All about my liver

At the end of the festive season, everyone’s feeling like they’ve over indulged a little; whether it’s too much cake and chocolate, or just being hammered for an entire week. Spending time with family does weird things. You might be tempted by what the hokey pseudo-health profession calls a “detox”. Detox is a made up solution to an imaginary problem and the bollocksness of this concept has been covered very well elsewhere. Sense About Science have published their guidelines on detox. But you’d have to be a foolhardy person indeed to take on caloric restriction, exclusion of food groups and caffeine withdrawal. Plus those vile disgusting magic veg detox juices, depending on how you detox and whose pockets you’re lining. Do they make you feel better? No idea, but you get the joys of starvation and everything that entails: tiredness, headaches, mood swings, depression, confusion and dizziness.

This is all beside the point; human beings have managed to exist quite happily for 200,000 years quite happily without having to go through this seasonal ritual purge. Do you know why? Because human beings are amazing. There’s this brilliant organ in your body called the liver. It’s large – about a kilo and a half in weight – and it’s the first port of call for the food absorbed by your stomach. Fat is metabolised with the help of bile which is made by the liver and secreted by the gall bladder. Proteins and carbohydrates (which, when absorbed by the stomach and intestines are already partly digested) are metabolised by the liver; it regulates protein and carbohydrate synthesis, carbohydrate storage, fat synthesis and usage. In short, it’s a busy little bunny after you’ve etted. It also absorbs a whole load of nutrients as well, like vitamins and minerals. The liver is also responsible for making all those little bits and pieces that make your blood clot and regulates other stuffs in your blood like red blood cells. It’s also important in breaking down stuff your body is finished with, like tired old blood cells. And then there’s the hormones…

As well as everything above, the liver breaks or modifies dangerous substances you consume so that the body can get rid of them. In this way it “cleanses” you body. But that’s a stupid, overly simplistic way of describing what the liver does. It has sets of enzymes that form metabolic pathways involved in drug metabolism. This means that most of the time the body can deal with most of the things you throw at it, or shove in your mouth.

The liver does struggle with some stuff, sometimes when it tries to metabolise things it inadvertently makes them more dangerous. This is the case for paracetamol. Normals paracetamol usage can be dealt with by the liver in most people. The problems occur when people overdose – not great news for failed suicides using paracetamol. The problem arises because paracetamol metabolism produces, among other substances, a particularly nasty one called n-acetyl-p-benzoquinoneimine (NAPQI), normally this gets converted to something safer, but when a large amount of paracetamol is taken, the large amount of NAPQI produced depletes the liver of a chemical called glutathione and damages liver cells. Rapid treatment with activated charcoal to reduce the absorption of paracetamol and replenishing the depleted glutathione can help. If the damage is too extensive, then a liver transplant is needed.

Alcohol is the most common cause of liver disease in Europe. While the liver can cope with moderate drinking and occasional bingeing, it can’t cope with persistent heavy drinking. When the body can’t actually metabolise all the alcohol we’re downing; you end up with large amounts of alcohol sloshing around in your blood and metabolising the alcohol produces some toxic substances that are harmful to the liver (and other tissues). Normally, the liver can recover from intermittent drinking – the build up of fatty globs in your liver cells can be reversed. But in heavy drinking and repeated binges, the liver is unable to recover, this leads to fatty liver disease, alcoholic hepatitis and cirrhosis. In fatty liver disease you are essentially turning your liver to paté. This can progress to inflammation of the liver, called hepatitis. Cirrhosis is where the dead liver cells are replaced by scar tissue. All this leads to liver failure, and as you may have guessed, you won’t survive long without your liver.

Despite all the horrible things you can do to your liver, you will have noticed that you have to try pretty hard to totally trash it. There are a list of things that are hepatotoxic over here. But pretty much, if you eat normally, don’t constantly drink and go easy on the illegal hallucinogens, you’re probably not going to need any kind of detox. Major amounts of toxicity can, and have to be treated medically, but no amount of fasting, caloric restriction, food-group exclusion or sick-tasting veg juice is really going to help. If anything, caloric restriction’s going to exacerbate the effects of stuff like alcohol and paracetamol on your liver. If you’re really worried about the state of your liver, stop drinking, you moron.

The good news is this, the liver is such a brilliantly amazing organ that if you destroyed up to 75 % of it, it will regenerate.

If you think you might be a bit toxic and are worried about your liver failing go here. But you probably won’t have any livery symptoms until you’re well and truly smurfed.


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