The liver is a beautiful color
A deep reddish-brown, its shade is reminiscent of rich leather, mahogany bookshelves, cigar papers. Its elegant appearance belies its purpose, which is to regulate chemical levels in the blood and excrete everyone’s favorite bodily fluid, bile. The liver also handles at least 500 other functions of which researchers are aware.
When we talk about toxins, we’re talking in large part about the liver. You can drink as much green juice and take as many detox supplements as you want, but if you’re not taking good care of your overall health, your liver will eventually feel it.
The holiday season, a time of equal parts joyous celebration and family-induced stress, is peak time for overworking your liver with alcohol and too much food. Yes, the body’s second-largest organ (after our skin) is a tough one, but if it fails, its jobs are difficult to outsource. A heart can be replaced by a pump, lungs can be assisted by a ventilator, but a liver is irreplaceable by anything other than another liver.
Luckily for holiday revelers everywhere, the liver is the salamander’s tail of the human body: It’s the only internal organ with regenerative abilities. Scientists aren’t totally sure why it can regenerate while others can’t, but this plays an important role in liver transplants. While humans can’t live without a liver, they can live with just a piece of it. (This means that sometimes, instead of a whole new liver, a recipient will get a large piece of the liver from someone currently alive, such as a relative. The chunk of liver then regenerates to form a complete — but maybe somewhat misshapen — new organ.) We’re talking superhero powers here.
Craig Lammert, a hepatologist (liver specialist) and assistant professor at Indiana University School of Medicine, says the regenerative power of the liver, and the history and myth around it, is one of his favorite aspects of the organ.
“Any hepatologist loves the story of Prometheus,” he says. “Prometheus was tortured each day by an eagle that tore out and devoured his liver, which then grew back each night in readiness for fresh ‘hepatophagy’ on the morrow… some say that Greeks actually knew this regenerative capacity of the liver, thus making the story of Prometheus rooted in possibility (at least the regenerative part).” While the theory that the Greeks were aware of this particular capability of the liver is disputed among scientists and historians, it certainly adds to the mystique around this powerful but underappreciated part of the body.
The liver is a busy crossroads
Two roads converge in the liver, carrying blood to be filtered and released back into the rest of the body. The hepatic artery, which is technically made of two smaller arteries, delivers oxygenated blood from the heart, while the portal vein brings blood rich in nutrients, medicine — and toxins. Cells within the liver, called hepatocytes, are then tasked with deciding what to do with all the different components of this oxygenated and nutrient-rich blood.
Some of it stays in the liver as storage, while much of it gets processed and detoxified. Trash that you burdened your poor liver with, like alcohol, drugs, fat, or too much Tylenol, gets shuffled along and disposed of in the bowels. The liver then directs the remaining oxygen and nutrients back into the body through the blood.
The liver is crucial to the metabolic process, playing a key role in converting fat into energy. It transforms carbohydrates into glucose, sending it off to keep you lively and awake and storing any extra as glycogen. It also keeps watch on blood sugar levels to ensure any energy spikes and dips are kept to a minimum. And lest we forget protein, the liver is in charge of that too. It alters proteins and amino acids, which in turn aid the liver in processing carbs and fats. Like an office manager who remembers everyone’s birthdays and duties while their own contributions are forgotten, the liver keeps the rest of the body’s functions running smoothly.
These are, of course, only its primary functions. The liver is more than just an office manager; it’s a hustler with hundreds of side gigs, which makes it all the more tragic that it doesn’t get the attention and care it deserves. Instead, it cedes all the fame and glory to its flashier neighbors, the lungs and the heart. But its primary product, bile, is a powerhouse substance that helps the small intestine digest and absorb fats and fat-soluble vitamins, and carts any waste out of the body in feces. We make a lot of it, too: between 14 and 30 ounces every day. That’s almost as much as a Big Gulp full of greenish-brown liquid. Delicious!
At your next holiday party, think of your liver. It’s happy to work overtime every once in a while — regenerative properties and all that — but it’s not completely immune to abuse.
The liver is a diligent workaholic
But it’s also vulnerable to abuse and burnout. Alcohol, drugs and medications, and excessive calories all do a number on the organ. Eventually, that maltreatment can lead to a number of diseases, including scarring, called cirrhosis, fatty liver disease, and cancer.
It might be easier than scientists previously thought to sicken your liver. “That’s an area of great controversy right now,” says Sammy Saab, a professor of medicine and surgery at the University of California Los Angeles and co-chair for the National Medical Advisory Committee for the American Liver Foundation. “The party line has always been that drinking more than three drinks [daily] for a man, and more than two drinks for a woman, will cause liver disease after a couple of decades.” But scientists are re-evaluating those recommendations, he says, because liver disease deaths have risen dramatically in recent years. Between 1999 and 2016, deaths from cirrhosis increased by 65%, while deaths from liver cancer doubled; young adults between the ages of 25 to 34 have experienced the highest increase of alcohol-related cirrhosis. Some researchers believe that the surge of disease is related to alcoholism caused by the 2008 financial crisis.
It could also be that our liver can’t take as much alcohol as doctors thought. “Alcoholic fatty liver or simple steatosis [a form of non-alcoholic fatty liver disease], which usually develops in 90% of heavy drinkers, may be seen within 2 weeks of heavy and regular alcohol ingestion,” says Lammert. That said, it “resolves rapidly following complete abstinence,” which, for those of us who drink to excess over the holidays, is a point in Dry January’s favor.
Drinking a lot is an especially potent way to abuse the liver, but it’s far from the only way to do so — overeating can be nearly as harmful. Most Americans gain a little under a pound following the holiday season. This doesn’t sound like much, but it comes as a result of excessive food and drink consumption between Thanksgiving and New Years. Overeating, in turn, does a number on the liver, as liver disease can occur when the liver stores some of that excessive fat as triglycerides. It can also lead to liver inflammation, which is another precursor to liver disease. These side effects are more pronounced in those who become overweight or regularly eat unhealthy levels of sugars and fats. And like a highway onto which thousands of daily drivers dump their fast food wrappers, soda cans, and cigarette butts, the hepatic artery and portal vein can clog when its mistreatment leads to liver disease, inflammation, and other traumas. Nobody likes a traffic jam, especially one that makes it harder for everyone else on the road to get to work.
Appreciate your liver, and keep it healthy
This doesn’t mean you have to become a sober ascetic just in time for Thanksgiving dinner, though. According to Brittany Wood, a dietitian and consultant for Nutrition on Demand, focusing on increasing your vegetable intake during the holidays — rather than denying your cravings altogether — can help you stay healthy and avoid overstressing your liver. “When we honor our cravings and go for that holiday cookie (or whatever it is that you want), it helps us to prevent eating more food than we intended because we are left unsatisfied when we tell ourselves ‘no,’” she says. “Give yourself permission to have your favorites, but remember to make fruits, vegetables, and whole grains a part of not only your daily diet, but the holidays too.”
Lammert points out that coffee can also lend a hand to your beleaguered holiday liver, which is great news for me and my cold brew addiction. “Coffee consumption has been associated with improvement in liver enzymes among variable groups of patients with risk factors for liver disease,” he says. “Coffee intake of more than two cups per day in patients with preexisting liver disease has been shown to be associated with lower incidence of fibrosis and cirrhosis, lower liver cancer rates, and better survival.”
At your next holiday party, think of your liver. It’s happy to work overtime every once in a while — regenerative properties and all that — but it’s not completely immune to abuse. It also loves vegetables and coffee, so consider bringing some delicious balsamic braised brussels sprouts and a vat of strong cold brew to your next potluck. Nobody, not even your liver, can be mad about that.