How to treat the cause
I saw an interesting gentleman in my clinic recently who had sclerosing cholangitis and wanted to treat it with nutritional medicine. This is a chronic inflammation in the bile ducts which over the years can lead to scarring and narrowing of the bile ducts. The word sclerosing means scarring and the scar tissue can narrow and distort the structure of the large and small bile ducts. The liver cells surrounding the bile ducts also become inflamed and this is why the liver enzymes are elevated in a liver function blood test. In some cases, including this man’s case, there is also infection with disease causing (pathogenic) bacteria in the bile ducts. When the infection flares up this produces pain over the liver in the right upper abdomen, fever, sweating and muscle aches and pains. To control the infection this man had been prescribed daily antibiotic drugs. He was also prescribed Ursofalk which is a synthetic form of bile acids.
He felt generally well but wanted to treat the cause of his disease on a deeper level and that is why he came to consult me. The left lobe of his liver had been so badly damaged by this disease that he had it surgically removed and this procedure is called a left hepatectomy. He was worried that the disease would gradually destroy the right lobe of his liver and was trying to avoid a liver transplant. His diet was reasonable and he was Italian and grew his own vegetables in his garden and consumed a lot of olive oil, which is a good fat for the liver. He was physically active and did not drink excess alcohol.
I explained to him that the cause of the inflammation in his bile ducts was caused by 2 factors
- Bacteria growing in the ducts
- Autoimmune dysfunction where his immune system was attacking the bile ducts
We had to address both these factors if we were to reduce the inflammation that could continue to destroy his bile ducts and the liver cells surrounding the bile ducts.
To achieve these goals I prescribed the following strategy -
- A gluten free diet as his blood test for the HLADQ genotype has shown that he carried the genes for gluten intolerance
- A good liver tonic containing Milk Thistle, all the B group vitamins, selenium, antioxidants and sulfur containing amino acids
- Vitamin C to strengthen the bile ducts
- An increased intake of water and raw juices to promote the flow of healthy bile. Suitable things to include in the juice are ginger, citrus, kale, cabbage, carrot, parsley and green apple
- An increased dietary intake of foods high in sulfur such as garlic, onions, chives and radishes
- An increased intake of essential fatty acids from oily fish, avocado, ground flaxseeds, hemp seeds, chia seeds and fresh walnuts
- A supplement of natural vitamin E which would reduce scarring
- A glutamine supplement in powder form to reduce inflammation in the gut and enhance the production of glutathione in the liver.
- Natural antibiotics to reduce the population of unhealthy bacteria in his intestines. This would reduce the source of the infection in his bile ducts, which was coming from the unhealthy bacteria in his intestines. These include herbal antibiotics such as Parasite Cleanse.
- Serrapeptase is an enzyme that can clean away debris from blocked and scarred tubes.
- A probiotic supplement and increase fermented foods in the diet (such as Greek yogurt, Kefir and sour kraut)
- Apple cider vinegar with his meals – sip one to two tablespoons of organic apple cider vinegar in a small glass of water during meals.
Other foods and herbs that can exert anti-inflammatory and protective effects in the liver include-
- Sesame seeds (best consumed as tahini paste or hummus) contain sesamin, which has liver protective effects
- Cruciferous vegetables – such as broccoli, broccoli sprout powder, cabbage, Brussels sprouts, cauliflower, kale and watercress ; these contain powerful protective liver factors such as sulforaphane and Indol-3-carbinol.
- Turmeric, which contains curcumin and induces phase 2 glutathione conjugation, increases glutathione production and is anti-inflammatory
- Green tea catechins provide many supportive effects on liver detoxification
- Citrus fruits and caraway oil contain D-Limonene, which enhances elimination of carcinogenic metabolites from the liver
I have had many patients with autoimmune diseases of the liver, from autoimmune hepatitis, primary biliary cirrhosis (PBC) and sclerosing cholangitis, who have been able to get their liver function back to normal and arrest the inflammation in their liver. This takes a little bit of effort and a change in diet for many sufferers but the outcome achieved is well worth the effort. Nutritional medicine is evidence based and very scientific and needs to be used much more widely in liver clinics.
Supplements to Support Liver Function
Livatone Plus Capsules/Powder
A specific liver tonic which contains a high dose of the herb Milk Thistle with a high standardized concentration of the active ingredient silymarin. This liver tonic would also contain additional supporting nutrients such as amino acids, vitamins and minerals.
Selenomune contains 200 mcg of organic selenium combined with high doses of other immune boosting minerals per capsule.
MSM Plus Vitamin C powder
MSM (Methyl-Sulphonyl-Methane) is an organic form of the mineral sulfur. Sulfur is a vital component of healthy bile. Sulfur is needed to produce the powerful liver antioxidant called glutathione. Vitamin C will neutralize free radicals generated during the phase 1 detoxification pathway in the liver. Toxic chemicals are far less dangerous if there is plenty of vitamin C in the liver.
Natural Vitamin E
Vitamin E is required to protect cell membranes from free radical damage. Make sure you use vitamin E supplements which are natural (d-alpha-tocopherol); synthetic forms (dl-alpha-tocopherol) are derived from petrochemicals and are not well utilised by the body.
Any powdered supplements could be stirred into fresh raw vegetable juices containing carrot, ginger, lime, celery and beet made with a juice extracting machine. Dr Cabot’s book Raw Juices Can Save Your Life is an excellent source of juice recipes for various conditions.
Dr Cabot has known about the incredible healing power of raw juices from a very young age. Her grandmother’s life was saved by raw juicing back in the 1930s. Raw juices are an incredibly powerful healing tool and can improve the function of the liver, bowels and kidneys. This increases the elimination of toxins and waste products from the skin.
Appropriate juice recipes include:
- Liver Tonic Juice
- Liver Cleansing Juice
can be found on p116 of Dr Cabot’s Raw Juices Can Save Your Life
Cholestyramine (or colestipol) can be very effective in reducing itching skin; it does this by increasing the clearance of bile acids in the bowel actions.
Ursodeoxycholic acid (actigall or ursodiol) may also improve clearance of bile from the blood stream.
Liver transplant prior to liver failure is required in end stage disease.
These statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any diseases.