Liver Cirrhosis Holistic Treatment
Cirrhosis is commonly associated with impaired glucose metabolism. Sixty to 80 percent of people with cirrhosis develop mild glucose intolerance associated with hyperinsulinism and increased insulin resistance (43). Diabetes mellitus develops in 10 percent to 30 percent of people with cirrhosis (43). Liver transplantation does not significantly modify pretransplant diabetes (43). Diabetes after liver transplant frequently develops de novo, is transient, and seems to be related primarily to immunosuppressive drug administration (43).
Alcoholics are people who can't control their drinking. Untreated alcoholism is a life-threatening disease that can lead to death either from an accident or suicide (both are more common among heavy drinkers) or from a toxic reaction (acute alcohol poisoning that paralyzes body organs, including the heart and lungs) or malnutrition or liver damage (cirrhosis).
The term metabolic syndrome (occasionally called insulin resistance syndrome) refers to a constellation of clinical findings including obesity, hypertension, hyperlipidemia, and insulin resistance, with increased risk for type 2 diabetes and cardiovascular disease. It has also been linked with chronic kidney disease, liver disease with steatosis, fibrosis, and cirrhosis, and cognitive decline and dementia. Despite recent controversy regarding the concept of a metabolic syndrome, the International Diabetes Federation (IDF) developed a new unifying worldwide definition building upon the World Health Organization (WHO) and ATP III definitions, as will be discussed in later chapters (82).
Approximately 75 of cases of liver cancer occur in developing countries, and liver cancer rates vary over 20-fold between countries, being much higher in sub-Saharan Africa and South-East Asia than in North America and Europe (11). The major risk factor for hepatocellular carcinoma, the main type of liver cancer, is chronic infection with hepatitis B, and to a lesser extent, hepatitis C virus (36). Ingestion of foods contaminated with the mycotoxin, aflatoxin is an important risk factor among people in developing countries, together with active hepatitis virus infection (13, 37). Excessive alcohol consumption is the main diet-related risk factor for liver cancer in industrialized countries, probably via the development of cirrhosis and alcoholic hepatitis (5).
When asked for scientific documentation, you'll usually receive stories of toxicity related to megadoses of vitamin A (especially in children), vitamin D excess (which is difficult to document except in serious extremes), liver failure with time-release niacin, or reports on the neurotoxicity of large doses of vitamin B6. While these toxicities do exist, they are quite rare and never occur when nutritional supplementation is designed by competent physicians versed in their appropriate use. Rather than a call to avoid the use of supplements, it should be a call for physicians to be trained in the proper and scientific use of supplements.
Oxidant damage to cells will indirectly create a pro-inflammatory effect by the production of lipid peroxides. This situation may lead to up-regulation of NFkB activity, since the transcription factor has been shown to be activated in endothelial cells cultured with linoleic acid, the main dietary n-6 polyunsaturated fatty acid, an effect inhibited by vitamin E and NAC (Hennig et al., 1996). The interaction between oxidant stress and an impaired ability to synthesize glutathione, which results in enhanced inflammation, is clearly seen in cirrhosis, a disease that results in high levels of oxidative stress and an impaired ability to synthesize GSH (Pena et al., 1999). In this study, an inverse relationship between glutathione concentration and the ability of monocytes to produce IL-1, IL-8 and TNF-a was observed. Furthermore, treatment of the patients with the GSH pro-drug oxothiazalidine-4-carboxylate (procysteine) (Fig. 7.7) increased monocyte GSH content and reduced IL-1, IL-8 and...
Some patients with cirrhosis of the liver require supplements of cysteine and tyrosine to maintain nitrogen balance and normal plasma levels of these amino acids. Plasma taurine concentration also declines in adults with low plasma cystine levels. Insufficient synthesis of these nutrients in cirrhotic patients has been attributed to impairment of the synthetic pathway in the diseased liver. In some cancer patients, plasma choline concentrations declined by 50 when they were maintained on TPN. This was attributed to precursors of choline bypassing the liver during feeding by TPN ( 18).
Wilson's disease is a rare inherited disorder of copper storage (affecting 1 in 200000 people), in which biliary excretion of copper is impaired.12 This results in accumulation of copper in the liver and brain that can lead to cirrhosis, liver failure, and neurologic damage. If diagnosed early and treated with regular copper chelation (using penicil-lamine together with zinc), damage can be avoided.
A number of disorders of copper homeostasis can result in toxicity leading to liver cirrhosis at dietary copper levels which are tolerated by the general population. Copper-induced cirrhosis is mainly restricted to children, possibly because of the lower capacity of their biliary excretory mechanisms.38 Indian Childhood Cirrhosis (ICC) is a fatal condition of copper metabolism which was, at one time, a major cause of infant mortality on the Indian subcontinent. ICC sufferers, usually infants aged between 6 months and 5 years, are often found to have been exposed at an early age to milk contaminated with copper from untinned brass or copper vessels.43 High copper intake, however, is not thought to be the sole cause of the illness both environmental and genetic components are thought to contribute.44 Cases of a similar infantile condition have been reported in Germany and in the Tyrol, Austria.45,46 Incidence of both ICC and Tyrolean Infantile Cirrhosis has dropped in recent years. One...
While alcohol abuse and alcoholism affect virtually every segment of the population, certain groups are at greater risk. Young adults between the ages of eighteen and twenty-nine have the highest prevalence of alcohol abuse, and persons who begin to drink at an early age, especially before the age of fourteen, have a greater risk for developing problems with alcohol. Persons with a family history of alcohol abuse or alcoholism are also more likely to experience alcohol-related problems. In the United States, American Indians and Alaska Natives (AI ANs) have the highest rates of current and heavy drinking of all racial or ethnic groups. Deaths from chronic liver disease and cirrhosis are nearly four times greater among AI ANs compared to the general U.S. population. They also have a higher prevalence of drunk driving compared to the general U.S. population. This illustration shows a healthy liver above, and a diseased liver below. Liver disease in alcoholics progresses from an...
P-cryptoxanthin and other carotenoids were observed compared to levels in healthy subjects (Ito et al., 1999). For cirrhosis patients (n 18), compared to controls (n 20), a decrease of P-cryptoxanthin was observed in both serum and liver tissue for the former (p 0.01) (Leo et al., 1993). (It was noted that cirrhosis patients having normal serum levels had depleted liver carotenoid levels, suggesting that cirrhosis interferes with liver uptake of carotenoids and normal carotenoid metabolism.)
A review of available data concerning the safety of glutamine supplementation reveals that in most circumstances it is quite safe 85 . There are certain circumstances wherein glutamine has been the cause of untoward side effects. Oral glutamine may cause or worsen hepatic encephalopathy in patients with cirrhosis, possibly as a result of its conversion to glutamate and ammonia 72 . This may also explain the fact that it may be unsafe in patients with liver or kidney disease. However, there is some evidence to suggest that glutamine degradation to glutamate and ammonia does not produce neurotoxic effects in humans 85 . A case report details a patient who suffered mania and hypomania as a result of ingesting 4 g of glutamine per day, which could potentially be attributed to the fact that glutamine is a precursor for GABA, a neurotransmitter 86 .
Over a decade ago, a time-release form was created to overcome this flushing effect. Unfortunately, it also resulted in several cases of massive liver failure resulting in liver transplant. More than anything, this should serve as a potent reminder that altering natural compounds may result in dangerous even fatal pharmaceutical side effects.
MVID is a congenital constitutive intestinal epithelial cell disorder leading, in its typical early-onset form, to permanent intestinal failure. The largest multicenter survey, of 23 MVID patients,15 revealed an extremely reduced life expectancy with a 1-year survival rate of less than 25 . Most children died of septic complications, liver failure, or metabolic decompensation. Few cases of MVID, especially with the late-onset form, may survive with limited stool output and may require only partial PN.29 Treatment with corticosteroids, colostrum or epidermal growth factor has not been successful, but octreotide has been used with partial success in one patient.15 In contrast to the initial outcomes before the 1980s, PN now allows most infants and children to survive. However, complications related to inadequate PN do limit long-term survival. These include recurrent
We recently evaluated the possibility and outcome of intestinal transplantation in ten consecutive patients with early-onset congenital MVID at Necker-Enfants Malades Hospital (Paris) (Rue-mmele et al, submitted for publication). Two patients died before they could be put on a waiting list for small-bowel transplantation one patient is still waiting. We performed cadaveric intestinal transplantation in seven patients aged between 3 and 11 years by using tacrolimus, steroids and interleukin (IL-2) blockers. Three transplantations were performed with isolated intestine, and four with intestine associated with the liver. Right colon transplantation was performed in five cases (two with isolated intestine). One patient died during transplantation surgery from acute liver failure and hemodynamic shock, probably due to re-perfusion shock. The six others (86 ) survived, with a median follow-up of 3 years (range 1-8 years). Graft rejections occurred in two patients (one with isolated...
Approximately two million Americans suffer from liver damage caused by alcohol abuse. About 10 to 20 percent of heavy drinkers will develop cirrhosis of the liver, which is characterized by scarring of the liver and causes irreversible damage. If heavy drinkers do not stop drinking, cirrhosis can cause poor health and, ultimately, death. In addition to cirrhosis, heavy drinkers may suffer from chronic liver disease or alcoholic hepatitis.