Tuesday, December 18, 2012

Liver Disease and Nutrition

Six and a half years ago, I was diagnosed with Liver Disease, and referred to the University of Virginia to see some liver specialists. The first thing they did was to refer me to the Transplant Program, where I underwent a battery of tests over several months to determine if the rest of my body was healthy enough to withstand the rigors of a liver transplant.

At the time, I was also having the same intermittent low thyroid symptoms I'd had for most of my life. I show all the symptoms of hypothyroidism, yet the thyroid tests always come back in the normal range. This time, the endocrinologist talked to me about foods that adversely affect the thyroid, most notably cruciferous vegetables and soy products. They are goitrogens, meaning they suppresses thyroid function and the uptake of iodine needed by the thyroid.

Cruciferous vegetables lose a lot of the goitrogens when cooked, but soy does not. I thought I had pretty much eliminated soy from my diet years ago... that is, until I discovered soy masquerades under 40 or more names as food additives. The first thing to eliminate from my diet was any food that came in a package with a long list of chemical ingredients on the label, many of which are soy-based (and from GMO soy).

The next thing to eliminate was sugars, high fructose corn syrup in particular. Fructose damages the liver and causes mitochondrial and metabolic dysfunction in the same way as any other toxin.

Sucrose (table sugar) is 50 percent glucose and 50 percent fructose. High fructose corn syrup (HFCS) is anywhere from 42 to 55 percent fructose depending on which type is used. Glucose is the form of energy our bodies are designed to run on. Every cell in our body uses glucose for energy, and it's metabolized in every organ of our body; only about 20 percent of glucose is actually metabolized in our liver. Fructose, on the other hand, can only be metabolized by the liver, because the liver is the only organ that has the transporter for it. 

Since all fructose gets shuttled to the liver, when we eat a typical Western-style diet, we consume high amounts of it, so fructose ends up taxing and damaging the liver in the same way other toxins (including alcohol) do. In fact, fructose is virtually identical to alcohol with regards to the metabolic havoc it wreaks. 

According to Dr. Lustig (an endocrinologist at the Univ. of California), fructose is a "chronic, dose-dependent liver toxin." And just like alcohol, fructose is metabolized directly into fat—not cellular energy, like glucose. So when eating fructose, it just gets stored in our fat cells, which leads to mitochondrial malfunction. 

The liver is the major site for converting excess carbohydrates and proteins into fatty acids and triglycerides, which are then exported and stored in adipose (fat) tissue.  I was advised to cut my carb intake to 50 grams a day until my system got clean, and then keep the intake to under 100 grams a day. 

The last thing to eliminate was any meat and eggs from animals that may have been fed the same soy and grain I was to avoid, as well as avoiding all fresh produce grown in a chemical cloud. That meant local free-range eggs, grass-fed beef, lamb, pastured pork, free-range chickens, and the Farmer's Market for veggies I don't grow.

Well, let me tell you, for 2-3 weeks I thought I would starve to death! Giving up the obvious addictive sugars was hard enough, but giving up bread and pasta was even worse. That's when I really started to delve into Real Foods, and things started to turn around.

Within a month, my energy levels and mental outlook began to increase, and my liver enzymes improved enough in 3-4 months that my liver docs took me off all meds.

I also began to lose a little weight. I learned to always carry a wholesome snack when I was away from home, usually a hard-boiled farm egg, or a piece of raw milk cheese (for the enzymes not found in pasteurized cheese). (Do not believe raw milk cheese might harbor pathogens. By Law, they must be aged at least 60 days before they can be sold, and if there were pathogens, the cheese would be rotten before the 60 days were up.)

Unfortunately, I have fallen partially off the "good diet" wagon over the last 12 months, mostly due to the increased cost of food and utilities versus my income (just a monthly social security check) and partly due to laziness. Eating right requires planning ahead and making time to prepare nutritious foods. In the last 3 weeks, I've had 3 sodas because I was experiencing low blood sugar while away from the house. That's 3 more than I've had in 5-6 years.

It's time to climb fully back up on that healthy food wagon no matter what else I have to give up. (Or continue a downward spiral in my health.)

There are many, many good things I can make from cheap cuts of meat and bones. Slow cooking a crockpot full of bones produces an incredibly nutritious broth/stock that's like jello when cooled.  Stock contains minerals in a form the body can absorb easily—not just calcium but also magnesium, phosphorus, silicon, sulphur and trace minerals.  Bone broth also supports joints, hair, skin and nails due to its high collagen content. In fact, some even suggest that it helps eliminate cellulite as it supports smooth connective tissue.

Cooked long and slow, bone broth also contains the broken down material from cartilage and tendons, stuff like chondroitin sulphates and glucosamine, now sold as expensive supplements for arthritis and joint pain.

The "odd bits" like heart, liver, kidneys, sweetbreads, etc. contain so much more nutrition than the muscle meats, and they are much cheaper to purchase. I just received a Christmas gift of the book Terrine, plus I found a used copy of Terrines, P├ątes and Galantines on ebay for under $4 earlier this year. (If you are not familiar with terrines, think meatloaf... and a galantine is just a meaty loaf encased in a pastry shell.)

What else did I eat when I felt so great?? Bacon, eggs, sausage, homemade yogurt, salads dressed with fresh lemon juice and a drizzle of EVOO, cheese, real butter, real cream in my coffee (not UP), fresh veggies, olive oil and coconut oil, sardines, not much fruit because of the sugar content, no legumes, no grains, and grass-fed meats daily. My one daily treat was a half-inch square of an 85% cacao bar at bedtime, and it was enough.

Eating those foods also brought the ratio of my Omega-6 to Omega-3 back into a better balance (about 4:1) than the SAD (Standard American Diet) which is as much as 40:1. 

All the meat and dairy provided the essential amino acids necessary to build proteins (essential because our bodies cannot produce them internally). The failure to obtain enough of even 1 of the 10 essential amino acids has serious health implications and can result in degradation of the body's proteins. Muscle and other protein structures may be dismantled to obtain the one amino acid that is needed. "Unlike fat and starch, the human body does not store excess amino acids for later use; the amino acids must be in the food every day.

I bought some wonton wrappers yesterday and intend to make and freeze some wontons (they contain just 4 grams of carbs per wrapper). A lunch of a wonton or two added to some home canned stock is quick, easy, and nutritious. 

It's a start. Salads will be scarce over the winter because I'm leery of bagged greens, even organic ones. Thankfully I froze lots of green veggies from my summer garden.


  1. i have been a long time reader of your blog and i must have missed the liver disease thing. my dad also has a liver disease, primary sclerosing cholangitis. i have tried to get him to clean up his diet like you had but as you know, it is easier said than done. he did it for a month with great success but fell off the wagon and never got back on.

    1. Chuck, That's sad about your Dad. More than once I have felt it was useless to try to improve my health, just a matter of my mental attitude. It's easy to get on the pity-pot.

      My diagnosis was a couple of years before I started this blog, and I guess I just never wrote about it because I was so much better on a Real Food diet. Lately my bilirubin levels have been going up, so it's back to 100% Real Food. Or die.

    2. i am not sure what you have but my dad's disease is an autoimmune disease with a tight link to gluten sensitivity. if he could eliminate gluten, it could help him immensely.

      he has been taking curcumin for a while now. i read many studies that showed it helped with liver health. not sure if it is actually doing the trick but he has been in remission ever since he started taking it.


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