Combined Approach to the Use of Nutraceuticals, Western Medicine, and Herbal Medicine in the Treatment of Liver Disease
Western medicine is very useful in diagnosing liver disease but less effective in its treatment. Integrative medical approaches are available that can improve the chance of success with even the most difficult liver disorders. This paper will cover some of the medical aspects of liver disease, available western therapies, and then include a variety of herbal, nutritional and nutraceutical treatments that have proven therapeutic value.
Introduction
The liver is able to regenerate itself completely, even after major damage. For example, two-thirds of the liver can be removed and the organ will regenerate in a few months. Although it is can effectively restore itself to normal function, Western medicine has, for the most part, failed to emphasize restorative liver therapies. In contrast, holistic or integrative medicine (also called functional medicine) does seek to utilize medicinal approaches that are aimed at liver protection and liver restoration.
Western medicine is at its most effective in diagnosing various pathophysiological changes, and in treating secondary sequelae of liver disorders, such as dehydration, ascites, hepatoencephalopathy, infections, and inflammation.
This presentation will include a discussion of the Western approach to liver therapy and then emphasize a variety of integrative approaches that often can successfully restore the patient's health.
Western Medicine and Liver Disorders
Liver disorders cannot be diagnosed with blood tests alone. An accurate diagnosis combines the use of blood tests, liver function tests (fasting and post prandial bile salts), ultrasound examination, radiographs, and liver biopsies.
Diagnoses for liver pathology include cirrhosis, hepatic lipidosis, infectious hepatitis, non-specific hepatitis, hemochromatosis, toxic hepatopathies (including aflatoxicosis, drug-induced hepatic inflammation and, in people, alcohol), hepatic neoplasia, sclerosing cholangitis, cholangiohepatitis, copper-induced hepatitis, insecticides and herbicides that cause hepatopathies (pendimethalin, dicamba, imidacloprid), nodular hyperplasia, portosystemic shunts, neoplasia, and fibrosis. Other liver disorders include lymphocytic cholangitis, lymphocytic-plasmacytic cholangiohepatitis, lymphocytic portal hepatitis, chronic nonsuppurative cholangiohepatitis, and biliary cirrhosis. All of these diagnoses are essentially histopathological descriptions, and most do not have specific etiologies and therapies, although they may have different prognoses.
There are a number of extra-hepatic diseases causing liver changes, including systemic infections, inflammatory bowel disease, pancreatitis, cholestasis of sepsis, endocrine diseases (diabetes, hypothyroid, hyperthyroid, hyperadrenocorticism). One should attempt to diagnose these causes and treat them and the associated liver disease.
Before therapy, Western medicine will attempt to achieve a histopathological diagnosis, mostly using ultrasound, ultrasound-guided biopsies, and educated guesses using breed and age-associated incidence. After diagnosis, most animals are placed on limited protein diets. Possible therapies include lactulose, antibiotics, corticosteroids, diuretics and, in some cases, colchicine for liver cirrhosis, D-Penicillamine (cirrhosis), H2 acid blockers, cisapride (Propulsid), and hypertensive agents.
In general, Western medicine is highly successful in the diagnosis and prognosis of liver disorders, but of much less success in therapeutically altering the course of the disease.
Holistic Approach to Liver Disease
A holistic approach to liver disease varies by the integrative therapies available to the practitioner. In general, the Western medical model is utilized for its ability to diagnose the severity of the disorder and capacity to institute life-saving therapeutics aimed at symptom reduction. Then, the doctor will employ alternative therapies to promote healing. These therapies include:
- Homeopathy
- Traditional Chinese Medicine
- Chinese Herbal Medicine
- Acupuncture
- Western Herbal Medicine
- Therapeutic Touch
- Distant Healing (Reiki, Pranic Healing, Nogier Pulse)
- Applied Kinesiology
- Nutraceutical and Functional Medicine
The rest of this paper will discuss the holistic or combined integrative medical approach to the treatment of liver disorders, emphasizing nutraceutical and herbal therapies.
The Liver and Detoxification
With liver disease, there will be diminished detoxification, since it is estimated that 75% of detoxification occurs in the liver and the other 25% in the intestine. While the liver is healing, the doctor must help support detoxification. One can do this by fasting and supplying detoxification factors, once one understands hepatic detoxification.
Hepatic detoxification functions are complex and vary by the individual. Two main detoxification pathways are the Phase I path involving cytochrome P450 and Phase II conjugation reactions. Phase I and cytochrome P450 is actually a large "super family" of isoenzymes involving the conversion of fat-soluble substances to more water-soluble molecules. Phase II detoxification involves enzyme conjugation reactions involving acetylation, glucuronidation, sulfation, glutathione conjugation and amino acid conjugation. Nutritional intervention can be employed to support and balance Phase I and II Detoxification. Products of Phase I detoxification are often more toxic than the products that preceded them. So, if Phase II detoxification fails, toxins are stored in fat and can spill over into the blood causing tissue damage.
Cats are relatively deficient in Phase II enzymes. Supplements that are particularly beneficial in support of feline detoxification include arginine, taurine, glucuronic acid and sulfate.
Most liver patients should be given a balanced Nutraceutical formula that addresses both Phase I and II detoxification needs. Adding herbs that assist detoxification and herbs that help remove bile and clean the blood will improve most patients.
Fasting-Limiting Nutrient Intake and allows for detoxification and healing
Fasting in cats-Caution, especially in obese cats
- Limited feeding of hard to digest foods
- Quality, moderate protein diets
- Low-fat diets
- Limiting synthetic chemicals, preservatives
- Feeding high quality readily digestible proteins
- Feeding hypoallergenic diets to patients with food allergies
Herbs
- Milk Thistle-Animal Apawthecary, Eclectic Institute
- Dandelion-Animal Apawthecary, Eclectic Institute
- Nutraceuticals
- N-Acetyl-L-Cysteine
- Coenzyme Q 10
- Antioxidants
- Vitamin A, C, E, Selenium
- Quercetin
- Alpha Lipoic Acid
- L-Glutamine
- L-Methionine
- Combination Products
- UltraClear Plus-Metagenics
- Gastriplex Small Animal-Thorne Veterinary (when the intestinal tract is involved)