The liver is an amazing workhorse in the body that does the heavy lifting. The liver processes toxins from daily environmental exposures and it also processes all hormones, prescription and OTC drugs as well as functions as part of our digestive system.
In today’s world we are being bombarded with chemicals. Of the roughly 84,000 chemicals now listed on the Toxic Substance Controls Inventory, 62,000 were in commerce when TSCA was enacted, and about 22,000 new chemicals have since entered commerce. The EPA reviews about 1,500 new chemicals every year, about half of which go on to enter commerce.
The fact is our liver was never designed to handle this massive amount of chemicals. To add to this assault on the liver is the fact that only the liver can make and process many vital enzymes to aid in the proper break down of food during the digestive process.
~ Testing liver enzymes: Is your liver crying out for help?
Often the first alarm bell rings that we have a sick liver when we see high liver enzymes on a blood test. It’s important to note that these enzymes are mostly contained inside the liver cells and only leak out into the blood stream when there is liver cell damage.
Liver enzymes and what they mean
- Total bilirubin: 2-20 umol/L or 0.174 mg/dL. This test measures total bile pigment in the blood. High levels indicate jaundice.
- AST: 0-45 U/L Not liver specific as high ranges can be present in heart and muscle diseases
- ALT: 0-45 U/L More specific for liver damage
- ALP: 30-120 U/L Is elevated in many liver disease but also other diseases.
- GGT: 0-45 U/L Often elevated in those who use alcohol or other liver toxic substances.
- Blood proteins
- Serum Albumin: 38-55g/L or 3.8-5.5g/dL
- A gauge to liver function. Healthy livers produce more albumin; livers in distress produce less.
- Globulin protein: 20-32g/L or 2-3.2g/DL
- Elevated levels usually mean inflammation in the liver and/or immune system. Also high in situations of cancer.
- Total protein 60-80g/L or 6-8g/dL
What to do if liver enzymes are high
Current estimates are that around 20% of people (or 1 in 5) in the US, UK and Australia have impaired liver function or a fatty liver.
First and foremost you must realize that your liver is incredibly important to your overall health.
A sick liver = a sick body.
Second, realize that your current liver health did not happen overnight, rather this is the result of some long term food and lifestyle choices you have made. According to Dr. Sandra Cabot M.D, you can improve the health of your liver and even reverse liver damage by changing your diet and lifestyle. 
NAFLD is much more complex that first thought. Our understanding of this condition is now pointing to NAFLD being a connected to in insulin resistance, poor gut microbiome as well as genetic variants.  In addition, Type I diabetes, which is an autoimmune disease, is also now associated with NAFLD 
NAFLD is associated with increased CVD and the scary aspect of this is that in many cases, by the time liver enzymes are elevated enough to be detected through testing many people have significant heart health risks. 
Dietary habits that lead to a fatty liver also lead to insulin resistance and prediabetes. These two conditions are two of the most common and growing health issues many clinicians are seeing today.
And sadly, while conventional medicine is quick to recommend statin drugs to lower cholesterol there is a better, safer way to reduce triglycerides by following a carbohydrate reduced diet, which I’ll outline next.
Tips for Reducing Fatty Liver
1. Shift to low carbohydrate eating.
Significantly reduce or all eliminate grains (flours), cereals, crackers, noodles pasta, rice, quinoa. Remember dyslipidemia (cholesterol and triglyceride imbalances) is actually due to eating too many carbohydrates which I have written about in this post – http://nourishholisticnutrition.com/whats-the-real-driver-of-elevated-cholesterol/
It’s particularly important to eliminate all processed carbohydrates, all sugars aka: agave, cane sugar/beet sugar, maltodextrin, polydextrose, high fructose corn syrup, corn syrup, molasses, candy, ice cream and frozen desserts, cookies, pies, cakes, pastry. Very often people make the mistake of reaching for these kinds of fast acting carbohydrates instead of lower carb vegetables and lean proteins for energy. It’s the blood sugar swings that then cause damage to insulin sensitivity inside the cells that eventually leads to insulin resistance or per-diabietes.
2. Boost plant foods and eat some raw vegetables each day (unless these are not tolerated as for those with IBS). Great easy sources are leafy green salads 1-2 a day, Raw green juicing is excellent for the liver…see my liver cleaning recipes at the end of this post.
Limit fresh (organic) fruit to two servings a day until your liver enzymes improve.
3. Eat only cold pressed healthy oils made from olive, coconut, avocado, macadamia nut. And be sure to eat some of these in their raw state each day. You may need to begin with very small amounts at first, especially if you have had gall bladder surgery and had this organ removed.
Absolutely do not eat fried foods or chips/crisps!
4. Be sure to get adequate quality protein at every meal or snack. Choose from organic, pasture raised and wild caught fish and seafood (best choices) and poultry. If you must eat red meat, limit your intake of red meat to twice per month and be certain it’s grass fed/pasture raised. No smoked or cured meats please. No pork.
Eggs should be pasture raised and ideally not fed a diet of corn, soy and wheat, which most you buy in grocery stores are even if they are labeled cage free. It’s best to source these from a local farmer and ask what they feed their chickens and how much time they are allowed to roam outdoors each day. Also ask if they are using artificial lights to increase the hens laying eggs. Hens naturally lay fewer eggs when the sun is not shining. Most people can safely consume 6- 8 eggs per week.
Remember raw, grass fed dairy is a good quality protein source provided you are not casein/dairy intolerant. Ferment dairy (yogurt and kefir) are loaded with probiotic and enzyme rich goodness to feed your microbiome.
Butter or ghee in small amounts is fine. Just limit your intake and don’t use butter on everything or you’re bound to have problems.
Nuts and seeds are also non- animal protein sources. Raw are best – keep refrigerated and buy in small quantities from a reputable source.
Legumes and beans (soaked for better digestibility) are fine additions to soups and as side dishes; just keep the portions small and don’t over eat these as they are high in carbohydrates.
4. Eat smaller meals. This helps minimize energy from the liver which is both a digestive organ as well as a detoxifying organ in the body
5.Reduce your toxic load! Read more about how to tell if your liver needs to detox
6. Eat liver supporting foods and tonics. Take a good Liver Support Formulation and read how to be kind to your liver
7. Drink plenty of filtered water each day.
8. Be sure to move your body each day. Stay active and not sedentary. Exercise in some form each day.
Improving a sluggish liver:
Purifying Raw Juice Liver Tonic
1 Organic Carrot
1 Organic beet
Organic ginger (1 “ piece)
1 Sweet organic apple
Handful organic parsley
1 organic cucumber
Process all ingredients in a juicer and pour into a glass. Add to this juice blend the following: 1 tablespoon organic green food and 1 tablespoon organic flax seed oil. Drink immediately. Drink 8 oz of this mixture 1-3 x a day to improve a sluggish liver.
Raw Red Salad (serves 4-6)
This is a very good salad to eat to help detoxify the liver and gall bladder. It also helps support healthy hormone balance. I got the idea for this recipe after reading Dr. Bob’s Drugless Guide to Balancing Female Hormones.
1 sweet apple (Gala or Honey Crisp work well) – skin on diced into small pieces
2 stalks celery – diced into small pieces
2 small carrots – shredded
1 leaf of kale chopped very finely (or I sometimes use beet tops thinly sliced)
2 Tbsp. fresh flat leaf parsley finely chopped
1 small raw beet with outer skin removed
1 Tbsp. flax seed oil
1 Tbsp. virgin olive oil
1 ½ Tbsp. fresh squeezed lemon juice
1-2 tsp. coconut amino
¼ tsp. dill weed
¼ tsp. fresh ginger root
¼ tsp. fresh ground pepper
Step 1: Wash all vegetables. Remove the outer skin from the raw beet. Using a food processor shred the carrot and beet. Finely dice the celery, apple, kale and parsley. Combine the vegetables & fruits in medium bowl.
Step 2: Combine dressing ingredients in small bowl and whisk together.
Step 3: Pour dressing over salad ingredients and mix thoroughly. May be made ahead and refrigerated. Eat within two days.
Concerned about your liver health? Contact me to see if we are a fit
Resources & links for further reading:
Dr. Sandra Cabot, MD author of Fatty Liver You Can Reverse It