Bayou Health | The Rise of Fatty Liver Disease

How to support liver health and prevent liver congestion
by Shannon Dahlum, FDN-P

Fatty liver disease, in which an excess of fat builds up in the liver, used to occur almost exclusively in those with heavy alcohol consumption, but is now on the rise in otherwise healthy individuals. According to the National Institute of Health, even 5-10% of children suffer with the disease today. Fatty liver causes bile to thicken, which impairs bile flow and negatively impacts hormonal balance, thyroid function, blood sugar regulation, cholesterol levels, and more. What’s going on, and how can we protect ourselves from fatty liver disease and all of its downstream consequences?

The liver is responsible for many hundreds of functions in the body. It produces bile, which helps us to digest fats and properly assimilate fat soluble nutrients, like Vitamins D, A, K and E. Bile also aids in the elimination of toxins from the body, like environmental chemicals, plastics, and heavy metals. Healthy bile recycling in the liver removes excess estrogen and helps regulate testosterone levels. Bile acids assist in converting inactive thyroid hormone (T4) into its active form (T3) which is imperative for healthy thyroid function, metabolism, and overall hormonal balance. The liver also plays an important role in regulating blood sugar levels by releasing stored sugar (glycogen) into the blood stream when needed. Cholesterol and triglycerides in the blood are created and regulated by the liver, as well. When excess fat builds up in the liver and bile flow is impaired, any or all of the previously mentioned functions can become compromised.

Some common signs of liver congestion:

• Hormonal imbalance

• Low thyroid function

• Blood sugar dysregulation

• Hypoglycemia

• High cholesterol

• High triglycerides

• Insulin resistance

• Gallstones or gallbladder issues

• Chronic fatigue

Catching liver congestion early can be tricky because it doesn’t raise red flags on bloodwork until it becomes more severe. In fact, abnormal bloodwork is very rarely the first sign of liver disease or dysfunction; it’s more often one of the last indications seen. Part of the reason for this is that “acceptable” lab ranges are far from optimal. This means that your liver enzymes (markers for liver function) on blood labs may all be in a “normal” range, but “normal” doesn’t always indicate “healthy.” A functional or holistic healthcare provider will likely look for much narrower ranges on lab work, which are better indicators of optimal function. All practitioners are different and likely use slightly varying ranges as guides. Below are general guidelines you can utilize to compare with your Comprehensive Metabolic Panel, which is usually part of your annual blood work that your doctor draws, to see if suboptimal liver function may potentially be correlated with some of your symptoms:

Bilirubin: 0.5- 1.0 mg/dl

AST: men 12-26 IU/L, women 10-20 IU/L ALT: men 12-22 IU/L, women 10-20 IU/L

Gamma Glutamyl Transpeptidase (GGT): men 12-24 IU/L, women 10-20 IU/L Alkaline Phosphatase: 60-90 IU/L

If you see some of these markers on your bloodwork outside of these ranges, read on to learn about possible contributors of liver congestion and how to support healthy function.

One major underlying driver of liver congestion is inflammation in the gut. The entire lining of the digestive system is incredibly delicate, with only a single cell of thickness to separate what’s allowed inside the body (needed nutrients from food) from what needs to stay out (infections, toxins, large food molecules, etc). This single cell wall is protected by a thick layer of mucus, and together, this barrier is maintained by healthy microbes that live within the large intestine. These microbes feed on fiber from the food we consume and create byproducts, called short chain fatty acids, that continually build and support that single cell wall and fend off inflammation that damages it. When there’s a deficiency in healthy microbes, there’s a deficiency in these gut protective short chain fatty acids, and the door is then open for unfriendly microbes, fungi and parasites to move in. This unfriendly environment increases inflammation and causes the mucosal barrier and the intestinal wall to become compromised. This is known as “leaky gut” because molecules and toxins that are not suitable for entering the body are now able to leak through the gut barrier and enter the body. These toxins travel directly to the liver, where they’re bound to bile and carried right back to the gut again. The toxins that re-enter the body after traveling to the gut dramatically increase the workload of the liver. The more toxins the liver has to deal with, the thicker the bile can become.

To support a healthy environment within the gut, nutrition is key. Healthy microbes require a variety of fiber and phytochemicals to thrive. This means eating a variety of plants, in a wide variety of colors is needed. Fruits, vegetables, roots, herbs, spices, legumes and whole grains all support various friendly gut microbes, while excess sugar, highly processed carbs, alcohol and artificial food additives and chemicals damage them. It isn’t only about food, though; sun exposure, exercise, and sleep also alter the gut microbiome. Chronic stress also impairs gut health by directly thinning the protective mucosal barrier that lines the gut, and by diminishing stomach acid which prevents pathogenic microbes from surviving passage through the stomach and into the intestines.

Toxins from within the body that make their way back to the liver through a leaky gut enhances the liver’s work load, but so do the many toxins we’re exposed to in our environment. There are currently 350,000 chemicals and chemical mixtures registered for use globally. The average baby is born with 232 different chemicals in their bodies, as measured in umbilical cord blood.

Unfortunately, completely avoiding environmental chemicals isn’t possible, but you can dramatically decrease your exposure by cleaning up the air in your home, the foods you choose to consume, and the products you apply to your body. Avoid home fragrances, like plug-ins and candles, and opt instead for natural essential oil room sprays or diffusers, if desired. Swap out harsh chemical cleaning products and detergents with natural solutions, like vinegar, hydrogen peroxide, baking or washing soda, or products made with these and natural plant enzymes. Avoid consuming highly processed foods, alcohol, and medicines that aren’t necessary. Pay attention to the products you use on your hair and body, and avoid those that contain phthalates, or have “fragrance” listed in the ingredients list. This one piece of the puzzle could turn into an entire article on its own, so I’ll just suggest that you refer to one of the following apps to guide your home and body care product choices: Healthy Living by the Environmental Working Group, Yuka, Clearya, or DetoxMe.

Mold exposure is another significant contributor to liver congestion, especially in this area of the country where humidity remains high most of the year. This is another area that you can’t control outside of your home, but you can manage within your residence. Mold grows where there is consistent moisture and dust, so be sure to regularly dust all surfaces in the home, and ensure moist areas get adequate air circulation. Condensation commonly accumulates in air ducts, so it may be wise to have your home’s vents cleaned regularly. Be sure to stay on top of replacing air filters consistently, as well. Maintain showers and other moist areas, and run dehumidifiers and fans. When there is visible mold developing on surfaces, spray it with a 3% concentration of hydrogen peroxide and let it sit for 10 minutes before wiping clean. Hydrogen peroxide will kill mold spores without introducing toxic chemicals into the environment.

Heavy metals are a big hitter for liver health by impairing insulin signaling in the liver and promoting liver fat accumulation. One of the most common sources of heavy metal exposure today comes from tap water. Reverse osmosis filters can remove most of these metals, but refrigerator filters and most water pitcher filters (like Brita, for example) aren’t effective at removing them. I personally utilize a water delivery service and have 5 gallon jugs of spring water delivered monthly to use with a water cooler. I have found this to be the most cost effective solution for clean drinking water for my family. I prefer spring water because it’s naturally filtered as it flows through and over rocks, and these rocks also add beneficial minerals to the water. These minerals not only enhance the ability of that water to be absorbed into the body’s cells and properly hydrate, but healthy mineral levels are also one of the best ways to protect against the accumulation of heavy metals in the system.

Speaking of healthy mineral levels, this brings us back to the topic of nutrition once again. Minerals, vitamins and chemicals found in foods that are grown and raised in nature are required for supporting energy production and detoxification processes in the body. Foods that support the liver specifically include broccoli, arugula, Brussels sprouts, cabbage, cauliflower, kale, lentils, radish, turnip, beets, turmeric and ginger. Choline (a nutrient found in egg yolks, organ meats, fish and fish eggs, shiitake mushrooms, beef, chicken and turkey, almonds, and cruciferous veggies) is important for bile production. Various herbs can support liver health and stimulate bile flow; look for teas or supplements containing dandelion root, milk thistle, artichoke leaf, chamomile, burdock root, or gentian. In short, a diet rich in a variety of naturally grown and raised plant and animal foods is need to support liver health.

We tend to blame the hormonal imbalances, the low thyroid function, or the insulin resistance so commonly experienced today as the root cause of our health challenges. Perhaps these are just another symptom of a deeper dysfunction, though, like liver congestion. Regardless of what the root cause of any symptom may be, there is no arguing that supporting healthy liver function is a very important piece to supporting the body’s ability to maintain optimal wellness overall.