Upcoming Issue Highlights

Non-Alcoholic Fatty Liver Disease

To a very large extent, the health of the liver determines a person’s overall health, energy levels and immune function. The liver is the second- largest organ in the body (your skin is the largest) and is the largest gland. All together, the liver performs more than 500 separate jobs. It is critically involved in all aspects of metabolism; it makes important cellular structural components; it produces many important blood proteins; and, of course, it plays critical role in detoxification of harmful substances.

If the liver is overloaded with toxins or not functioning up to par, it can lead to low energy levels, since a great deal of the body’s energy resources are being devoted to detoxification. That leaves very little energy for other body processes. Supporting liver function can help energy levels soar to new heights.

What is Non-Alcoholic Fatty Liver Disease?

When the liver is damaged it leads to the depositing of fat within the liver. This process can occur with liver damage caused by alcohol, but there is a new epidemic form called non-alcoholic fatty liver disease (NAFLD). It ranges in severity from a rather benign impairment of liver function to an inflammation of the liver referred to as non-alcoholic steatohepatitis (NASH), which may advance to cirrhosis and eventually liver failure.

NAFLD is thought to affect more than 20 percent of Americans, making it the most common liver disease in the United States. NASH affects roughly 2-3 percent of those with NAFLD, making it a major cause of cirrhosis of the liver. Almost 20 percent of patients with NASH progress to cirrhosis over a decade.

What Causes NAFLD?

While we are now exposed to toxic compounds in the air, water and food like never before the biggest reason why there is an epidemic of NAFLD is that so many Americans are overweight. NAFLD occurs in more than 70 percent of patients who are 10 percent above ideal body weight and nearly 100 percent of those who are obese. In addition to obesity, NASH is also associated with other factors that impair liver function including nutritional abnormalities, drugs and occupational exposure to toxins. The common factor in all of these causes is inflammation. Being overweight or obese is associated with insulin resistance and an inflammatory state.

What are the Treatment Goals in NAFLD?

The primary goal in most cases is improving insulin sensitivity through diet and supplementation. If NAFLD occurs in someone who is overweight, weight loss is critical. The bottom line is that weight loss is the most effective treatment for NAFLD in overweight individuals.

The secondary treatment of overweight individuals and those lean individuals with NAFLD involves the use of liver protecting compounds and of herbal compounds that also promote the flow of bile and fat to and from the liver (choleretics).

Are There Special Dietary Recommendations for NAFLD?

Absolutely, and the first step is elimination of high glycemic foods. In addition, special foods rich in factors which help protect the liver from damage and improve liver function include: high sulfur containing foods like garlic, legumes, onions and eggs; good sources of water-soluble fibers such as pears, oat bran, apples and legumes; cabbage family vegetables such as broccoli, Brussels sprouts and cabbage; and artichokes, beets, carrots, dandelion, and many herbs and spices like turmeric, cinnamon and cilantro.

What Dietary Supplements are Key in NAFLD?

Lipotropic agents are compounds that promote the flow of fat and bile to and from the liver. In essence, they produce a “decongesting” effect on the liver and promote improved liver function and fat metabolism. SAMe, betaine, choline, n-acetylcysteine, vitamin B6, folic acid and vitamin B12 are important “lipotropic agents.” Lipotropic formulas appear to increase the levels of two important liver substances: SAMe and glutathione.

Formulas containing lipotropic agents are very useful in enhancing detoxification reactions and other liver functions. Lipotropic formulas have been used for a wide variety of conditions by nutrition-oriented physicians including a number of liver conditions. Prior to the use of the term NAFLD, many naturopathic and nutrition-oriented physicians used terms such as the “congested liver” or “sluggish liver.” Historically, naturopaths have also used lipotropic factors to address this condition.

Most major manufacturers of nutritional supplements offer lipotropic formulas. The important thing, when taking a lipotropic formula, is to take enough of the formula to provide a daily dose of 1,000 mg of betaine and choline, and 1,000 mg of either methionine and/or n-acetylcysteine. Alternatively, SAMe can be used at a dosage of 200 to 400 mg daily.

If additional support is needed, carnitine may be quite useful. Carnitine is a physiological substance that we make in our body, but sometimes we may not manufacture sufficient quantities— NAFLD may be an example. Carnitine plays an extremely important role in the utilization of fatty acids in the liver as well as in the function of mitochondria—the energy- producing compartment in cells. Low levels of carnitine in the liver can increase the susceptibility to NAFLD. Not surprising, carnitine supplementation has been shown to significantly inhibit, and even reverse, alcoholinduced fatty liver disease.

Herbal Medicines for NAFLD 

There is a long list of plants that exert beneficial effects on liver function. However, the most impressive research is with the extract of milk thistle (Silybum marianum), known as silymarin. Silymarin refers to a group of flavonoid compounds. These compounds exert tremendous effect on protecting the liver from damage as well as enhancing detoxification processes including increasing the liver’s content of glutathione—a key compound in liver function that is low in patients with NAFLD. The standard dose of milk thistle is based on its silymarin content. For this reason, standardized extracts are preferred.

The best results in clinical studies were achieved at higher dosages, i.e., 140 mg to 210 mg of silymarin three times daily. And, even better results have been seen with silybin phytosome is a special extract of milk thistle bound to phosphatidylcholine that produces increased absorption of the key component of milk thistle. The typical dosage for silybin phytosome is 80 to 160 mg twice daily.

Final Comments 

A fantastic way for your customers to jump start improved liver function is through a three-day “juice fast.” This fast consists of three or four 8- to 12- oz., juice meals spread throughout the day. During this period the body will begin ridding stored toxins. Drinking fresh juice for cleansing reduces some of the side effects associated with a water fast such as light-headedness, tiredness, headaches, etc. While on a “fresh juice fast,” individuals typically experience an increased sense of wellbeing, renewed energy, clearer thought, and a sense of purity. Be sure to focus on fresh, organic fruit and vegetable juices. To further aid in detoxification, follow the following guidelines:

1. Take a high-potency multiple vitamin and mineral formula to provide general support.

2. Take a lipotropic formula according to the guidelines above.

3. Take 1,000 mg of vitamin C three times daily.

4. Take 1-2 tablespoons of a fiber supplement at night before retiring.

The best fiber sources are the watersoluble fibers such as PGX®, powdered psyllium seed husks, guar gum, pectin, etc.

5. Take a lipotropic formula and milk thistle extract as described above.

Michael T. Murray, ND, is widely regarded as one of the world’s leading authorities on natural medicine. He is a graduate, former faculty member and serves on the Board of Regents of Bastyr University in Seattle, WA. The author of more than 30 books on health nutrition, Murray is also director of product development and education for Natural Factors Nutritional Products. For more information, visit www.doctormurray.com.