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The Sluggish Liver Explained

 The liver

The liver performs a wide range of functions like detoxification, protein synthesis and production of biochemicals essential for digestion. It produces bile, an alkaline compound which helps in digestion through the emulsification of lipids.
The liver also performs different biochemical reactions involving highly equipped tissues for synthesis and breakdown of small and complex molecules.

Some other functions performed by the liver are:

  • Generation of fats emulsifying substances
  • Glucose to glycogen conversion
  • Manufacturing of amino acids (proteins)
  • Removal of toxic substances from the blood
  • Storage of vitamins and minerals, Iron B12, fat soluble vitamins A, D, E & K.
  • Maintaining proper levels of glucose in the blood
  • The liver also performs methylation

What is methylation?
In simple terms it is a process in which certain chemicals called ‘methyl groups’ are added to various constituents of proteins, DNA and other molecules. These are needed to keep them in good ‘working’ condition. For example, if the antidepressant, “feel-good” brain chemical serotonin is not methylated it will become inactive which leads to depression. Hormones, homocysteine, histamine and even heavy metals are all methylated in the liver.

Methylation and cancer
The pattern of methylation has recently become an important topic for research. Studies have found that neoplasia (cancer) is characterised by "methylation imbalance" where genome-wide hypomethylation is accompanied by localised hypermethylation and an increase in expression of DNA methyltransferase.

Methylation and homocysteine
Probably the most important methylation process is when it is applied to homocysteine. Homocysteine is a by-product of the amino acid methionine and is what remains when methionine is used to methylate your proteins and DNA. Homocysteine needs to be methylated to convert it back to methionine. If this process is impeded there is an increased risk of many diseases including heart disease, osteoarthritis, eclampsia and even cancer.

High levels of homocysteine result in low levels of a valuable substance known as nitric oxide also known as endothelial derived relaxing factor(ENDR). ENDR relaxes arterial muscle walls therefore reducing blood pressure. Exercise also increases nitric oxide.

High levels of homocysteine also results in low levels of sulphur being available for the disulphide bridges used in making connective tissue. This leads to a weakening of connective tissue in the body and leads to early ageing, weak vascular walls and weak bones.

Methylation and Histamine
Histamine is also methylated in the liver by Histamine N-methyltransferase (HMT, HNMT) one of two enzymes involved in the breakdown of histamine. Histamine N-methyltransferase catalyses the methylation of histamine in the presence of S-adenosylmethionine (SAM) forming N-methylhistamine. The other enzyme involved in histamine breakdown is diamine oxidase. Diamine oxidase is a B6 dependent enzyme therefore deficiency in B6 will result in histamine excess such as seen in histadelia.

Some people are over-methylators which leads to low histamine levels, whilst others are under-methylators, leading to high histamine levels. As latest research in mental illnesses shows, histamine imbalance is associated depression, bipolar disorder, schizophrenia, OCD anorexia/bulimia and even autism. This is due to problems with either over-methylation or under-methylation and needs to be INDIVIDUALLY determined. You cannot say for example that all people with depression are under-methylators.

The liver and allergy
As histamine is also associated with allergy, allergy itself indicates a sluggish liver. I don't believe in allergy. I believe allergy is merely a symptom of an underlying cause, notably a sluggish liver. A good naturopath should always treat the causes. Complete avoidance of wheat and milk may alleviate symptoms but is it also important to improve the breakdown of histamine in the body. I believe that people should be able to handle normal amounts of the top 8 allergens (the most common food allergies are to dairy, egg, wheat, soy, peanuts, tree nuts, fish and shellfish) without developing symptoms of allergy. It is not necessary for total elimination of suspect allergens. It should be enough to reduce and rotate whilst treating the “cause” of the allergy which is not wheat etc. per se, however excess histamine resulting from poor methylation by the liver. As naturopaths we should always treat the cause. In TCM also, there is also no such thing as allergy. Allergy symptoms such as itching and rash, are seen are a Liver pathology.

The increase in allergies nowadays is due in part to the hygiene hypothesis and molecular mimicry. Please see also The Naturopathic Causes and Treatment of Autoimmune Disease for more information.

What causes a sluggish Liver?

  • Excessive accumulation of fat within the liver cells due to alcoholism, obesity, diabetes, drugs (like corticosteroids, tetracycline and aspirin) or elevated serum triglyceride levels can lead to impeding liver function.
  • Other cause for sluggish liver function is intrahepatic problems which occur due to over exposure to food additives, solvents (cleaning materials, formaldehyde, toluene, benzene, etc.), heavy metals (lead, mercury, cadmium, arsenic, nickel, and aluminium), and other toxins.
  • Plastic age. Burning and inhaling (plastic is in the sea get sucked up sequentially into the clouds and air) plastics is ubiquitous and emits liver damaging  dioxins & furans, the most toxic chemicals known to science and the most serious public health threat. There is no "safe" level of exposure to dioxin or furans. The Environmental Protection Authority EPA confirmed that Dioxins & furans are a Group 1 carcinogen, meaning that they are known to cause cancer. 
  • Toxic water. Drinking water is one of the leading causes of environmental toxic exposure. Fluoride Chlorine. Lead. Mercury. PCBs. Arsenic. Perchlorate. Dioxins to name a few. I would recommend drinking  tap water. I would equally never recommend drinking from a poisonous BPA containing plastic bottle. Change your life and help end the Plastic Age. Buy a Plastic Electricity Free Carahealth Gravity Fed Water Filter today and fill your stainless steel bottle.
  • Viral infections of liver like hepatitis, inherited disorders like Gilbert's syndrome, hyperthyroidism, consumption of anabolic steroids/synthetic oestrogens/oral contraceptives are some other factors that can restrict the bile flow in the liver and cause impaired liver function.
  • Lack of physical activities, poor nutritious diet, ageing, etc, are some other common causes for sluggish liver function.

Symptoms of a sluggish liver
Here are some signs or indications that may help to identify if the liver is sluggish or not functioning properly.

  • As 80% of the cholesterol is generated by the liver, if the liver is not functioning well there will be abnormalities in the level of fats in the blood like elevated LDL cholesterol and reduced HDL cholesterol and elevated triglycerides.
  • A sluggish liver leads to poor digestion, bloating or flatulence after the meals.
  • Since the liver plays an important role in eliminating toxins from the body skin disease is considered as the first sign of liver damage. Rashes, psoriasis, eczema, boils or acne indicate the liver is removing toxins through the skin.
  • The liver also helps regulate blood sugar levels, hence signs that the liver is not maintaining blood sugar levels may include, loss of appetite, weakness or dizziness, nausea and vomiting.
  • As the liver filters hormones, a sluggish liver in women results in symptoms including heavy or clotted menstruation, irregular periods, fibroids in breast or uterus, hot flushes, ovarian cysts, mood swings or menopausal problems.

Naturopathic lifestyle and dietary advice for a sluggish liver
As I always say good food isn’t rocket science! It is time to spring into action and flush your liver with a detox. Eat a diet low in bad fat high, in good fat, high in soluble fibre, nutrients and clean water. Avoid alcohol and processed food and incorporate plenty of fruits and vegetables in your daily diet along with lean protein foods like fish, tofu, legumes, etc. This will work to assist liver function. 

For a liver flush if you are feeling brave please see also The Liver Flush.

For Dietary advice that benefit the liver please see also Naturopathic Dietary Guidelines and Love thy Liver.

Below is an example of a liver tincture that is part of my range. These herbs are organic practitioner strength 1:1 at least 3 x stronger than others on the market. When it comes to benefiting the liver, there is no pill that can do what a herbal tincture can. The bitter taste stimulates the bitter receptors on the tongue, which stimulates the vagus nerve (the main nerve of the parasympathetic nervous system to promote salivation, bile flow, pancreatic juices and stomach acid. This is a physiological reaction incapable of being produced by any supplement. Buy a month supply today and see the difference this makes to your life.

Herbal medicine for a sluggish liver

Milk thistle Silybum marinarumBupleurum/Chai Hu柴胡 Bupleurum falcatumGlobe artichoke Cynara scolymus,  Barberry Berberis vulgaris

Carahealth Liver contains herbs that regenerate liver cells, promote the flow of bile and assist liver functions in particular, digestion and detoxification. It is recommended for liverish conditions such as irritably, melancholia, nausea, feeling sluggish and particular disorders of the liver. The tincture treats organic liver disease such as hepatitis, cirrhosis, alcoholism, haemochromatosis, cancer of the liver, Wilson's disease, autoimmune disease of small bile ducts, Budd-Chiari syndrome, obstruction of the hepatic vein and Gilbert's syndrome and assists detoxification, especially of heavy metals.

Milk thistle Silybum marinarum – Milk thistle is astringent, bitter, cholagogue, diaphoretic, diuretic, emetic, emmenagogue, galactogogue hepatic, stimulant, stomachic and tonic. Milk Thistle increases the secretion and flow of bile from the liver and gall bladder and contains constituents that protect liver cells from chemical damage. Silymarin, an extract from the seed, acts on the membranes of the liver cells preventing the entry of virus toxins and other toxic compounds to prevent damage to the cells from toxic chemicals and medications. Milk thistle is used internally in the treatment of liver and gall bladder diseases, jaundice, cirrhosis, hepatitis and poisoning. It is indicated in skin complaints associated with a sluggish liver. As a galactogogue it specifically stimulates the flow of breast milk. Milk thistle also lowers cholesterol levels, reducing insulin resistance and reduces the growth of cancer cells in breast, cervical and prostate cancers. Regeneration of the liver is particularly important in the treatment of cancer since this disease is always characterised by a severely compromised and often partially destroyed liver.

Bupleurum / Chai Hu柴胡. / Thorowax Bupleurum falcatum - Bupleurum is antioxidant, antiseptic, antifungal, antiviral, immune stimulant, reduces cholesterol and triglyceride levels and sedative. In TCM Bupleurum is said to be bitter, pungent and cool and to enter the gallbladder, liver, pericardium and san jiao channels. Bupleurum clears less yang disorders such as fever, chills, bitter taste, irritability and vomiting, treats liver Qi stagnation disorders such as vertigo, menstrual disorders, chest pain, bloating and tonifies spleen and stomach deficiency to treat symptoms such as prolapsed organs, diarrhoea and haemorrhoids. Bupleurum is used for fevers, flu, the common cold, cough, fatigue, headache, tinnitus, liver disorders, premenstrual syndrome (PMS), dysmenorrhoea, depression, anorexia, cancer, inflammation, lung congestion, malaria, angina, epilepsy, pain, muscle cramps, rheumatism, asthma, bronchitis, indigestion, ulcers, haemorrhoids, diarrhoea, constipation.

Globe artichoke Cynara scolymus – Globe artichoke is anticholesterolaemic, antirheumatic, cholagogue, digestive, diuretic, hypoglycaemic and lithotropic. The globe artichoke has become important as a medicinal herb in recent years following the discovery of cynarin. This bitter-tasting compound, which is found in the leaves, improves liver and gall bladder function, stimulates the secretion of digestive juices, especially bile, and lowers blood cholesterol levels. Globe artichoke is used internally in the treatment of chronic liver and gall bladder diseases, jaundice, hepatitis, arteriosclerosis and the early stages of late-onset diabetes.

Barberry Berberis vulgaris – Barberry is antibacterial, antipruritic, antirheumatic, antiseptic, appetizer, astringent, anticancer, cholagogue, diaphoretic, diuretic, expectorant, hepatic, laxative, ophthalmic, purgative, refrigerant, stomachic and tonic. It is indicated for correcting liver function and promoting the flow of bile. It ameliorates conditions such as gallbladder pain, gallstones and jaundice. It is indicated when there is cholecystis (inflammation of the gall-bladder) or in the presence of Cholelithiasis (gallstones). Barberry is also indicated when jaundice occurs due to a congested state of the liver. As a bitter tonic with mild laxative effects, it is used with weak or debilitated people to strengthen and cleanse the system. An interesting action is its ability to reduce an enlarged spleen. It acts against malaria and is also effective in the treatment of protozoal infection due to Leishmania spp. Berberine, a constituent of barberry, is antibiotic, antibacterial, antifungal, antiviral, antispasmodic, carminative, sedative, hepatic, hypotensive, immunostimulatory and uterine tonic. Berberine has showed some activity against fungal infections, candida, yeast, parasites, and bacterial/viral infections. Some research has been undertaken into possible use against infection. It is used orally in the treatment of various enteric infections, especially bacterial dysentery. Berberine has also shown anticancer activity. A tincture of the root bark has been used in the treatment of rheumatism, sciatica etc.

Carina Harkin BHSc.Nat.BHSc.Hom.BHSc.Acu.

Cert IV TAE. ARCHTI mem.