Alcoholic liver disease (ALD)
Alcoholic liver disease (ALD)
Alcoholic liver disease is the accumulation of toxins due to excess alcohol consumption. The most recognised forms of liver disease are fatty liver, alcoholic hepatitis and alcoholic cirrhosis.
Causes of Alcoholic Liver Disease
Alcoholic liver disease is the result of hepatocellular injury caused by excessive consumption of alcohol. The degree of liver damage is also determined by nutritional status and genetic factors. Poor nutrition results in reduction of antioxidant defense mechanisms.
Fatty liver
Reversible if abstinence from alcohol can be maintained. If alcohol consumption continues, fatty liver is a prognostic indicator for the development of chronic liver damage. Fatty liver is characterised by:
- Hepatomegaly
- Elevated liver enzymes (especially GGT)
- Ultrasound may show fatty infiltration
Alcoholic hepatitis
Involves active inflammatory damage to the liver and is a precursor to cirrhosis (can also occur in the presence of cirrhosis). Severe hepatitis has a > 40% mortality rate.
Alcoholic cirrhosis
The end result of liver damage caused by chronic alcoholism. It is characterised by irreversible scarring and fibrosis of the liver and mortality rate is high.
Alcoholic hepatitis and cirrhosis are both characterised by some or all of the following:
- Weakness
- Anorexia and weight loss
- Nausea and diarrhoea
- Fever
- Jaundice
- Neutrophilia
- Elevated liver enzymes
- Tender hepatomegaly
- Spider naevi
- Gynaecomastia
- Ascites
- Gastrointestinal bleeding
TREATMENT STRATEGY FOR ALCOHOLIC LIVER DISEASE
- Remove underlying cause i.e. alcohol consumption
- Balance neurotransmitters to combat addictions
- Address underlying body system dysfunction
- Ensure methylation and detoxification systems are optimized
- Reduce hepatic inflammation and oxidative stress
- Stimulate liver cell regeneration
Diet plan guidelines for Alcoholic Liver disease
- Eliminate alcohol
- Fresh, whole food, anti-inflammatory, antioxidant diet: Mediterranean / Paleo style diet high in fresh fruit and vegetables, whole grains, legumes, fish, nuts and seeds, olive oil, grass fed meats
- High-kilojoule, high-protein diet. Protein should come from fish, lean meats, eggs and plant sources.
- Minimise pro-inflammatory foods: sugar, refined carbohydrates, trans fats, feedlot raised animal meats, saturated fats, omega-6 fatty acids, caffeine and alcohol
- Emphasise anti-inflammatory foods: in cold-water oily fish, berries, nuts and seeds, turmeric, ginger, green tea, olive oil
Liver Disease Supplements to consider
- B vitamins to support liver function
- Glutathione – helps remove ammonia from brain, a complication of cirrhosis; glutathione is also an important antioxidant in the liver and known as the master antioxidant
- Magnesium: enhance detoxification, reduce sympathetic nervous system activity and reduces alcohol cravings
- Desiccated liver – helps provide nutrients to promote liver repair
Herbal medicine treatment options for Alcoholic Liver Disease
- St Mary’s thistle: prevents free radical damage in the liver, stimulates regeneration of hepatocytes, aids in digestion of fats
- Globe artichoke: helps liver cell regeneration
- Barberry: corrects metabolic abnormalities in cirrhosis
- Turmeric: antioxidant, hepatoprotective, anti-inflammatory
FUNCTIONAL MEDICINE TREATMENT OF ALCOHOLIC LIVER DISEASE
The above nutritional, dietary and herbal treatment advice may help support someone with Alcoholic Liver disease. However, supporting the system is only part of the picture, to recover from disease investigation into the underlying dysfunction across a number of body systems is required.
In the case of Alcoholic liver disease, supporting the neurotransmitters, addressing gut/brain axis and blood sugar regulation are key areas to successfully implement and manage sustainable change. Assessing key liver pathology, detoxification pathways, methylation and healing blocks are all factors we commonly see with Alcoholic liver disease.
At our Peth clinic of Advanced Functional Medicine we have experience with alcoholic liver disease, impaired liver function and substance addictions.
If you are suffering Alcoholic liver disease, impaired liver function of a substance addiction we would love to hear from you, tell us your story, please write a comment below.