Detoxing your liver: Fact versus fiction

Your liver is on the right side of your body, just under your rib cage. Your liver represents the human body’s primary filtration system, converting toxins into waste products, cleansing your blood, and metabolizing nutrients and medications. A healthy liver naturally cleanses itself. Over time, however, exposure to chemicals can damage your liver. For example, drinking alcohol is a well-known way to ruin liver function over time.

When the liver is diseased, the body cannot filter out toxic substances as efficiently. This can cause a wide range of symptoms, including:

• itching
• yellow jaundiced skin
• swelling
• blood vessel problems
• gallstones
• fatigue
• nausea
• diarrhea.

As such a fundamental part of the body’s overall regulation, it’s paramount to keep your liver healthy and to limit overindulgence.

In recent years, many products have flooded the market purporting to detox and cleanse your liver, whether it’s after a weekend of bingeing on food or alcohol, to maintain daily liver function, or to repair an already damaged liver. However, an unhealthy liver will not get better with just a liver cleanse. Some evidence suggests that supplements, such as milk thistle, may improve liver health. However, there is no evidence that these supplements will detox the liver, or that they can cure any liver condition. Liver cleanses cannot replace medical treatment, a person with liver disease needs proper medical treatment and may require lifestyle or dietary changes.

Tinsay Woreta, M.D., a Johns Hopkins hepatologist, is here to help debunk persistent liver health myths and determine the value of cleanses.

Myth #1: Liver cleanses are important for daily health maintenance and are especially helpful after you’ve overindulged.

Though liver cleanses are packaged to claim that they’re a cure-all for daily liver health and overindulgence, Johns Hopkins hepatologists do not recommend them. “Unfortunately, these products are not regulated by the FDA, and thus are not uniform and have not been adequately tested in clinical trials,” explains Woreta.

While some common ingredients in liver cleanses have been shown to have positive results — milk thistle has been shown to decrease liver inflammation, and turmeric extract has been shown to protect against liver injury — there have not been adequate clinical trial data in humans to recommend the routine use of these natural compounds for prevention.

As for overindulgence of alcohol or food, less is always best when it comes to liver health, and cleanses have not been proven to rid your body of damage from excess consumption.

Myth #2: Liver cleanses are a safe and healthy way to lose weight.

Many liver detoxification products are also sold as weight loss cleanses. However, there are no clinical data to support the efficacy of these cleanses. Supporters believe that flushing the liver of toxins can improve metabolism, but there is no evidence to support this claim. In fact, some dietary supplements can actually cause harm to the liver by leading to drug-induced injury and should thus be used with caution.

Myth #3: You cannot protect yourself against liver disease.

“Contrary to this myth, there are many preventive steps you can take to protect yourself against liver disease,” says Woreta. The following measures are recommended:

• Do not drink alcohol in excess

On a routine basis, men should not consume more than three drinks per day, and women should not consume more than two drinks per day to prevent the development of alcoholic liver disease.

• Avoid weight gain

Maintain your body mass index in the normal range (18 to 25) by eating healthy and exercising on a regular basis to decrease your risk of developing nonalcoholic fatty liver disease.

• Beware engaging in risky behaviors

To avoid the risk of acquiring viral hepatitis, do not engage in behaviors such as illicit drug use or having unprotected sex with multiple partners.

• Know your risk factors

If you have the following risk factors for liver disease, it’s important to go for screening, as chronic liver disease can be silent for years and go unrecognized:

• Excessive alcohol use
• Family history of liver disease.

If you have the following risk factors for hepatitis C, it is important to speak with your physician about screening, as nearly 50 percent of patients do not know they’re infected:

• Anyone who received a blood transfusion prior to 1992
• Current or former illicit drug use
• Patients on hemodialysis
• Patients with HIV
• Health care workers who have been stuck by needles with hepatitis C-infected blood
• Anyone with a history of tattoos inked in an unregulated setting.

Myth #4: Liver cleanses can correct existing liver damage.

“Liver cleanses have not been proven to treat existing liver damage,” says Woreta, “but there are many other forms of treatment available for those who are affected.” Here are a few types of liver disease and their available treatment options:

• Hepatitis A and B

You should be vaccinated against hepatitis A and B if you are not immune or have any other underlying liver disease. Highly effective oral medications for patients with chronic hepatitis B infection are available as well.

• Alcoholic liver disease

All alcohol consumption should cease in order to allow the liver the best chance for recovery. The liver has an amazing ability to regenerate and heal once active injury has been stopped.

• Hepatitis C

Highly effective, well-tolerated oral medications now exist to treat hepatitis C.

• Nonalcoholic fatty liver disease

The most effective treatment for nonalcoholic fatty liver disease is weight loss, which has been shown to decrease the amount of fat in the liver and the inflammation caused by the fat.

Myth #5: Obesity does not increase your risk of liver disease.

Obesity significantly increases your risk of developing nonalcoholic fatty liver disease. As mentioned in myth #4, fat in the liver can cause inflammation, which may lead to the development of fibrosis and cirrhosis. “Due to the rising epidemic of obesity in the United States, the prevalence of nonalcoholic fatty liver disease is rapidly increasing and is expected to overtake hepatitis C as the leading indication for liver transplant in the next 30 years,” explains Woreta.

Ultimately, the best thing you can do to keep your liver healthy is to treat it well. Avoid frequent overconsumption of food and alcohol, maintain a healthy diet and exercise regimen, and get screened if you have liver disease risk factors. If you do have liver damage, work with your physician to come up with the healthiest and safest plan for your personal needs.

Sources: Johns Hopkins Medicine, Medical News Today

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