Cardiometabolic Health

Glutathione in the Treatment of Fatty Liver/NASH/NAFLD

Have you been told you have a “fatty liver” despite not consuming high amounts of alcohol? If so, you have NAFLD or NASH.

 

What is NASH/NAFLD?

>> Nonalcoholic Fatty Liver Disease (NAFLD, Hepatic Steatosis, NASH)

Non-alcoholic fatty liver disease (NAFLD) is a chronic and multifactorial disorder characterized by excessive fatty acid accumulation in liver cells. Associated with metabolic syndromes, NAFLD is increasingly being recognized as a major cause of liver disease. It is a spectrum of liver abnormalities that ranges from nonalcoholic fatty liver to steatohepatitis, cirrhosis, and liver cancer. It is estimated that 25% of the global population has NAFLD, a number projected to continue to rise, and as it does, it is expected that more of these cases will progress to end-stage disease states requiring liver transplantation. A larger percentage of liver cancers in these cases occur before end-stage liver failure, and thus are less likely to be screened for, increasing the tendencies for liver tumors to be larger and more difficult to treat at the time they are diagnosed. Testing and diagnosis of NAFLD may include blood tests, imaging, and biopsy.

 

What causes it? 

Risk Factors

•    Metabolic syndrome (strongest risk factor)

  • increased waist circumference (obesity)

  • insulin resistance

  • elevations in:

    • blood sugar

    • cholesterol

    • triglycerides

    • blood pressure

    • uric acid

•    Diabetes (up to 75% of individuals with type 2 diabetes have NAFLD)

•    Sleep apnea

•    Gut microbiome effects

•    Genetic factors

Image: Friedman et al. 2018

Why is it important to address?

Patients with NAFLD are twice as likely to die of cardiovascular disease than liver disease as a result of these shared risk factors. NAFLD in itself is an independent risk factor for cardiovascular disease due to its impacts on vascular health and inflammation.

How does it happen & what you can do about it?

Free fatty acids from either adipose tissue (fat), or from the conversion of excess carbohydrate intake, accumulate in the liver cell resulting in oxidative stress, inflammation, and liver injury.

As such, healthy eating habits and regular exercise can reduce the amount of free fatty acids and thereby prevent or reverse NAFLD. Glutathione supplementation can also help in the recovery of NASH/NAFLD.

What is Glutathione?

Glutathione (GSH) is a tripeptide made from amino acids, that is present in every cell of the human body, though is highly concentrated in the liver. Known as the ‘master antioxidant’ it directly scavenges reactive oxygen species, protecting your body from oxidative damage, and plays a crucial role in detoxification and cellular health. Reduced levels of glutathione have been associated with increased disease risk and progression, including NAFLD and other liver pathologies.

In addition to healthy diet and lifestyle habits, preliminary studies have shown beneficial effects of supplemental glutathione in the treatment of NAFLD, demonstrating a reduction of ALT–a liver enzyme elevated in liver dysfunction and one of the principal NAFLD biomarkers–after four months of treatment. Other studies demonstrated intravenous glutathione rapidly improved liver function, also evidenced by reduced biomarkers, in the treatment of other liver pathologies including chronic hepatitis B. Various nutrients, amino acids, herbal extracts, and probiotics have also been shown to increase glutathione activity in the body, and may be used in conjunction for enhanced therapeutic effect.

Find out if Glutathione is an option for you!

At Saskatoon Naturopathic Medicine, we offer both oral and intravenous glutathione for the treatment of NAFLD and other conditions, as part of our comprehensive approach to our patients’ unique health history and needs. If you are interested in learning more about how we can assist you, give us a call or book online to connect with one of our naturopathic doctors who would be happy to assess your case and discuss treatment options appropriate for you.

*IV therapy requires a consultation and evaluation by one of our IV doctors to assess patient eligibility and treatment goals. For more information see our IV therapy page. 

Jacalyn Sieben, ND

 

Sources:

Friedman, S. L., Neuschwander-Tetri, B. A., Rinella, M., & Sanyal, A. J. (2018). Mechanisms of NAFLD development and therapeutic strategies. Nature medicine, 24(7), 908–922. https://doi.org/10.1038/s41591-018-0104-9

Honda et al. (2017). Efficacy of glutathione for the treatment of nonalcoholic fatty liver disease: an open-label, single-arm, multicenter, pilot study. BMC Gastroenterology. 17:96 DOI 10.1186/s12876-017-0652-3. https://pubmed.ncbi.nlm.nih.gov/28789631/

Vairetti, M., Di Pasqua, L. G., Cagna, M., Richelmi, P., Ferrigno, A., & Berardo, C. (2021). Changes in Glutathione Content in Liver Diseases: An Update. Antioxidants, 10(3), 364. MDPI AG. Retrieved from http://dx.doi.org/10.3390/antiox10030364

Qian, L., Wang, W., Zhou, Y., & Ma, J. (2017). Effects of reduced glutathione therapy on chronic hepatitis B. Central-European journal of immunology, 42(1), 97–100. https://doi.org/10.5114/ceji.2016.65894

Lower Blood Sugar and Cholesterol and Improve Heart Health with Berberine!

BERBERINE AND CARDIOMETABOLIC HEALTH

Berberis Vulgaris (Barberry)

Berberis Vulgaris (Barberry)

Berberine is a bright yellow-coloured alkaloid compound found in many plants, some of the more common ones including Hydrastis canadensis (goldenseal), Berberis vulgaris (barberry), Coptis chinensis (Chinese goldthread), and Berberis aquifolium (Oregon grape). Berberine has been used traditionally to combat inflammatory disorders, infectious diseases, diabetes, digestive disorders and many others, and has demonstrated benefits on blood sugar metabolism, cardiovascular effects, cholesterol and atherosclerosis.

Berberine appears to exert its cardiovascular effects through various mechanisms that play a role in protecting the blood vessels, decreasing inflammation and modulating levels of cholesterol and blood sugar. Berberine has been shown to affect the modulation of an enzyme called adenosine monophosphate-activated protein kinase (AMPK). AMPK is responsible for maintaining healthy blood vessels through a variety of different mechanisms, including the regulation of another enzyme, called endothelial nitric oxide synthase (eNOS), which is responsible for producing nitric oxide in the cell layer lining our blood vessels. Nitric oxide is important in regulating how our blood vessels dilate (which plays a role in our blood pressure), platelet and white blood cell activation and adhesion (which plays a role in the development of arterial plaques), and antioxidant functions (which is important for preventing damage from free radicals like glycated blood sugar, which is prevalent in diabetes). In simpler terms, AMPK and eNOS are important for maintaining a healthy cardiovascular system. When eNOS is not functioning properly, it can contribute to the development of high blood pressure, diabetes and high cholesterol. Berberine has been found to increase the production of nitric oxide through enhancing activity of eNOS [1, 2, 6, 7].

Current research on berberine has been focused on its metabolic and cardiovascular properties. A research study suggested that berberine was shown to decrease levels of total cholesterol, triglycerides and LDL cholesterol levels, while increasing HDL-cholesterol (which is thought to be protective, or the “good” cholesterol). A meta-analysis demonstrated that the addition of berberine to simvastatin, a cholesterol-lowering drug, resulted in a greater reduction of triglycerides and total cholesterol, and a reduction in the number of side effects, compared to the use of simvastatin on its own [5].

Berberine also benefits blood sugar levels and reduces body fat mass. A research study on diabetic patients showed that those who were given berberine had a reduction in blood sugar levels and cholesterol levels, and those with metabolic syndrome also experienced a decrease in their body mass index (BMI) and waist circumference [3]. A study on women with polycystic ovary syndrome (PCOS), a disorder characterized by insulin-insensitivity, obesity and high cholesterol, found that berberine decreased waist circumference and waist-to-hip ratio, insulin sensitivity and blood sugars and cholesterol levels comparable and/or superior to that of metformin [4].

Berberine is generally well-tolerated, and side effects of usage are usually mild in nature, such as abdominal discomfort, diarrhea, constipation, decreased appetite, and dermatological rashes. Berberine may interfere with certain medications and may not be suitable for everyone. As always, with any natural health product it is important to consult with your naturopathic doctor to see if berberine is safe for you.




References:

[1] Neag M, Mocan A, Echeverria J, et al. Berberine: Botanical Occurrence, Traditional Uses, Extraction Methods, and Relevance in Cardiovascular , Metabolic, Hepatic, and Renal Disorders. Front Pharmacol. 2018; 9:557. https://pubmed.ncbi.nlm.nih.gov/30186157/

[2] Hoffmann D. (2003). Medical Herbalism: The Science and Practice of Herbal Medicine. Healing Arts Press.

[3] Pirillo A, Catapano AL. Berberine, a plant alkaloid with lipid- and glucose-lowering properties: from in vitro evidence to clinical studies. Atherosclerosis. 2015; 243(2): 449-61. https://pubmed.ncbi.nlm.nih.gov/26520899/

[4] Wei W, Zhao H, Wang A, et al. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012; 166(1):99-105. https://pubmed.ncbi.nlm.nih.gov/22019891/

[5] Zhang LS, Zhang JH, Feng R, et al. Efficacy and safety of berberine alone or combined with statins for the treatment of hyperlipidemia: a systematic review and meta-analysis of randomized controlled trials. Am J Chin Med. 2019; 47(4):751-767. https://pubmed.ncbi.nlm.nih.gov/31094214/

[6] Affuso F, Mercurio V, Fazio V, et al. Cardiovascular and metabolic effects of berberine. World J Cardiol. 2010; 2(4):71-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999047/

[7] Bagade A, Tumbigeremutt V, Pallavi G. Cardiovascular Effects of Berberine: A Review of the Literature. Journal of Restorative Medicine. 2017; 6: 37-45.