‘DILI’ is killing more people every year

North Americans must rid themselves of a major misconception. Too much Cabernet Sauvignon is not the only way to damage the liver. Today liver injury is being caused by prescription drugs, over-the-counter (OTC) drugs, and some herbal supplements. More than 1,000 drugs and supplements have been associated with drug induced liver injury (DILI) which is increasing every year.

Everything we consume, with both good and toxic ingredients, are eventually filtered by the liver. This organ has great regenerative powers, but it is not indestructible. Moreover, advanced age and being a woman can decrease the liver’s ability to metabolize toxic products, resulting in DILI.

For example, many people take Tylenol (acetaminophen). It’s an effective painkiller if label instructions are followed, but there’s a big problem. Acetaminophen is used in hundreds of prescription and OTC drugs. Patients who are taking several remedies may unwittingly be consuming a toxic dose of acetaminophen. This is why acetaminophen accounts for most cases of needless DILI.

Other medications such as methotrexate used to treat rheumatoid arthritis, isoniazid for tuberculosis, anabolic steroids used by body builders, and excessive amounts of Vitamin A and iron can all impair liver function. And in rare cases cholesterol-lowering drugs.

But there’s another big problem. Television contributes to liver abuse day after day. Its recurring ads persuade unsuspecting consumers that there’s no reason to suffer even minor pain. Tens of thousands of people swallow painkillers daily as if they were M and M candy. But they all have to be metabolized by an overworked liver.

For several years I’ve confessed that, in many instances, I favour natural remedies to treat medical conditions. But that does not make every natural remedy safe. The Mayo Clinic cautions that herbal remedies such as kava, comfrey, chaparral, kombucha tea and skullcap can be toxic to the liver. And don’t forget it was the natural drug hemlock that killed Socrates 2,000 years ago.

But there is more to DILI than medication. It’s also prudent to be aware of what touches your skin which covers 18 to 22 sq. ft. of the body. So, when using an aerosol spray device for painting or controlling insects, make sure the work area is well ventilated or wear covering and a mask.

Also, don’t take needless chances with viral infections that can damage the liver. Large numbers of North Americans develop Hepatitis A by drinking or eating food contaminated by sewage.

Others are infected with Hepatitis B, spread by sexual contact, saliva and contaminated needles. This can result in cirrhosis and liver cancer. A vaccine is available that provides dual protection. Ideally, everyone should have this protection, but it’s essential for healthcare workers, travelers and those who engage in hazardous sex.

As I view the current medical scene, I see a huge tragedy in the making. Johns Hopkins Medical Centre reports that 25% of North Americans suffer from nonalcoholic fatty liver disease (NAFLD). Worse still, it claims that 15% go on to develop nonalcoholic steatohepatitis, which causes scarring of the liver. Pathologists say these changes are indistinguishable from liver damage caused by too much alcohol. The final tragedy is that NAFLD is now being seen in young obese children.

To prevent liver damage, keep an accurate list of all the drugs and natural supplements you take and keep it up-to-date. It’s also advisable to use the same pharmacy and health food store that will alert you to adverse drug interactions and overdose.

Be aware that symptoms may not occur before significant injury is done. Liver injury is associated with fatigue, itchy skin, a low-grade fever, loss of appetite, and upper abdominal pain. As the disease progresses, urine becomes dark, stools clay-coloured, and eyes develop a yellow tint, a sign of jaundice.

Let’s end on a happier note. Centuries ago more people died from drinking contaminated water than alcohol. Today people are dying from excessive use of alcohol and questionable drugs. But I believe that alcohol in moderation is still safer and beneficial for many people, particularly the elderly.

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