Liver Cirrhosis

The liver is a marvelously sophisticated chemical laboratory, capable of carrying out thousands of chemical transformations on which the body depends. The liver produces important chemicals from scratch, modifies others to allow the body to use them better, and neutralizes an enormous range of toxins. Without a functioning liver, you can't live for very long.
Unfortunately, a number of influences can severely damage the liver. Alcohol is the most common. This powerful liver toxin harms the liver in three stages: these are called alcoholic fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. Although the first two stages of injury are usually reversible, alcoholic cirrhosis is not. Generally, more than 10 years of heavy alcohol abuse is required to cause liver cirrhosis. Other causes include hepatitis C infection, primary biliary cirrhosis, and drug toxicity.
A cirrhotic liver is firm and nodular to the touch, and in advanced cases is shrunken in size. These changes reflect severe damage to its structure. A high percentage of liver cells have died, and fibrous scar-like tissue permeates the organ.
A cirrhotic liver cannot perform its chemical tasks, leading to wide-ranging impairment of bodily functions, such as the development of jaundice (yellowing of the skin due to unprocessed toxins), mental confusion, emaciation, and skin changes. In addition, the fibrous tissue impedes blood that is supposed to pass through the liver. This leads to abdominal swelling as fluid backs up (ascites), and to bleeding in the esophagus as veins expand to provide an alternative fluid path. Ultimately, coma develops, often triggered by internal bleeding or infection.
Treatments for liver cirrhosis begin with stopping the use of alcohol and all other liver-toxic substances. A number of treatments such as potassium-sparing diuretics can ameliorate symptoms to some extent, but they do not cure the disease.
The liver is too complex for a man-made machine to duplicate its functions, so there is no equivalent of kidney dialysis for liver cirrhosis. Only a liver transplant can help. Unfortunately, this is a very difficult operation, with a high failure rate. In addition, the supply of usable livers is inadequate to meet the need.
NOTE: Individuals with cirrhosis of the liver should not take any medications, herbs or dietary supplements without first consulting a physician. The liver is in charge of processing many substances taken into the body, and when it is severely damaged, as in liver cirrhosis, ordinarily benign substances may become toxic.

Principal Proposed Treatments for Liver Cirrhosis:
Milk Thistle;
The herb milk thistle appears to offer numerous liver-protective benefits. In Europe, it is used to treat viral hepatitis, alcoholic fatty liver, alcoholic hepatitis, and drug- or chemical-induced liver toxicity. An intravenous preparation made from milk thistle is used as an antidote for poisoning by the liver-toxic deathcap mushroom, Amanita phalloides.
According to some but not all studies, milk thistle may be helpful for liver cirrhosis as well.
What Is the Scientific Evidence for Milk Thistle?
A double-blind, placebo-controlled study of 170 individuals with alcoholic or non-alcoholic cirrhosis found that in the group treated with milk thistle, the 4-year survival rate was 58% as compared to only 38% in the placebo group. This difference was statistically significant.
A double-blind, placebo controlled trial that enrolled 172 individuals with cirrhosis for 4 years also found reductions in mortality, but they just missed the conventional cutoff for statistical significance. And a 2-year, double-blind, placebo-controlled study of 200 individuals with alcoholic cirrhosis found no reduction in mortality attributable to the use of milk thistle.
Other double-blind studies of cirrhotic individuals have found improvements in tests of liver function, although one did not.
For more information, including dosage and safety issues, see the full milk thistle article.
Other Proposed Treatments for Liver Cirrhosis:
SAMe: May Improve Survival in Liver Cirrhosis;
Individuals with liver cirrhosis have difficulty synthesizing the substance SAMe (S-adenosylmethionine) from the amino acid methionine. For this reason, supplemental SAMe (best known as a treatment for depression and arthritis) has been tried as a treatment for cirrhosis. However, as yet the evidence that it works is not strong.
A 2-year double-blind placebo-controlled trial followed 117 people with alcoholic liver cirrhosis. Overall, those given SAMe didn\\\\\\\\\\\\t do significantly better than those given placebo. However, when the results were reevaluated to eliminate individuals with severe liver cirrhosis, a significant reduction in mortality and liver transplantation was seen with SAMe.
For more information, including dosage and safety issues, see the full SAMe article.
BCAAs: Might Be Helpful for Hepatic Encephalopathy;
In advanced liver cirrhosis, individuals experience severe mental confusion and may slip into a coma. This condition is called hepatic encephalopathy. One of the primary causes of hepatic encephalopathy is excessive ammonia levels in the body.
There is some reason to believe that special amino acids called BCAAs (branched-chain amino acids) might be helpful for individuals with hepatic encephalopathy, based on how they are metabolized in the body. However, the evidence that BCAAs actually help is not yet conclusive. Furthermore, individuals with cirrhosis of the liver should not increase amino acid or protein intake except under physician supervision.
For more information, including dosage and safety issues, see the full BCAAs article.
OPCs: Might Help Prevent Internal Bleeding;
Individuals with cirrhosis are susceptible to internal bleeding. Highly preliminary evidence suggests that OPCs (oligomeric proanthocyanidins) might help prevent this problem.
OPCs are best documented as a treatment for varicose veins, where they are thought to work in part by stabilizing blood vessels. Individuals with cirrhosis have what amounts to internal varicose veins, caused by the shunting of fluid around the damaged liver. For more information, including dosage and safety issues, see the full OPCs article.
Other Natural Treatments That Might Help;
The amino acid taurine might help reduce muscle cramps in individuals with cirrhosis. (However, see warning in BCAA section.)
One study suggests that protein from vegetable sources might be preferable to protein from animal sources, presumably due to differences in amino acid content.
Preliminary evidence from animal studies suggest that the supplement phosphatidylcholine might help prevent alcoholic liver cirrhosis.
The bones of individuals with biliary cirrhosis often become thin. Taking calcium and vitamin D supplements might help. Antioxidants such as vitamin C, vitamin E, and lipoic acid have been tried for biliary cirrhosis, with promising results in very preliminary trials.