October is Liver Awareness Month

BY JAMES S. BURKHARDT, D.O.

             When we think of liver, most of us turn up our noses, make a face, and say something like “yuck.”  Most people do not like liver.  But most people also take their own liver for granted.

            The liver is the second largest organ in our body (the skin is the largest) and is located under the rib cage on the right side.  It weighs about 3 pounds and is shaped like a football that is flat on one side.

            It is a vital organ that performs a wide array of functions.  It plays a major role in metabolism including glucose production and storage, protein synthesis, hormone production, chemical production to aid digestion and detoxification of many substances.  It produces bile to help digest fats for energy use.  The various functions of the liver are carried out by the liver cells called hepatocytes (medical terms referring to the liver usually start in “hepato” – or hepatic”).  The liver is thought to be responsible for 500 separate functions usually with other organs and systems. 

            Liver function tests help your doctor check if your liver is healthy and detect liver damage.  These blood tests measure the levels of certain proteins and enzymes in your blood.  Proteins are large molecules that are needed for our overall health.  Enzymes are protein cells that help important chemical reactions to occur in your body. 

            Liver function tests may be done for many reasons.  I will sometimes order these tests as part of a regular checkup.  Other times, I may use liver function tests to screen patients who are at risk for liver disease.  I will also use them to monitor a person’s liver disease to check if treatment is working. 

            Certain medicines can affect the liver (cholesterol medicines can do this) so I will check liver function tests to ensure that the medicines are not creating any liver damage.  Below are the most common liver enzyme tests:

            Alanine Transaminase (ALT) is an enzyme mainly found in your liver.  The ALT test measures the level of ALT in your blood.  Consistently high levels of ALT in your blood can be a sign of liver damage.

            Aspartate Transaminase (AST) is an enzyme found in large amounts in your liver, bile ducts, and other parts of your body.  The ALP test measures the level of ALP in your blood.  High levels of ALP can be a sign of liver or bile duct damage. 

            Gamma-glutamyl transpeptidase (GGT) is an enzyme found in large amounts in your liver, bile ducts, and pancreas.  The GGT test measures the level of GGT in your blood.  High levels of GGT can be a sign of liver or bile duct damage. 

            There are several common diseases of the liver.  One out of every ten Americans is affected by liver disease.  Liver disease is one of the top ten causes of death in the United Sates. 

            There are several types of hepatitis infections. 

-HEPATITIS A is caused by hepatitis A Virus (HAV), it is the least serious hepatitis infection and does not usually lead to chronic liver disease. 

-HEPATITIS B is caused by hepatitis B Virus (HBV), it can lead to long term liver disease, cirrhosis, and liver cancer. 

-HEPATITIS C is caused by hepatitis C Virus (HCV) it can cause the liver to swell and lead to cirrhosis. 

            Hepatitis B and C are more serious.  There is a vaccine for Hepatitis B and a vaccine for Hepatitis C. 

            There are also other common liver diseases.  Non alcoholic fatty liver disease (NAFLD) is the build up of fat in the liver.  There should be no fat in the liver, it should be like a very lean piece of meat.  Once fat begins to invade the liver, it will make the liver function less efficient.  That may cause swelling of the liver and eventually cirrhosis.

            For more information about your liver and risk of liver disease, you should talk to your family doctor.