Q: I have been diagnosed with a serious liver disease, but I hardly drink any alcohol! How did this happen to me? My doctor says I'm at increased risk for liver cancer and may need a liver transplant soon. What can I do to prevent that?
-John A., Juneau, Alaska
A: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in the United States. It has two stages: first, a relatively benign stage called hepatic steatosis (fatty liver), which is almost always due to an increasingly prevalent condition called insulin resistance. The second, more problematic, phase of NAFLD is known as NASH (nonalcoholic steatotic hepatitis), which is an inflamed fatty liver.
What can happen after liver inflammation is scarring of the liver tissue, known as cirrhosis, which can progress further to fibrosis and then necrosis (tissue death). If you already have NASH, work with both a hepatologist (liver specialist) in case you need a transplant, and a naturopathic physician who will guide you in liver detoxification and regeneration techniques.
The crux of liver detox is to stimulate the smooth flow of bile, an important secretion made in the liver that gives a healthy bowel movement its dark brown color. Bile flowing through the liver into the small intestine is the single most crucial aspect of healthy liver function. Many "bitter" foods act as cholagogues, agents that stimulate the production and flow of bile. Among my favorites are freshly steamed dark leafy greens, such as kale, collard greens, chard, spinach, and beet greens. Eat greens daily. Additionally, refrain from drinking any alcohol at all. The pre-eminent herbal remedy for the liver is milk thistle (Silybum marianum), and a standardized encapsulated extract in the range of 300 to 600 mg should be taken daily, depending on your weight.
All thistles are said to be good for the liver, and a tasty one is artichoke. You should have a container of artichoke hearts preserved in a light brine (not oil) in your fridge at all times for decorating your daily salad or greens. Beets are phenomenal cholagogues and are tasty however you serve them. I particularly like a hearty borscht, but I also like to pickle peeled, cubed organic beets in the "water" strained off plain yogurt, or else I use Bubbies pickle water after eating the pickles from the jar. If you have not yet discovered amazing Bubbies pickles, run to your nearest health food store. You'll never want another brand of pickle. And the pickle water can be used several times over to pickle up a batch of leftover veggies. You can also grate raw beets over a salad or plate of warm whole grains and drizzle with balsamic vinaigrette.
For those with chronic hepatitis C, other liver concerns (such as a routine blood test showing high liver enzyme levels), or an apple-shaped body-which can mean fatty heart and liver as well as fat in the abdomen-now is the time to take a close look at your self-care habits. Minimize processed foods in your diet, and get regular exercise-at least 20 minutes of cardiovascular exercise five times per week. Movement is key to health! Sleep is also enormously important. Schedule enough time for eight hours nightly. And get whatever help you need to prevent or treat insulin resistance, a prediabetic condition. Insulin resistance is a huge problem in the United States and is a precursor to liver disease as well as a wide array of cardiovascular diseases, type 2 diabetes, and possibly even Alzheimer's disease.
The "cure" for NASH is to systematically address and reverse all the factors that induced this disease in your liver. You probably need to lose weight: this can only be accomplished long-term by exercising more and eating less. Amino acids and protein shakes may be very useful as meal replacements. You need to turn down your appetite and enjoy the feeling of a shrinking stomach! Avoid chemicals, including alcohol, that are toxic to the liver. Get some counseling if you are angry or frustrated-those feelings are destructive to the liver. If you are diabetic or prediabetic (fasting blood glucose level over 100 in the morning) see a diabetes professional or your family doctor. You get only one body and one life-treat them well.