This is the term used to describe the end stages of liver disease where chronic inflammation of liver cells has caused an extensive build up of scar tissue in the liver. Scar tissue is the same as collagen as it is tough fibrous tissue, which replaces damaged liver cells. This scar tissue is not functional and cannot do the work of liver cells. Liver cells known as stellate cells produce the scar tissue to protect themselves from the inflammation that is occurring in the liver. This inflammation is produced by free radicals generated by viruses, toxins, unhealthy fats, alcohol, and some drugs or antibodies that are attacking liver cells. A healthy liver does not have many stellate cells and they do not produce excessive amounts of scar tissue. In contrast, in a liver that is chronically inflamed, the stellate cells become activated and they multiply and produce excessive collagen.
A cirrhotic liver is hardened with scar tissue, which reduces its blood supply. There is not enough healthy liver tissue to perform the metabolic and detoxification processes that the liver must perform to keep the body healthy.
Cirrhosis of the liver is the fourth most common cause of death among people aged between 30 and 50. Chronic hepatitis (caused by the hepatitis B and C virus) is gaining on alcohol as the leading cause of cirrhosis.
With millions of people worldwide suffering with cirrhosis, it is impractical to rely exclusively on expensive and in short supply, liver transplants as the ultimate cure.
Causes of Cirrhosis
Excessive alcohol, chronic hepatitis B and C infection, immune liver diseases such as auto-immune hepatitis and primary biliary cirrhosis, metabolic disorders such as Wilson’s disease and Haemochromatosis, adverse reactions to some drugs such as methotrexate and vascular disorders of the liver.
Signs of advanced cirrhosis may include:
- Spider naevi – spider shaped capillaries on the skin
- Excessive bruising
- Jaundice (yellow discolouration of skin and eyes)
- Altered liver size
- Enlarged spleen
- Clubbing of the ends of the fingers
- Ascites (fluid build up in the abdomen)
- Swelling of the limbs with fluid (oedema)
- A flapping tremor of the hands
- Mental confusion and disorientation
Nutritional Medicine for Cirrhosis
Increase the intake of antioxidants to neutralize free radicals.
Natural vitamin E 1000 IU daily (some people may need 2000 IU).Vitamin E is able to reduce the ability of the liver’s stellate cells to manufacture collagen; this reduces scar tissue production. Vitamin E can also soften existing scar tissue and therefore improve blood flow to the liver, which is essential for regeneration of the liver cells. Vitamin E assists in the maintenance of high levels of glutathione, which is the most powerful liver antioxidant to prevent cirrhosis. A clinical study of hepatitis C sufferers not responding to Interferon therapy, showed that nearly 50% improved dramatically with 800 i.u. daily of vitamin E. Use only natural vitamin E which is known as d-alpha tocopherol.
Vitamin C 1000 mg twice daily
Selenium 200 mcg daily – See www.seleniumresearch.com
It is vital to obtain plenty of beta-carotene and its related carotenoids from eating a wide variety of raw brightly coloured fruits and vegetables. Beta-carotene is converted in the body to vitamin A when needed. Thus beta-carotene cannot lead to vitamin D overdose or excess in the body. Beta-carotene, other carotenoids and vitamin A exert a vital anti-cancer effect in those with cirrhosis. This will reduce the risk of cirrhotic livers developing cancer. Those with liver disease need to be careful not to take excessive amounts of vitamin A and should not take more than 10,000 IU daily.
Take a liver tonic that contains the essential nutrients to support the liver’s ability to break down and excrete toxins. This will reduce the damage that toxins can inflict upon liver cells.
Many people with cirrhosis have a problem with bruising or excessive bleeding because their liver does not manufacture sufficient amounts of clotting factors. This can be helped by the daily consumption of a fresh juice made with a mixture of raw dark green leafy vegetables. Good vegetables to use for this purpose are spinach, kale, beetroot tops, parsley, mint, watercress, wheatgrass and alfalfa sprouts which are high in vitamin K. Vitamin K will help to reduce this deficiency of clotting factors and will reduce bruising and bleeding.
Minimise the use of all medications, especially liver toxins such as alcohol, analgesic drugs (especially acetaminophen and narcotics), anti-inflammatory drugs and antibiotics. Avoid using household and workplace chemicals such as insecticides, ammonia, pesticides, chlorine, bleach, paints, glues and solvents.
Reduce consumption of sugar as this leads to fatty liver and fatty liver will worsen all types of cirrhosis.
Supplements of glutamine, NAC and selenium may help the liver to reduce ammonia levels in the body.
N-Acetyl Cysteine (NAC) is an amino-acid derivative (small protein) that may offer considerable help to those with cirrhosis and impaired liver function. NAC’s powerful health benefits derive from its ability to restore intracellular levels of glutathione (GSH), which is the body’s most powerful antioxidant.
For more information on NAC, see N-Acetyl Cysteine.
Glutathione is a very powerful antioxidant that helps the liver to protect you against toxicity, and it is most needed by those with liver disease. The stress of chronic liver disease depletes glutathione and this is why supplementing with one of its precursors, NAC helps to protect against ongoing liver damage. NAC may be able to reduce a large range of chronic, degenerative diseases, including liver disease.
Diet in Cirrhosis
See the principles of the Liver Cleansing Diet in Dr Cabot’s Liver Diet Guideline, click here to download.
The cirrhotic liver cannot handle large amounts of concentrated animal protein at one time and for this reason minimize, the consumption of animal meats and poultry. If you eat too much animal protein, ammonia levels will build up in the blood stream causing fatigue and mental confusion.
You may have to consume only very small amounts of animal protein (including eggs, seafood, red meats, white meats, and dairy products), and increase plant protein sources such as legumes (beans, peas, lentils), grains, cereals, seeds and nuts. In this situation you will need to take supplemental Taurine 1000mg twice daily, and vitamin B 12 100 mcg daily.
Make sure that you remain under the supervision of your specialist and a good dietician.
Avoid constipation by consuming plenty of raw fruits and vegetables, and grind fresh seeds (flaxseed, pumpkinseed, sunflower seeds etc) and almonds to increase intestinal fibre. You can also use psyllium husks and FiberTone powder to increase bowel fiber. Increased fibre will speed the passage of toxins out of the bowels and reduce the ability of these toxins to recirculate back to the liver. Osmolax and Lactulose are also good products to draw fluid into the bowel to ease constipation. If the bowel function is poor because of constipation and excess populations of unhealthy bacteria, this can lead to excessive fermentation of the bowel contents, which will increase absorption of toxic ammonia and other nitrogen compounds from the bowel. A healthy liver can convert nitrogen into urea, which is excreted in the urine. In patients with cirrhosis and very poor liver function, the liver is not able to handle these high levels of ammonia and toxic brain symptoms may occur. In this situation bowel function should be improved by increasing raw food fibre, consuming fermented foods (such as fermented vegetables and coconut yogurt etc) and taking a probiotic supplement. Enemas and colonic irrigations can also help if there is severe constipation and auto-intoxication from the bowel.
Fifty percent of your diet should consist of raw vegetables and fruits. Dressings can be made with organic vinegars (balsamic, apple cider vinegar etc) and cold pressed olive oil. Drink one or two glasses of raw vegetable juices daily. Replace regular coffee with dandelion or cereal coffees.
Eat cruciferous vegetables including broccoli, cauliflower, brussel’s sprouts, kale, cabbage, bok choy and watercress as well as garlic and onions to help the detoxification ability of the liver.
Make sure that you are not consuming excessive iron and that your body’s total iron content is within normal limits. This can be confirmed with a simple blood test known as “iron studies”. See our section on iron overload.
Excess iron, even of a slight degree, can increase liver damage. Hepatitis viruses thrive in high-iron environments and surplus iron can cause immune dysfunction.
Reducing iron intake can increase the success rate of interferon therapy. Avoid iron-enriched cereals, vitamin pills containing iron, liver, red meats, and molasses and cooking in iron pots.
|A normal healthy Liver||Liver affected by Cirrhosis|
Dr Cabot’s famous liver cleansing and liver healing soup recipe
- 8 cups water
- 2 – 3 tablespoons of cold pressed olive oil
- 2 potatoes, chopped
- 3 tomatoes, chopped
- 2 carrots, chopped
- 2 beets, chopped
- 2 stalks of celery (including the tops), chopped
- 1 large red onion, chopped
- 1 inch finely chopped and peeled ginger
- 1 clove garlic, minced (optional)
- 1 bunch sliced kale or beet greens
- 2-3 fresh artichoke hearts
- 2 cups shiitake mushrooms, fresh or reconstituted, sliced
- 1 whole reishi mushroom (remove when cooked)
- L cup arame or wakame seaweed, chopped
- 1 cup cooked beans or lentils
Add small amounts of celery seed, turmeric, pepper and miso (or tamari) to taste.
In a large saucepan add the oil and bring to a moderate – high heat.
Add the celery (plus tops), ginger, turmeric, tomato, potato, carrots, beets, onions, celery seed and garlic and some pepper. Stir continuously so the vegetables do not stick to the bottom.
When the vegetables begin to brown, carefully add the water. Bring to the boil. Reduce the heat to a simmer.
Add the seaweed, mushrooms, artichoke hearts, lentils/beans and stir. Simmer for about 2? hours.
Add the kale and beet greens 15 minutes before you serve. Remove the reishi mushrooms. Stir in the miso/tamari to taste.
Serve alone or with a side salad.
These statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any diseases.