Liver And Gallbladder - Oct

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

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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

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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

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Want hepatoprotective and immune support Silybum marianum Want to impair the progress of the virus Licorice  Aldosterone effect Treat the symptoms: asymptomatic Causes  Crossed out and put down LIV  Want to restrict herbs to hepatic function 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 Curcuma Longa  Helps to slow down the inflammation of the LIV  Mode of action – antihepattotixic 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

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can treat the symptom of constipation