Hepatics

Oct. 2, 2006

 Functions of liver
o Protein metabolism, degradation of metabolism, synthesis of a variety of
proteins including clotting factors, etc…CHO metabolism (in the form of
LIV glycogen), place where Lipids are metabolized
o LIV drains both bile and blood
o If LIV damaged, can remove up to ½ of it and it will regenerate itself
o Where there is general toxicity, esp. after a viral infection, or where there
is an intoxication b/c of a high level of intoxication, then need the
regeneration of every LIV cell
o Can transport bilirubin, and biotransforms wastes, drugs, and toxins
o Produces a variety of proteins
 Hepatoprotective
o All of these herbs protect and restore the functioning of individual
hepatocytes
o Silybum marianum (milk thistle) is the primary herb for this
 Has flavoligands called silymarium
o Protect against viral diseases and hepatotoxic chemicals (eg. Alcohol,
peroxidated foods, toxins found in peanuts, pharmaceutical drugs,
o Accelerate protein synthesis so that cells can regenerate
o Potentiate phase 1 and phase 2 detoxification pathways and inhibit
enzymes responsible for carcinogenic change
 Choleretic
o Definition overlaps with cholagogue
o Increases the excretion of bile – amt. of bile produced by each hepatocyte
is increased
o increase the body’s ability to detoxify, provided everything else is in order
o if going to stimulate detoxification with choleretic, must make sure that
the bowels are ‘open’ (having at least one bowel movement a day)
 cholagogue
o stimulates function of the GB
o produce between 1 2 L of bile a day
o most of the bile is going directly into the intestine, some stored in GB.
o When have heavy meal, GB squeezes bile into S.I to emulsify fats, and
help get them into portal circulation
 Anti-infective
o Very important, need to protect the LIV against infection (bacterial)
 Anti-cancer
 Herbs will have one of these five characteristics
 Conditions of LIV that we can treat
o In everyday living we make waste materials in the LIV
 o Principle that want to introduce to person is to reduce the amount of
garbage entering the body
 Eat foods that are less contaminated
 Those that are greater absorbed
 Therefore reduces toxic load
 Certain drugs place a demand on the LIV
 Person who has a LIV disease – very high level of LIV enzymes
(monitored by blood tests) therefore, LIV on brink of collapse
 Herbs that can improve metabolic rate, but efficacy of conjugation
are very valuable
 If person has Hep. C to make cell more resistant to virus is very
important to do
 While that can be life-saving, see almost miraculous results when
person who’s suffering from this disease to eat a pure organic (live)
foods.
 Live foods – fresh vegetables, fruits, and meats that are still
metabolizing when eaten.
o Reduce contamination to body and gives LIV a chance to recover
 Need to develop own language for toxicity and hypertoxicity of LIV.
 Fatty Liv
• LIV begins to deposit fat in its own LIV
• If eating more CHO than can burn, goes to LIV
• Not a life threatening condition, but will reduce functioning
• Eg. Chronic hepatitis – LIV doesn’t have the capacity to
eliminate them virus
• In TCM – heat in LIV
o Initially edges of tongue is red
o Eventually whole tongue will be red
o The whole coat will peal right off ‘the moss has no
root
o The tongue looks like a piece of LIV
o If there is a coat on the tongue – yellow/brownish
 As heat body fluids they become darker
 Viral Hepatitis
• Infection Hep. B/C…which cause severe damage to LIV
which results in scarring or cirrhosis
• Only a matter of time before it cuts across the major LIV
function and develops into fatal jaundice unless go through
surgery
• Hepatitis predisposes the LIV to cancer
• Anti-viral – licorice (solid extract) – can maintain
equilibrium
• Problem with Hep. Enzyme levels are not indicative of
level of cirrhosis in live
 • Only way to determine how damaged the LIV is though
LIV biopsy
• Mysterious disease
 Cirrhosis
• Already talked about
• Response to inflammation
• Can have inflammation from a viral infection
• Can have it as a response to alcohol
• Using a hepatoprotective herb can delay or even stop the
process of cirrhosis
 Cancer of the LIV
• Except for a couple of cases where the cancer had invaded
the bile ducts and had surgery to open up the pathways
again, been impressed that LIV cancer can be kept under
controlled
• Impressed how the mushroom based immune herbs can do
this
• Product: John Redden – Deep Immune Activation: based
primarily on immune activation, get a reduction in tumor
size
 Jaundice
• Excess bilirubin in the blood stream
• As bilirubin builds up in blood streams person turns yellow
• First notice it in the sclera – looks a little yellow-ish, then
shows up on their face
• Why do people have jaundice?
o Overload of bilirubin – causes by hemolysis (give
the wrong blood to someone)
o Obstructive jaundice
 Stone or calcius in the bile duct (right or
left) causing the bile to back up and bilirubin
goes into the blood stream
 Cholecystitis
• Inflammation of the bile duct and GB
• Can sometimes occlude the bile ducts
• Can have occlusion of bile ducts in tumor
 Cholelethiasis
• Calculi or stones in GB
• Gallstones
• Key: many of the herbs which are choleretics and
cholagogues are contraindicated for cholethiasis
 • If have obstruction that prevents bile from flowing and
causes it to back up into the LIV – don’t want to support
the increase production of bile
• If examine patient and have no pain, then obstruction of
GB
• If have intense pain then obstruction is in the bile duct
• Not going to stay active for very long
• Stones caused by stagnant bile in the GB that is crystallized
• Want to keep bile thin and clean all the time, this will help
it to dissolve the stones
 Hemorrhoids
• Toxicity contributes to the formation of bile
• Especially constipation
• Inflammation of veins around the anus and causes them to
swell
 Case 15
o Has bilirubin in her blood
o Can use cholagogues and choleretics and hepatoprotective herbs
o Can use taraxacum officinale
 Use root – benefical to LIV
 Choleretic and cholagogue
 (don’t forget to read about diuretic effects)
 It’s so rich in nutrients (esp. K+)
 Sweet and bitter flower (can virtually live off of it)
 Constituents (responsible for )
o Silybum marianum
 Chosen next because it’s hepatoprotective
 Trying to increase the efficacy of this women’s hepatofunction so
can metabolize more quickly the toxins coming into her body
 Disrupts the general flow of bile in the LIV
 Women has elevated LIV enzyme levels (not in outline)
 Ground up milk thistle leaf - thistlen
 Choose one of very high quality
 Use the thistle seed
• Flavoligands – marium
 Bitter – always tonic to digestive system (increase secretion of
juices and peristalsis)
• Facilitates transport of products by the use of bitters
• Get better functioning Digestive system
 Restorative
o Cynara scolymus
 Very strong for LIV
 Her son had recently passed away and she wanted to follow him
 He wanted to give her a reason to live
She felt that she was responsible for his death (he committed
suicide)
 Not restorative
o Chionanthus Virginicus
 Good for jaundice
 Alterative – GB function, supports LIV function
 LIV tonic
 Cholagogue
 Hepatomegaly – enlarged LIV (either from inflammation,
cirrhosis)
• Can have compensatory hyperplasia
o Peumus Boldus
 No info abt. Whether there were any stones involved
 Used in jaundice caused by bile duct obstruction
 A lot of discomfort around the gallstones
 Contraindicated for bile duct obstruction – but at this point she had
the jaundice for a couple of months, there was no information of
bile duct obstruction. If it was, she would have been dead
o Leptandra Virginica
 Not a laxative, but does result in improved elimination over time
 Works though it’s cholagogue effect, but also through effect of
colon
 Case 14
o Want to use herbs that will heal the GB and LIV and take care of the
infection
o Need herbs that are anti-infective
 Several that contain berberine – hydrastasis Canadensis, berberis
aquifolium, berberis vulgaris
o Berberis Vulgaris
 Anti bacterial and anti-protozoal
 Cholagogue and hepatic
 GB inflammation
o Hydrastasis Canadensis
 Major anti-infection herb
 King of the mucous membranes
 Important for the reduction of inflammation and phlegm
 Works on so many systems
 Mucous membrane tonic
 Inflammation subsides in the presence of it
 Only need a little bit of this herb, don’t need a lot
o Leptandra Virginica
 Case 13
 o Want hepatoprotective and immune support
o Silybum marianum
o Want to impair the progress of the virus
o Licorice
 Aldosterone effect
o Treat the symptoms: asymptomatic
o Causes
 Crossed out and put down LIV
 Want to restrict herbs to hepatic function
o Cynara scolymus
 Compositae family
 Leaf part used
 Seed of silybum marianum
 Contains a group of chemicals – cyanarum which contains the
sequiterpene lactones….
 Very good hepatoprotective and choleretic
 Stimulates digestive system as a whole
 Woman has a very strong constitution therefore no hesitation in
using it
 Protects LIV in many ways
• Reduces cholesterol production by increasing its excretion
• General cleanser to the system
 Generally useful herb
 Speculative indication with cholesterol lowering drugs
• Doubt whether that’s true b/c drugs are so toxic to LIV that
it would protect LIV from being damaged
o Curcuma Longa
 Helps to slow down the inflammation of the LIV
 Mode of action – antihepattotixic
o Chisandra and Licorice
 Both tonics
 Case 12
o Gallstone is passing through the bile duct
o Acute pain will last until it moves right though
o Obstructing pancreatic ‘juice’ – get autodigestion of pancreas (severe life
threatening condition)
o Want to keep the bile ducts open
o Diet is extremely low in fats and oils
 Effort to control his tendency to gain weight
o Probably not enough GB activity, so the bile became thicker and thicker
that crystallized
o Standard protocol by Hoffman (sorry, don’t know all the names, but it’s in
the text book)
  Peumus boldus
 Need spasmolytics
 Don’t want anything that would cause the GB to contract
 Valarian, Bybernum to stop cramping and spasming
o Dr. Godfrey’s List
 Puemus Boldus
• 5ml tincture tid
 Leptandra Virginica
 Chionanthus virginicus
 Diascura volosa
 Valria officinalieus
 Olea Europea
• In the infection herbs
• Both as leaf and as olive oil
• On 2nd or 3rd day recommend to take olive oil tid gradually
increasing
• No powerful cholagogic effect
 Rapid resolution
 Case 11
o Toxicity – focus botanical therapy on LIV
 Also focus on GI, esp. elimination; KI
o If have toxic build up in the skin the lymph causes it to show up on the
skin
o Must get lymphatics moving – cannot detoxify a person with sluggish
lymphatics
o Lymphatic – do hot and cold showers, keep physically active so that
lymph can keep moving
o Silybum marianum
o Taraxacum Officinale
o Cynara scolymus
o Berberis aquiforium
 Has affinity for skin
 Remember this for skin conditions like eczema
 Tends to be more harsh on the bowel
o Curcuma longa
 Anti-inflammatory – helps person feel better
 Cholagogue – increase flow of bile
 Anti-oxidant and protective of the tissue
 Have to use the extract instead of the root
o Other herbs:
 Burdock and yellow dock
• Both are blood cleansers that have an affinity for skin
conditions
 can treat the symptom of constipation