The Liver And Cholesterol: What You Should Know
Introduction and overview
Balanced cholesterol levels are important to maintaining good health. The liver is an underrecognized part of that effort.
The liver is the largest gland in the body, located in the upper right part of the belly. It is the bodys master detoxer of drugs and other foreign substances. It stores glycogen, which the body uses for energy. Its also important in metabolizing fat, carbohydrates, and proteins. A healthy liver does all this unnoticed.
An important function of the liver is to produce and clear cholesterol in the body. Most of the attention focused on cholesterol describes its potential for harmful health effects. But cholesterol is necessary for the creation of hormones, vitamin D, and enzymes needed for digestion.
Bundles called lipoproteins carry cholesterol throughout the body. Two important types are high-density lipoproteins and low-density lipoproteins . High and low refer to the relative proportion of protein to fat in the bundle. The body needs both types in regulated proportions.
Its important to know the levels of HDL , LDL , and total cholesterol in your body. A rough estimate of total cholesterol is HDL, plus LDL, plus one-fifth of a third type of fat called triglyceride.
The National Heart, Lung, and Blood Institute recommends the following levels:
|LDL cholesterol levels|
What Are The Risk Factors For Liver Disease
Some liver diseases are potentially preventable and are associated with lifestyle choices. Alcohol-related liver disease is due to excessive consumption and is the most common preventable cause of liver disease.
Hepatitis Bis a viral infection most often spread through the exchange of bodily fluids .
Hereditary liver disease can be passed genetically from generation to generation. Examples include Wilson’s disease and hemochromatosis .
Chemical exposure may damage the liver by irritating the liver cells resulting in inflammation , reducing bile flow through the liver , an accumulation of triglycerides . Chemicals such as anabolic steroids, vinyl chloride, and carbon tetrachloride can cause liver cancers.
Acetaminophen overdose is a common cause of liver failure. It is important to review the dosing guidelines for all over-the-counter medications and to ask for guidance from your health care professional or pharmacist as to how much of any medication may be taken safely. While over-the-counter medications are relatively safe, they may cause complications directly or as an interaction with prescription medication.
Can High Cholesterol Be Prevented Or Avoided
Making healthy food choices and exercising are two ways to reduce your risk of developing high cholesterol.
Eat fewer foods with saturated fats . Choose healthier fats. This includes lean meats, avocados, nuts, and low-fat dairy items. Avoid foods that contain trans fat . Look for foods that are rich in omega-3 fatty acids. These foods include salmon, herring, walnuts, and almonds. Some egg brands contain omega-3.
Exercise can be simple. Go for a walk. Take a yoga class. Ride your bike to work. You could even participate in a team sport. Aim to get 30 minutes of activity every day.
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Your Routine Blood Work Has Your Doctor Worried
Findings such as high triglycerides, high fasting blood sugar, and excessive amounts of liver enzymes in your blood are all seen in fatty liver disease.
These findings are evidence that the liver cant do its job like used to and that its damaged cells are leaking out their contents.
At the same time, people can have a fatty liver and still get normal blood test results .
How Is Fatty Liver Disease Diagnosed
Because fatty liver disease often has no symptoms, your doctor may be the first one to spot it. Higher levels of liver enzymes that turn up on a blood test for other conditions may raise a red flag. Elevated liver enzymes are a sign your liver is injured. To make a diagnosis, your doctor may order:
- Ultrasound or computed tomography to get a picture of the liver.
- Liver biopsy to determine how far advanced liver disease has progressed.
- FibroScan®, a specialized ultrasound sometimes used instead of a liver biopsy to find out the amount of fat and scar tissue in the liver.
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What Conditions Can Cause Very High Ast Or Alt Levels
AST and ALT serum levels in some liver conditions can range anywhere from ten times the upper limits of normal to thousands of units/liter. The highest levels of AST and ALT are found with disorders that cause rapid death of numerous liver cells . Although this degree of liver enzymes elevation is not common, it can occur in such conditions as:
- Acute viral hepatitis A or B
- Profound liver damage inflicted by toxins as from an overdose of acetaminophen or mushroom poisoning
- Prolonged collapse of the circulatory system when the liver is deprived of fresh blood providing oxygen and nutrients
Also, very high AST and ALT levels can be a result of severe muscle diseases.
Can Liver Disease Cause High Cholesterol
There are many different liver diseases.
Hepatitis, alcohol-related liver disease, and non-alcoholic fatty liver disease or NAFLD are some of the most common liver diseases.
Liver disease causes damage to the liver, which can mean that it is not able to work as well.
One of the functions of the liver is to break down cholesterol. If the liver is not working properly, it can cause cholesterol to build up in the body.
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What Other Liver Enzymes Cause Medical Problems
Aside from AST and ALT, there are other enzymes including alkaline phosphatase, 5′-nucleotidase , lactate dehydrogenase , and gamma-glutamyl transpeptidase that are often used to detect liver disease.
LDH is not specific to the liver and can be elevated in many diseases with inflammation in other tissues.
Alkaline phosphatase is another liver enzyme that is frequently measured. This enzyme is usually found in the walls of the bile ducts . Elevation of alkaline phosphatase may indicate an injury to the biliary cells. Common causes of biliary injury or biliary obstruction are gallstones and certain medications, although, some of the conditions listed previously can also raise the levels of this enzyme. Alkaline phosphate is also found in the bone and can be elevated in bone diseases. GGT and 5′ nucleotidase levels can be elevated in biliary conditions along with alkaline phosphatase.
The Link Between Liver And Cholesterol Explained
Most of the cholesterol present in the body is synthesized in the liver and despite the popular belief about cholesterol, some of its forms are actually beneficial for the body. However, there are a few forms of cholesterol that are harmful for the body and liver.
Cholesterol is a fatty molecule that is synthesized in the liver and can also be obtained from some foods that we eat. It primarily has two types high density lipid , which is the good cholesterol, and low density lipid, which builds up in the body and can result in a number of health problems.
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The Effects Of High Cholesterol
High levels of LDL cholesterol increase the risk of fatty deposits on vessels that bring blood to the heart. Too-low levels of HDL cholesterol suggest the body may not be able to clear plaques and other fatty deposits from the body. Both conditions create a risk for heart disease and heart attack.
Liver damage can progress for months or years with no symptoms. By the time symptoms appear, liver damage often is extensive. Some symptoms warrant a visit to the doctor. These include:
When Should You Call Your Doctor For Liver Disease
Often, the onset of liver disease is gradual and there is no specific symptom that brings the affected individual to seek medical care. Fatigue, weakness, and weight loss that cannot be explained should prompt a visit for medical evaluation. Jaundice or yellow skin is never normal and should prompt an evaluation by a health care professional. Persistent fever, vomiting, and abdominal pain should also prompt medical evaluation as soon as possible.
Acetaminophen or Tylenol overdose, whether accidental or intentional, can cause acute liver failure. Emergent evaluation and treatment are required. Antidotes to protect the liver can be provided, but are effective only when used within a few hours. Without this intervention, acetaminophen overdose can lead to liver failure. Symptoms only occur after potential liver damage has occurred.
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Why Is Fatty Liver Disease Bad
In most cases, fatty liver disease doesnt cause any serious problems or prevent your liver from functioning normally. But for 7% to 30% of people with the condition, fatty liver disease gets worse over time. It progresses through three stages:
Your liver becomes inflamed , which damages its tissue. This stage is called steatohepatitis.
Scar tissue forms where your liver is damaged. This process is called fibrosis.
Extensive scar tissue replaces healthy tissue. At this point, you have cirrhosis of the liver.
Cirrhosis of the liver
Cirrhosis of the liver is a result of severe damage to the liver. The hard scar tissue that replaces healthy liver tissue slows down the livers functioning. Eventually, it can block liver function entirely. Cirrhosis can lead to liver failure and liver cancer.
Risk No : A Fatty Liver
As weights rise in the U.S., theres been along with an alarming increase in diabetes and other metabolic ills a growing incidence of non-alcoholic fatty liver disease , in which too much fat is stored in the liver.
Obesity, diabetes, high blood pressure, high cholesterol common features of metabolic syndrome are all known major risk factors for the development of fatty liver disease, says Craig Lammert, M.D., assistant professor of medicine at the Indiana University School of Medicine and a practicing gastroenterologist and hepatologist at IU Health. As with alcohol-related liver damage, these conditions cause fat to be deposited in the liver.
The scary piece of this is, anywhere from 15 to 50 percent of the nations population may have too much fat in the liver, says Lammert. Of those, he says, about 5 percent are at risk of inflammation that can damage the liver. But we dont always know who thats going to be.
Inflammation hurts the liver by way of a condition known as non-alcoholic steatohepatitis , which damages and kills liver cells. Were hearing a lot about this because over the next few years, fatty liver disease will probably be near the top, if not the top, cause for liver transplantation in this country, Lammert notes.
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Risk No : Drugs & Supplements
Certain drugs and supplements can also injure your liver, depending on the dose and other factors. Taking too much acetaminophen is the most common over-the-counter risk. People who overdose with Tylenol overwhelm the metabolizing system and drive liver toxicity, Lammert says.
But patients should have few problems if they take the painkiller as prescribed, which includes consuming no more than 4,000 milligrams in a day. Those with existing liver disease may be advised to take less than 2,000 milligrams. One caveat: If youre taking acetaminophen at those levels, be sure to avoid alcohol, which would add to the cumulative burden on the liver, Lammert advises. Other painkillers, including NSAIDs like ibuprofen and naproxen , can be similarly harmful under the same circumstances.
If you are taking anything approaching the maximum dose of acetaminophen, be aware that the drug is often found in other products, such as multi-symptom cold and flu formulations, making it easy to unwittingly double the amount you are taking. So be sure to check product labels for acetaminophen.
There are also reports of liver damage with certain supplements, including bodybuilding and weight-loss supplements that contain green tea extract, linoleic acid and androgenic anabolic steroids. Even two essential nutrients, vitamin A and niacin, can harm the liver if taken above the recommended doses.
What Do High Liver Tests Mean
AST and ALT are reasonably sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. However, it must be emphasized that higher-than-normal levels of these liver enzymes should not be automatically equated with liver disease. They may mean liver problems or they may not. For example, elevations of these enzymes can occur with muscle damage. The interpretation of elevated AST and ALT results depends upon the entire clinical evaluation of an individual, and so it is best done by physicians experienced in evaluating liver disease and muscle disease.
Moreover, the precise levels of these liver enzyme tests do not correlate well with the extent of liver problems or the prognosis . Thus, the exact levels of AST and ALT cannot be used to determine the degree of liver disease or predict the future prognosis for liver function. For example, individuals with acute viral hepatitis A may develop very high AST and ALT levels , but most people with acute viral hepatitis A recover fully without residual liver disease. Conversely, people with chronic hepatitis C infection typically have only a little elevation in their AST and ALT levels while having substantial liver injury and even advanced scarring of the liver from ongoing minor inflammation of the liver.
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Is It Possible To Prevent Liver Disease
- Alcohol abuse is the most common cause of liver disease in North America. Consuming alcohol in moderation may help minimize the risk of alcohol-related liver disease.
- The risk of contracting Hepatitis B and C can be decreased by minimizing the risk of exposure to another person’s bodily fluids.
- Vaccination is available for Hepatitis A and B.
- Screening for Hepatitis C is recommended in some populations.
- Fatty liver disease is a preventable illness with the promotion of a healthy lifestyle including a well-balanced diet, weight control, avoiding excess alcohol consumption, and routine exercise program. These lifestyle modifications do not guarantee success in disease prevention, as some people will develop the fatty liver disease even with maximized lifestyle practices.
What Is The Function Of The Liver
As part of its function, the liver makes bile, a fluid that contains among other substances, water, chemicals, and bile acids . Bile is stored in the gallbladder and when food enters the duodenum , bile is secreted into the duodenum, to aid in the digestion of food.
The liver is the only organ in the body that can easily replace damaged cells, but if enough cells are lost, the liver may not be able to meet the needs of the body.
The liver can be considered a factory, and among its many functions include:
- Production of bile that is required in the digestion of food, in particular, fats
- Storing of the extra glucose or sugar as glycogen, and then converting it back into glucose when the body needs it for energy
- Production of blood clotting factors
- Production of amino acids , including those used to help fight infection
- The processing and storage of iron necessary for red blood cell production
- The manufacture of cholesterol and other chemicals required for fat transport
- The conversion of waste products of body metabolism into urea that is excreted in the urine
- Metabolizing medications into their active ingredient in the body
Acute liver failure may or may not be reversible, meaning that on occasion, there is a treatable cause and the liver may be able to recover and resume its normal functions.
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What Is The Treatment For Liver Disease Will You Need Surgery
Except for gallstone disease and some viral infections such as hepatitis A, C, and infectious mononucleosis, most liver diseases are managed and not cured. Liver disease can progress to cirrhosis and liver failure. Associated complications may include increased risk of bleeding and infection, malnutrition and weight loss, and decreased cognitive function. Some liver diseases are associated with an increased risk of developing liver cancer.
How Does Cholesterol Impact The Liver
A diet can create fat around the liver if it is high in cholesterol. This scenario can lead to NAFLD, which may result in liver damage long-term.
NAFLD can increase the risk of health problems, such as a stroke or diabetes. If the condition is found and treated at an early stage, it is often possible to stop it from getting worse.
A person can also reduce the amount of fat in their liver at an early stage.
Usually, high cholesterol does not cause any symptoms.
But a simple blood test measures cholesterol levels.
A doctor may recommend a cholesterol test if a person has a family history of heart disease, a medical condition such as diabetes, or if they are overweight.
A liver biopsy or liver function test is usually used to diagnose liver disease.
A biopsy will remove a tiny piece of liver tissue to test for disease. A liver function test is a blood test that can measure proteins and enzymes in the blood.
The levels of these proteins and enzymes can show if the liver is damaged.
A person can make lifestyle changes and sometimes take medication to treat high cholesterol. Usually, they will be encouraged to make changes to diet and exercise first. If they are overweight, they may be advised to lose weight.
A doctor may prescribe medication if these changes do not lower cholesterol after a few months.
The most common medication is statins, which a person needs to take for life. Statins are drugs that block a chemical in the liver that makes cholesterol.
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