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Wellness expert Carrie Demers, MD, answers your questions about how to repair and revitalize the liver.
I recently went to see an acupuncturist for some chronic digestive problems and she told me that my liver is congested. Is this something serious? What should I do?
Consider this diagnosis a wake-up call. A congested or stagnant liver won’t put you in immediate danger, but it will produce symptoms—in your case digestive problems—that can lower your quality of life and indicate that you’re headed for trouble down the road. Think of liver congestion as a precondition for more serious problems. It occurs before Western medicine can detect any sign of liver malfunction, and it is a “condition” you and a traditional medical practitioner—such as a traditional Chinese medicine (TCM) or ayurvedic doctor—can remedy.
Both TCM and ayurveda attribute liver congestion to heat that is trapped in the liver. They seek to clear and cool the organ through lifestyle changes and herbal treatments.
Both TCM and ayurveda attribute liver congestion to heat that is trapped in the liver, and they seek to clear and cool the organ through lifestyle changes and herbal treatments. The liver is a natural multitasker: it plays a large role in metabolism, helps build proteins, breaks down hormones, clears toxins from the bloodstream, and much more. Ayurveda views the liver as “hot” or “pittic” because the fiery, dynamic energy of pitta—one of the three doshas (along with vata and kapha) that regulate the physiological functions of the body—guides and supports these myriad functions of the liver. Too much fiery energy, however, can accumulate in the liver and lead to physical problems.
Ayurveda describes symptoms caused by excess pitta that are very similar to what is called “liver fire” in TCM: headaches; flushed face; red, burning eyes; acne; nosebleeds; and outbursts of anger. Ayurveda adds inflammation, allergies, and symptoms of indigestion (like heartburn) to the list. Changes in lifestyle—like eating cooling foods, getting regular exercise, and taking time to relax—are often enough to bring pitta back into functional balance.
HERBAL FIRST AID TO TREAT A WEAK LIVER
Many herbs that support liver function can calm and pacify imbalanced pitta and reduce liver congestion. Some of them increase bile flow, others support the enzymatic detox processes, and some simply nourish or stabilize the liver. The herbs listed below are generally safe for clearing liver stagnation, but if you have a significant liver condition, it’s best to consult an experienced health practitioner before treating yourself.
BITTERS
Universally recognized as strengthening for digestion, bitter herbs cause a reflexive secretion of gastric juices and tone the muscles of the digestive tract. They also support detoxification by helping the liver process incoming nutrients and filter impurities from circulation. And they have antibacterial and heat-clearing properties, which support immunity and pitta balance. Herbalists often combine barberry, turmeric, dandelion, celandine, goldenseal, gentian, chiretta, and/or neem in “bitter” formulas. These herbs are best taken in small doses as tea or diluted extracts 20 to 30 minutes before a meal to support liver function, detoxification, and digestion. (Pregnant women should check with their doctor first.)
PURGATIVES
Herbal wisdom says that in order to efficiently clean up a toxic liver, your bowels need to move—otherwise, toxins removed from the liver get reabsorbed rather than excreted. According to ayurveda, pitta accumulates in the small intestines, and purgatives (laxatives) help to release it.
One of the gentlest purgatives, and the one I prescribe most often, is the soluble fiber psyllium, which can safely be used on a daily basis for months. Start with one teaspoon in two cups of liquid, and chase that with one-third cup of liquid once a day at least 30 minutes before ingesting anything (supplements and medications included)—or two hours after. I also recommend the ayurvedic classic bowel tonic triphala for long-term regulation; try two capsules before bedtime daily for two to three months.
LIVER TONICS
Milk thistle has become a relatively well-known liver tonic in recent years, as more research has demonstrated its effectiveness in reversing chemical-induced liver damage and preventing liver toxicity during chemotherapy. Considered nontoxic, milk thistle can be taken for months and is a common ingredient in “liver support” formulas because of the way it nourishes and strengthens the organ.
In the Chinese system, many herbs—notably schisandra and bupleurum—fortify and protect the liver. These can be taken as part of herbal formulas for several weeks and help repair liver damage. Take liver-tonifying herbs separately from bitters, as directed on the labels or as prescribed by a knowledgeable practitioner.
FASTING
The liver is a resilient organ, so it can often “decongest” itself if you reduce the burden on it. Every time you eat anything, you flood the liver with nutrients and potential toxins. Fasting helps it catch up. Detoxification processes require energy and nutrients, however, so it’s wise to drink fresh vegetable and fruit juices every three hours or so when fasting to provide this needed support.
Drinking easily digestible nutrient-dense juice gives you the minimum you need calorically to prevent the breakdown of muscle for fuel. Ideally, fasting only lasts one to three days, and occurs when you’re calm and relatively at ease—not when you’re racing around and stressed out. Don’t starve yourself or let yourself become weak or depleted and always stop a fast at any sign of exhaustion (dizziness, weakness, cold sweats, or trouble with thinking). Pregnant women and people with chronic illnesses (especially diabetes and low blood sugar) should consult their physician before undertaking a fast.
LIVE FOR YOUR LIVER
Overall, both ancient wisdom and modern science agree that how we live has a huge effect on our livers. So even though you can’t avoid chemical contaminants completely, you can keep your liver healthy if you just take care of it by following these suggestions:
- Nourish yourself well. Eat good-quality food when you are hungry. Avoid overeating (more liver burden) and refined or heavily processed food.
- Remember that high-fiber diets help keep the bowels, liver, and blood clean by facilitating elimination. Hydration also helps.
- Fast on fresh juices for a day—or even just a meal—every week or two.
- Minimize exposure to chemicals of all sorts—from food additives and cosmetics to caustic cleaning agents. Remember that the liver needs to break down every chemical entering the body either for use or excretion.
- Use recreational drugs and alcohol sparingly—or better yet, quit!
- Experiment with some bitter or liver tonic herbs for six to eight weeks. Note any changes in body, energy, or mind.
- Take time to breathe deeply, relax, meditate, or pray. Stress can aggravate liver congestion.
Your liver is incredibly capable. Trust that it can cope with whatever you’ve exposed it to so far and then do your best to make its to-do list a little less long!
CONSIDER A FEW LIFESTYLE CHANGES
The obesity epidemic has everyone concerned about body mass index, but the condition called nonalcoholic fatty liver disease (NAFLD) that often accompanies it also demands our attention (incidence in the West is estimated at 20 to 40 percent). In many ways, it is the physical manifestation of what TCM and ayurveda call liver congestion. The liver is literally clogged with undigested fat (triglycerides).
Studies have linked this condition to the increased consumption of poor-quality food (especially high-fructose corn syrup and trans-fats). In agreement with TCM and ayurveda, recent research points to lifestyle modifications such as diet, moderate exercise, and stress management for treating NAFLD and improving liver function.
STIMULATE YOUR LIVER CHI
Traditional Chinese medicine identifies “four gates” for relieving liver stagnation—two acupuncture points each at Liver 3 (Taichong) and Large Intestine 4 (Hegu). These are located in the hollow between your big toe and second toe on your feet, and on the fleshy area between your thumb and index finger on both hands. You can increase the flow of chi (vital life force, the equivalent of prana) and blood throughout your body—and relieve stress and anxiety—by massaging them as follows:
Taichong: Place your right heel in the space between the big and second toes on your left foot—it’s similar to Liver 3 on your hands—and knead for 30 seconds. Reverse feet and repeat.
Hegu: Press your right thumb between the bones that attach to your thumb and index finger on your left hand and massage for 30 seconds. Reverse hands and repeat.
FOLLOW A PITTA-BALANCING LIFESTYLE
Pitta can be an asset: Physically, pitta creates strong digestive fire, warmth, and vitality. Mentally, people with strong pittic constitutions are intelligent, organized, industrious, and efficient. But to their detriment, pitta-dominant people can also get overheated easily, sweat readily, and get irritable when hungry or frustrated. They tend to work long hours, push themselves hard, and often have perfectionist, critical temperaments.
This intense state of mind creates more energetic “heat” on top of an already hot physical system. Not everyone has a pittic constitution, of course, but stress, hot chilies, and even the summer sun can cause just about anyone to overheat, which may lead to excess pitta, inflammation, headaches, skin rashes, allergies, high blood pressure, or liver congestion. Below is a list of tips for keeping pitta in check:
EAT FOOD THAT IS COOL, DRY, LIGHT, SWEET, AND BITTER, SUCH AS:
- beans
- green vegetables (especially bitter salad greens and cabbage family)
- sweet fruits
- whole grains (especially oats and barley)
- and fresh dairy (in moderation).
If you have strong, pittic digestion you can also handle large amounts of raw food, which is cooling and balancing for excess heat.
CUT BACK ON HEATING FOODS AND HEATING TASTES, INCLUDING:
- oil
- salt
- hot spices
- fermented food (alcohol, vinegar)
- tomatoes
- egg yolks
- coffee
- red meat
- refined flour and sugar
CHILL OUT!
- Take a break from mental work and stretch, breathe, walk, or create. Practicing yoga, taking a bike ride, spending a day in the mountains, singing in a choir, and taking a pottery class are all great ways to shift your mind to a more relaxed, open place.
EXERCISE REGULARLY AT MODERATE INTENSITY.
- Avoid being supercompetitive and stop before exhausting yourself.
EXPRESS YOURSELF.
Pittic intensity needs an outlet, so use art, movement, and speaking to express yourself.
Carrie Demers
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