Everything You Have Wanted to Know About You Liver
Most of us know where our heart and lungs are located in the body as well as the job they do. But not everyone knows a whole lot about the liver. It is time we corrected that. One of the organs that can be infiltrated by CLL cells is the liver. The word for a swollen liver is “hepatomegaly” and it is an indicator of advanced stage CLL. A dysfunctional liver can kill you a lot sooner than you think.
Did you know that the liver is also a gland, in fact it is the largest gland in your body? We are more familiar with thinking of lymph nodes under your chin or armpits and groin as glands. Well, liver and spleen are glands too. So, “swollen glands” or “lymphadenopathy” can apply equally well to swollen liver and swollen spleen (“splenomegaly”). Rai staging system uses liver health as one of its parameters in defining progression to Rai Stage-II CLL.
Location of the Liver
Your liver is on the right hand side of your body, just below your diaphragm. In healthy individuals it weights anywhere between 3-4 lbs. A human liver looks pretty much the same as animal livers you may eat as food, sort of a reddish brown color. I have no idea how it tastes – hey, I am a life long vegetarian and this is about as far as I go on culinary taste of animal livers.
There are two major blood vessels that bring blood and nutrients to the liver. The first is “hepatic artery” (start thinking of anything to do with the liver as “hepatic”) that comes directly from the aorta of the heart. The function of the hepatic artery is to bring oxygen rich blood from the heart.
The second blood vessel is called the “portal vein”. This brings blood directly from your GI tract. When you eat food, the job of the GI tract is to absorb nutrients from the food into the blood vessels lining the GI tract. Before this nutrient rich blood goes anywhere else, it has to be sanitized and certified safe by the liver. As you can imagine, not all the food we eat is exactly good for us – and I am not even talking about junk food. Many plant based and animal based foodstuffs have small amounts of toxic materials that can do real damage to the body. Your liver does the job of cleaning the blood coming from the portal vein. It neutralizes the toxins and the blood leaving the liver is rich in nutrients but without the toxic stuff. Think of the liver as the garbage processing center of your body, an important function that protects the rest of the body and more sensitive organs (such as heart, lungs, brain etc) and you are well on your way of understanding what the liver does.
Other Functions of the Liver
Besides getting rid of poisons, the liver does many other things as well. It is deeply involved in how we use glucose – it is responsible for maintaining appropriate levels of glycogen in your blood. Diabetic patients are quite aware that their sugar levels are influenced by the liver.
Liver is also a storage depot for trace amounts of vitamins and minerals that our bodies need for proper function. Very often we have a feast or famine situation when it comes to how much trace vitamins and minerals we consume in the food we eat. Liver stores the excess vitamins and gradually releases them into the blood as needed. Did you know that your liver makes as much as 80% of the cholesterol in your body? Cholesterol in the food we eat adds up to just 20%.
It is all too easy to poison this hard working organ and bring it down to its knees. The single biggest culprit for liver toxicity is alcohol. Believe it or not, alcohol is toxic to our body. When you down a couple of martinis, the first place that alcohol goes is to the portal vein which then heads straight to the liver for cleansing. You don’t have to be a certified alcoholic to have significant level of damage done to your liver because of alcohol toxicity. Long term drinkers suffer from liver cirrhosis, where the liver is inflamed and eventually fails to do its job well. All those toxins it can no longer handle flow unchecked to the rest of your body.
Here is the other cause that most of us do not think about: mega doses of “healthy” supplements such as vitamins, over the counter potions and stuff that interacts with each other and causes massive damage to the liver. Remember this mantra: everything you put in your mouth and swallow eventually goes to your liver. Be kind to your liver, don’t overload it with too much stuff to detox all at once.
One of the jobs the liver does is get rid of debris that accumulates when cells die due to old age or damage. For example, when red blood cells die, they release the hemoglobin that is so crucial for proper function (oxygen carrying) of red blood cells. One of the breakdown products of hemoglobin is bilirubin, a yellow colored pigment. If your liver is not functioning properly, not able to get rid of bilirubin as well as it should, this yellow material builds up in the rest of your body. Where you will see it is in your eyes and skin. “Jaundice” is easily diagnosed by even lay people because the yellow tinge of the skin and eyes is hard to miss. Jaundice is a clear indication of potential liver distress.
Liver Function Tests (LFTs)
Most of the time liver function tests involve nothing more than a simple blood test. These tests are now automated and quite cheap. If you have any concerns about your liver function, see if you can talk your GP into regular (monthly) full panel of metabolic blood tests. Different labs call this test by different names. Basically, the panel includes liver function tests, kidney function tests, levels of various electrolytes such as potassium, sodium, calcium etc, protein and sugar levels. If you want to keep track of all this information we have a nifty Excel spreadsheet where you can monitor your charts. The first page is useful for monitoring your CBC data. Third page is devoted to the metabolic panel we are discussing here.
Below is an easy cheat-sheet of the important liver functions that you should keep an eye on.
• ALT (alanine transaminase; it is also referred to as SGPT by some testing labs) is an enzyme that is present in all liver cells. When liver cells are damaged or die, this enzyme leaks into the blood where it can be detected. Normal range of ALT is between 3.9 -5.0 g/DL. Your lab will have the normal ranges spelled out in the report, as well as your level of ALT. ALT can rise very dramatically when the liver is damaged in any way, often going as high as many times the normal level. One of the major culprits of elevated ALT is acetaminophen – Tylenol. Overdose of Tylenol is a sure way of killing your liver – damage that is often irreversible.
• AST (aspartate transaminase, used to be called SGOT) is also a liver enzyme and levels can rise well above the healthy level of 10-40 IU/L if the liver is damaged. But since AST is also present in red blood cells, muscle and heart cells, elevated AST is not necessarily specific pointer of liver damage. In fact, if the AST is elevated but the ALT is well within healthy limits, this is an indication that the problem area is not the liver but something else.
• Bilirubin. As we discussed above, bilirubin results from the breakdown of red blood cells. Normally, bilirubin is captured by your liver and is excreted in your stool. (Incidentally, bilirubin is the reason why $hit is the color it is. I thought I would pass along that little bit of information). Jaundice is the clear symptom of excessive amounts of bilirubin in the blood.
• LDH(lactate dehydrogenase) is another enzyme found in many body tissues, including the liver. Elevated levels of LDH may indicate liver damage.
• Albumin is a protein made by the liver. This and total protein levels are indicators of the health of your liver since your body needs these proteins to fight infections and perform other functions. Lower than normal levels may indicate liver damage or even poor nutrition.
Specific Issues Related to CLL Patients
As I mentioned above, CLL cell infiltration of the liver is quite common in late stage disease. When your doctor pokes and prods under your diaphragm during a physical examination he is looking to see if your spleen is enlarged (left side of your body). It is a bit harder to feel an enlarged liver (on the right side and under your rib cage) and in any case there can be plenty wrong with the liver without it getting unduly enlarged. In other words, moral of the story is to get your liver function tests done on a periodic basis.
There is one more reason why CLL patients are smart to keep an eye on their livers’ health and that has to do with the many medications and drugs we take in the process of controlling the CLL.
Potent chemotherapy drugs and combinations such as FCR can overload the ability of the liver to get rid of the dead and dying cells – not just CLL cells but red blood cells and platelets etc. When red blood cells die in large numbers, not only will this be seen in dropping red blood counts but increased bilirubin levels – an indication that the liver is having a hard time getting rid of all the garbage resulting from the mayhem. When this problem rises to critical levels, the patient is said to be having tumor lysis syndrome. TLS can be potentially fatal and not something to be taken lightly.
Besides conventional therapy needed to control the CLL, many patients over-indulge in over-the-counter medications that their doctor knows nothing about. Too many pills taken without taking into account their interactions with each other can become very dangerous, very quickly. This syndrome is called “polypharmacy” and I strongly urge you to keep that in mind when you pop too many pills. The single biggest thing to worry about when you take even green tea extract capsules is the potential for liver damage. You may not be taking too much EGCG (green tea extract), but what else are you taking? Remember, you have only one liver that has to do the cleanup of all the stuff you are throwing at it. If your most recent metabolic panel tests showed elevated liver function tests, talk to your doctor about it right away. The usual protocol is to withdraw most if not all of the medications the patient is on, and after the LFTs have stabilized, gradually bring back the necessary medications.
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33 comments on "Take Care of Your Liver"
No sun, no booze… you really know how to put a ding in my summer fun!
Thank you so much for this very important and very informative article.
jorje & Ana
tpo4444:
Sun and booze – there are plenty of ways of having fun that do not involve either of them. This is an adult site and all that, but surely you do not need me to spell out all the ways you can have fun without being out in the sun or drinking too much. Right? :)
Do you have any info on the effect of possible kidney damage relating to having cll?
Chaya:
No sun, no booze, but plenty of green leafy veggies, which I din’t read. Actually, I think this article is very timely, and it is the perfect segway to the notion that a healthy diet and exercise is key to overall health. Most doctors have no clue what that means. They often repeat what they receive in mailings; they receive little to zero training in nutrition and diet.
“You are what you eat” was true in ancient Greece and will be until we mutate into …alien beings or something. That means when we eat “sick” cows, pigs and chickens, we will be ingesting toxins– boo for the liver. Industry confines them (no exercise? check), feeds them a grain diet which their systems were not designed to digest (bad diet, check; loaded with pesticides -liver load, double check), then boosts their growth with hormones (more toxic load, check) and keeps infections at bay with boatloads of antibiotics (more toxic load- check). No wonder Chaya is vegetarian –just kidding, most nutritionists do prescribe animal protein to help the liver in phase two detox reactions, but need to be clean food: organic pasture, free ranging, grass-fed, animals.
Same applies for dairy products. If from “sturdier” animals such as goat and sheep, all the better (farmers never bother to administer antibiotics preventively because they don’t require it.)
The same appplies to vegetables, especially the leafy ones: the cleaner the better. Nutritionists will also tell you that bitter is a liver’s best friend. That is one flavor that the American palate does not favor, and industry consistently removes it from the offerings– even in the case of breeding of vegetables–seed growers are stimulated to develop less bitter varieties because those veggies will sell better.
I could go on til tomorrow on this subject, but the final concept I would like to offer is this: if the food comes in plastic, box, bag; or if it does not spoil within 24hours on your counter-top, then most likely that is not food. It is something that probably has little to no nutritional value. That means you are overburdening your already hard-working CLL liver with “stuff” but are not feeding any organs with that tasty treat or hunger-killer.
We CLLers and other C folks process and inordinate amount of dead cells, so you need to think about feeding your liver next time you take something to your mouth. Did I mention clean filtered or mineral water?
Chaya, thanks a million. The liver is my dear favorite subject when it comes to nutrition, because it’s so vital for health maintenance. For all the more knowledgeable readers than me out there I apologize if I over-simplied the concepts for ease of sythesis.
I would like to know if drinking a LOT of diet sodas, like Coke, is hard on the liver, especially if one is undergoing chemo.
Chaya,
Thanks
A couple points in no particular order.
Fat soluble vitamins, mainly vitamin A and its analogues are among the most liver toxic OTC supplements. Every med students knows the story of the arctic explorers who died from too much Vit A after eating a bear liver.
Many wild mushroom are extremely toxic. Careful foraging.
And even long term ” safe” doses of tylenol can hurt the liver. Many common antibiotics and especially antifungals can be hard on the liver
The list goes on and on. And many infections and STDs targets the liver including hepatitis B.
There are vaccines for hep A (mostly food borne) and B (mostly sex and IV drugs and mother to child). Both are killed vaccines and so are safe for CLL but there is none for C (mostly IV drugs).
The liver is also involved in digestion (think gall gladder) and most docs I think would agree it is easier to palpate an enlarged liver than an enlarged spleen, The liver is made of thicker stuff.
Milk thistle is an herbal remedy with some science behind it for liver issues.
Be well
Brian
I am a newly diagnosed, early stage CLL person who also has a senovial cyst on my spine (nothing to do with CLL..have had degenerative back issues for a long time). Am currently taking oxycontin 20 with percocet 5/325 about 4 times a day for breakthrough pain. I am planning to begin a course of epidurals in October (have to wait because I’ll be out of the country for a month-hooray!). I am assuming that all that pain medication can’t be making my liver happy. The pain is more than I can bear without help.Had also been taking green tea extract and D3. This sure gives me pause for thought since conventional practitioners don’t seem to know much , if anything , about the interaction of these medications. I am so glad to see all this information but it also makes me wonder how you ever know if you’re doing the right thing!! I am so grateful for this site..any comments are appreciated!
Bummer! Can’t drink so much red wine with our healthy dinners! I guess it doesn’t make much sense to eat organic, low-fat, high-nutrient food…and then slosh it down with toxin.
Barb & Blair
Water x Liquids
Just because sodas are liquid does not qualify them in the water intake requirement. It is the exact opposite, as they actually dehydrate you. Rule of thumb is: for every soda, you should take 2 of water – one to replenish what they take away, and the other for your body’s general needs.
If you don’t “like” water, try herbal teas (chamomille, mint, valerian, orange peel, lemon grass, etc.) The bitter teas actually nurture the liver (chicory, endive, radicchio, dandelion, and a host of ayurvedic and chinese herbs and combinations.)
Alcohol is quite the same–two waters for every dose of it. Red wine, with additional anti-oxidant benefits, is generally accepted for us in moderation, but also using the additional water intake recommendation.
Reinforcing what Chaya has said: your liver does not know if what you are taking comes from your chemo clinic, your doctor, from OTC meds & supps, from your friendly neighbor and so on– it knows that what comes down those chutes must be processed. In other words, it is best if you consult with a knowledgeable nutricionist and doctor with a wholistic approach, who can guide you in optimizing drug+herb+vitamin, tailored to you (this professional must understand herb/plant/drug interactions.) You shoud not have to burden your liver with too much of one thing, nor with one thing which will interfere in the absorbtion of another nutrient, nor that will antagonize each other. Nor do you want two nutrients that will potentialize each other, and you get a higher dose than you think you are taking.
On that note, reinforcing Brian, many nutritionsists and herbologists recomend that you “rest” from taking fat-soluble vitamins once a week, even if taken at the appropriate dose.
Hope this helps.
An excellent article on the liver. Vitamin suppliments by the handfull and possible liver damage is an eye opener for my morning coffee, protien drink and suppliments…I’ll be changing the routine tomorrow.
Many thanks Chaya…
William Bates
A CT scan has disclosed a fatty liver. Can this be related to CLL?
I am not an expert on nutritional therapies – unless you count eating a balanced and healthy diet as nutritional therapy. Frankly commonsense and eating a variety of healthy foods is the best nutritional therapy as far as I am concerned.
But I am a “trust but verify” kind of gal. If you are planning to start any OTC drug or nutritional supplement, anything other than your normal diet, I strongly urge you to get the metabolic panel run on a regular basis. It is cheap, needs just a couple of teaspoons of your blood. The best way of telling if there is any damage being done to your liver is to look at the liver function tests I described above in the article. Proof of the pudding is in the eating. If your liver cannot handle something you are doing to it, you will see it plainly in your next metabolic panel lab test results.
Once again, I want to point out it is the trends that are important. If you have many months of LFTs plotted on a small piece of graph paper (or use the Excel spreadsheet we developed, it does a neater job of the graph plotting) and if the latest LFTs fall clearly outside the normal scatter of data points you have accumulated in the past, you know something is not right. Don’t drive yourself crazy by tiny blips in the LFTs that are just random changes from month to month – perhaps due to built in error bars of the instrumentation.
I preach proper level of hydration. But I must confess I have never heard of the two for one rule one of our members quoted above. Diet colas are very popular, but I have stopped drinking them. Amazing how much money we spend on these “fake” foods. At the very least you are probably doing damage to the enamel of your teeth.
I provided a link to what happened to my husband PC in the body of the article. In his case too the “polypharmacy” crept up on us without warning. It was only because we were getting monthly metabolic panel tests done along with his CBC that I was able to catch the problem right away, take the proper precautions.
By the way, as Brian pointed out, fat soluble vitamins can be dangerous to the liver if taken in very high doses. Everything adds up. If you take your daily multivitamin tablet, follow that up with a nutritional supplement of vitamin A and E tablets, and drink several glasses of carrot juice etc – you get the picture. Any one of these things may have been OK, but not in combination and especially not when your liver is already struggling to deal with CLL and its necessary medications (including any antibiotics and anti-viral medications you may be taking to control infections). If your liver is swollen because of CLL you should be particularly careful in what you ask it to do. Same goes for people with prior history of hepatitis related liver injury. Alcohol consumption makes it all that much harder for the liver. EVERY LITTLE THING ADDS UP!
Yes, there are vaccines (dead virus) for several types of hepatitis. Unfortunately, our guys still have the same problem – they do not respond sufficiently to vaccines, whether the vaccine is nothing more than the annual flu shot, pneumonia vaccination or hepatitis vaccinations. For anyone with advanced CLL – especially if they have already been through chemotherapy – vaccinations are not very useful at all. Reducing the load on the liver is still the only real option available to our guys.
Here is how I see it. Down the road you may have no choice but to use chemotherapy drugs to control the CLL. It makes sense to try and keep your liver in very healthy condition so that it can handle the load when the time comes. Your chances of getting a good remission are significantly reduced if therapy has to be interrupted because of liver toxicity. You may not even be considered eligible for a min-allo transplant or many of the clinical trials out there if your liver is not doing well. That unknown herbal supplement may shut many important doors for you. If you are a fan of herbal medicine, the least I ask of you is to follow the “trust but verify” approach. As long as you have lab tests showing your liver is not dying in the process you are not harming yourself. Herbal therapies that may be helpful in healthy people may not be helpful or safe in CLL patients. Buyer beware!
Another point I would like to make is the role of “maintenance” drugs such as statins, diabetic medications etc in adding to the overall liver toxicity. I am NOT suggesting that you stop taking your prescribed medications because of excessive concerns about your liver. But doctors are supposed to do periodic liver function tests before they continue prescriptions for many of these drugs. Make sure your doctor does not skimp on this testing.
I like the red wine comment Cristina since I’ll be headed to Italy soon…I’ll just make sure I also drink lots of water!!!!
Drinking water is a good thing. But no matter how much water you drink your liver still has to de-toxify the alcohol you drink. The load on the liver depends on the amount of alcohol you consume. I cannot see how drinking more water will necessarily reduce the work the liver has to do, for a given amount of alcohol consumed.
Of course, keeping well hydrated with plenty of clean water – and emptying your bladder at regular intervals – does wonders for your kidneys. I also understand drinking plenty of water might make hangover the next day less painful.
Thank you very much for this artical.
It seems that at this present time, I am having a problem with my Liver. My AST is high (255) and my ALT is also high (333). My CBC work up is fine as of 7-12-10. I went through Chemo last May to July and have been in remission. The only pill I pop is a Multi Vitamiun in the morning with my breakfast.
Once again, thank you very much Chaya for all you do for us who have CLL.
Bob Tobin
Chaya,
Brian wrote re: vitamin A. During chemo I was diagnosed with macular degeneration, the wet kind. I lost much vision in my right eye due to a retina bleed.
I am on Preservision (Bausch&Lomb). I take two softgels daily. the gels include vitamin A, 14,320 IU, 286%DV per soft gel.
I am now worried if that amount is too much for my liver.
It seems to be the standard dose. But they do have other eye med.
By the way, my eye has been injected three times with aviston( a chemo drug)that stopped the bleeding. I am aware that it could happen again.
Thanks for any information.
Rita
Rita:
Get your metabolic panel run. If the Preservision is causing liver damage, it will be clearly seen in the LFTs.
Folks, it is next to impossible to judge what causes liver damage in each individual case without getting the lab results. The good news is that the test is easy, cheap and pretty good at getting you solid information.
Fourteen years ago, I got into liver problems from supplements (esp vitamin A) and a virus, and a cleanse all at the same time. Alt med was in its infancy and Virginia a wasteland for alt med at the time. I had to find one up north and dumped the guy that got me into that mess.
My ND is careful about combinations and everything I take. I recommend always being under the care of an Md or ND physician for guidance. I have followed my liver functions faithfully ever since.
I would think that chemo would be the hardest on the liver of all drugs supplements etc.
I need to ask my doctor about my occasional glass of red wine.
But as to the diet soda aspartame is not a good additive for anyone!!!!! And something I wanted to mention is anyone with a cancer diagnosis needs to be careful about sugar. (Otto Warburg) Cancer cells love sugar. And sodas are loaded with sugar. Marilyn
Marilyn
Nice article as usual. The points about tylenol and alcohol are good but I also want to add that both together are much more dangerous than each alone. One of the things I learned in medical school was that there is a specific reaction between tylenol and alcohol that is extremely toxic to the liver. People read the warning label about not to use with alcohol and think they have seen that on all meds. There should be a more clear warning. I lost a friend to a tylenol/alcohol induced coma and liver failure.
Here is a pretty good lay site on the subject.Someone asks if alcohol and tylenol are the biggest cause of liver faiure, after mentioning Sam Donaldson reporting on this, they say it is tylenol alone.
Hi All,
Rita: consider lutein, zeaxanthin and Zinc for the eyes , particularly if only in one presently; some studies show positive results. As far as the Vit A, I take 8000IU per day. A study ( you can google it at “Kakizoe T 2003; Meyskens FL, Jr. et al 1995″) indicates 40-50,000 IU DAILY as part of a leukemia protocol! Too chancy for me.
Milk Thistle is the liver supplement of choice; make sure it has an extract of silimarin, silibinin and isosilybin B.
I used to be a very heavy drinker and rarely ate much (years ago). I ended up with the liver enzymes Chaya noted at almost 5 times the normal ranges and it almost killed me. I still drink some red wine and an occasional beer…but all things in moderation…and I take milk thistle religiously. Liver enzymes came back down to normal and have been that way for over a decade.
It’s been a while so quick update; pretty good visit to Bethesda in the study; CLL reclassified to MBL; 5 years and ok for now; only complaint is fatigue, but at just about 59 I guess I’m really not the 40 year old I think I am!
Jim
One of the liver function tests that people forget about is the prothrombin time. The clotting factors II, VII, IX, and X are made in the liver and measurement of the prothrombin time is a measure of the liver’s protein production function. It is much more sensitive than the serum albumin.
Wen liver function is being measured after an overdose of acetominophen (paracetamol), the prothrombin time is the measurement that determines whether or not the liver will recover from the insult. One of the reasons that alcoholics come into hospital bleeding from their stomachs is that their clotting mechanisms have been severely damaged.
Speaking of alcohol and liver function, since having CLL, I seem to have become totally alcohol intolerant – one beer or wine is enough to cause a monstrous headache a few hours later. I was wondering if anyone else has noticed this or if the two things are purely coincidental? (My CLL is still early stages so I guess it shouldn’t be affecting my liver that much… but is there any other reason why CLL should interfere with the ability to handle alcohol?). I haven’t been a regular drinker for many years but it was nice to have the occasional wine with a meal…
Hi, particularly to those taking Green Tea (EGCG) supplements
I noticed a direct correlation of my ALT and AST levels as I increased my Green Tea capsule dosage and as Chaya observed, the AST level can rise (and rapidly at that) when your liver is stressed. I observed this first hand and I wasn’t even taking half the dose that those on the recent Mayo trial were on (I’d reached a dose of just over 1 gram per day throughout the day). Thankfully due to Chaya’s earlier postings, I knew what to look for, so cut back my EGCG dose promptly. My AST and ALT levels had dropped back into the normal range in the next monthly blood test results, but took a few months to drift back down closer to their long term norms. (They are still higher than my baseline as I’m still taking Green Tea capsules.
I’ve also observed my LDH results very strongly correlate with my lymphocyte counts – even tracking the monthly variations (about 80% correlation). My hematologist expected this and I gather if you don’t see a strong correlation, it is worth further investigation as it could indicate you have a secondary cancer…
Neil
Chaya,
My liver functions have been good. But I have been mildly stressed re:
vitamin A for awhile.
Thank you to Jim (Jandg) for reminding me and I will change my vitamin A to the Lutein kind.
Many thanks to Brian for his update.
And, of course, Many thanks to you, dear Chaya, for providing this wonderful vehicle of updates.
Many Blessings,
Rita
Besides damaging your liver, excessive amounts of some vitamins is one of MANY causes of peripheral neuropathy, whose symptoms include weakness and sensory loss or pain in the arms and/or legs. Because vitamin deficiency may also cause peripheral neuropathy and other problems, getting the right amounts is important.
Please note that one of the non-prescription “energy supplements” now being advertised on U.S. television contains a whopping 2000% and 8333% of the daily values of vitamins B6 and B12 respectively!
Also, eating two servings of anything with 100% vitamins in one serving gives you 200%. Consuming two servings (two cups) of fortified breakfast cereal or fruit juice is not difficult!
Thank you Chaya for another excellent article.
I agree with Chaya – keeping a “trend chart” of my lab work has been most helpful. Being analytical by nature & profession a (I’m a financial analyst) I began a trend chart of all my blood lab work years ago (long before I was diagnosed with CLL)- actually my trend chart was the trigger leading to an early CLL diagnosis. It also helps monitor all the other items being tested (cholesterol, liver, kidney, etc.). My doctors love my trend chart – it helps them (and me) to better access my situation in general (not just my CLL).
Due to Chaya’s excellent articles I knew that green tea (EGCG) & D3 supplements can effect the liver & kidneys so I closely monitored these markers on my trend charts. I give my docs copies of all the data Chaya provides so we can do all the necessary blood work every 3 months.
Cathyjazz – mentions a very painful senovial spinal cyst with degenerative back issues) and great pain. Based on my experience I would recommend seeing a highly qualified orthepedic surgeon specializing in spinal issues. Back pain can be a serious problem.
Four months ago my husband suddenly began experiencing a high level of pain in his low back & down his legs. After x-rays & an MRI a large synovial cyst was discovered. Onlt he MRI showed a large cyst pressing against the nerves in the spinal column. This along with his degenerative disks L4&L5 made surgery the only sensible option. Luckily our primary care doc had referred us to an outstanding orthopedic surgeon (who specialized in the neck & spine). The pain was gone after the cyst was removed (and L4&5 were fused using the latest micro surgery technique). It is now almost 3 months post surgery and he is doing fine.
Thank you again Chaya for all that you do! And thank you Dr. Hamblin for your most helful comments.
Patti Kruse
Thank you Chaya for an excellent article on the liver.
Carolyn Bookspun
As Juliah1 noted, my husband has had the same problem with alcohol intolerance after the CLL had progressed a bit. He can no longer tolerate any alcohol, and doesn’t even dare try. Luckily, he wasn’t much of a drinker anyway, so he can deal with it, but sure would like to be able to have a small drink now and then. Just not sure what may be the cause…he is on various meds and finished only 3 months of FCR a couple months ago. He seems to have had a neurological problem after the 3rd month, so we are heading to Mayo for more analysis. Luckily he is in remission and on Rituxan maintenance. There are so many things to monitor, and so many changes that occur in the body once this disease has set in. And from reading comments over time, it affects every person in slightly different ways. I wish you all well, and I think Chaya’s comments and articles are the best I have found online. Thanks!
Jim (jandg)I am concerned about your recommendation of Milk Thistle. It sounds like it’s working well for you, but it may be a poor choice for some.
I have read that it may mimic estrogen which could be a problem for women like me, who must avoid excess estrogen. (In addition to CLL, I am at high risk for breast and ovarian cancer.)
Also, milk thistle may have problematic interactions with a number of common drugs such as ibuprofen and other NSAIDs, warfarin, statins, and many others.
Always talk with your doctor and your pharmacist (who may know more than your doctor about drug interactions)about everything you take, even if you fear your MD might not be very receptive to your choices – better safe than sorry!
This is my first post. I’ve been reading CLL Topics since my diagnosis 4 years ago. Chaya, I appreciate the incredible work you do for us.
Thank you for keeping us informed. I appreciate all you do for us.
Thank you for keeping us informed. I also appreciate the great work you do for us.
Stay well,
Monique
I agree with the caution pointed out abvoe by Firf with regard to milk thistle.
Here is a nagging worry I have regarding naturopaths and their advice. How well informed are they about the special needs of CLL patients? How many CLL patients have they treated? Have their treatmetn protocols been reported in peer reviewed journals or are they just anecdotal information – or worse still, self-serving testimonials?
For example, I hear from a lot of patients who are adviced to take “immune boosting” concoctions in an effort to fight cancer. That may prove to be dangerous if indeed the herbal remedy boosts the production of immune system cells – as in B cells – since we are talking of a B-cell cancer here. CLL is a complicated cancer with many tentacles into every major function of the immune system as well as all of most of the major organs. Simplistic and gut-feel solutions can make things a lot worse.
Before we get off on a big discussion tangent here I would like to remind our members ever so respectfully that this website is focused on mainstream medicine and information culled from peer reviewed professional journals. I have neither the background nor interest necessary to moderate alternative medicine practices. Make no mistake, this is very much a moderated site. As the owner of this site I have both the responsibility and the right to set the ground rules.
If you are a big fan of alternative or herbal medicines, I am well aware you will most likely find these ground rules frustrating and restrictive. Fortunately the internet has many other sites that cater to different needs and belief systems, so everyone can indulge in their particular biases.
Much food for thought here. I do take vitamins as well. Mainly D-3,
calcium-mag-zinc combo,vit K-2, echinacea, and green tea capsules. Also like to have a glass or so of red wine. I can see how all of these things can affect the liver through time.
All things in moderation and especially if one is doing any other types of medicine for CLL.
Good article Chaya… I looked at my MBP from May 2010, so far everything is looking fine with my liver counts. I am still not in chemotherapy yet for my CLL. 7 years since diagnosis. We just found out in June that my husband also has been diagnosed with CLL. I am currently in a clinical trial with NIH and now they want to do one with my husband as well. I still say this disease has much to do with environment..
We have been exposed to so many things throughout our lives that would put our systems in toxic overload.