Dr Deepak K Agarwal
The writer is senior consultant gastroenterologist, hepatologist & endoscopist and is running a successful medical Centre in Lucknow
True proportion of cases of hepatotoxicity or toxic-induced liver disease is unknown, as this entity is underdiagnosed and underreported. The main reasons why toxic-induced liver disease goes unnoticed is the lack of pathognomonic data and the lack of spontaneous reporting by doctors and pharmacists. In some cases, the toxic substance can leave its signature in the form of clinical semiology suggestive of an underlying toxic cause. Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you're exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements. In some cases, toxic hepatitis develops within hours or days of exposure to a toxin. In other cases, it may take months of regular use before signs and symptoms appear. The symptoms of toxic hepatitis often go away when exposure to the toxin stops. But toxic hepatitis can permanently damage your liver, leading to irreversible scarring of liver tissue (cirrhosis) and in some cases to liver failure, which can be life-threatening.
Mild forms of toxic hepatitis may not cause any symptoms and may be detected only by blood tests. When signs and symptoms of toxic hepatitis occur, they may include: Yellowing of the skin and whites of the eyes (jaundice); itching; abdominal pain in the upper right portion of the abdomen; fatigue; loss of appetite; nausea and vomiting; rash; fever; weight loss; dark or tea-colored urine. See your doctor right away if you have any signs or symptoms that worry you.
Avoiding too much unhealthy fat and salt may help to keep your liver healthy because a high-fat diet is another contributor to fatty liver disease. Choose healthy fats from plant sources such as almonds, coconut, walnuts, chia seeds, flax seeds, and pumpkin seeds or animal sources such as eggs and fatty fish (salmon). Keep the daily sugar intake up to 20-30 g or less because the liver is responsible to digest the sugar level in the blood. Too much sugar in the blood may exhaust liver function. Manage your stress with meditation and yoga. It will control your cortisol level that may reduce stress on your liver. You can use certain counselling for better results.
How does alcohol affect health?
The most well-established complication of long-term alcohol use is liver disease. Alcohol, although legal and socially acceptable, arguably has the most profound impact on the human body both mentally and physically. Alcohol has an effect on many different organs such as the liver, pancreas, stomach and esophagus. Alcohol use can cause malnutrition and vitamin deficiencies such as low thiamine. Most notably, alcohol use can have life-threatening effects on the liver. Many alcoholics have an elevated Bilirubin which is responsible for the normal breakdown of red blood cells. Other liver problems are destruction of liver cells and cirrhosis – scarring of the liver. Alcohol is a central nervous system depressant and affects everything from the liver to the heart. It is thought that alcohol and benzodiazepines are the most common substances of abuse that cause death both during use and during detoxification and withdrawal.
However, the human body has an amazing capacity to heal itself. At the same time, a limit exists for what it can do. The human body can reverse damage from several types of minor liver damage; however, in some cases, the damage might be permanent. If you can reverse liver damage from alcoholism, it will occur in the earliest stage of dependency. In the case of cirrhosis, for example, you cannot undo the damage that has already occurred. Scarring is permanent, and the liver has lost its previous ability to function normally. However, a healthy lifestyle can help mitigate the risk of further damage. In other cases, such as fatty liver disease, you can reverse the damage from alcohol. The liver has the benefit of being the body’s only regenerative organ. In fact, if you lost 75% of your liver, it would regenerate to its previous size. When the Alcohol Liver Disease (ALD) is in its early stages, it is possible to heal the liver and restore its functioning completely. Improving liver health will require adherence to a healthy lifestyle and a dedication to feeling your best.
The Pillars of Good Liver Health
If you’re interested in promoting good liver health and reversing any damage from chronic drug and alcohol use, there are a few steps you can take to boost your efforts.
Stop drinking: Firstly, and most importantly, stop drinking alcohol. If it is difficult for you to stop drinking, seek help. Evidence-based interventions can help you on your road to addiction recovery. By cutting out alcohol use altogether, you have made the most vital step in helping your liver cells heal and regenerate.
Assess your other unhealthy behaviors: Drinking is not the only unhealthy behavior that can damage your liver. Other common causes of liver disease include smoking, excess consumption of saturated fats, and obesity. A healthy diet is essential to protecting the health of your liver. If your diet is high in processed fats or sugars, you are putting more stress on the organ as it works to filter out substances your body doesn’t need. A diet rich in fruits, vegetables, lean sources of protein, and whole grains will help your body heal your liver.
Exercise More: Regular, moderate intensity exercise has documented benefits for your liver and other organs. Excess cholesterol is a known risk factor for liver disease, and exercise has the unique benefit of increasing your HDL (“good”) cholesterol while simultaneously lowering your LDL (“bad”) cholesterol, which boosts your liver health. Additionally, exercise is good for your immune system, which aids in the healing of your liver overall.
Talk to your doctor about your medications: Certain medications, such as acetaminophen (Tylenol), can be harmful for your liver when taken in excess or for long periods. Talk to your primary care provider about the medications you take and how they can affect your liver health.
Be aware of your risk: Exposure to toxins in common household and industrial items such as aerosols, insecticides, and chemicals can also increase your risk of liver damage. If you are in a profession that regularly handles these substances, take precautions such as wearing a mask and gloves. Limit exposure to household toxins and choose safer alternatives when feasible.
Drink plenty of water: Chronic dehydration is a common problem in those who suffer from alcohol dependence. The body needs water to effectively flush toxins from the body, and alcohol inhibits the production of an antidiuretic hormone the body needs to reabsorb water. Dehydration also makes the blood thicker, which makes it more difficult for the liver to perform its functions, in turn making it work harder. Drinking plenty of water seems to have the opposite effect. Water helps keep your blood thin and helps your body absorb nutrients. Drinking at least 64 ounces of water each day can help improve your body’s ability to filter toxins and heal itself.
Vitamins for liver health: Vitamin A is an antioxidant, but it also has a synergistic effect with iron. When Vitamin A levels are low, it can affect the body’s iron levels, which in turn can lead to anemia. Vitamin B12 is commonly found in meats, eggs, and other sources of protein such as nuts. B12 deficiency – anemia – can affect your body’s ability to transport oxygenated blood throughout the body, leading to decreased immune system functioning and slowed regeneration.