Showing posts with label liver health. Show all posts
Showing posts with label liver health. Show all posts

Friday, January 18, 2019

Many Popular Dietary Supplements Can Yield Dangerous Liver Results

Many Popular Dietary Supplements Can Yield Dangerous Liver Results
January 15, 2019 
A recent paper from two U-M hepatologists highlights the liver dangers associated with consuming some herbal and dietary supplements designed to build muscle or lose weight.

Athletes often use over-the-counter products to help lose weight or improve their energy and performance levels.

However, the vast majority of herbal and dietary supplements (HDS) never undergo formal efficacy or safety tests because their manufacturing, production and content are not closely regulated by the Food and Drug Administration, says Robert Fontana, M.D., University of Michigan’s medical director of liver transplantation, and Ammar Hassan, M.D., a U-M hepatology fellowship graduate, who have explored several over-the-counter HDS products linked to liver injury.

As the number of HDS products available in the United States continues to grow, more than 80,000 commercial products are available to consumers, with nearly 50 percent of adults reporting regular use of at least one kind of supplement. Many adverse effects are linked to consuming HDS products, including hepatotoxicity, or chemically induced liver damage, according to the Drug-Induced Liver Injury Network.

Fontana and Hassan explored several popular over-the-counter HDS products linked to liver injury in a recent article in Seminars in Liver Disease. Here is a rundown:

Bodybuilding supplement hepatotoxicity

The majority of bodybuilding HDS products that lead to liver injury appear to contain androgenic anabolic steroids (AAS) or are contaminated with these and other chemicals.

AAS are synthetic derivatives of testosterone. Some medical conditions require the use of AAS products, including primary male hypogonadism and hereditary angioneurotic edema, but athletes use many of these steroids without medical supervision for their performance-enhancing and muscle-building properties.

SEE ALSO: Troubling Trends in Drug-Induced Liver Damage

“The use of these products is very common among amateur and professional athletes, including many active-duty military personnel,” Fontana says. “Data suggests that 69 percent of these individuals use at least one HDS product, while 22 percent report using more than three a day.”

These products are often purchased at health food stores or online in bulk. Over the past two decades, a significant increase in the incidence of liver injury related to the illicit use of AAS has been reported.

“Bodybuilding supplements that contain AAS can lead to liver damage, including severe cholestatic hepatitis, which can take months to resolve,” Fontana says. “Additionally, various multi-ingredient nutritional supplements taken to enhance energy, increase performance and facilitate weight loss can lead to potentially severe, or even fatal, liver damage.”

Non-bodybuilding supplement hepatotoxicity

Some of the most frequently used non-bodybuilding supplements associated with hepatotoxicity include green tea extract and multi-ingredient nutritional supplements that contain both botanicals and other compounds. These products include familiar names like Hydroxycut, Oxy ELITE Pro and LipoKinetix.

Green tea extract, or GTE, is derived from unfermented leaves of the Chinese tea tree, Camellia sinensis. One of the active ingredients in GTE is epigallocatechin gallate, which is a catechin, or a compound that is abundant in teas, cocoa products and certain berries. It boasts purported weight-loss properties by stopping fat-causing lipogenic enzymes.

While the public tends to view HDS products as safer than most conventional medications because they are derived from plants and other “natural sources,” this is not always the case, Fontana says.

“Various animal studies have shown the hepatotoxic (and possibly deadly) potential of GTE,” he says. “Extreme levels of GTE will lead to elevated aminotransferase (enzymes) in mice that significantly reduce their survival rates.”

Further, the Drug-Induced Liver Injury Network reported a study in which six patients who took GTE-containing Slimquick weight-loss products suffered hepatocellular injury, while four of the six were also severely jaundiced. Additionally, three patients from this group were hospitalized, and one had to have a liver transplant.

Hydroxycut hepatotoxicity

The first reported incidents of hepatotoxicity attributed to ephedra-containing Hydroxycut involved 12 patients in the U.S. who developed severe hepatitis after consuming supplements. Of the patients, 75 percent were female, with a mean age of 38.

It took an average of just eight weeks for an individual to develop hepatocellular injury after taking Hydroxycut.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

Eight of these patients recovered from their liver damage, while three underwent liver transplantation, Fontana says. One patient died before transplantation.

At least 17 additional cases of Hydroxycut-associated liver injury have been reported with similar phenotypes of liver injury and outcomes. And in 2004, the FDA banned the sale of supplements containing ephedra.

In May 2009, the FDA published a warning about Hydroxycut-related hepatotoxicity, resulting in withdrawal of 14 Hydroxycut products from the market.

“Without regulations like standardized chemical analyses and product manufacturing guidelines, it is nearly impossible to determine the exact chemical makeups for these types of supplements,” Fontana says. “And that just adds another element of danger to consuming them.” 


Fontana has received research grants from AbbVie, Gilead Sciences and Bristol-Myers Squibb. He also provides consulting services for Alnylam Pharmaceuticals.

Friday, January 11, 2019

Three-part series: What’s the Difference: Hepatitis B vs Hepatitis C?

Hepatitis B Foundation


With five different types of viral hepatitis, it can be difficult to understand the differences between them. Some forms of hepatitis get more attention than others, but it is still important to know how they are transmitted, what they do, and the steps that you can take to protect yourself and your liver!

This is part one in a three-part series. 

Thursday, November 22, 2018

Blogging About Liver Disease: Reasons To Be Grateful


Happy Thanksgiving! This year, and every year, I am grateful for a small group of talented bloggers who continue to keep us informed about all types of viral hepatitis.

In the spirit of the holiday, each blog has featured many reasons to be thankful this year; from curing HCV to improving the treatment of HIV.

Latest Articles 
Some of the following blogs are published by support organizations, healthcare professionals or physicians, while others are written from a patients perspective, offering us healthy tips about each stage of liver disease.

New @ HIV and ID Observations
Paul E. Sax, MD
As noted here before, I’m a big fan of Thanksgiving, a great excuse to get together with family and friends, and to eat a gargantuan amount of food.*

Hepatitis B Foundation
Holidays with Hepatitis B: How to Tell Your Family
hepbtalk
As the holidays approach, families are planning parties and dinners and preparing to spend time with their loved ones. In such a merry atmosphere, the idea of discussing hepatitis B – whether its a recent diagnosis or the first time that you are ready to disclose your status – may be intimidating. However, it doesn’t have to be! In honor of National Family Health History Day – which falls on Thanksgiving – we put together some tips to help you start the conversation.

Joseph Galati, M.D.
Tips for a Healthier Holiday
Ahh, the holidays. A time to celebrate all the good that has come our way during the previous year. First up: Thanksgiving. What better way to begin the year-end wrap-up than to sit down at a hearty meal with family and friends? But the holidays are arguably the toughest time of the year to eat..

Hep Blogs
Finding Gratitude in Sickness, Health and Hepatitis 
By Lucinda K. Porter, RN
Some good news in the hepatitis C realm, plus a look at the practice of gratitude.

Mavyret versus Epclusa
By Greg Jefferys
Both Mavyret and Epclusa give cure rates above 97% for all genotypes of Hepatitis C except for G3 where both give a cure rate of around 95%.

The End Times
By Grace Campbell
Who gave cirrhosis such a catchy generic title? End stage liver disease. There’s a name sure to invoke confidence.

Liver Meeting 2018 Wrap-Up: Vaccines, Diet, and an Increasing Liver Menace 
By Lucinda K. Porter, RN
Ending the week with summaries of research from the 2018 Liver Meeting. I cover hepatitis B vaccination, diet and alcoholic liver disease.

HepatitisC.net
Options for Treatment with Liver Cancer
By Karen Hoyt
After my diagnosis of liver cancer, I had to find out what options for treatment were available.

ADRLF (Al D. Rodriguez Liver Foundation)
Who says a fantastically delicious Thanksgiving spread can’t be healthy? This year, make your Thanksgiving feast even more special with these liver-healthy options that won’t give you or your family that post-holiday guilt; nor will they keep you stuck in the kitchen for hours on end! Check out these appetizing recipes for a healthy, scrumptious, easy-to-prep (or time-saving) Thanksgiving meal!

Finding Hope in Affordable Hepatitis Screening
Screening remains to be the best defense against detecting the hepatitis virus in its earliest stages, and potentially developing life-threatening complications, later down the line. Dubbed as the “silent killer,” hepatitis doesn’t exhibit obvious symptoms in many people, who may live, comfortably, with the virus for years and only discover their condition at its advanced, acute stage. Noting the importance of the timeliness of testing, Texas-based Link2Labs is making affordable hepatitis C tests available to uninsured and underinsured people.

HCV News
Weekly Review
Catch up on what you missed this week, read HepCBC's - Weekly Bull.

FYI - Lettuce Recall 
“I believe it’s all related to a big increase in obesity and type 2 diabetes in this country,” lead study author Zobair M. Younossi, MD, MPH, said in an interview in advance of the annual meeting of the American Association for the Study of Liver Diseases. “Those two risk factors drive NAFLD and its progressive type, nonalcoholic steatohepatitis (NASH). That accounts for at least part of the increase in mortality related to liver disease.”

AGA Journals - Blog
Dr. Kristine Novak
Persistent drinking of very hot coffee can cause exfoliative esophagitis due to thermal injury, researchers report in the November issue of Clinical Gastroenterology and Hepatology. Florian Schertl et al describe the case of a 55-year-old woman with new retrosternal pain upon swallowing. She had been receiving continuous and successful proton pump inhibitor.

Fatty Liver Disease
Canadian Liver Foundation
It Happened To Me | My Fatty Liver Journey
Melanie was all too familiar with fatty liver disease, with her husband being diagnosed 5 years earlier. But, she never thought it would happen to her.

The Flu & You
Canadian Liver Foundation
What’s intended to help shouldn’t hurt
Before you head to the cabinet for medication, there are a few things you should know to ensure that what you take will help, not hurt.

One Medical blog
So you’ve come down with a nasty bug that’s been making the rounds.

This Blog
Flu Activity Updated Nov 10/News Articles Nov 16
Weekend Reading - Baby Boomers and the Flu

Recommended Blogs
Dr Paul Gow talks all things the liver and answers call-in questions on ABC Nightlife 


Source - Hepatitis Victoria

On Twitter
Shared by @HenryEChang 

Just Because
Matthew Kaskavitch
CU Anschutz Medical Campus experts share Thanksgiving health insights
Thanksgiving is almost here, and that means two things: 1) time spent with family and friends around the television watching football, and 2) eating turkey. Lots and lots of turkey. At this time of year, we often overindulge and loosen our belt and wonder how we fit all that stuffing and gravy into our stomach. Don’t worry. We asked leading health experts from the University of Colorado Anschutz Medical Campus a few of the Thanksgiving questions you’ve always wanted to know the answer to.

Happy Thanksgiving!

Wednesday, October 24, 2018

'The food supplement that ruined my liver'

BBC
'The food supplement that ruined my liver'
Tristan Quinn
It should have been one of the happiest days of his life. But Jim McCants looks back on his youngest son's high school graduation with mixed emotions. As he sat down next to his wife Cathleen in the university auditorium, just outside Dallas, Texas, she turned to look at him.

"She said 'Do you feel OK?'" Jim recalls. "I said, 'Yeah I feel fine, why?' 'Your face is yellow, your eyes are yellow, you look terrible.' When I looked in the mirror it was shocking."
Read More: https://www.bbc.com/news/stories-45971416

On This Blog
Current articles investigating herbal and dietary supplement-induced liver injury 

Wednesday, October 17, 2018

Combination immunotherapy may increase liver injury risk

Combination immunotherapy may increase liver injury risk
October 17, 2018
PHILADELPHIA – Patients who received treatment with multiple immunotherapy drugs had increased risks for drug-induced liver injury compared with single therapy courses, as presented at the American College of Gastroenterology Annual Meeting.

“This is a rather new subsection of drug-induced liver injury that has come to our attention since the advent of immunotherapy drugs in the treatment of various different cancers, ranging from metastatic melanoma ... to colorectal cancer and renal cell carcinoma,” Vivek Bose, MD, from the Rutgers Robert Wood Johnson Medical Group in New Jersey, said during his presentation. 

Healio Meeting Coverage
See more from American College of Gastroenterology Annual Meeting

Wednesday, September 26, 2018

Heavy drinkers and teetotalers alike may have heightened dementia risk

Of Interest
Alcohol use disorder therapy could improve chronic liver disease outcomes
Fuster D, Samet JH. N Engl J Med. 2018;doi:10.1056/NEJMra1715733.
September 26, 2018
Details from a recently published review discussed expanded use of alcohol use disorder medications and treatments in everyday clinical practice for patients with advanced liver disease.

In HCV, alcohol use increases infection exposure and persistence, causes more extensive liver damage than the infection alone, leads to faster progression of liver fibrosis and results in higher rates of mortality. These effects are common in HBV as well, although alcohol use in patients with HBV also demonstrated an increased risk for hepatocellular carcinoma.

Along with increased fibrosis progression and an increased risk for hepatocellular carcinoma, alcohol use in patients with NAFLD leads to a greater prevalence of steatosis and abnormal liver tests. In hereditary hemochromatosis, alcohol use increases fibrosis progression as well as iron overload.

“Assessment of alcohol use is appropriate for any person with liver disease, given the elevated risks of alcohol-related hepatotoxicity,” Fuster and Samet wrote. “In fact, there is no known safe threshold of alcohol consumption for patients with chronic liver disease, especially those with HCV infection, obesity, or the metabolic syndrome.”


Heavy drinkers and teetotalers alike may have heightened dementia risk 
Lisa Rapaport
(Reuters Health) - Middle-aged adults who avoid alcohol altogether, and those who consume the equivalent of seven glasses of wine or more a week are both more likely than light drinkers to develop dementia in their later years, a long-term study suggests.

Abstinence is also associated with a higher likelihood of having heart disease or diabetes, which explains part of the increased dementia risk for teetotalers, the study found. Abstinence may also be tied to dementia in people who stopped drinking due to misuse or addiction, Sabia said by email...

“Findings on abstainers should not motivate people who do not drink to start drinking alcohol due to the adverse effects of alcohol on mortality, cirrhosis of the liver and cancer,” Sabia noted. “In addition, given the detrimental effect of alcohol for several health outcomes, people who drink in an excessive manner should be encouraged to reduce their alcohol consumption.” 

Recommended Reading
Alcohol abuse kills 3 million a year, most of them men: WHO
Of all deaths attributable to alcohol, 28% were due to injuries, such as those from traffic crashes, self-harm and interpersonal violence; 21% due to digestive disorders; 19% due to cardiovascular diseases, and the remainder due to infectious diseases, cancers, mental disorders and other health conditions...

Study: Damaged liver cells undergo reprogramming to regenerate

Study: Damaged liver cells undergo reprogramming to regenerate
Sep 26, 2018 8
by Steph Adams | Science Writer

The Greek hero Prometheus was punished by being lashed to a rock and having his liver eaten each day by an eagle, a myth that hints at the extraordinary regenerative powers of the human liver. A new study offers insight into how RNA splicing generates alternate forms of the “Hippo signaling pathway” to promote liver regeneration.

Graphic by Jose Luis Vasquez, Beckman Institute

CHAMPAIGN, Ill. — In Greek mythology, Zeus punishes the trickster Prometheus by chaining him to a rock and sending an eagle to eat a portion of his liver every day, in perpetuity. It was the right organ to target – the liver has the ability to regenerate itself, though not overnight nor for eternity.

New research conducted by biochemists at the University of Illinois has determined how damaged liver cells repair and restore themselves through a signal to return to an early stage of postnatal organ development. The findings are reported in the journal Nature Structural & Molecular Biology.

“The liver is a resilient organ,” said U. of I. biochemistry professor Auinash Kalsotra, who led the new research. “It can restore up to 70 percent of lost mass and function after just a few weeks.

“We know that in a healthy adult liver, the cells are dormant and rarely undergo cell division,” he said. “However, if the liver is damaged, the liver cells re-enter the cell cycle to divide and produce more of themselves.”

The human liver can become chronically damaged by toxins such as alcohol and even certain medicines, but still continue to function and self-repair, Kalsotra said.

“This research looked at what is happening at the molecular level in a damaged liver that enables it to regenerate while still performing normal functions,” he said.

Using a mouse model of a liver severely damaged by toxins, the researchers compared injured adult liver cells with healthy cells present during a stage of development just after birth. They found that injured cells undergo a partial reprograming that returns them to a neonatal state of gene expression.

The team discovered that fragments of messenger RNA, the molecular blueprints for proteins, are rearranged and processed in regenerating liver cells in a manner reminiscent of the neonatal period of development. This phenomenon is regulated through alternative splicing, a process wherein exons (expressed regions of genes) are cut from introns (intervening regions) and stitched together in various combinations to direct the synthesis of many different proteins from a single gene. These proteins can have different cellular functions or properties.

“We found that the liver cells after birth use a specific RNA-binding protein called ESRP2 to generate the right assortment of alternatively spliced RNAs that can produce the protein products necessary for meeting the functional demands of the adult liver,” said graduate student Sushant Bangru, the lead author of the study. “When damaged, the liver cells lower the quantity of ESRP2 protein. This reactivates fetal RNA splicing in what is called the ‘Hippo signaling pathway,’ giving it instructions about how to restore and repopulate the liver with new and healthy cells.”

Kalsotra described the science in mythological terms: “When Zeus’ eagle comes in for its daily snack, damaging the liver, the alternatively spliced form of Hippos come into play – repairing Prometheus’s liver so the poor guy can go through this whole punishment again the next day.”

The National Institutes of Health, March of Dimes and American Heart Association supported this
research.

The paper “Alternative splicing rewires Hippo signaling pathway in hepatocytes to promote liver regeneration” is available online and from the U. of I. News Bureau.
DOI: 10.1038/s41594-018-0129-2

https://news.illinois.edu/view/6367/698670

Blood flow forces liver growth

NEWS AND VIEWS
26 September 2018

Blood flow forces liver growth
Sina Y. Rabbany & Shahin Rafii
Increases in biomechanical forces in the liver’s blood vessels have now been shown to activate two mechanosensitive proteins. The proteins trigger blood-vessel cells to deploy regenerative factors that drive liver growth. 

The molecular pathways that initiate and sustain liver growth during development and after injury are orchestrated in part by a balanced supply of stimulatory and inhibitory factors secreted from specialized liver sinusoidal endothelial cells (LSECs), which line the organ’s blood vessels14. But it is unclear how the liver vasculature senses the need to produce these endothelial-cell-derived (angiocrine) growth factors, such as hepatocyte growth factor (HGF) and Wnt proteins, to guide proper organ growth4. In a paper in Nature, Lorenz et al.5 show how mechanical forces created by the passage of blood through the liver activate signalling pathways that promote the production of angiocrine factors and the proliferation of the organ’s main cell type, hepatocytes, in mice.

Continue reading online @ Nature

Monday, September 24, 2018

What Is a Healthy Stool ?

Of Interest - posted Feb 2018:
Clinical Gastroenterology and Hepatology (CGH)
February 2018 Volume 16, Issue 2, Page A22
What Causes Constipation?
Constipation is usually a symptom, not a disease. Some of the most common causes of constipation are as follows....

What Does My Stool Color Or Change In Bowel Movement Mean?
On this page an overview of stool color changes due to either medications, diet, or indicate an underlying medical condition such as gallstones and liver disease is explored. For instance according to a recent article published 21 September 2018 online at Medical News Today, a yellow stool may indicate problems with the pancreas, liver, or gallbladder.

Further down this page is the famous Bristol Stool Scale, developed by UK gastroenterologists at the University of Bristol. The chart explains various stool types by identifying physical attributes and the length of time the stool remained in the colon.