Does your liver need a break?

Last Updated on July 31, 2019

The Holidays are over. It’s the time when many people make resolutions to ease their over-taxed livers.

The liver is the body’s largest internal organ. It provides essential functions in digestion, metabolism, immunity, and nutrient storage. It’s also the primary organ responsible for eliminating alcohol from the body. The average healthy functioning liver can break down about one shot of liquor per hour, or one 5 oz. glass of wine, or one 12 oz. can of beer.

Ethanol (the substance in alcohol that gets you tipsy) is a very small molecule that is soluble in both fat and water, so it can easily permeate organ tissues. The circulatory system draws ethanol to the liver where it’s metabolized by first converting it into acetaldehyde, an extremely harmful substance. In most people the acetaldehyde is quickly converted into acetate, a molecule that is now suggested as being responsible for sleep disruption and hangover symptoms. The acetate is retained and burned for energy over a period of about 6 hours. The body’s normal source of energy, glucose, is displaced by the acetate, disrupting normal metabolism, and affecting liver function and insulin regulation.

People seeking to hasten the liver’s recovery often turn to liver detox cleanses, crash diets, and supplements. Unfortunately such interventions are not backed up by evidence proving their effectiveness.


Milk thistle is a widely available herbal supplement suggested by some as a treatment for liver problems including cirrhosis, jaundice, and hepatitis. Silymarin, the main active compound in milk thistle is an anti-inflammatory and antioxidant. Evidence for its efficacy has simply not been documented. The studies have varied in dosing, duration, and the extent of liver disease and none have proven effective. Fortunately there is little evidence to suggest taking milk thistle has adverse effects. As is often the case with anecdotal evidence, the claimed benefits have not been separated from the placebo effect which can be surprisingly strong, or from the effects of cofactors such as healthy changes in behavior or diet.


The practice of juicing, or fasting on juice for a period of time has been promoted as likely to remove toxins from the body and has become a popular trend in health-conscious communities. Health food stores and dedicated juicing outlets offer very pricey bottles of juice. Adjectives like “cold-pressed”, “organic”, and “probiotic” pepper the marketing language. There are $700 juicing machines for discriminating juicers intent on preventing oxidation and breakdown of the juice’s beneficial properties. However, the idea that juicing can eliminate toxins has not been proven. The term “toxin” covers a broad range of possibly harmful compounds a healthy body naturally handles.


“Colon irrigation” proponents claim toxins in poo can remain in the colon for months or years as plaque, eventually finding their way back into the body’s systems. Colon irrigation is exactly what you don’t want to picture: a hose up your bum, spray washing the colon. Unfortunately, (or fortunately) these fecal plaques remain as elusive as the Loch Ness Monster. Gastroenterologists have yet to see one. (Yet the procedure has some real risk of perforating bowel.)


Liver detox cleanses follow the same script late night infomercials use to tap into our culture of instant gratification through fast solutions. The body is designed to recover from moderate alcohol abuse. In fact, a study of communities with the highest rates of centenarians found that two to three servings of alcohol were part of their daily diet. There is a blurry line between alcohol use as part of a fulfilling social life and life threatening abuse. If you are concerned about your alcohol use, consider taking our simple quiz. Alcohol is fun. It doesn’t have to be harmful. We are here to help you keep it in check.

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