Ask the Liver Specialist

By admin

By Brittany Gannon, MSN, ARNP

Brittany Gannon is a board-certified adult-geriatric nurse practitioner who graduated from the University of Florida with her Bachelor of Science in nursing (BSN), followed by her Master of Science in nursing (MSN).

What does my liver do?

Your liver is an amazing organ! It has multiple functions including 1) metabolism, which is the breakdown of nutrients and molecules and the build up of nutrients and molecules; 2) the storage of nutrients that are used for energy, including carbohydrates and fats in three different ways (glycogen, lipoprotein and triglycerides); 3) protein synthesis, including an essential protein albumin; 4) detoxification — toxins are modified so that they do not harm your body; and 5) bile production, which is needed for the absorption of fats ingested from our foods that is secreted into our small intestine.

What foods are good for the liver?

Black coffee, black coffee, black coffee! Though any coffee is suitable, black coffee is preferred in order to eliminate unnecessary cream and sugar additives. It has beneficial, protective effects on fatty liver disease. There are increasing rates of individuals being diagnosed with fatty liver disease. Risk factors for fatty liver disease include your genetic predisposition, frequent alcohol consumption, and other metabolic diseases including central obesity, diabetes and high cholesterol. There is a lot of research concerning foods good for your liver, some of which include turmeric, green tea, foods rich in omega-3 fatty acids (walnuts, avocadoes, fish oil and chia seeds), foods high in vitamin C (fresh fruits like oranges, apples and grapefruit), vegetables (broccoli, spinach, kale, carrots, beets and cabbage), and lean proteins (chicken, fish and legumes). The goal is to ensure a well-balanced diet, and a general rule of thumb is to always make a colorful plate! If you’d like more information, consulting with a nutritionist may be helpful.

Note: If you have any cardiac disease, please speak with your health care provider regarding recommendations for coffee consumption.

How much alcohol drinking can affect your liver?

Alcohol, made up of ethyl alcohol or ethanol, is found in beer, wine and liquor. After consumption and absorption by your intestines, alcohol is directly metabolized by your liver enzymes. It is true that certain characteristics including age, gender, race/ ethnic background, physical condition (weight, fitness level, additional co-morbidities), amount of food consumed prior to drinking, use of additional prescribed and non-prescribed drugs, and how quickly the alcohol is  consumed may influence how an individual reacts. In short, everyone is different!

In general, women have a lower threshold for alcohol consumption than men. Also, it’s important to note that it’s not what you drink, it’s how much you drink! According to the Centers for Disease Control and Prevention (CDC) one 12-ounce beer is equivalent to one 5-ounce glass of wine or 1.5-ounce shot of liquor. In regard to your liver’s health, heavy drinking is not advised. Heavy drinking is defined as consuming 15 or more alcoholic drinks per week for men and eight or more drinks per week for women. Binge drinking is also not advised. Binge drinking is defined as consuming four or more drinks for women and five or more drinks for men over a short period, during one occasion. Thus, how much you drink is directly related to the intensity of the effect of the alcohol on your body. Chronic, heavy alcohol consumption may damage your liver and lead to advance liver disease, also known as cirrhosis. For more information on alcohol consumption and its impact, visit Cdc.gov/alcohol.

Is it true that light-colored bowel movements mean my liver is sick?

Light-colored bowel movements, often described as clay-colored, may be a sign that your liver is sick. Poop gets its brown color from a component called bilirubin, which is made by the liver and secreted into the intestines. If you have persistent yellow stools, you should speak with your doctor for further evaluation and management.

What are some signs my liver might be sick?

Typical signs that your liver is sick may include non-specific symptoms such as fatigue, weight loss, weakness and anorexia, but they vary upon disease severity. Cirrhosis of the liver, for example, may include (but is not limited to) yellowing of the skin and/or eyes (jaundice), upper intestinal bleeding (e.g., throwing up blood and/or black bowel movements), abdominal swelling with fluid (ascites) and swelling of the legs. Often, the white part of your eyes, known as the sclera, will turn yellow before your skin does. If you are of darker complexion, the whites of your eyes are a good place to look.

Note: Not all liver disease presents with these signs/symptoms. Some liver diseases may be asymptomatic, thus it is important that you consult with your local health care provider for more information and blood work.

Can you survive any amount of time when your liver is sick?

It depends on what is causing your liver to be sick, like viral hepatitis (hepatitis A, B or C) or autoimmune liver disease (in other words, your immune system, which normally works to fight infections, begins inappropriately attacking yourself — in this case, your liver). If you are diagnosed with cirrhosis (late stage of hepatic fibrosis), your prognosis again depends on what has caused damage to your liver, the necessary treatments for your liver disease and how far advanced it is (i.e., cirrhosis with complications or without complications). It is necessary to seek out medical advice with a liver specialist in order to discuss appropriate treatments, screening for hepatocellular carcinoma (cancer of the liver) and further complications to your health that may result from a damaged liver.

How can I maintain a healthy liver?

1. Maintain a healthy diet (lean proteins, complex carbohydrates, vegetables and fruits) and reduce or eliminate processed (meaning packaged) foods, trans fats and foods with a high sugar content.

2. Abstain from heavy alcohol consumption.

3. Do not exceed the recommended adult dose (> age 12 and above 50 kilograms) of Tylenol (acetaminophen). Tylenol can be toxic to the liver in high doses, so < 4000 mg/day of immediate release tablets is preferred.

4. Discuss newly prescribed medications that may be metabolized by the liver and have the potential of hepatotoxic (harmful to the liver) effects with your doctor.

5. Maintain an exercise routine with 30–60 minutes of mild- to moderate-intensity exercise, including cardio, at least three times per week.

6. Strive to reduce central or abdominal obesity. The goal for your abdominal circumference (measurement in inches with a tape measure around your waist at the level of your belly button) is < 40 inches in men and < 35 inches in women.

Note: Please look at the bottle or formulary of Tylenol you use for appropriate dosage consumption, route of use, timing of medication and so forth.