In our liver clinic, we see lots of patients
who have misconceptions about both what makes
their liver sick and what makes their liver
well.
We see a lot of patients who come to us with
the thoughts of "Can I take something for
my liver?
Is there an herbal cleanse that I can take?"
The short answer is "no."
In general, most of the supplements that help
detoxify or cleanse the liver, they really
are nothing more than a way to spend some
money.
The bigger concern is that herbal and dietary
supplements can actually cause a lot of damage
in the liver.
As a class of agents, herbal and dietary supplements
are the second most common cause of drug-induced
liver injury.
When you think about prescription medications
that are FDA-approved, they go through a very
long vetting process of clinical trials.
Herbal and dietary supplements don't go through
that vetting process, so we just don't know
if they will cause liver toxicity.
Cirrhosis is the advanced stage of liver disease,
but it can be caused by alcohol.
It can be caused by hepatitis C, but it can
also be caused by a myriad of other liver diseases
such as autoimmune liver disease or nonalcoholic
fatty liver disease.
Because of the obesity epidemic, the prevalence
of nonalcoholic fatty liver disease has skyrocketed.
We estimate that one in every four people
in North America has
nonalcoholic fatty liver disease.
Nonalcoholic fatty liver disease is caused
by elevated blood sugars of diabetes or prediabetes.
It's caused by gaining weight in your midsection.
It's caused by high triglyceride levels or
cholesterol problems.
We think that nonalcoholic fatty liver disease
is going to be the number one cause of liver
transplants in the next, say, 10 to 15 years,
and maybe sooner.
None of this is to discount the damage that
alcohol can do to the liver.
And unfortunately, the group that is having
the highest increase in alcohol-related liver
disease is young people — people age 25 to
34.
When patients come to see me with abnormal
liver tests or a new diagnosis of some type
of liver disease, very often they're concerned
that that means that their liver is failing
and that they're going to need a liver transplant.
And more often than not, in fact, 90% of the
time, that's just not true.
You can have just simple liver test abnormalities,
let's say due to a medication, where there's zero
injury in the liver.
You could also have a chronic liver disease
that's resulted in cirrhosis, but you don't
have any symptoms from it.
And then, of course, unfortunately, there are
situations where you develop more advanced
liver disease.
The goal will always be to preserve your own
liver rather than trying to get you over to
a liver transplant.
A Mediterranean diet that's rich in vegetables
and lean proteins and healthy fats has been
shown to have benefit in fatty liver disease
as well as other liver diseases.
But people do like to hear about superfoods,
and the one superfood that I think that I
can endorse is, believe it or not, coffee.
Flat, filtered coffee has actually been shown
to have really tremendous benefits
in the liver.
The more coffee you drink, the lower your
risk of developing cirrhosis if you drink
a lot of alcohol.
That's not to say that you should drink a
lot of alcohol and that coffee will save your
life but that we do see a protective effect
of coffee on the development of liver cirrhosis
as well as the development of liver cancer.
So it's been a major focus of our liver clinic
to help patients with weight loss, and we've
done this by getting specialized training
in obesity medicine.
One of the most rewarding things that I do
in the Liver Clinic is helping people
feel enabled to help them lose weight.
I think that because the liver does so many
things, there are often a lot of myths and
misconceptions.
