Can a unhealthy liver cause cognitive disturbances?

valentinelynx

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Depends what you mean by an "unhealthy liver." If you have end stage liver disease from cirrhosis of the liver you could develop hepatic encephalopathy (personality changes, intellectual impairment, and a depressed level of consciousness) caused by shunting of portal blood into the systemic circulation. Treatment is focused on reducing high ammonia levels in the blood.

If you don't have liver disease, chances are your liver is working just fine. There's no evidence that you can "detox" a liver. Nor is there evidence that "toxins" can be eliminated from the body by sweating.

Your exposure history is potentially concerning. Here's a really good article on aluminum toxicity in Medscape (if you don't have or can't set up a free Medscape account, see the attached file).
I suggest you find a doctor experienced in such things such as an occupational medicine physician. If you are positive for aluminum toxicity, the treatment is typically chelation with deferoxamine.

Best of luck!
 

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The liver plays a very important role and is overlooked in Western medicine. The Chinese understand this well btw.

The liver can be attacked in ME (and many other diseases) for several reasons including the high oxidative stress that occurs from immune activation. Not only does this burden the liver with more toxins but it also uses up the available antioxidants.

Addressing liver stagnation was a major turning point for me. An important factor was using things to collect the toxins such as Pascalite clay or bulk charcoal. These will escort the toxins out of the body so you do not reabsorb the toxins.
 

valentinelynx

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Western medicine does not "overlook the liver". For example, it manufactures many of the essential proteins in the body, including albumin, the primary blood protein and the clotting factors that prevent you from bleeding to death, stores glycogen for fuel, produces bile used to digest fats, stores vitamins and minerals, is an essential immunological organ and, of course, it modifies substances to prepare them for elimination from the body, including your own steroids and drugs and toxins from food and the environment. You cannot live without a liver. Lose your kidneys and you can live with dialysis (though not well), lose your heart and it can be substituted temporarily. Nothing can replace a liver except a liver. The liver is the only organ in the body that can regenerate itself. As long as you have enough left, your liver can heal.
 

ScottTriGuy

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My fatigue doctor things detoxing the liver before doing a metal dump would reduce my symptom's greatly. This due to the fact Ive worked around heavy metals especially aluminum without proper PPE . Treatment also includes going to infrared saunas twice a week
@mariovitali can shed some light on the liver with our symptoms: results from his extensive, and ongoing, data methodology of ME point toward the liver as a problem site for a subset of us.

Check out his most recent post here: https://forums.phoenixrising.me/thr...e-must-be-many-more.62893/page-7#post-2207269
 

pamojja

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Western medicine does not "overlook the liver". For example, it manufactures many of the essential proteins in the body, including albumin, ..
Western medicine doesn't only overlook a weak liver, but for any organ system has lab-reference ranges mainly derived from 95% of the population tested, which aren't optimal functioning ranges. Or predict worse all-cause mortality down the road.

One thing I observed always with liver enzymes rising, was lipids worsening too. Instead of addressing the weak liver, only statins were prescribed to counter that downstream effect. Or did anyone ever meet a western trained doc, who ever addressed a too low albumin? I didn't, in my experience they watch and wait till more profitable interventions are asked for.

But god thanks there are enough natural intervention to bring lab-values into optimal ranges again, and with it decrease the risk for worse outcome. After which western invasive medicine is even less needed.
 

valentinelynx

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Or did anyone ever meet a western trained doc, who ever addressed a too low albumin?
Yes. In critically ill patients in the hospital and patients with severe liver disease. I had low albumin for a while. It was pretty obvious to me that it was from my gut. I had/have an enteropathy that appears to have been caused by NSAIDs, even though it persists to some extent 2 years after I stopped taking them. I had what's called a "protein losing enteropathy" but fairly mild. There was no treatment except to be kind to my gut. Admittedly, I got no advice from other physicians about this; I did my own research. Whether the supplements I took helped more than time and no NSAIDs, I have no way of knowing.

There are many causes of low albumin, but if your albumin is low because of liver failure, you are in big trouble!
 

pamojja

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What is a weak liver?
Ultrasound would find structural weakening. In my case it found NAFDL, at an other time non-circulated nodules in the liver.

Liver enzymes are much more sensitive. I give here some examples from labtestanalyzer.com, which now already since 1 year sieve through the whole of literature to find scientifically valitated ranges for all lab tests. Tough of course not having completed that monumental task yet, with those ready I find it highly interresting to correlate well with optimal referenge ranges given by functional practitioners. Which I assumed to have been derived by clinical experience mostly.

Aspartate Aminotransferase - AST - Optimal 18 - 33 IU/L
- High AST levels are associated with a higher risk of all-cause mortality [R, R, R].

Alanine Aminotransferase - ALT - Optimal 17 - 30 IU/L
High ALT increases:
- Liver disease and liver-disease mortality [R, R, R]
- All-cause and heart disease mortality [R, R]
- Diabetes-related mortality [R]

Alkaline Phosphatase - ALP - Optimal 30 - 80 IU/L
High ALP is linked with:
- a higher risk of all-cause mortality, and mortality in heart attack, chronic kidney disease, and metastatic cancer patients [R, R, R, R, R]
- high blood pressure and an increased risk of metabolic syndrome [R, R]

Albumin - Optimal 4.4 - 5.5 mg/dl
Low albumin can increase the risk of:
- Heart failure in the elderly [R]
- Worse kidney function in heart disease patients [R]
- Mortality from all causes [R].

GGT, even within normal ranges, is associated with an increased risk of diabetes, heart disease, kidney disease, cancer, and all-cause mortality [R, R, R, R].
GGT above 30 U/L and LDH beyond 140 - 200 are considered non optimal by functional practitioners too. Only ALP optimal at 70 - 100 by functional practitioners differs. Where below 70 could indicate a zinc deficiency. Which in my case indeed correlated with whole blood zinc (serum still to be tested).

Ultimately it is a little bid like finding a personally fitting shoe-size. Though not as easy as that, through observation of symptoms and correlation to blood markers of all body systems one can come pretty close.

Of course, there are also too many 'trivial' causes for non-optimal liver enzymes. Like alcohol consumption, exercise, infection, etc. Therefore I never get too excited about one test result, but by trends. Just trends towards optimal was already enough in my case to normalize lipids. Don't let yourself be scared, if a lab results means you should already be death by now, it most probably was an lab error. :nerd:
 
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pamojja

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Whether the supplements I took helped more than time and no NSAIDs, I have no way of knowing.
Some references to look up:

Whey protein [R]
Branched chain amino acids (BCAAs) [R, R, R]
N-acetyl cysteine (NAC) [R, R, R]
Vitamins C and E (low albumin means the antioxidant capacity of your blood is compromised, vitamin C and vitamin E are great antioxidants that can help) [R, R]
Vitamin D (if you are deficient) [R, R, R]
Thiamine (vitamin B1) [R]
Folate/5-MTHF (vitamin B9) [R, R]
Selenium [R]
Glutathione [R]
Fish oil (omega-3 fatty acids) [R, R]
Probiotics [R, R]
Carotenoids [R, R]
Soluble fiber [R, R]
Curcumin [R]
Ginseng [R]

Personally made the experience that not only the liver, but even other structures can heal themself. But only up to age 41 in my case, when I was hid with a walking-disabilty from PAD. By that time with all bodily system in bad shape, my liver was at loss too.

For example, the sonography wich found the NAFDL was done after a x-ray for a seemingly herniated disk, and becaused the radiologist mentioned the yellow in my eyes, at a small town in India.

However, 6 years later it was found at home it hasn't only been the disk, but a spondilodiscitis, an infection of the spinal-cord, which usually would be deathly without antibiotic IVs. 2 vertebreas on the old x-rays overseen already were in the process of dissolving, and the new x-ray showed them calcified and fused again!

The Orthopedist asked what I would have done to make that impossible happen? (in total this spondilodiscitis made me inmoveable for 8 month). Only been patient, took the only pain-medication available and helping: high dose Ibuprofen, got some Acupuncture by a Canadian traveller, and Ayurvedic LIV.52. Unexpectectly to me, he thought the in my opinion weak Ayurvedic responsible for the healing of my spine.

My scepticism he countered with a cryptic: 'What heals is always right'. And that I should better stay away from 'school' mediciene. He is retired now, and never met such an excentric doc again. And of couse, I only stayed as far away from western medicine, as was practical for condinuing to monitor blood-work.
 
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sb4

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What is a weak liver? What tests determine that you have a weak liver?
I recently tested high on ALT (?) liver enzymes. This could be a test to determine a weak liver, or at least a problem there.

I had/have an enteropathy that appears to have been caused by NSAIDs, even though it persists to some extent 2 years after I stopped taking them.
That's interesting. Could you expand on this? Did you take NSAIDs at the start of illness. What where the symptoms you experienced? I got a stomach ulcer after taking high dose NSAIDs at the start of my illness, the ulcer went away a few weeks later.
 
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Second star to the right ...
@HABS93, @valentinelynx
There's no evidence that you can "detox" a liver. Nor is there evidence that "toxins" can be eliminated from the body by sweating.
To the best of my knowledge and research this is absolutely true.


For some reason, we have, as a nation, become absolutely fixated on 'cleanses', most of which are pointless and useless, some of which are actually potentially damaging. Maybe it's the early foundational Puritan influence, telling us that we're fundamentally in need of cleaning up. Who knows.
 
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pamojja

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. Admittedly, I got no advice from other physicians about this; I did
Well I would not say non-alcoholic fatty liver disease (NAFLD) is overlooked by Western medicine
Western medicine is happening at the doctors office, by it a GP, internist or any other speciality. And my health insurance pays for. Just as in valentinelynx case with low albumin I got no advice from any physician how to handle my NAFDL, or the non-circulated nodules ever.
 

pamojja

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To the best of my knowledge and research this is absolutely true.
I never been in a Sauna, but made extensive use of the sun (also the Indian in yearly vacations) for sunbathing, sweating and cold-water adaptation. Though I can't exatly know how much that contributed beside getting a root-canal extracted and stoping my runaway magnesium deficiency with Mg-IVs since almost 2 years ago, along with long-term lifestyle changes and comprehensive supplementation. That 2 years with loads of pacing have also been the first time without any real PEM anymore.

With being able to sweat, getting dirty, it feeling really good, and it obviously not hindering a remission process in my case, it might be worth a second look beyond the absolute truth ;):

https://www.foundmyfitness.com/search?q=sauna

https://selfhacked.com/blog/reasons-sweating-far-often/
 

nanonug

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I recently tested high on ALT (?) liver enzymes.
Mildly elevated ALT has been with me since pretty much forever. The only thing that brings it down, to the middle of the range, is N-Acetyl-Cysteine. So I take 1.3g/day of NAC religiously.

If one test I did several years ago is to be believed, I have intestinal hyperpermeability. My pet hypothesis is that the liver is working overtime to deal with all the crap (LPS included) that enters the hepatic portal system.
 
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With being able to sweat, getting dirty, it feeling really good, and it obviously not hindering a remission process in my case, it might be worth a second look beyond the absolute truth ;):
Totally agree, @pamojja.


There's a world of difference between concerted efforts to support your liver along with all your other body systems, and a liver 'cleanse'. If sweating in a sauna helps, you should definitely do it, just don't think that it's detoxing your liver or any other organ in your body. Sweating activates and supports a lot of functions in our bodies, but not 'detoxing' it. If the heat of the sun does it, even better, at least in moderation. If sleeping 12 hrs a day helps, burrow into those pillows and turn off the alarm. If eating a Paleo diet helps, graze away. If cutting out gluten ..... well, you can take it from here.

I'm so glad that you found something to turn the tables on this crappy little ass-hat illness, and that you're doing better. It not only lifts my spirits, it gives all of us hope.

Rock on !!! :) :woot::woot::woot::thumbsup:
 
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valentinelynx

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That's interesting. Could you expand on this? Did you take NSAIDs at the start of illness. What where the symptoms you experienced? I got a stomach ulcer after taking high dose NSAIDs at the start of my illness, the ulcer went away a few weeks later.
I believe the NSAID enteropathy is incidental to my illness. I've been ill since 1993 but this problem started 4-5 years ago. At one point a few years ago, I discovered that I could reduce my continuous high pain levels by about half by taking around the clock a "maximum safe" dose of ibuprofen: 800 mg three times per day, or 2,400 mg per day. I, like most everyone, including most physicians, was unaware of the risk to the small intestine from NSAIDs. I had an ulcer in medical school from taking ibuprofen, so I decided I would be "smart" and take hydrochloric acid suppressors with my NSAIDs. For a long time, I took a proton pump inhibitor (e.g. Prilosec). Later, when I read that chronic PPI use can cause problems, such as increased risk of H. pylori and gastric cancer, I switched to ranitidine, an H2 blocker. It worked; I didn't get any stomach or duodenal ulcers.

After maybe 2 years of taking ibuprofen and H2 blockers I had to go to the hospital at one point because of severe abdominal pain. No the pain wasn't coming from my stomach or intestines. After an extensive workup I was diagnosed with Sphincter of Oddi Dysfunction (Type II). This is a very painful spasm of the sphincter that regulates bile and pancreatic juice entry into the upper small intestine. It usually happens after gallbladder resection, but I never had my gallbladder removed. Well, anyway, while I was there, it was noted that I was very anemic. So, I got to stay an extra night to get an upper and lower endoscopy, looking for the blood loss. Nothing found: no ulcers in my stomach, no bleeding polyps or other badness in my colon. Next step: video endoscopy, otherwise known as the PillCam study. This is pretty cool: you swallow a camera the size and shape of a large capsule. It's activated just before you swallow it and you wear a device to pick up its radio-transmissions of photo it takes of your innards for 8 hours. Later you poop it out and flush it away (only I saved mine...)

The pictures showed my small bowel was full of ulcers and strictures. These strictures look like little diaphragms across the lumen of the small bowel, with a hole in the middle of varying sizes. Here's a picture of what this looks like. If you look closely, you'll see a little bleeding lesion at about 2 o'clock on the opening in the stricture shown:

1559556706243.jpeg


Note that I did not have any idea this was going on. It was not in the least painful. The strictures are problematic for me because sometimes, if I overeat, I will get a partial small bowel obstruction (nausea, vomiting, sevre bowel swelling, and inability to eat or drink for several days). Before the diagnosis I thought these episodes were due to food poisoning. But, aside from those very infrequent (thank God!) episodes, this syndrome is asymptomatic except for the bleeding causing iron deficiency anemia. It got so bad that I needed 4 blood transfusions last year, and still need periodic iron infusions. I test my stool for blood periodically and, although the bleeding is far less than last year, it persists. I stopped taking NSAIDs entirely about 1 1/2 years ago. Before that, I'd quit ibuprofen in 2015. I started taking Celebrex occasionally in 2017, thinking it would be less likely to cause a problem, especially only taken occasionally. Well, wrong: it definitely made the bleeding worse. But, still, I stopped NSAIDs 18 months ago and I'm still bleeding.

Last year, I had a repeat PillCam study. What fun: this time the camera got stuck in me! One of the strictures wouldn't let it pass. My GI doc freaked out: kept threatening me with surgery. Thankfully, someone suggested a different approach. I had to travel to Phoenix (120 miles) to get a "double balloon enteroscopy". It didn't work, but I came back to try again from the other end and the fabulous doc snared the thing!

In my work as an anesthesiologist, I see a lot of folks with iron deficiency anemia of unknown cause. Unknown, because no one has bothered to look further after negative upper and lower endoscopy. These are patients in chronic pain, almost certainly taking NSAIDs. I'm willing to bet that they have NSAID enteropathy, and they need a PillCam study to find it. I found, in reading the literature, that it is likely that NSAIDs more frequently cause small bowel injury than stomach ulcers. Apparently, a single dose of an NSAID increases small intestine permeability. Different papers say different things about whether some NSAIDs are excluded from this effect, but my conclusion from reading them all is that all NSAIDs, including aspirin and celecoxib (Celebrex) can. The most appalling thing to me about the general lack of knowledge of this syndrome is that it has been known at least since the early 1990s. Before video endoscopy, double balloon endoscopy, which is so difficult that hardly anyone does it anymore, was needed to see the inside of the small bowel, so the frequency of NSAID enteropathy wasn't known until about 10 years ago. But now there really is no excuse.

Here's some references:

1999 High prevalence of NSAID enteropathy as shown by a simple faecal test

2006 Is non‐steroidal anti‐inflammaory drug (NSAID) enteropathy clinically more important than NSAID gastropathy?

2012 Non-Steroidal Anti-Inflammatory Drug-Induced Enteropathy

2017 Non-steroidal anti-inflammatory drug-induced enteropathy

I discovered, in this interesting paper, that phosphatidylcholine is protective of the small intestine mucosa against the injury caused by NSAIDs. It discusses the development of medications combining NSAIDs with phosphatidylcholine. So, I started taking large quantities of phosphatidylcholine, hoping it would help heal my gut. Maybe it has; my bleeding has greatly decreased.

A group in Texas has been working on bringing this concept to market as a drug since the 1990s. Their company (PLx Pharma, Inc) have developed a PC-aspirin product called Vazalore which has been FDA approved, and a PC-ibuprofen product (PL1200, ibuprofen 200) which may be called Zavryl if it gets FDA approval. The most amazing thing to me, looking at their product release information, is that is does not mention NSAID enteropathy anywhere! The aspirin product is touted for it being "the first liquid-filled aspirin capsule" approved by the FDA (who cares?) and for faster platelet inhibition, which is important when using aspirin for treating heart attacks. The aspirin page also mentions decreased gastric ulcer frequency but nothing about the small intestine. The PC-ibuprofen product page has graphs showing decreased incidence of ulcers and erosions in the GI tract, but doesn't say where! This strikes me as very odd. Do they think educating doctors about the risks of NSAID enteropathy would be damaging to the marketing campaign? It's almost like there's a conspiracy of silence about NSAID enteropathy. Are the makers of NSAIDs blackmailing this startup company somehow: forcing them to keep silent about the greater threat of NSAID enteropathy?

I have a tendency to preach on this topic with the hope of preventing others from going through what I have. Please be careful with those NSAIDs!
 

sb4

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I have a tendency to preach on this topic with the hope of preventing others from going through what I have. Please be careful with those NSAIDs!
Yeah I would agree, I haven't taken any NSAIDs since "the incident".

I imagine drug companies market there drugs to hospitals / doctors where they will no doubt accentuate the pro's and down play the con's. It would be then on the doctors to find out the true side effects. Is it true that doctors take a cut every time they put a patient on a drug?
 

pamojja

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Thanks for these valuable explanations.

I discovered that I could reduce my continuous high pain levels by about half by taking around the clock a "maximum safe" dose of ibuprofen: 800 mg three times per day, or 2,400 mg per day.
My goodness, I must have had a whole troop of guardian angels shielding from my ignorance. With the 8 months lasting spondylodiscitis I took ibuprofen up to every 4 hours or 5 g on worst days. Still moaning and groaning for 2 hours of the 4. Though since then 20 years ago never took ibuprofen again.

I discovered, in this interesting paper, that phosphatidylcholine is protective of the small intestine mucosa against the injury caused by NSAIDs.
Years later it was also my experience that PC, or even in the form of Lecithin, would prevent any blood in stools I would get from aspirin otherwise.