Despite its size (about the volume of a football, and about 3 pounds in weight), we’d probably never know we had a liver unless something goes wrong with it. It doesn’t beat; it doesn’t rumble; it doesn’t relax or contract, and yet the liver constantly performs many complex functions that are absolutely essential to good health.

The liver’s multiple functions fall into three general categories:

  • Vascular functions. The liver stores blood, regulates blood clotting, cleanses blood of toxins, and filters blood to remove bacteria and add immune factors.
  • Secretory. By synthesizing and secreting bile, the liver aids digestion. It also helps keep hormones in balance.
  • Metabolic. The liver manufactures new proteins; produces quick energy on demand; regulates fat storage; controls production and excretion of cholesterol; stores certain vitamins, minerals, and sugars; neutralizes, detoxifies, and destroys xenobiotic (alien to the body) substances (e.g., drugs, chemicals, alcohol, pollutants); and metabolizes carbohydrates, fats, and proteins.

In the everyday process of neutralizing toxins, the liver takes a “direct hit” from these toxins. Moreover, it may also produce potent free radicals that can and will injure the liver tissue itself. In order to protect itself, the liver relies on the presence of potent antioxidants, such as glutathione, cysteine, and taurine, as well as vitamins A, B1, and C, the phospholipid phosphatidylcholine, enzymes, and other substances. In addition, the liver possesses an amazing ability to regenerate itself when its cells, known as hepatocytes, become damaged.

Diseases of the liver are almost always serious and can often be life-threatening. The most common liver disorders include:

  • Fatty liver: An abnormal accumulation of fat, primarily triglycerides, that is often associated with heavy long-term alcohol use. Fatty liver is usually asymptomatic and invisible on standard liver function tests. Diagnosed early enough, most cases of fatty liver can be treated (primarily by stopping alcohol consumption) and reversed by taking nutrients such as phosphatidylcholine. Untreated, fatty liver can progress to fatal liver disease.
  • Fibrosis and cirrhosis: Caused by a wide variety of agents, but usually a result of chemical exposure or excessive long-term alcohol use. Fibrosis is a scarring of liver tissue in response to injury. Fibrotic regions do not function like normal liver tissue and, depending on the location, may block important ducts or blood vessels. Cirrhosis is basically widespread fibrosis. As scar tissue progresses, blood flow through the liver falls, leading to further liver damage. There is no cure for advanced cirrhosis.
  • Xenobiotic liver damage. Too heavy a load of environmental toxins, drugs (including many common prescription and over-the-counter drugs), alcohol, and other everyday chemicals, can overwhelm the liver’s abilities to neutralize free radicals and other toxic byproducts of metabolism. High levels of these toxins are believed to be at least partly responsible for liver cancer.
  • Cholestasis. The blockage of bile flow is not so much a liver disease in itself, as a manifestation of other liver disease processes. Bile, which is essential for digesting fats, is produced by special cells in the liver and stored in a pouch called the gallbladder, located just outside the liver. Cholestasis may result from hepatitis or alcoholism, or any other condition that damages bile-producing liver tissue or clogs the intrahepatic ducts that transport bile. The most commonly known form of cholestasis is caused by gallstones, rock hard stones formed in the gall bladder from cholesterol and other substances that impede the flow of bile from the gallbladder.

There are a number of safe and natural therapies that can protect and restore liver function. Remember that, with proper care, the liver has a tremendous capacity to heal itself.

Essential Phospholipids

Phospholipids are lipid-protein complexes that bind together to form a membrane or “skin” that surrounds every living cell in the body, serving at its most basic level, to keep the cell’s contents from spilling out onto the sidewalk. Phospholipids are among the most plentiful of substances in any living organism, and with good reason. We need lots of them, especially a variety called phosphatidylcholine (PC), to live; and in order to keep on living, we need to keep on replenishing them. The body creates much of what it needs, but dietary supplementation can be very helpful, especially when certain organs are overstressed and increasingly, as the body ages. Cell membranes consist primarily of PC molecules (about 40% overall) plus other phospholipids interspersed with cholesterol, glycolipids, and protein molecules.

One of the most common sources of phospholipids is lecithin, which appears naturally in foods like egg yolks, soy beans, sunflower seeds, and rapeseeds. Food processors commonly add lecithin as a natural “emulsifier” to certain foods, and you can also take lecithin as a nutritional supplement.

But, while lecithin has become synonymous with phosphatidylcholine in common parlance, in fact, dietary lecithin may start with PC, but it also includes other lipids. In most cases, the percentage of actual PC in lecithin may be as low as 20%. Depending on its source, PC can also vary in its fatty acid make-up. PC derived from soy has far lower levels of saturated fatty acids and relatively high levels of the more healthful mono- and polyunsaturated fatty acids, including important amounts of linoleic and a-linoleic acids. PC is generally well-tolerated and nontoxic. The FDA classifies it as GRAS (generally regarded as safe), the highest level of safety.

The most impressive clinical benefits of PC supplementation have been achieved using a product known as “essential phospholipids” (EPs). EPs are highly purified extracts containing from 76% to 94% PC, or four to five times as much as ordinary dietary lecithin. Essential phospholipids also supply a high content of polyunsaturated fatty acids, especially linoleic acid, and choline. Choline is an essential nutrient the body uses to make several compounds required by healthy cell membranes, as well as the neurotransmitter acetylcholine (ACh), a crucial brain chemical involved in functions from memory to muscle movement. In fact, PC is the body’s primary source of choline.1

Many studies have demonstrated that PC supplementation, especially with EPs, provides consistently significant clinical benefits. These include normalization of liver enzymes and other biochemical markers of hepatic function, accelerated hepatocyte replacement, and improved liver function all leading to improved overall wellbeing, and ultimately, to enhanced survival.

In a classic study of baboons fed alcohol for years at a time, those whose diets were not supplemented with PC all progressed to liver cirrhosis, while the PC-fed primates evidenced only fatty liver and mild fibrosis.2-4

Tests of EPs in human alcoholics are in their early stages, but the results are encouraging. In one study from Slovakia,5 29 men and women diagnosed with alcoholic fatty liver took two capsules of an EP formulation (2 x 300 mg) 3 times a day over 3 months. EP therapy subjectively improved well-being in 76% of the patients. Objectively, it improved liver function within 2 to 3 months of treatment, as evidenced by significantly reduced levels of key liver enzymes. Elevation of these enzymes is an indication of fatty liver (and other liver pathology), which, as shown here, is completely reversible in most instances with appropriate nutritional therapy, including PC.6

Another double-blind study from Germany7 found a similar result. In this trial, 40 alcoholic men diagnosed with fatty liver and possibly liver inflammation (an indication of even more severe disease), randomly received daily doses of either 1350 mg of PC (fortified with B vitamins) or placebo. Beginning as early as 2 weeks after the start of therapy, the results showed improvement in the PC-treated group. By Week 8, every important parameter of liver function was significantly improved (P <0.05). A double-blind Spanish study confirmed the benefits of “fortified PC” in men with alcoholic fatty liver.8 A third double-blind study found that PC was effective in alleviating fatty liver due to causes other than alcoholism.9

Overall, studies in both animals and humans suggest that PC can be effective not only for slowing the progression of alcoholic liver damage, but for actually halting it in its tracks, before it develops into generalized fibrosis (cirrhosis), which is usually fatal unless the patient receives a liver transplant. Moreover, PC can provide protection against other liver toxins, such as drugs, anesthetics, certain foods and herbs, pollutants, viruses (eg, hepatitis A, B & C) and even radiation.10

Hangover Protection

A hangover (called veisalgia in medical jargon) has been estimated to affect three-quarters of the people who consume alcohol. Although there is no precise definition, most researchers agree that a hangover consists of multiple common symptoms, including headache, nausea, diarrhea, fatigue, cognitive impairment, and an general poor sense of well-being (which, sometimes, is putting it mildly). Aside from its social and economic costs (decreased productivity, poor job performance, absenteeism, estimated to cost American employers $148 billion annually), alcohol-induced hangovers have been linked to increased cardiovascular disease.11

Alcohol causes hangovers by a variety of mechanisms. First, it inhibits the effects of many hormones, including antidiuretic hormone (ADH), also known as vasopressin. As its name implies, ADH tends to suppress urination, so inhibiting its action has the opposite effect: it promotes urination. Alcohol, in fact, induces urination that’s out of proportion to the amount of fluid taken in. This can cause dehydration, which in turn can cause some of the symptoms of hangover, such as headache and nausea.

Alcohol is also thought to promote inflammation. People who are hung over have elevated levels of prostaglandins, hormone like substances that are involved in inflammatory reactions.12 Furthermore, the most severe hangovers are generally associated with the consumption of ethyl alcohol containing high levels of congeners (closely related alcohols, natural by-products of the fermentation or distillation processes by which alcoholic beverages are made) which are believed to elicit an inflammatory response.

Probably the most important factor in hangover is alcohol’s inevitable metabolism to the toxic compound acetaldehyde, which can literally dissolve the cell membrane off liver cells. Fortunately, acetaldehyde is itself metabolized to the benign compound acetic acid (i.e., vinegar). These metabolic processes take time, however, so if you drink too much or too quickly, you will get drunk, and your body will accumulate more acetaldehyde than it can readily handle without discomfort. The result: a hangover.

Besides complete abstinence, there are some simple things we can do to minimize the chances of feeling rotten the morning after. First, drink plenty of water or other nondiuretic fluids. Because alcohol is a diuretic, the more water you take in, the less chance you’ll have of becoming dehydrated. Second, don’t smoke! Cigarettes produce significant amounts of acetaldehyde, among many other toxins. Last, but certainly not least, consider using supplements, such as the amino acid L-cysteine, along with vitamin B1 (thiamine), and vitamin C (ascorbic acid), which have been found to be helpful – especially in combination – for preventing hangover.13, 14

The best results have been achieved with a combination of vitamin C, L-cysteine, and vitamin B1, which provided virtually complete protection for rats fed high doses of acetaldehyde against acetaldehyde lethality for 72 hours (but not complete protection against acetaldehyde toxicity). The researchers postulated that these three nutrients functioned synergistically, stating, “Metabolically, ascorbic acid, cysteine, and thiamine are known to be interrelated in ways which could enhance their individual activity in the body.”14

Vitamin B6 may also be useful in warding off the irritating – often debilitating – symptoms of hangover. Researchers examined the effects of vitamin B6 in people who were drinking to intoxication (Who says scientific studies are boring?).15 During an evening of heavy drinking, 17 men and women received 1200 mg of either vitamin B6 or placebo, in three equal doses of 400 mg each: the first at the beginning of alcohol consumption, the second 3 hours later, and the third at the end of the evening. Using a 20-symptom scale to assess hangover complaints, the participants taking vitamin B6 had about a 50% reduction in their symptoms compared with those taking placebo. (See Going to a Party? Be Prepared!)

References

  1. Gundermann KJ. The “Essential” Phospholipids as a Membrane Therapeutic. Szczecin, Poland: Polish Section of European Society of Biochemical Pharmacology, Institute of Pharmacology and Toxicology, Medical Academy, Szczecin; 1993.
  2. Lieber CS. Relationships between nutrition, alcohol use, and liver disease. Alcohol Res Health. 2003;27:220-231.
  3. Lieber CS. Alcohol and the liver: metabolism of alcohol and its role in hepatic and extrahepatic diseases. Mt Sinai J Med. 2000;67:84-94.
  4. Lieber CS, Leo MA, Aleynik SI, Aleynik MK, DeCarli LM. Polyenylphosphatidylcholine decreases alcohol-induced oxidative stress in the baboon. Alcohol Clin Exp Res. 1997;21:375-379.
  5. Turecky L, Kupcova V, Szantova M, Uhlikova E. Plasma lipid parameters in patients with alcoholic fatty liver after treatment with essential phospholipids. Bratisl Lek Listy. 2003;104:227-231.
  6. Lieber C. Pathogenesis and treatment of alcoholic liver disease. In: Lam S, Paumgartner G, Wang B, eds. Update on hepatobiliary diseases. Dordrecht, Germany: Kluwer Academic Publishers; 1996:69-84.
  7. Knuchel F. [Double-blind study in patients with alcoholic toxic fatty liver. Effect of essential phospholipids on enzyme behavior and lipid composition of the serum]. Med Welt. 1979;30:411-416.
  8. Schuller-Perez A, San Martin F. Controlled study using multiply-unsaturated phosphatidylcholine in comparison with placebo in the case of alcoholic liver steatosis. Med Welz. 1985;72:517-521.
  9. Buchman AL, Dubin M, Jenden D, et al. Lecithin increases plasma free choline and decreases hepatic steatosis in long-term total parenteral nutrition patients. Gastroenterology. 1992;102:1363-1370.
  10. Kidd P. Phosphatidylcholine: a superior protectant against liver damage. Alt Med Rev. 1996;1:258-274.
  11. Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000;132:897-902.
  12. Wiese J, McPherson S, Odden MC, Shlipak MG. Effect of Opuntia ficus indica on symptoms of the alcohol hangover. Arch Intern Med. 2004;164:1334-1340.
  13. Sprince H, Parker CM, Smith GG. Comparison of protection by L-ascorbic acid, L-cysteine, and adrenergic-blocking agents against acetaldehyde, acrolein, and formaldehyde toxicity: implications in smoking. Agents Actions. 1979;9:407-414.
  14. Sprince H, Parker CM, Smith GG, Gonzales LJ. Protective action of ascorbic acid and sulfur compounds against acetaldehyde toxicity: implications in alcoholism and smoking. Agents Actions. 1975;5:164-173.
  15. Khan MA, Jensen K, Krogh HJ. Alcohol-induced hangover. A double-blind comparison of pyritinol and placebo in preventing hangover symptoms. Q J Stud Alcohol. 1973;34:1195-1201.

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