Last week (here), I discussed liver function, detoxification and the tremendous exposure we all have to environmental chemicals that are clearly linked to chronic disease. In this article I discuss liver serum tests and how to monitor your liver function without blood tests. Next week, I’ll examine what you can do to keep your liver in optimal health.

Liver Function Versus Liver Function Blood Tests

Most people believe their doctors can test the blood for liver function; they are mistaken. Blood tests for the liver don’t really show its function; they reflect the severity of damage or disease. Therefore, they are actually late at uncovering disease.

These tests are known as AST (SGOT), ALT (SGPT), alkaline phosphatase, LDH, bilirubin and GGT.

Here’s what each test checks for:

• AST/SGOT (aspartate aminotransferase): An enzyme found in body organs maintaining high levels of metabolism such as your heart, skeletal muscle, kidney, brain, pancreas, spleen, lungs and liver. When these organs are damaged or irritated, AST is released into the blood, causing serum levels to rise.
• ALT/SGPT (alanine aminotransferase): An enzyme primarily found in liver cells, but also found in kidney cells. When both ALT and AST are elevated, it is a strong indication that the liver has been damaged because of a problem like viral hepatitis or alcoholism.
• Alkaline phosphatase: An enzyme primarily found in the liver and bone tissues. Serum levels are much higher in young people.
• LDH (lactate dehydrogenase): An enzyme with subtypes (isoenzymes). LDH-4 and LDH-5 are primarily found in liver and skeletal muscle.
• Bilirubin: The yellow-green pigment found in bile. It is formed when hemoglobin (the pigment protein of red blood cells that carries oxygen to tissues) breaks down. Too much bilirubin may mean that excessive red cells are being destroyed or that the liver is incapable of removing bilirubin from the blood.
• GGT (gamma glutamyl transferase): A liver enzyme whose elevation reflects acute liver damage, biliary tract obstruction, alcohol-induced liver disease or viral hepatitis.

As you can see, when these levels are elevated, it does not mean your liver is beginning to slow down; it means you liver has already been damaged or is nearing total failure.

Causes Of Liver Slowdown

Less common causes for declining liver function include viral hepatitis, multiple prescription medication use, autoimmune liver disease and alcoholism. However, liver function is most often a function of lifestyle.

When you consistently consume caffeine, alcohol, processed food, artificial sweeteners and chemicals in processed food, these substances adversely affect your intestinal lining over time. The condition called “leaky gut” develops, and molecules pass into your blood that should not get past the intestinal wall, setting up an autoimmune inflammation response that burdens your liver. Added to this burden are the many environmental chemicals to which we are all exposed.

To counter this effect, your body produces antioxidant nutrients such as glutathione that detoxify harmful substances in a complex series of chemical reactions. Foods high in antioxidant nutrients support this process and also protect your liver. (I’ll discuss these foods and nutrient supplements in detail in my article next week.)

Evidence That Your Liver Is Suffering

Initially, when your liver falters, you don’t experience an ache or have skin that becomes yellow with jaundice. Instead, you usually experience more subtle indicators of sluggish liver function.

Remember that blood tests can’t reveal a faltering liver early in the process because there are no tests able to detect this.

Signs and symptoms of a liver starting to have trouble:

• Increases in (bad) LDL cholesterol, decreases in (good) HDL cholesterol and elevation of triglycerides. These are all linked to a slowdown in the liver’s ability to metabolize fats. The result is usually high blood pressure or cardiovascular disease and may lead eventually to a heart attack or stroke. It is also accompanied by sugar cravings, hypoglycemia, diabetes mellitus and insulin resistance. The classic example is what is seen and known in conventional medicine as “fatty liver disease.” It is the most common cause of chronic liver disease in the United States, striking up to 20 percent of adults. Over time, this enlarged fatty liver can develop into cirrhosis, liver failure or even liver cancer. However, that’s not what I’m concerned about for this discussion. What is more worrisome for most of us is the subclinical liver disease that is much more widespread. Many people have a liver that’s slowing and contributing to other diseases, yet they never suspect their liver is in trouble.
• External signs of slowing liver function, including: a coated tongue, bad breath, red palms and soles, a flushed facial appearance or excessive facial blood vessels, acne or rosacea, yellowish conjunctivae on the eyes, brownish blemishes on the skin (aka liver spots), and itching skin, even without a rash.
• Digestive problems that include gallstones, gallbladder disease, difficulties with fatty foods or alcohol, indigestion, reflux, nausea, constipation and irritable bowel syndrome.
• Depressed mood, anger, irritability, “foggy brain,” overheating and headaches with nausea.
• Immune dysfunction, including: allergies, hay fever, asthma, hives, sensitivities to chemicals and many foods, autoimmune diseases, chronic fatigue syndrome, fibromyalgia, recurrent viral infections, and frequent bacterial or parasitic infections.
• Menopausal symptoms or premenstrual syndrome symptoms that are unusually severe; side effects from hormone replacement therapy.

All of this should give you a better idea of how your liver function relates to many signs and symptoms of illness. In my next article I’ll discuss what you can do for optimal liver health: That translates into overall better health.

To feeling good for life,
Michael Cutler, M.D.
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