Most of my blogs are started out of my own curiosity, and this one is no different.
I’ve read in numerous sources that people with Endometriosis need to keep our livers in tip-top condition; well-greased and in proper working order. I’ve seen a few Facebook posts from other EndoWarriors that they have heightened levels of *something* when they have a liver panel blood test done, and they wonder if their Endometriosis may have something to do with that. That struck a chord with me because I have Gilbert’s Syndrome, which is a liver disease diagnosed through heightened liver panel results.
Does my Endo affect my liver’s functions? And does that, in turn, add to or affect my Gilbert’s Syndrome? My liver blood panel test results?
I may not have found any definitive answers to my questions above, but I did learn A LOT about my liver, hormones, diet, and health. Intrigued? Read on, Dear Reader, read on.
What Does the Liver Do
The liver is the second largest organ in your body (weighing about 3 pounds) and is a big, ugly, rubbery reddish-brown organ that resides in the upper right cavity of your torso, and is protected by the rib cage. Think of it as a filtration laboratory: the liver receives blood coming from our heart (rich in oxygen) and digestive tract (rich in whatever was absorbed from the foods or beverages we ingest) and even toxins that were absorbed through our skin; filters it (removing chemicals, bacteria, and toxins); and then sends the good & clean blood and nutrients back throughout your body. It also helps metabolize medications and breaks down alcohol.
Our livers secrete bile (which helps break down fat) and delivers it to our intestines or stomach to help with digestion. The liver also creates proteins that are vital for blood clotting and stores sugar, vitamins, and minerals. Is this all the liver does? NO! It has actually hundreds of different functions throughout the body. Huuuuundreds!
Hormones & the Liver
Among its many other functions, the liver manufactures estrogen and testosterone. It is also responsible for maintaining and destroying excess hormones. Research is ongoing into understanding the estrogen breakdown and distribution by the liver, and possible effects of estrogen-related symptoms and cancers.
Many physicians and patients with Endometriosis believe there is a direct link to Endometriosis and estrogen/hormone balance. If you are one of those Believers, you’ll want to take efforts to maintain a happy and healthy liver. It’s been shown that a diet high in eating complex carbs in veggies and grains aids in the metabolism of estrogen and high in fiber intake increases the amount of excess estrogen secretion (aka, you poop it out). Less stress on our livers to have to filter it out itself. There are also many women out there who believe it is not a hormone-driven condition, but one based off of many other factors. So, this article may mean nothing to you.
Regardless of your thought process of hormone levels and Endometriosis, maintaining healthy liver function is key to keeping your entire body in tip-top condition. Which helps in the long run. With everything.
Can Endo Grow on the Liver?
It’s not a far-fetched question as it grows in so many other places of the body. During my 2014 diagnostic laparoscopy, an Endometriosis legion was found on my liver. It was deemed too dangerous to remove at that time. And by my 2016 surgery, it had vanished on its own. So, it’s not unheard of. And I personally know three other EndoWarriors who have Endo lesions on their livers. Liver-involved endo is considered VERY rare.
But in the August 2018 issue of Annals of Hepatology, a 40-year-old woman had a large mass on her liver show up in imaging studies. An exploratory surgery was performed and the mass was removed from the left hepatic lobe of her liver and a biopsy confirmed the cystic mass was, indeed, endometriosis.
An article published in 2019 was of a 42-year-old with occasional severe upper right quadrant pain, oftentimes accompanied by nausea and vomiting. She had a medical history of a hysterectomy and they had also removed her right ovary, but the article didn’t state why. And had previously been diagnosed with a hepatic mass at another hospital because of her symptoms. Physical examination showed tenderness to her right upper quadrant, tests for Hep B and C, as well as tumor markers, were normal. A CT scan showed a 3-4cm cyst on both the right and left lobes of her liver. She was given a therapy treatment and sent home with the plan to return for a hepatic resection. But a few weeks later, she was returned to the hospital due to increased instances of pain. More CT scans were ordered; the left lobe cyst remained, but they couldn’t find the right one. They immediately performed surgery and removed the cystic portion of the left lobe of her liver. Two most after surgery, she had no recurrent symptoms. The biopsy confirmed it was hepatic Endometriosis: Endo of the liver.
How to Help the Liver
Maintaining a healthy diet is critical to assisting your liver do it’s job better! The American Liver Foundation suggests eating grains, proteins, dairy, fruit, vegetables, and good fats. Also, eat plenty of fiber, which you can get from fruits, veggies, grains, breads, and cereals. Of course, those of us following the EndoDiet will be avoiding dairy, soy, and gluten.
Certain supplements are rumored to help with liver strengthening and cleansing : SAMe (aka Sam-E; S-adenosylmethionine), Milk Thistle, and Milk Thistle Seed Extract are some of the well-known ones. Magnesium is said to help with estrogen detoxification. Magnesium and calcium have been shown to decrease the symptoms of PMS. All of which is related in one way or another to, you guessed it: the liver! Tumeric has also been shown to help increase the liver’s ability to detoxify certain estrogens (it’s also great for inflammation!).
How to Strain and Harm the Liver
Alcohol is the most famous way you can damage your liver. “Pickle your liver,” is a common expression. Alcohol is processed through the liver and can cause irreversible damage, leading to many different types of alcohol-related liver disease.
Fatty foods and obesity can lead to non-alcoholic fatty liver disease. Mind your diet. Exercise. You only get one body…
If you’ve taken pain killers or headache medicine before, you may recall seeing the label about consulting with your physician regarding Acetaminophen. And you also may recall about not taking more than the instructed dose, which also means not mixing medications : taking 2 Tylenol and an hour later 2 Midol or 1 Percocet. Too much Acetaminophen can cause serious liver damage. Acetaminophen may also interfere with the effectiveness of your birth control pills. Read the fine print and talk to your doctor.
When I was 14 years old, I was diagnosed with Gilbert’s Syndrome, I was told it was a rare condition that mostly affected men. The doctor surmised I must have contracted it during a blood transfusion when I was born (I was 3.5 months premature and spent a long time in the hospital) and that I would not be able to ever donate my blood or organs. However, I’ve since learned a few things:
- Gilbert’s Syndrome is not as rare as I first suspected, and is actually considered common. 3-7% of the United States population has it, and is more common in men more than women.
- Gilbert’s Syndrome is an inherited gene mutation, which means you’re born with it. One or both of my parents has this gene, but they may not know it.
- The American Red Cross does accept blood donations from people with Gilbert’s Syndrome.
It’s relatively harmless. And there is no treatment. But just what does it do to me?
Every once in a while my skin and eyes will turn yellow…aka jaundiced. I can also suffer from extreme fatigue during these times. The jaundice is caused by heightened levels of bilirubin in my system, because my liver is unable to process it out of my blood as quickly as it should…Bilirubin is created when old red blood cells break down, and is normally filtered through the liver. Since my liver has a defective enzyme due to Gilbert’s Syndrome, it cannot breakdown the bilirubin levels as well as it should, so it continues to circulate through my system. If the levels get too high, I go yellow, but it goes away on its own. Due to the ineffective cleansing levels of my liver, medications may have increased side effects.
Certain circumstances can affect my G.S. : fasting, skipping meals, having a cold or flu, exercising too much, dehydration, being on my period, stress, or lack of sleep.
What Have I Learned Today
My original question was, “Does my Endo affect my liver’s functions? And does that, in turn, add to or affect my Gilbert’s Syndrome?” It remains unanswered. But what I did learn was that my liver’s health and efficiency may affect my Endometriosis…And although very rare, Endo may develop on the liver. Don’t ignore your symptoms!
I learned a lot about my Gilbert’s Syndrome that I didn’t already know. I also learned that the liver does a whole lot more than I thought it did…a whole lot more. Since my diagnosis with Endometriosis, I’ve altered my diet habits, so I feel much better about that, and it seems to go with the American Liver Foundation’s dietary recommendations. I’ve also drastically reduced the amount of alcohol I drink. Which I probably should have done a decade ago…hindsight…
And I want to continue to strive to keep my liver strong and healthy. Especially because my liver already functions at a lesser rate than the average person.
What did you learn?
*Updated June 11, 2019*
Annals of Hepatology – (Abstract; Aug. 2018) Rare Case of Hepatic Endometriosis as an Incidental Finding: Difficult Diagnosis of a Diagnostic Dilemma
Case Reports in Hepatology – (Article; 2019) Endometrioma of the Liver: A Case Report and Review of the Literature
~ Again, I am a layman. I do not hold any college degrees, nor mastery of knowledge. Please take what I say with a grain of salt. If curious, do your own research 😉 Validate my writings. Or challenge them. And ALWAYS feel free to consult with your physician. Always. Yours ~ Lisa