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Liver Health

Fall 1999

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

A healthy liver is important for everyone. If you are HIV positive and taking medications, your liver will be working hard to process them and keep up with all of its normal functions. If you are infected with HEP C and HIV and your liver is damaged or overly stressed by HEP C, it may be difficult for your liver to process all of your medications. It is important to do everything you can to keep your liver healthy and avoid things that harm the liver. Unfortunately, unlike other organs in the body, the liver can’t let you know when it is in trouble, or often not until it is too late.

Liver Basics

The liver is located behind the lower ribs on the right side of your abdomen; it weighs roughly three pounds and is about the size of a football. Besides being one of the largest organs in your body (second only to your skin), the liver is responsible for thousands of essential body functions. Most people know that the liver processes alcohol and can be damaged by excessive drinking, but many are unaware that the liver is also responsible for aiding other important functions such as digestion, the processing of medications and toxins, general metabolism and a healthy immune system.

The liver is involved in detoxifying just about everything that enters the body. Substances can enter the body in many different ways, (by eating and drinking, through our skin or the air we breath). Excessive alcohol and substance use can negatively affect the liver and for those with HEP C, alcohol and street drugs, can increase the chances of developing cirrhosis and liver cancer. Experts recommend that individuals with liver disease avoid street drugs and alcohol.


Functions of the Liver
  • Produces quick energy when needed
  • Metabolizes alcohol
  • Stores vitamins, minerals, and sugars
  • Maintains hormone balance
  • Regulates blood clotting
  • Produces proteins for the immune system
  • Helps in the digestive process
  • Manufactures new body proteins
  • Removes toxic substances from the blood
  • Regulates the transport of fat stores
  • Processes and eliminates drugs from the blood
  • Removes bacteria from the blood
  • Avoid environmental pollutants and chemicals. Fumes from paint, paint thinners, chemical solvents, spray adhesives, insect sprays and other aerosol sources enter the body through the lungs and skin and are carried to the liver by the blood, where they must be detoxified and may damage the liver. If you use chemicals or sprays, make sure to take the manufactuers suggested precautions. Avoid skin contact and breathing of chemical fumes whenever possible. Always wash your hands and any other exposed body parts after working with chemicals. Household cleaning products should be used with similar caution as they too can damage the liver.

    Avoiding other hepatitis viruses is also important. Becoming infected with HEP A or B in addition to HEP C could be potentially life threatening. Ask your doctor or healthcare provider about vaccines for HEP A and B.

    Because almost all medications must pass through the liver before entering the circulation system, it is important to talk to your doctor about any over the counter medications you may be taking, even if they are generally considered safe. Combining medications can be dangerous. Keep a list of all your current medications especially if you have more than one doctor, so you can remind each of them what you are taking.

    Diet and Liver Health

    A balanced diet is important. If your liver is stressed by disease, it is particularly important to watch your diet carefully. Although there have been no formal studies that show HEP C infected individuals can positively change the course of their disease through diet, there is some evidence that a balanced diet may help liver cells damaged by hepatitis viruses to regenerate (regrow). In general, a healthy balanced diet is one that contains whole foods from a variety of sources like fresh vegtables and fruits, beans, whole grains, and fresh meats. Avoid processed foods such as cookies, cakes, frozen dinners, packaged foods with long shelf lives and "instant" foods. Overeating can also adversely affect the liver as well as other organs because they are forced to process the additional food.

    Diets that contain excessive fat, protein or carbohydrates can damage the liver. Too much protein may cause hepatic encephalopathy (mental confusion) in individuals who already have extensive liver damage. Adequate protein intake is important, however, to build and maintain muscle mass and to assist the body in repairing itself. A general rule for individuals with HEP C infection who do not have cirrhosis related encephalopathy is to eat about 0.8 grams of protein per kilogram of body weight each day. Excess carbohydrates can add to liver dysfunction and may cause fat deposits in the liver. Eating too much fat, especially processed fats and deep fried foods, can put an extra strain on the liver and may complicate laboratory tests used to monitor liver health in HEP C infected individuals.

    Individuals with advanced cirrhosis may have an abnormal accumulation of fluid in the abdomen, referred to as ascities. Individuals with HEP C who have ascities usually must be on sodium (salt) restricted diets. To avoid foods high in salt, stay away from canned meats, canned vegetables and soups, cold cuts and condiments such as ketchup and mayonnaise to name a few. Be careful of fast food restaurants since most of the food they serve is very high in salt and fat.

    It is best to consult your doctor or qualified nutritionist about the appropriate diet if you have liver disease. Be weary of fad diets that may not provide the body with the proper nutrition.

    Vitamins are necessary for proper body functioning and good health, however megavitamins, particularly vitamins A , D, E and K are dangerous for the liver when used in large amounts. Iron supplements should not be taken unless adviced by your physician. Always consult your doctor or healthcare professional before adding vitamin or mineral supplements to your diet. In addition, some herbs are toxic to the liver and should be avoided by individuals with liver problems. Herbal preparations that include the Crotalaria, Heliotopium, and Senecio plant families are toxic to the liver and should be avoided. Other herbs that are toxic include: chaparral, germander, comfrey (bush tea), mistletoe, skullcap, Jin Bu Haun, nutmeg, tansy ragwortsenna, sassafras, valerian and pennyroyal. As with all over the counter medications and therapies, it is very important to discuss herbal preparations with your doctor or healthcare provider before taking them.

    Regular exercise and a stress reduction plan are also important for people with chronic illnesses and should always be included in a health plan.

    David Pieribone is the Managing Editor of CRIA Update and the Director of CRIA's Treatment Education Program.

    A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

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    • Glossary Glossary

    This article was provided by AIDS Community Research Initiative of America. It is a part of the publication CRIA Update. Visit ACRIA's website to find out more about their activities, publications and services.
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