place, like the inside walls of arteries.

Bile is a greenish-yellow fluid that is the consistency of egg whites before they are whipped. This fluid consists of bile acids (or salts) and waste products, such as bile pigments. Eventually the bile finds its way into the small bowel, where more absorption and digestion takes place.

Did you know that some medications can interfere with the flow of bile, which can also lead to liver inflammation? (These include erythromycin, some oral contraceptives, chlorpromazine, and anabolic steroids.) So if you are on any of those, do you think it might be a problem for your bile to work effectively? Therefore if your bile isn't helping to break down the fat, can you see how fat "hangs around"?

How do you even begin to figure out if you might have problems? Many people find this out by accident. They go for a routine blood test and here comes a completely unexpected outcome. It might mention "elevated liver count" or "we need to investigate with some more tests".

When you read some of the causes, you might recognize familiar things. You are reading this article BECAUSE you are interested in health. So chances are that you may want to pay more attention to the acute causes. The same symptoms are present for both acute and chronic conditions, in different degrees of severity. The difference is in the timing of the arrival of these symptoms. The diagnosis will be based on many factors, including a detailed medical history.

Basically in liver disease, you are looking at causes, effects, and possible further outcomes. There are many causes of liver disease. The term "Hepatitis" simply means an inflammation or infection of the liver. But we have learned to use it for the actual diseases related to the A, B, C, etc. of Hepatitis. The term "hepatitis" really does scare people! There are several types of hepatitis, and they show up as acute and chronic, but there are other liver-related conditions. More about that a little later. Many "infected" people won't have symptoms until liver damage occurs: sometimes many years later.

If you keep in mind the true definition (inflammation of the liver), it isn't so scary.  Hepatomegaly means an enlargement of the liver beyond its normal size. If it 's large enough, it can be easily felt (palpated) just under the ribs on your right side. It would be tender to touch. This is usually an indication of a liver-related disease such as cancer of the liver. I had a good friend whose co-workers thought he had a big beer belly. They would punch him in the stomach in jest, until he had to tell them that he had cancer of his liver. What a shock! But many people don't have symptoms until a lot later.

The signs and symptoms for both the chronic and acute forms of liver disease are very similar. But the origins are very different. Chronic conditions include the viral infections such as Hepatitis. The acute forms would come most commonly from drug-induced hepatitis.

As well, other conditions such as infections, tumors, parasites, anemias, toxic states, storage diseases, heart failure, congenital heart disease, and metabolic disturbances may all cause an enlarged liver. (Hepatomegaly)

As I mentioned in the beginning, the liver has over 500 functions to handle.  So there will be many ways in which it can be harmed or deterred from functioning properly. You need to rule out many other possibilities.

Can you see how confused finding a diagnosis can be? We latch onto "hepatitis" right away, but more investigation has to be done. That's where a thorough medical history comes into play.

But how does a Hepatitis virus get to the liver in the first place? This is a good spot to describe how a virus "works". Hepatitis B & C  are contagious viral infections that cause chronic liver disease. These viruses find healthy liver cells and uses them to reproduce (replicate) themselves.  Reproduction is the primary job of any virus.  It uses the healthy liver cells as food or energy to reproduce itself. As a result, the liver cells are unable to carry out their jobs (metabolism, storage, filtration or excretion) due to a decrease in function capability or cell death. When your body cells die, they turn into scars. Scar tissue acts as a block to normal functions. (It's like a dead car on a freeway: you have to go around it.)  The virus, in various forms, is specialized to seek out the liver. These viruses live in body fluids, including blood and seminal fluid. The
Hepatitis B virus also lives in saliva and, unlike the AIDS virus, can be transmitted through this fluid with relative ease.

Cirrhosis of the liver is the result of multiple fibroids or scarring. (When a cell dies and this process becomes extensive, it ends up as scarring.) Due to this extensive viral attack on the liver, your liver will have problems carrying out its job. The blood is unable to flow correctly through the liver and is not properly cleaned or restored by the liver cells.

Signs and symptoms include jaundice (yellow tinge to your skin), fatigue, loss of appetite, nausea and vomiting, headache, abdominal pain, dark urine (dark yellow), diarrhea, and distinctive white or clay-colored stools. These could be attributed to many things. It usually takes a long time for these to occur.

As you would expect, symptoms that are apparent because of an unhealthy liver condition would be reflected in the function that is "disabled". Here are a couple of examples. If the blood isn't circulating adequately, it won't provide the body with red (oxygen carrying) blood cells and adequate nutrients: hence you would be really tired.

If something is interfering with bile metabolism, you would be seeing a yellowish colour on your skin and on the whites of your eyes. Your skin would also probably feel very itchy (bile salts). If something is interfering with nutrient absorption and filtering, your stools may change colour, and you would certainly be very fatigued.

Once you show some signs or symptoms, or suspect you have a possible problem, testing as ordered by your medical practitioner has to come next.  Testing pertains to liver "functions". Lab Tests Online has some good general explanations.

Basically these tests will try to determine what part of your liver's responsibilities is not being carried out: metabolism, storage, filtration, or excretion. And the actual results can be measured in normal, higher or lower levels. But again, please be reminded that you are one whole "entity" or body. Everything in you relates to everything else. What affects one part will have an affect on another. Nothing lives in isolation.

Relevant questioning will also add to the results. Often this all pinpoints high risk areas quickly. Although the lab will do the objective testing of the sample, a medical practitioner has to interpret those "findings" and give them some relevant meaning.  A blood sample can show all kinds of chemicals you are exposed to. Your liver is expected to render them harmless.  (Filter and excrete) This is its natural role of detoxification.
Some of these chemicals are so toxic that they can cause cancer or central nervous system problems, even birth defects.

Drug-induced hepatitis involves inflammation of the liver as caused by medication: drugs. (Liver failure is a possible but rare complication of drug-induced hepatitis.)

 "Problem drugs" for the liver include the general anesthetic halothane, methyldopa, isoniazid (used for the treatment of tuberculosis), methotrexate, and amiodarone. Here is one you should be recognizing: drugs that are HMG-CoA Reductase Inhibitors, which are also called statins.

This is why I try to get people to always check for possible side effects and drug interactions. You have to do your own research and then take action. Analgesics and antipyretics that contain acetaminophen are a common cause of liver inflammation.

If you use over-the-counter medications, follow the recommended doses. Did you realise that these medications can damage the liver when taken in doses that are not much greater than the prescribed dose? Call your health care provider if symptoms of hepatitis develop after you start a new medication.  (They include: Jaundice (yellow tinge to your skin), fatigue, loss of appetite, nausea and vomiting, headache, abdominal pain, dark urine (dark yellow), diarrhea, and distinctive white or clay-colored stools.)

If you already know you have liver disease for whatever reason, it is crucial that you make your medical team aware and prevent further possible damage. Also check Medline for drugs you should not be taking. There is no specific treatment for drug-induced hepatitis other than discontinuing the medication that's causing the problem. Usually, drug-related hepatitis subsides within days or weeks after the offending drug is stopped.

If you have been diagnosed with drug-induced hepatitis and have been advised to discontinue taking a medication, call your health care provider if symptoms do not improve after the medication is discontinued or if any new symptoms develop.

If the liver's filtration mechanism and other processes aren't in good working order, these chemicals or toxins will not be removed. They will then continue to circulate in your body and find new, but less desirable homes.

But here are some examples of other problems areas. Did you realise that you are exposed to significant levels of potentially toxic compounds each time you use common household items such as cleaning agents, furniture polish, bug spray or even cosmetics and hair spray? Did you realise that there is formaldehyde in many things? (Another toxin.)  How about artificial sweeteners or now the big one: amalgam or mercury fillings? Time-release fertilizers and pesticides, etc. plus many other chemicals are included.

Under normal conditions, your body can fight off disease and stay healthy. However, in an increasingly toxic world, we are bombarded by pollution, pesticides, processed food, stimulants, stress, and other toxins.

While your body is trying to deal with these toxins, we then deprive it of essential nutrients needed to neutralize and dispose of them or add more chemicals in the form of drugs. They used to be in our foods, but now our highly processed foods have lost a lot of their nutrient value. "If these toxins or blockages are left in the system too long, they can manifest themselves into a physical disorder, an imbalance, or even a degenerative disease such as cancer. Whenever the body is out of balance, the first order of events is to remove the toxins."

Nothing to be done except rest and eat well? I would challenge that. We now know that many degenerative conditions can be helped or even overcome. How?  You need to rebuild the body's defense mechanism including the immune system. You also need to think about removing the offending "causative  agent". Much of hepatitis regime is built on the concept of eating well and rest. Eating well is the real challenge, but nutrients are the only way to restore energy to the liver and all its activities.

Let's discuss detoxification a little bit. Before it is sensible to think about healing, it is important to do things that are in your immediate "reach". Much of it has to do with common sense and avoidance. If you drink heavily or regularly, you should completely avoid these medications or discuss safe doses with your physician.

Other problem drugs for the liver include the general anesthetic halothane, methyldopa, isoniazid (used for the treatment of tuberculosis), methotrexate, and amiodarone. Here is one you should be recognizing: drugs that are HMG-CoA Reductase Inhibitors, which are also called statins.

Use caution and common sense regarding intimate contact. Hepatitis C, spread primarily through direct blood contact, can be transmitted through contaminated needles used in tattooing, body piercing, or IV drug injection.  Did you know that untreated, chronic hepatitis B and C can cause cirrhosis and liver cancer and is the most frequent reason for liver transplants. So not only is the cirrhosis causing scar tissue, but it also causes the toxins to be stored. (That part of the liver is useless now.)

Here are a few things we can all do to keep our livers in good working order. The American Liver Association has more good ideas.

Eat when you are hungry. Have raw fruits and vegetables and drink plenty of water. It washes a lot of the toxins out. Avoid eating large amounts of sugar, especially refined sugar, as the liver will be forced to convert them into fat and cholesterol. Avoid all artificial sweeteners, as these are toxic to the liver and cause hypoglycemia and fatigue. If you must have something sweet, have fresh raw fruits, sun-dried fruits, honey or blackstrap molasses. You can also try Stevia.

If you recall one of the liver's area of responsibility was bile production.  The more unhealthy fats you ingest, the more bile it needs to manufacture.  So study the need for the omega 3 essential fatty acids. People are so obsessed with removing fat from their diets that they tend to go overboard.  Your body needs some fat. It's like lubricating it. Know the right kind of fat and use it properly. Simply put, a healthy liver pumps the unwanted fat out of your body.

Familiarize yourself with homocysteine and its role in cholesterol metabolism. What you will learn will really help you deal with your risk of arteriosclerosis, heart disease and high blood pressure.

Learn what antioxidants are all about, where to find them, and how they can help you fight back. Many vegetable antioxidants have a healing and cleansing effect on the liver. Understand oxidative stress and how you can prevent it from destroying your liver.

As soon as you are prescribed a drug, check it out on Medline

or any of the other drug sites. That is what the internet is for! If there is any sign of possible liver toxicity, beware. If you are on more than one drug, and they, too, have possible liver toxicity, you may just be increasing your chance of overloading your liver with problems.  Many people only look at the individual drug when checking them out. You need to see your body as a cauldron or laboratory of chemicals, all interacting.

I mentioned corresponding with people about this very situation over the last few weeks. In one week, I had three people talking about Methotrexate.  This is a drug that makes your immune system less active. (Making your immune system less active means your body doesn't get quite the same signals as it would without the drug. If your body is reminded of something it doesn't want in it, it sets off its inflammatory process or builds up antigens.  It acts as an warning system Is it a good idea to dampen the warning system? I liken it to closing the door on a courier if you don't want the bad news.  The news is still there, you just don't know about it. Again, is this is
good idea? You need to think about this.)

Methotrexate is used to treat rheumatoid arthritis, psoriasis and other diseases that are associated with an immune system that is too active. It is also used for Meniere's patients to lessen their symptoms. Methotrexate can help people with these problems. But because it can cause some serious side effects, it must be used carefully.

One of the people I worked with had this treatment done for her Meniere's "disease" and now has elevated liver function results. This is a very common drug used to reduce the body's natural response (inflammatory process) to things that set off the symptoms. This drug is very commonly administered.  There is a written caution about liver toxicity.

One of the other people I worked with this past week, had SEVEN drugs prescribed. Three out of the seven all had cautions about possible livers damage!  A fourth drug was contraindicated if "such and such" drug was ordered. (It was.) Two were prescribed for high blood pressure even though his blood pressure was already slightly on the low side and he had the symptoms that were mentioned on his drug profile sheet.

He was also taking some nutritional supplements which were meant to rebuild his immune system. However, I wonder how that could happen very effectively in view of all the chemicals that continued to be put into his body! For the supplements to work, he would need to take in more antioxidants than were being removed via all the chemicals he had with his drugs.

Previously, I mentioned that analgesics and antipyretics that contain acetaminophen are a common cause of liver inflammation. This gentleman had two such drugs prescribed. The problem with all of this was that he had two sets of medical groups prescribing medications. When the pharmacists voiced their concerns, they were told to continue with both. It is so important to keep an eye on any drugs.  That goes for over-the-counter (OTC) ones as well as the prescribed ones.

You frequently read "There is no specific treatment for drug-induced hepatitis other than discontinuing the medication that's causing the problem." People with acute hepatitis are told to "avoid physical exertion, alcohol, acetominophen, and any other hepatotoxic products toxic to the liver) substances. Usually symptoms subside when the causative agent (drug) has been discontinued". We hear treatment for AIDS is massive doses of antioxidants and other nutrients.

61. Treatment like this is based on resting a lot and eating well. The concept here is to restore your body's ability to fight back. It is designed to restore health to your immune system so it can do its natural job of protecting you. Your body instinctively wants to do this!

I would like to offer you an analogy and then a challenge. Pretend you are working for a large cleaning company. It doesn't matter what department you are in. The company employs 200 people and the workload is manageable. Then the company wins a few new contracts. No one else is hired and you need to work faster and harder. More contracts: no other changes. You are now working so fast and so hard that your health gives out and you need to take a couple days of sick leave. The work steadily increases, but your health is wearing down. Eventually you have to go on short term disability. When you come back, co-workers who have pitched in to take on your jobs, are now also wearing out. Things get done as energy and health permit, but it's all done poorly and new things can't be handled at all. The obvious solution would have been to hire qualified people as the additional workload appeared. This is how your liver reacts. It, too, gets sick and isn't able to store the required items. Things aren't getting metabolized, filtered, or excreted.  All things that should be IN your body are not and toxins that shouldn't be there still remain, somewhere.

One of the very interesting things about your liver is that it is always trying to clean (detoxify) itself. That is why it takes so long for the negative effects to accumulate. These are microscopic (only visible with a microscope) in size, so it will take years to show up. But if your doctor finds something "untowards" in your liver function studies, it increases your chances of repairing the damage dramatically. The alternatives to
living with a diseased liver are not a desirable option.

So don't ignore these results. Don't panic, but explore them carefully.

Here is my challenge. Earlier you learned some functions of the liver. Now with this new knowledge, you make a decision to put yourself on an effective nutritional supplement (complete, balanced and in optimum amounts). You decide to help your liver and the rest of your body be healthier. You accept  the fact that quality will cost a little more, but you now understand why.  You know the results will be a big benefit.

You have also learned that one of the liver's functions is to store vitamins and minerals. Would it not make sense now to review everything you are doing? To find ways of changing your lifestyle to "enhance" this healing? To enhance its "working power"? To allow your liver to metabolize and store these supplements that you are about to take?

Let's take this to another level of understanding. Another liver function is to "make factors that help the human immune system fight infection". Would it now make good sense to find ways to rebuild your immune system, and therefore really enhance every part of your liver's ability to keep you healthy and comfortable? That is the function of quality nutritional supplements.

If you create or recreate an environment that promotes your liver's ability to metabolize, store, filter and excrete, do you not think your life will be longer, happier and much more comfortable? If you visited the SANOVIV site and are interested in learning more about these supplements, please get back to me. I will put you in touch with people who can help you.

I have another treat for you. Preserving Your Emotional Autonomy -- a Key to Increasing Your Personal Power This is the link to a site and an article that I feel is very supportive for people who want to take back control of their lives, but still are emotionally attached to others. You can apply this "technique" in many instances. One special area I urge you to consider is your health. Study and understand how to be what you are supposed to be: a happy, healthy human being.


By Karin Henderson - Nurse, Retired.


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