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Townsend Letter, Nov, 2009 by Ingrid Kohlstadt

Introduction

The Townsend Letter invited expert commentary on multiple chemical sensitivity (MCS) and fibromyalgia years before their slow acknowledgment by mainstream medicine. Now both MCS and fibromyalgia are well established to be associated with metabolic disturbances, especially liver inflammation.

Liver inflammation is measured clinically by an increase in liver enzymes beyond a certain range. It can be mild with increases that remain below the diagnostic threshold; it can also be so severe that it presents as jaundice. Often, the inflammation can be reversed by removing the primary offenders and providing nutritional support. In any situation, an inflamed liver cannot fully defend itself against incoming toxins. So treating the inflamed liver may be comparable to securing the tent flap after the mosquitoes have flown in.

Sometimes the underlying cause of liver inflammation is not clear and can leave patients scouring their surroundings for hidden toxins. Furthermore, two people with a seemingly equal exposure to one particular toxin may respond differently, prompting the question, who is at risk?

Who arthritis pain relief Is at Risk?

Do genetics increase susceptibility? Yes.

One example is genetic polymorphisms of methylene tetrahydrofolate reductase (MTHFR), which can be identified through blood testing. It is possible to compensate for the unfavorable genes through supplementation with certain forms of folate. This can aid the liver in its detoxifying function.

Is liver inflammation due to exposure to other toxins? Yes.

One example is that certain occupations such as landscaping, dentistry, and cosmetology are associated with exposure to toxins, and some data suggest increased risk of liver inflammation as well. Most of us are exposed to a broad variety of poorly characterized toxins at varying doses, a situation that does not lend itself to public health studies.

Do diet choices beyond alcohol use increase risk? Yes.

Avoid trans fats and refined carbohydrates. Sugar is converted into fat and can increase liver enzymes in short order. I illustrate this point with a personal vignette from a recent doctor visit:

While 28 weeks pregnant, I took the glucose tolerance test (GTT) required by the American College of Obstetrics and Gynecology as a screen for gestational diabetes. The GTT involves drinking an extremely sweet orange-flavored beverage, followed 1 hour later by a glucose blood test. For those of us who already think Orange Crush is too sweet, this drink tastes poisonous.

My blood glucose tested “normal,” confirming that my pancreas could crank out enough insulin to manage the sugar surge. But I did not feel “normal.” Within 30 minutes of consuming the beverage, I became restless and unable to focus on my work the rest of the day. I experienced the cabin-fever equivalent of a three-day snowstorm. Come to think of it, I may have met the criteria for ADHD as well.

The second thing I noticed is that instead of being sick of sugar, my body craved it. Apparently, so much insulin had been called into action first thing in the morning that it lingered long after the sugar surge was over. The insulin surplus demanded more sugar, and the cravings continued throughout the day.

Thirdly, within 48 hours, two acne craters emerged on my face, as if I were going through puberty rather than pregnancy. The association between sugar and acne is presented in a scholarly way by Valori Treloar, MD, in her chapter “Acne” in the book Food and Nutrients in Disease Management.

Although liver enzymes are not part of the GTT blood work, a few more days on the sugar roller coaster and my liver would be sure to show it.

Can Medications Contribute to Liver Inflammation?

Yes, as illustrated by a large list of medications, which include the following:

* Tylenol (acetaminophen) is an example of a medication known to inflame the liver. This side effect was highlighted by the recent decision to discontinue Vicodin and Percocet, combination pain products that contain acetaminophen. With combination products, as patients need more of the narcotic pain medication, they also receive more acetaminophen. Additionally, patients may take over-the-counter Tylenol, not realizing that they are already consuming it.

* Lamisil (terbinafine) oral tablets are prescribed to treat fungal nails. The benefits of the medication should be weighed with the side effects, which include increased liver enzymes.

* Tamoxifen is taken by breast-cancer survivors to prevent disease recurrence. Elevated liver enzymes in a breast-cancer survivor can signal metastatic disease, so if Tamoxifen is identified as the cause, it is viewed as comparatively good news. However, it also suggests that a medication could promote recurrence of the very disease it is prescribed to prevent.

* Hormonal contraception (birth control pills) can increase liver enzymes