Caring for your Liver

Caring for your Liver

Malaysian Liver Foundation

The MLF is a charitable organisation supported by membership subscriptions and donations from interested individuals and corporations. Fund-raising events are held throughout the year to help support the Foundation’s work in public education, training programmes for doctors and research into liver diseases.
The Malaysian Liver Foundation (MLF) is the only national voluntary, non-profit, charitable organisation in Malaysia dedicated to the prevention, treatment and cure of liver, gallbladder and pancreatic diseases through education, training and research.

The MLF works towards the goal of better health for all Malaysians through activities such as:
Public awareness campaigns on liver conditions such as hepatitis
Educational forums and events for doctors
Research into liver diseases in Malaysia
Provision of laboratory services to test patients for liver conditions

Donation to Malaysian Liver Foundation

All donations to the MLF are tax exempt under Section 44(6) of the Income Tax Act, 1967. If you would like to make a donation, send a cheque or money order made payable to the Malaysian Liver Foundation or Yayasan Hepar Malaysia, to the following address:

Donations to Malaysian Liver Foundation
Jalan PJU 1a/3, Taipan 2 Damansara, 47301 Petaling Jaya, Selangor, Malaysia
+60 3-7842 6101

Whether you know it or not, the liver plays one of the most important roles in your body. In fact, being the largest single gland in your body, it is very much the organ that keeps you alive because if your liver fails, it means that your entire internal system fails.

The liver is the agent that does the most important task for your diet. The food that you consume is all stored here after they have been digested. On top of that, the liver is in charge of destroying all the damaging poisons which could harm your body.

This means that if your liver is unwell, the functions will suffer.

One of the most influencing factors that could cause your liver to damage is your lifestyle. What you eat each day will affect your liver both directly and indirectly. Never eat too much of something. Skipping breakfast is a known cause of liver damage while you should not consume too much medication, unless absolutely necessary.

Food which contain too many preservatives, coloring or artificial substance is damaging agents while you should not take food with too much oil. Generally, manufactured foods are not recommended while vegetables and fruits should be eaten raw where possible.

Avoid sleeping late

In terms of your lifestyle, avoid sleeping late and waking up too late into the day. Always urinate in the morning and do not drink too much alcohol.

To maintain a healthy liver function, you should practice a proper schedule so that your liver can function at its best.

Where this is concerned, you must ensure that you take a healthy breakfast. As mentioned, skipping breakfast can be very detrimental to the general health of your liver. Hence, breakfast must be taken and you will need a healthy diet for this. Ensure that your first meal is rich with nutrients, fiber and other minerals to keep your body strong throughout the day.

Minimal meal for dinner to let your liver rest

Lunch should be heavy but you must not overeat while dinner should be minimal where possible as you will be going to bed soon. The last thing you want is to have your liver working overtime while you are sleeping.

About your Liver

What’s so great about it?
Your liver is for life. You have only one and though it is unique in its ability to regenerate, it can only survive limited damage – so it does need looking after.

What is its position?

Place your right hand over the area under your ribs on the right side of your body and it will just about cover the area of the liver. The liver is the largest gland and solid organ in the body, weighing some 1.8 kg in a men and 1.3 kg in women. It holds approximately 13 per cent (about one pint or 0.57 litres) of the total blood supply at any given moment, and it has over 500 estimated functions.

What does it look like?

The liver is dark reddish brown in colour and is divided into two main lobes (the much larger right and the smaller left), which are further subdivided into approximately 100,000 lobules. About 60 per cent of the liver is made up of liver cells (hepatocytes), and each of these has an average lifespan of 150 days. In every milligram of liver tissue there are approximately 202,000 cells. Two-thirds of the body of the liver is the parenchyma, which contains the hepatocytes, and the remainder is the biliary tract. The liver receives its blood supply via the hepatic artery and portal vein which transports nutrients from the intestine (gut).

The liver and biliary tract

The biliary tract contains the right and left hepatic ducts, which meet to form the common hepatic duct. This is joined by the cystic duct from the gall bladder, which then forms the common bile duct. The common bile duct joins the intestine at the duodenum through a valve called the Sphinter of Oddi.

The gall bladder is a pear-shaped bag 9 cm long with a capacity of about 50 ml. Breakdown products, such as bile salts, bilirubin, cholesterol, phospholipids, proteins, electrolytes and water, are secreted by hepatocytes, and they are eventually transported down the bile ducts (this is bile and it is modified by cholangiocytes lining the bile ducts). The gall bladder stores bile, a greenish-yellow coloured liquid, which is delivered during a meal into the gut to assist with the breakdown (emulsifying) of fat in the food digested to allow easier absorption of fat and vitamins A, D, E and K. The liver produces approximately one pint (or 0.57 litres) of bile a day.

What is its role?

The liver is a complex chemical factory that works 24 hours a day. Virtually all the blood returning from the intestinal tract to the heart passes through the liver. This means everything you swallow that is absorbed into the bloodstream passes through the liver.

The liver functions can be divided into four basic categories:
1. Regulation, Synthesis and Secretion

a) Glucose – The liver plays a key role in the homeostatic control of blood glucose, by storing or releasing it as needed in response to the pancreative hormones insulin and glucagons.
b) Proteins – Most blood proteins (except antibodies) are synthesised and secreted by the liver, e.g. Albumin; decreased amounts of serum albumin may lead to oedema – swelling due to fluid accumulation in the tissues. The liver also produces most of the proteins responsible for blood clotting called clotting factors.
c) Bile – Bile is both excretory and secretory. In addition to bile salts, it contains cholesterol phospholipids and bilirubin (from the breakdown of haemoglobin). Bile salts acts as ‘detergents’ that aid in the digestion and absorption of dietary fats.
d) Lipids – The liver synthesises cholesterol, a lipid that is an essential component of cell membranes. Cholesterol then circulates in the body to be used or excreted into bile for removal. The liver also synthesises lipoproteins, which circulate in the blood and shuttle cholesterol and fatty acids between the liver and body tissues.

2. Storage
The liver stores glucose in the form of glycogen, and also fat-soluble vitamins (A, D, E and K), vitamins B6 and B12 and minerals such as copper and iron. However, excessive accumulation of certain substances can be harmful.

3. Purification, Transformation and Clearance

The liver removes harmful substances from the blood and breaks them down into less harmful compounds. It also converts most hormones and drugs to less active products.

a) Ammonia – The liver converts ammonia to urea which is excreted in urine by the kidneys through a process called deamination. In another process called transmination, the liver can convert one amino aid into another (but not the eight essential amino acids) via the ‘citruline-ornithine pathway’.
b) Bilirubin – Bilirubin is a yellow pigment formed as a breakdown product of red blood cell haemoglobin. The spleen, which destroys old red cells, releases bilirubin into the blood, where it circulates to the liver which excretes it in bile. Excess bilirubin results in jaundice, a yellow pigmentation of the skin and eyes.
c) Hormones – The liver plays an important role in hormonal modification and inactivation of steroids testosterone and oestrogen.
d) Drugs – Nearly all drugs are either modified or degraded in the liver. In particular, oral drugs are absorbed by the gut and transported to the liver, where they may be modified or inactivated before they enter the blood. Alcohol, in particular, is broken down by the liver, and long-term exposure to its end products can lead to cirrhosis.
e) Toxins – The liver is generally responsible for detoxifying chemical agents and poisons.

4. Fighting Infections

The liver plays a vital role in fighting infections, particularly infections arising in the bowel. It does so by mobilising part of the body’s defence mechanism called the macrophage system. The liver contains over half of the body’s supply of macrophages (known as Kuppfer cells), which destroy any bacteria that they come into contact with.
Between 9pm and 11pm, your liver will need to rest. This is the best time to detoxify. Anytime after that, your liver should no longer be working and should be allowed to rest. This is because throughout the day, your liver has been working non-stop.

Center for Disease Control: Hepatitis
Medline Plus: Hepatitis
Atlas of Liver Pathology: A Multimedia Textbook of Liver Pathology
The Liver Malaysia from Myhealth