Hepatitis and Liver Problems
Liver is the largest and the most important metabolic organ in our body. It has several function affecting other organs function, such as metabolism in our body. Impaired metabolism in liver will disrupt entire blood function resulting in impaired distribution of nutrients throughout our body.
As metabolic organ, liver may experience inflammatory reaction, so called hepatitis. Cause of hepatitis can be classified to infection and non infection. Infection cause of hepatitis usually occurs due to viral infection, resulting in hepatitis A, B, C, D, E, or F. Non infection cause of hepatitis may include alcohol and drugs that impair liver metabolism. Hepatitis has become one of top ten cause of death worldwide. Indonesia is ranked in third place after India and China for the total number of patients suffering hepatitis.
Liver is a well-regenerating organ and able to recover from tissue or cell damage. The regeneration ability of liver cells is excellent, as example is in patients undergoing liver transplantation, liver cells recover in approximately 3 times 24 hours. However, if liver cells are continuously damaged (i.e experiencing repeated inflammation), they will form connective tissue that will disrupt structure of liver tissue, resulting in disorder of liver function. The connective tissue will induce stiffness in liver tissue, resulting a condition called cirrhosis of liver. Cirrhosis of liver will end in liver failure once the cirrhotic part occurs in most of liver tissue.
As detection of damage, liver itself secrete some enzymes which can be examined through laboratory examination. Essential enzymes known as liver function test indicator are Aspartate Transaminase (AST) or Serum Glutamic Oxaloacetic Transaminase (SGOT), Alanin Transaminase (ALT) or Serum Glutamic Pyruvic Transaminase (SGPT) and Gamma Glutamate Transferase (GGT). These enzymes are mostly secreted abundantly in state of liver inflammation in which the level of these enzymes may multiplicate to hundred times.
Detection of liver damage can be performed by gathering information about patient’s sign and symptom. Signs and symptoms of liver damage may vary, from mild, moderate to severe signs and symptoms. Signs and symptoms that usually occur in patients suffering liver damage are nausea, vomiting, change in skin color (i.e yellowish color of skin), loss of appetite, fatigue, rapid weight loss, liver enlargement, swelling, abnormal venous enlargement in abdominal wall and other signs or symptoms. These signs and symptoms should be warning for early treatment since further delay of treatment will result in worse condition. Physical and laboratory examination should be performed simultaneously for early detection of liver damage. As mentioned before, liver is equipped with excellent ability to recover, making liver able to sustain to perform its function even if there is mild damage. Obvious disruption of liver function will occur once there is approximately 80 % of liver tissue is damaged. Therefore, it will bring most benefit if we support liver health by adding hepatoprotector in early stage of liver damage to prevent worsening condition of liver damage.
Curcuminoid and Sylimarine as Hepatoprotectors
Hepatoprotector is term for groups of chemical substances that perform protection to liver tissue and enhance recovery in damaged-liver tissue. Curcuminoid and Sylimarine are natural and well-known ingredients for their hepatoprotective mechanisms. These substances protect and recover liver tissue from hepatotoxic agents such as alcohol, drugs, metal particles, pollutants and pesticides.
Curcuminoid is natural substance derived from curcuma plant (Curcuma xanthorhiza). It has been used worldwide as natural medicine since early of 18th century. It performs anti oxidant and anti inflammatory function to cells, especially liver cells. In a study performed in male Wistar rats using carbon tetrachloride (CCl4) as hepatotoxic agents shows that group using curcumin is capable to prevent liver injury. It is suggested that curcumin prevents acute liver damage by acting as antioxidant and supressing inflammatory mediators. Another clinical trial performed in Indonesia involving 38 patients with liver disorder and SGOT and SGPT levels above normal range shows that based on statistical result, after 14 days of therapy using curcumin level of SGOT may decrease up to 2,89 times and SGPT level may decrease up to 3,28 times than before therapy. For hepatitis patients, level of SGOT may decrease up to 3,48 times and level of SGPT may decrease to 3,82 times than before therapy.
Other substance well-known for its hepatoprotective mechanism is sylimarine. Sylimarine is chemical substance containing mixture of flavonoids such as Sylibin, Sylidianin and Sylichristin. These substances are derived from plant named Sylibum marianum, also called “milk thistle”. Sylimarine has been used since medieval times to treat liver disease for it performs antioxidant profile and promotes regeneration of liver cells. Sylimarine is also capable to block toxins entering liver cells by inhibiting absorption of harmful substance to liver cells. In a randomized, placebo-controlled trial involving more than 20 patients with chronic hepatitis, group consuming sylimarine for one week shows decrease in SGOT, SGPT and GGT significantly. Another study also shows similar result in which sylimarine given for 8 weeks in 2637 patients with chronic hepatitis. The study shows that subjective complaints improve up to 63%, level of SGOT decrease up to 36 %, level of SGPT decrease up to 34% and level of GGT decrease up to 46%.
PROLIVER as Hepatoprotector
Good Life Proliver from Simex Pharmaceutical Indonesia is an excellent hepatoprotector product, containing curcuminoid and sylimarine as main content to prevent liver cells damage and promote regeneration in liver cells. Aside from curcuminoid and sylimarine, Good Life Proliver also contains choline bitartrate and vitamin B6 to reduce lipid accumulation in liver tissue and improve liver metabolism. With great combination of natural products, Good Life Proliver is the right choice as protective therapy for liver.
- Mayer KE, Myers RP, Lee SS. Silymarin treatment of viral hepatitis. Journal of Viral Hepatitis.2005;12:559-567.
- Flora K, Hahn M, Rosen H. Milkthiste (Silybum marianum) for the therapy of liver disease.Am J Gastroentero.2009; 93:139-143.
- Reyes-Gordillo, José Segovia, Mineko Shibayama, Paula Vergara, Mario G. Moreno, Pablo Muriel. Curcumin protect against acute liver damage in rat by inhibiting NF-κB, proinflammatory cytokines production and oxidative stress. Biochimica et Biophysica Acta Vol 1770 . 2007; 989–996