Introduction and Overview
Balanced cholesterol levels are essential to maintaining health. The liver is an under-recognized part of that effort.
The liver is the largest gland within the body, located in the upper right part of the belly. It’s the body’s master detoxer of medicine and other foreign substances. It stores glycogen, which the human body uses for energy. It’s also essential in metabolizing fat, carbohydrates, and proteins. A healthy liver does all this unnoticed.
An essential function of the liver
An essential function of the liver is to supply and clear cholesterol within the body. Most eyes focused on cholesterol describe its potential for harmful health effects. But cholesterol is essential for creating hormones, vitamin D, and digestive enzymes.
Bundles called lipoproteins carry cholesterol throughout the body. Two crucial types are high-density lipoproteins (HDL) and low-density lipoproteins (LDL). The human body needs both types in regulated proportions. “High” and “low” refer to the relative balance of protein to fat within the bundle.
Healthy Levels of Cholesterol Within the Body
It’s essential to understand the amount of HDL (“good” cholesterol), LDL (“bad” cholesterol), and total cholesterol in your body. An idea of total cholesterol is HDL, plus LDL, plus one-fifth of the third sort of fat called triglyceride.
The National Lung, Heart, and Blood Institute recommends the following levels:
- HDL levels of not less than 40 milligrams per deciliter (mg/dL) of blood.
- A status of a minimum of 60 mg/dL helps lower your risk for a heart condition.
Anything but that increases your risk of a heart condition.
Liver Function Complications
Liver function complications can hinder the organ’s supply or clear cholesterol. Both conditions can increase cholesterol and affect a person’s health. The following situations can affect the liver, causing cholesterol levels to be abnormal.
Nonalcoholic Liver Disease (NAFLD)
The most common liver malfunction is a nonalcoholic liver disease (NAFLD). It affects approximately one-quarter of the population. It’s often seen among people that are overweight or have diabetes.
NAFLD is related to dyslipidemia, abnormal cholesterol levels, and similar compounds within the blood. NAFLD can also trigger lipodystrophy, irregularities in the body’s fat distribution.
NAFLD covers a spectrum of conditions. Within NAFLD is the more serious nonalcoholic steatohepatitis (NASH). A diagnosis of NASH often results in cirrhosis, liver failure, and hepatoma.
Cirrhosis
Cirrhosis can cause scarring and stop the liver from completing essential metabolic functions. The condition may be a reaction to a long-term injury to the organ. The damage can include inflammation from a disease such as hepatitis C. After hepatitis C, long-term alcohol abuse is the most familiar explanation for cirrhosis within us.
Drugs
Another significant explanation for liver problems is damage from drugs. The liver’s job is to metabolize chemicals within the body. That makes it vulnerable to prescription, over-the-counter, or recreational drug injury.
Common drug-induced liver injuries and, therefore, the drugs related to these conditions include:
- Acute hepatitis: Acetaminophen, bromfenac, isoniazid, nevirapine, ritonavir, troglitazone
- Chronic hepatitis: Dantrolene, diclofenac, methyldopa, minocycline, nitrofurantoin
- Mixed pattern or atypical hepatitis: ACE inhibitors, amoxicillin-clavulanic acid, chlorpromazine, erythromycin, sulindac
- Nonalcoholic steatohepatitis: Amiodarone, tamoxifen
- Microvesicular steatosis: NRTIs, valproic acid
- Veno-occlusive disease: Busulfan, cyclophosphamide
After discontinuing the drug, liver damage is usually not severe and sometimes subsides. In rare cases, the damage is often severe or permanent.
The Effects of High Cholesterol
High LDL cholesterol levels increase the danger of fatty deposits on vessels that bring blood to the heart. Too-low HDL cholesterol levels suggest the body might not be able to clear plaques and other fatty deposits from the body. Both conditions create a risk of heart condition and attack.
When to See a Doctor
Liver damage can grow for months or years with no symptoms. By the time symptoms appear, liver damage generally is extensive. Some symptoms warrant a doctor. These include:
- Jaundice (yellow skin and eyes)
- Fatigue
- Weakness
- Loss of appetite
- Accumulation of fluid within the abdomen
- Tendency to bruise easily
Diagnosis
A doctor could also be ready to diagnose liver problems by observing your symptoms and completing a medical record. You’ll also undergo tests of your liver function. These tests include:
- Liver enzyme test: Common enzymes during this panel are alanine transaminase, aspartate transaminase, alkaline phosphatase, and gamma-glutamyl transpeptidase. High levels of any of those enzymes may indicate damage.
- Liver protein test: Low protein globulin and albumin levels can show a loss of liver function. Prothrombin may be a liver protein needed for clotting. A standard test measures how long it takes for your blood to clot. A slow time can mean a scarcity of prothrombin, which will cause liver damage.
- Bilirubin test: The blood conveys bilirubin to the liver and gallbladder. Then it’s excreted within the stool. Blood within the urine or excess bilirubin within the blood can indicate liver damage.
- Single lipoprotein panel: The panel examines blood cholesterol and triglycerides together. Blood is typically drawn after fasting.
Treatment of Liver Disorders
Treatment of liver disorders commonly starts with addressing the underlying condition. Different liver conditions involve particular dietary modifications, but the American Liver Foundation has some broad tips.
Treatment of high cholesterol includes dietary recommendations like those for liver disease. Medical treatment of high cholesterol also often consists of a class of medicine called statins. Researchers have checked whether statins are safe for people with liver diseases.
“In general, statins are harmless in patients with liver disease,” says professor David Bernstein, MD, FACG, chief of hepatology at Northwell Health and professor of medicine at Hofstra Northwell School of Medicine in Hempstead, NY. “Patients who have regressed cirrhosis should be monitored very closely, but generally, they’re safe.”
“Is there a risk? Yes, but it’s minimal risk, and patients are monitored within the first three to six months,” says Bernstein.
Conclusion
Therapeutic interventions promise more straightforward cholesterol control, even among people with liver disease. But lifestyle changes and dietary management remain essential and compelling parts of an entire approach to cholesterol control with liver involvement.
Prevention
The National Lung, Heart, and Blood Institute suggests the way to manage high amounts of blood cholesterol with nutrition and lifestyle changes.
Bernstein recommends these lifestyle guidelines are good advice for anyone trying to keep cholesterol in restraint, including those with the additional challenge of underlying liver disease.