By Chris Chlebowski, ND, DC

In the minds of many, the liver’s sole purpose is the body’s primary detoxifier; but the more complex truth is that it has an array of responsibilities that are incredibly diverse, interwoven, and complex. This complexity arises from the fact that this organ must constantly integrate countless forms of biological information, including endocrinological, hematological, dietary, immunological, and toxicological. Consequently, when I think of the liver, I picture it in all its archetypical manifestations—the General of the Blood, the Queen of Hormones, and the King of Detoxification.

Due to the diversity of information the liver receives, this can lead to it becoming a seat of either great illness or health—depending on how well it is taken care of. When great care is taken and it is operating efficiently, the blood and skin are clear, hormones are balanced, energy abounds, and toxins are moved through with ease. When the liver is unwell, people feel tired, full, fat, in pain, and can have a multitude of symptoms in every system in the body.

The purpose of this writing is to help you better appreciate the varied roles of the liver. This recognition should aid your ability to see subtle dysfunction in this organ long before it becomes pathological. I have also provided some less common treatment ideas that may be used in order to keep this precious organ well.

The General of the Blood

Ancient tradition holders in Chinese medicine were the first to name the liver the “Commanding General of the Body.” It earned this anthropomorphized moniker due to its foremost duty—moving blood and chi about the body. The liver is unique in that it receives a dual supply of deoxygenated and oxygenated blood from both the portal vein and the hepatic artery respectively—filtering this blood from the digestive tract at nearly a gallon of blood every two and half minutes.¹

Armies need fuel and the liver is a major storage site for our primary energy source—glucose (in the form of glycogen.) Around 6% of the organ’s weight is glycogen stores. The vitamins A, B12, and D are also stored in large quantities in the liver as well as ferritin, the body’s substantial iron repository. “Transport protein” synthesis also occurs largely in the liver, without which, hormones would not arrive safely and intact at their required destinations. And like the general who can conscript new members into his troops when the others have been killed off, the liver is the only organ capable of complete regeneration in the body—if as little as 25% is intact it can grow back into a completely new organ.²

The Queen of Hormones

Kingdoms need generals, but they also require a queen.  In the liver’s role as the female sovereign, she brings balance to the body regarding sex, thyroid, and adrenal hormones. For example, the total amount of circulating hormones, say estrogen from the ovaries, is determined by both the ovaries and the liver, but the liver has the final say; if she deems it necessary to remove, inactivate, or transform estrogens she can excrete them into the bile. And if the corresponding glands (thyroid, adrenal, ovary, testes) are under-functioning, the liver can help maintain a normal level of hormones by decreasing excretion. Thus, the healthy functioning liver may, for some time, maintain the normal balance of hormones when the endocrine organ is disturbed.³

The queen is also the transformer. She brings hormones into action for use. The thyroid hormone thyroxine (T4) is transformed in the liver into its four times more biologically active form triiodothyronine (T3)—much “hypothyroidism” is due to the poor liver function.  Vitamin D3 is also remodeled into its biologically active form 25-OH in the hepatocytes.

The King of Detoxification

In its most widely recognized and celebrated duty, the liver acts as one of the body’s primary organs of detoxification.  The King protects us from toxic chemical assaults via his ability to convert fat-soluble compounds into water-soluble metabolites that can be more easily excreted in the urine or stool. It does this through a complex series of enzymes that oxidize, reduce and hydrolyze (Phase 1) or conjugate (phase II) the toxins. These toxins can include plastics, mycotoxins, metals, and a host of the other chemicals—and they are everywhere.   In 2009, the Environmental Working Group commissioned several laboratories to check the stored umbilical cord blood of ten random infants born in US hospitals during the summer of 2004. What they discovered was astounding. Each of the infant’s blood contained more than 200 chemicals, including substances like mercury, organochlorine pesticides, and polyaromatic hydrocarbons.⁴ This landmark study showed that these exposures start before we ever leave the womb; the number and diversity of chemicals our newborns are exposed to is astronomical.

Every single patient we check in our clinic has some combination of molds, metals, pesticides, and plastics in their body and there is hardly a patient whose liver could not use some additional assistance. Simple natural medicine therapeutics can reverse fatty liver, cure jaundice, purge congested gallbladders, lower transaminases, and remove harmful toxicants from the liver. But first we need to be able to recognize liver dysfunction in order to decide on the correct course of action.

You See What You Look For

To recognize liver dysfunction, we can return to the lost art of the in-depth history and physical examination. These highly accessible and inexpensive tools can point to brewing dysfunction when we don’t have access to a comprehensive metabolic panel, ultrasound, MRI, or CAT scan to illuminate elevated transaminases, NASH, NAFLD, fibrosis or cirrhosis.  

Systems like Chinese medicine, iridology, reflexology, Western herbalism, chiropractic, and homeopathy all have a long history of assessing physical signs associated with the liver to uncover pathology. These are the subtle signs (or not so subtle in advanced disease) in the physical examination and history that can point towards liver and gallbladder dysfunction. If we listen for the faint sounds perhaps, we can head off disease before it becomes a raging symphony.

Below is a simple reparatory, which can help to assess the need for further investigation or treatment of liver dysfunction.

Findings in the Physical Examination and History Suggesting Liver Dysfunction

• Hair: Early graying of the hair whether it is the whole head or just a streak. This is a sign of compromise of detoxification pathways and points to liver dysfunction particularly when it occurs before the age of thirty.
• Forehead: A high forehead indicating a cerebral nature—one who spends many hours locked in their mind as opposed to the heart or body.
• Head: Acne or eruptions on the temples, above the eyes, or along the eyebrows. Headaches, pain, or pressure in the region of the temples or forehead.
• Ears: Red and swollen ear lobes.
• Nose: Frequent runny nose. Allergies.
• Eyes: Yellowed or darkened sclera. Floaters in the field of vision. Loss of vision, in general, points to a taxed and overburdened liver. Between 7 and 8 o’clock in the right iris is the region associated with the liver; look for dark dots or discoloration in this region.
• Mouth: A bitter taste in the mouth. Acne along the jaw line.
• Teeth: Gum loss, pain or cavities at teeth (#6, 11, 22, 27).
• Tongue: A dark tongue, blue spots or discoloration particularly on the right side of the tongue. Dark, engorged and branched sublingual veins are highly indicative of liver dysfunction.
• Skin: Excessive sweating or the absence of sweat—both can point to liver congestion.  Jaundice or any yellowing of the skin. Spider veins on the chest. Hot flashes of menopause. Acanthosis nigricans can indicate fatty liver.
• Abdomen: Cherry angiomas (indicating estrogen dominance) point to the need for liver assistance. Lipomas. Caput Medusa.  Inability to lose abdominal adiposity.
• Gastrointestinal Tract: Nausea. Easy intoxication. Light or clay-colored stools.
• Back: Pain/weakness in the rhomboids. Pain at inferior angle of the right scapulae. Subluxation of ribs or vertebra in the region of T5.
• Upper Extremities: Weakness or pain in the pectoralis major muscle. Bluish lunula of the fingernails.  Pain or weakness in the tendons or joints.
• Lower Extremities: Pain in the big toe. Nail fungus, particularly of the big toe.
• Seasonality: Complaints that reoccur every spring.
• General Constitution: High energy. Inappropriate regulation of temperature or warm blooded. Easy perspiration.
• Mental State: Easy to anger. Quick to judgement. Impatient. Always in a hurry. Easily annoyed by little things. A mind predominated by the intellect.
• Food cravings: Rich foods. Alcohol. Sweets. Coffee and stimulants.
• Sleep:  Difficulty falling asleep due to busyness of the mind. Waking between 11-1 am (Gallbladder). Waking between 1-3am (Liver). Perspiration at night.

Before we begin any treatment in our clinic for chronic infections, balancing sex or adrenal hormones, or general gastrointestinal health we always assess and treat the liver.  If we skip this step patients will often fail treatment and must start back at more basic steps before reaching a new desirable level of health. Detoxification is fundamental in all CMSDD (chronic multisystem degenerative diseases), and you can’t talk detoxification without discussing the liver. 

Our armamentarium is vast with tools for the treatment of the liver, including countless herbs, remedies, supplements and physical procedures and is well beyond the scope of this article. That being said, I would like to discuss a common botanical that is frequently overlooked for liver health as well as a simple procedure that can dramatically improve the health of this critical organ.

Liver Lovers

Most people and practitioners know about the most common herbs used for the liver (dandelion, milk thistle, bupleurum, berberis, reishi, etc.). These appear in countless herbal combinations or supplements and form the foundation of botanicals used to treat hepatic dysfunction.

But what about one of the less common plants that grow easily and prolifically in the wild? A plant that can be recognized, cultivated, and utilized for improving the health of one of our most important organs. Let’s discuss the often-overlooked Red Root.

Red Root (Ceanothus americanus)

On sunny rocky hillsides in North America, you will find this low-lying bush thriving in poor, well drained soils. Hummingbirds and butterflies are attracted to its groupings of five petalled white flowers. This natural attraction has helped to make it a staple and subtle addition to many gardens.

Ceanothus’ introduction into Western herbalism was via the surgeons of the Civil War as an indispensable antihemorrhagic on the battlefield. Subsequently, the eclectic physicians began to utilize the plant in their formulas because of the coagulation properties of its leaves.^5,6; Not only do the leaves stop bleeding but apparently, they lower blood pressure—in a 1940s study the leaves were shown to be antihypertensive in a cohort of rats.⁷

Over time the use of leaves faded from Western herbalism, and it was the root that gained notoriety—primarily due to the writings of English homeopath Dr. James Compton Burnett. Burnett taught the world that red root was one of our most important lymphagogues, spleen remedies, and indispensable in cancer.

Red Root performs well in cancers of the liver, pancreas, spleen, and Hodgkin’s lymphoma. It should be thought of in cases where there is fullness, swelling, enlargement or pain in any of these organs secondary to cancer, running neck and neck with remedies like Chelidonium, Lycopodium, and Carduus marianus.

What has largely gone unrecognized is Ceanothus’ direct and powerful effect on the liver. And this really should come as no surprise if we remember that the liver is the largest lymph-producing organ in the body.⁸; With our lymphatic systems and livers toxic like never before, it is time Ceanothus (re)gains it recognition for its liver-healing abilities.

I give this plant in so many cases but the ones that stand out are where the patient has a markedly enlarged spleen or liver due to Epstein Barr virus, a Bartonella infection, or painful cysts and swollen breasts during the menstrual cycle, which all subside when ceanothus is given.

A tea or a tincture of the root is the traditional preparation. The medicinal part of the plant that effects the lymph and liver is the root bark. Bring a good shovel and a strong back when you go to dig up the roots in the fall or spring—the soil Ceanothus prefers is rocky and hard to break up. Wash and strip the roots of their dark red bark. Make medicine quickly as the properties tend to fade rapidly. Teas and tinctures work well, and I have seen as little as 10 drops once a day of the tincture make a dramatic difference in swollen lymph nodes and painful livers in both children and adults.

Plants that heal our bodies and the earth at the same time are of the greatest interest to me and red root is one of these. It is a plant that fixes nitrogen.⁹ And it sprouts up after fires to regenerate the soil, providing food for animals and then dying back to allow growth of more hardy long-lasting plants.  Ceanothus’ use in future regenerative agriculture just makes sense.

Physical Means to Move the Liver Chi

In any detoxification plan I always like to add something physical to help move the blood and lymph. Patients get tired (as do their pocketbooks) of taking too many supplements. Providing a few physical treatments they can do at home helps balances out expenditures and means by which we heal our organs.

We have many techniques that accomplish this task like rebounding, deep tissue massage, dry skin brushing but there is one simple one that I use in case after case that does some very deep work in healing the hepatic system.

Castor Oil Packs. This is an old tried and true method for encouraging discharge and detoxification of both the hepatocytes and the lymphatic system of the liver. And no, you don’t have to drink the castor oil. To encourage the detoxification and cleansing of the liver, perform the following technique two to five times per week.  This practice is best done in the evening before bed as it will often led to relaxation and better sleep.

The Simple Castor Oil Pack

1. Buy a bottle of organic castor oil.
2. Lie on the couch or in bed on your back in a relaxed position.
3. Apply a half dollar sized amount of castor oil over your liver. Your liver is in the upper right-hand quadrant of the abdomen, below the diaphragm and mostly above your ribs.
4. Place an old towel over the area where you applied the castor oil. 
5. Place a hot water bottle or heating pad over the towel for twenty to thirty minutes. Be careful not to burn yourself with the heating element or fall asleep with the heating pad still turned on.
6. When you are finished most of the castor oil should be absorbed leaving very little clean up.

Countless patients in my practice have noted the following effects after using castor oils packs on a regular basis:

• Diminished intensity or frequency of hot flashes
• Improved liver enzymes
• Better blood sugar control
• More restful sleep
• Healthier bowel movements
• Clearer skin
• Diminished Herxheimer reactions
• Fewer headaches and neck pain
• Less gallbladder/liver pain
• Improved tolerance for fatty foods
• Less anger and irritability
• Less perspiration 

For such a simple procedure, it is worth trying if you have signs of liver congestion.

A Kingdom of Good Health

As in any country, region, or kingdom for true prosperity to reign all aspects of the society must be attended to. The kingdom of our body is no different. Recognizing dysfunction before it progresses to pathology and protecting our livers assures excellent metabolism, healthy hormones, and proper processing of toxicants. And in a world where toxicity is rising with no end in sight it makes sense to take the best care possible of our organs that do so much for us. Viva La Liver!

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References

1. Eipel C, Abshagen K, Vollmar B. Regulation of hepatic blood flow: the hepatic arterial buffer response revisited. World J Gastroenterol. 2010;16(48):6046-6057.
2. Sheedfar F, et al. Liver diseases and aging: friends or foes? Aging Cell. 2013 Dec;12(6):950-4. doi: 10.1111/acel.12128. Epub 2013 Jul 30.
3. Genes SG. Rol’ pecheni v obmene gormonov i v reguliatsii ikh soderzhaniia v krovi [Role of the liver in hormone metabolism and in the regulation of their content in the blood]. Arkh Patol. 1977;39(6):74-80. Russian.
4. Goodman S. Tests Find More Than 200 Chemicals in Newborn Umbilical Cord Blood. Scientific American. December 2, 2009.
5. Wood M. The Book of Herbal Wisdom. North Atlantic Books. Berkeley California. 1997.
6. Lynch TA, Miya TS, Carr CJ. An investigation of the blood coagulating principles from Ceanothus americanus. J Am Pharm Assoc Am Pharm Assoc. 1958 Nov;47(11):816-9.
7. Wastl H. Influence of tea from leaves of Ceanothus americanus on blood pressure of hypertensive rats. Fed Proc. 1948 Mar;7(1 Pt 1):131.
8. Arrivé L, et al. Non-contrast MR lymphography of the lymphatic system of the liver. Eur Radiol. 2019 Nov;29(11):5879-5888.
9. Delwiche CC, Zinke PJ, Johnson CM. Nitrogen Fixation by Ceanothus. Plant Physiol. 1965 Nov;40(6):1045-7.

Dr. Chris Chlebowski is naturopath, chiropractor, clinical herbalist, and homeopath with a medical practice, Ashland Natural Medicine, in southern Oregon. At the clinic, Dr. Chlebowski and his staff use cutting-edge technology blended with traditional therapies, with particular specialty in the treatment of chronic Lyme disease, mold illness, cancer, neurological disorders, and—most commonly—“mystery” diseases that other doctors have been unable to diagnose. Dr. Chlebowski lectures regularly on holism and the root causes of illness and his articles have appeared in Naturopathic Doctor News and Review and Simillimum. He holds doctorates from Western States Chiropractic College and the National College of Natural Medicine. His upcoming book published by Chelsea Green, The Virus and The Host: How to Protect Yourself from Infectious Disease by Reducing Toxicity, Improving Immunity, and Minimizing Chronic Illness will be on bookstore shelves September 2022. When he isn’t working up a difficult case or spending time with his wife and their two children, you can find Dr. Chlebowski climbing up the rocks or skiing down the mountains of southern Oregon and northern California.