We all know that our liver is important, but how much do we really know about the liver? Let’s explore this extremely important organ and come to a better understanding and appreciation of it. The liver is involved in five main areas of body functioning: filtering your blood, digestion via bile production, blood sugar regulation, blood clotting, and biotransformation of endogenous (made by the body) and exogenous (introduced to the body) toxins - AKA detoxification.

Blood Filtration:

Have you ever heard of the portal circulation system? Don’t worry if you haven’t, it’s still woking away within you, even if you didn’t know about it. The portal circulation system is a connection between your digestive tract and your liver. Here, blood full of substances absorbed from your intestines is shunted to your liver for physical filtration of bacteria, immune complexes, and other large substances before they are circulated through the rest of your body. At this step, some biotransformation occurs, and some of the medications we take are transformed into different forms. Because of this step, and the action of hydrochloric acid from our stomach and enzymes in our small intestine, some of our medications cannot be taken orally - think insulin, testosterone, and many biologic drugs taken for autoimmune conditions.

While inconvenient for some drug delivery, blood filtration by the liver is very important. It keeps bacteria and some toxins in our food from making their way through the rest of our bodies. If we back up a step, we can see how increased intestinal permeability (leaky gut) can put excess pressure on this system, allowing substances into the blood that normally would pass through our intestines. Keeping our gut healthy with organic, nutrient-rich diets hight in fiber keeps our intestinal cell barrier tight and functioning optimally. Eating plenty of fiber (a minimum of 25 grams daily for women and 38 grams daily for men) also helps as toxins are bound up in insoluble fiber and escorted out when you have a bowel movement. Keep those bowels moving!

Your Liver and Digestion:

Your liver is located on the right side of your abdomen just under your lower ribs. If you were to put your hands on your lower ribs, your right hand would be holding your liver, and your left hand would be on your pancreas and spleen. The liver and pancreas point at each other and both work hard to help you break down your food into absorbable forms. Think of a kid breaking down a lego creation into its individual bricks so something new can be made; this is akin to the process of digestion. Each day, our livers produce about a quart of bile. Not all of this is pushed into your digestive system at once; much of it is stored in your gall bladder.

Tucked on the underside of your liver closer to your midline is your gall bladder (or that’s where it was if yours has been removed). This little organ works closely with your liver, storing bile until you need it. When you eat, your enteric (digestive) nervous system sends messages ahead to your organs of digestion including your gall bladder. When it get the signal, your gall bladder releases bile into your intestines, which breaks down fats. This is if it’s flowing unobstructed and fluidly.

As we have learned in our previous discussion about dandelion, the consistency of your bile will determine whether you develop gall stones or not. The thicker and slower moving your bile, the more likely you will develop stones. If you have your gall bladder removed but don’t address the health of your bile, you can continue to have issues. One of the more common side effects of gall bladder removal is chronic diarrhea and difficulty with digesting fats. Unfortunately, the surgery isn’t a permanent solution to all your gall bladder woes. Luckily, addressing your bile health is simple: eat a high-fiber, organic, and nutrient-dense diet; stay well hydrated; get your exercise and rest; and when needed give your system some encouragement with liver loving herbs.

A note on bile:

Bile is made by the liver and is made up mostly of bilirubin from red blood cell recycling, bile salts, lecithin, cholesterol, and whatever your liver has been breaking down for release from the body. (1) Cholesterol? You read that right, most of the cholesterol in our circulation is actually made by the body. The cholesterol we eat is broken down (Lego blocks) and absorbed in a different form. We make cholesterol for many purposes including hormone production and it’s very important for our bodies. But as always, too much of a good thing isn’t a good thing. States of high blood sugar, inflammation, high toxic load, and liver damage create high cholesterol. When the liver is really damaged — as in cirrhosis — the cholesterol levels plummet as the liver loses its ability to function.

For some, including those with familial hypercholesterolemia where their bodies are designed to make high levels of cholesterol due to genetic changes in their DNA blueprint, statin drugs can be quite helpful. In others who have very high levels of cholesterol and are at increased risk of heart attack or stroke, statins can also be a part of their solution. But it is important to realize that there is more to the story than putting the brakes on cholesterol production. High cholesterol is a symptom of a larger imbalance, not a disease on its own - even if there is a name and drug for it.

Another quick note on statins: they work by inhibiting the activity of an enzyme called HMG-coA reductase. This is the same enzyme we use to make CoQ10, an important compound that we need to turn our food into energy (ATP) in our mitochondria (the powerhouse of the cell). This is why many people on statin therapy develop fatigue and muscle weakness. So, if you are on a statin, be sure to talk to your doctor about adding a CoQ10 supplement. If you are opposed to supplementation, then be sure to eat plenty of heart as it is very rich in CoQ10. I get mine from Kookoolan Farms when I pick up my beef share once a year. I’m sure you can find a good source as well.

Your Liver and Blood Sugar:

We are all mostly familiar with the hormone insulin and that it is involved in blood sugar regulation - this is a common therapy for people with diabetes after all. Insulin is made by the pancreas and shuttles glucose (blood sugar) from your blood and into your cells where it can be broken down into energy by the mitochondria. The pancreas also releases the hormone glucagon. This hormone works to signal the release of glucose from its storage in the liver. That’s right: your liver also acts as an energetic storage depot. When blood sugar levels get too low, the pancreas sends that glucagon out and the liver answers the call. Not only does your liver store and release glucose, it also makes it. Remember how insulin shuttles glucose into your cells? When it gets to your liver cells, they can turn glucose into a larger storage molecule called glycogen. When glucagon makes its way to your liver cells through the blood stream, your liver gets to work breaking glucose molecules off glycogen molecules and releasing them into your blood stream.

What happens when you run out of glycogen? Your liver and kidneys get to work making glucose out of amino acids, lactic acid, triglycerides, and other sugars such as fructose. This is called gluconeogenesis. When this isn’t enough energy, your liver will save glucose for your brain, red blood cells, and kidneys and turn fats into energy molecules called ketones through a process called ketosis. (2) Your liver has plans A, B, and C to keep you up and running.

Your Liver and Blood Clotting:

Blood that clots is a good thing. This is what keeps us from bleeding to death from a paper cut. However, blood that clots too readily is too much of a good thing - this leads to complications such as heart attack and stroke. Like in most of life’s areas, a balanced middle path is what we are striving for.

Blood clot formation and deconstruction is a complex system coordinated mostly by blood cells and enzymes made in the liver. When you are injured, your body will work to stop blood loss. It does this first by causing your blood vessels to clamp down, like putting a kink in a hose. Next your platelets, which are tiny cell fragments in your blood, will clump together creating a temporary plug. Then your body jumps into gear strengthening this plug by forming a mesh of protein called fibrin around that plug - this is what we call a clot. Your liquid blood has formed into a gel. Once your tissues have begun to heal, your body then breaks the clot back down so it cannot cause harm elsewhere - this begins within two days of the original injury. (3)

Where does the liver come in? The liver is what makes the enzymes that will create a blood clot. Without these enzymes, we couldn’t get past the platelet plug stage. The liver also makes some of the enzymes involved in breaking the clot back down.

When the liver is injured, your body will begin to lose its ability to form clots. This damage greatly increases the risk of blood loss and hemorrhagic strokes. In more severe cases of liver disease, we see an increase of blood pressure in the portal system. The portal system is where blood rich in nutrients gets filtered by the liver before heading to the heart for general circulation. This pressure creates a back up into the liver enlarging it and the veins around it. In advanced cases, people can form esophageal varices - weak spots in the veins of the esophagus. These weak spots are at risk of rupture, and without the ability to form strong clots, people have been known to bleed to death.

Liver disease is very serious. Let’s do everything we can to keep our livers functioning well.

Your Liver and Detoxification (Biotransformation):

Now we get to the function that most people think of when considering the liver: detoxification.

As you may suspect given the journey we have taken with the liver thus far, this is no simple feat! Toxins that enter the bloodstream cannot simply be denied access and ejected. The liver catches what it can as the river of blood courses through and transforms these substances into forms that can be more safely removed from the body. This is a three-step process: phases one, two, and three. It should also be noted that these processes happen in every cell of the body, but the majority occurs in the liver and the walls of your intestines.

Phase One:

In phase one, specific enzymes in a family called Cytochrome P450 change toxins into more water-soluble forms making them easier to remove from the body. (1) This process can make some toxins harmless, but it makes others even more dangerous. It also creates free radicals (also known as oxidants), which cause cellular damage. The most important anti-oxidant we have to neutralize these free radicals is glutathione. Glutathione production requires selenium, magnesium, vitamin C, the B vitamins riboflavin, pyridoxine, niacin, folate, B12, branch-chained amino acids, and flavonoids. Now you can see why a nutrient rich diet is so important! We need to keep glutathione levels high, and we need glutathione in phase two. Two herbs that work to keep glutathione levels up are turmeric and milk thistle seeds. These two herbs can be incorporated into your diet easily. Use your nut and seed grinder to grind milk thistle seeds fresh, and add organic whole turmeric root or high quality organic powdered root to your foods while cooking. Golden milk is another great way to get more turmeric into your diet.

Phase Two:

In phase two, a small chemical is attached to the toxin making it less dangerous and easier to remove from the body. This is done in many different ways either involving glutathione or sulphur compounds or by adding a small chemical, such as a methyl group, to the toxin. Each of these methods needs many different vitamins and minerals - again showing why a nutrient dense diet is important!

Phase Three:

Both phases one and two take place inside cells. Phase three is the process by which the transformed toxins are removed from the cell and either carried through the bile into the intestines for removal or moved to the blood to be removed by the kidneys in the urine. This last step is far less understood currently, but curious minds are working to figure it out.

Our Hard Working Ever-Loving Livers:

I hope you now have a better appreciation for your liver. It is a hard working and vital organ. With the changes in our lives as humans over the past few hundred years, we can see that our livers are working harder than ever. Herbs like dandelion, milk thistle, and turmeric are much more important than we give them credit for. Simple vitamins and minerals also do much more than we could ever have suspected.

To give your liver the support it deserves, you can take the following steps:

• limit your alcohol intake - for some people, even 1 oz can cause liver damage.

• Quit smoking if you are a current smoker

• Get tested for Hepatitis and get treatment if you have it - the treatments are getting better all the time

• If you have diabetes, work with your doctor to get your levels under control

• Avoid high fructose corn syrup like the plague

• Don’t use Tylenol - it is a potent liver toxin

• Eat 7-10 servings of vegetables and fruit daily - organic is best, but if you need to budget in this area, follow the EWG’s Clean 15 and Dirty dozen list.

• Eat plenty of fiber: 25 grams minimum for women, 38 grams minimum for men

• Stay well hydrated and drink clean water - filter it if you need to

• Limit your exposure to household toxins in cosmetics and cleaners

• Avoid heating foods in plastic containers

• Avoid drinking beverages from plastic containers

• Don’t use pesticides or herbicides around your home

• Add milk thistle seeds, turmeric, and dandelion to your diet liberally and regularly

What else do you do to support your liver? Did you learn anything here that surprised you? Do you have more to share with us about livers? Do you have any other questions? I would love to hear from you.

To our health!

References:

1. Tilgner, S. Herbal ABC’s: The Foundation of Herbal Medicine. Wise Acres LLC, 2018

2. Diabetes.co.uk. The Liver and Blood Glucose Levels. https://www.diabetes.co.uk/body/liver-and-blood-glucose-levels.html January 15, 2019 accessed January 18, 2019

3. Marieb, E. Hoehn, K. Human Anatomy & Physiology 9th edition, Pearson Education Inc, 2013