HEALTH REMEDIES: LIVER AND GALL BLADDER

Deficient Liver

The liver and kidneys are the organs that "age" us. When your liver is
deficient, your blood plasma becomes dry and loses both oiliness and
sweetness. A Vata condition, your blood will be thin and lacking in fats,
proteins, and sugar. Nourishment to your tendons and blood vessels is
curtailed, your joints become stiff, and muscles become spasmodic and
numb. A deficient liver can aggravate anxiety & worry. Liver deficiency can
also create shakiness and erratic emotions. Most nutrients pass through
your body without being assimilated if the liver is weak. In this case your
liver should be restored and nourished.

Liver Deficiency in strongest in Autumn. The most likely time of liver

deficiency is August through September.

Foods to nourish and restore the liver

 Almonds, almond milk

 Ghee, coconut oil

 Carrots, sweet potatoes, beets

 Applesauce

 Licorice root, ashwagandha, shatavari

Congested Liver

Conversely when your blood plasma is too rich with sugars, fats, or
proteins, your blood becomes thick and the lymphatic system congested.
Due to the thickness and richness of blood, your liver and gall bladder
become congested, a Kapha condition. A congested liver leaves you
feeling sluggish, the muscles flabby and lacking in tone, and causes weight
gain. Liver congestion creates suppression of emotions. As the gall
bladder becomes stagnant, there may be sludge or gallstones. In this case
the liver should be cleansed with cholagogues. Eliminate all liver and
kidney weakening foods such as white flour, white sugar, dairy especially
cheese & ice-cream, & deep fried foods. Avoid cold drinks and foods which
chill the liver and kidneys.

Liver congestion is most likely in the the spring. You may experience

waves of bitterness, discouragement and a sense of failure in February.
Try not to take these 'liver' emotions too seriously. Instead, these
emotions offer an important cue. February is the month of liver
bitterness.

February comes at the bitter end of winter, the time of ashes. The natural
environment offers slim pickings this time of year and the pantry is nearly
bare. Early spring is the hardest month for animals in the wild. Anxiously
awaiting the hope and promise of spring, lovers will make a last ditch
effort on Valentine's Day to resurrect the dying embers of affection.

Blood remains stagnant due to cold temperatures. However, the body is

already releasing fats in preparation for spring. The result is stagnation
and congestion of the liver & gall bladder. Gall bladder attacks are more
common in early spring so favor cholagogues at that time in your diet to
flush out bile sludge. Gall Bladder Tonic is a perfect early spring tonic.

Cholagogues & Liver Cleansing

Cholagogues encourage the gall bladder to release bile, and the the liver
to produce and dilute bile. This action cleanses both the liver and gall
bladder, and helps to prevent gallstones. Since bile is fatty and the
primary pathway for cholesterol metabolism, releasing bile also reduces
cholesterol and boosts fat metbolism. Cholagogues directly reduce
triglycerride levels in the blood. Cholagogues include anything bitter or
sour. Some famous examples include.

 beets
  dandelion

 lemons

 vinegar

 aloe vera

 bhumyamalaki

 Gall Bladder Tonic

 Tikta Ghrta

Toxic Liver

The liver is responsible for neutralizing toxicity. Sources of toxicity and

liver stress could be due to environmental toxins, recreational drug use,
chronic infection, or fermentation of food in the digestive tract. If the liver
lacks the strength to detoxify the blood, the toxins will be released
through the kidneys & skin, causing rashes, & bladder infections. A toxic
liver can make a person angry and aggressive. Avoid tomatoes & gourds
which have mild toxicity. If the source of liver toxicity is fermentation in
the small intestine, the intestines should be cleaned with triphala, amalaki,
or haritaki.

The Liver, Inflammation & Heat

The liver and gall bladder are generally the home of Pitta dosha. The liver
is an irritable organ. The first sign of liver irritation are stinging eyes,
aggression and intense emotions such as anger, jealousy, and envy.
Advanced signs include yellow hands or eyes, or other heat related
conditions such as rashes. In hepatitis or liver inflammation, liver enzyme
levels in the blood are elevated because of the ruptured liver cells which
contain high contents of liver enzymes. Avoid citrus fruits, cinnamon,
chocolate, caffeine and other hot, spicy foods that irritate the liver. Avoid
tomatoes and reduce any conditions that increase the toxic burden on the
liver. The summer is the most likely time of liver heat & irritation. Lifestyle,
foods and herbs that cool the liver:

 Foods high in beta carotene

o Carrots

o Sweet potatoes

o Butternut squash

o Beets

o Purple cabbage

o Pomegranate

o Blueberries

o Grapes

o Raisins

 Astringents such as

o Raw apples

o Rose petals

 Applesauce due to malic acid

 Cilantro, amalaki

 Guduchi, milk thistle are hepato protectives

 Moon bathing

Liver & Emotions

When balanced, the liver regulates the graceful flow of blood physically
and emotions mentally. The liver is the most emotionally sensitive organ
and its weakness is often connected to emotional instability. The liver,
when disturbed, is emotionally reactive and sensitive. It is a proud organ
and easily insulted by intensity and imperfection. Pitta drive & discipline
often aggravates and exhausts the liver, with the result that Pitta is
Ayurveda's most volatile dosha. Pleasant, soothing remedies help calm a
distrustful, paranoid liver.

Liver and Blood

In Ayurveda, the liver is said to generate the red part of the blood (rakta
dhatu). Yet, western medicine says blood is made in the bone marrow.
How can these differences be resolved? Bile components are produced in
the liver from broken down red blood cells (a mala or waste product of
blood). Some of these bile components are released into the blood, which
"heats" up the blood as bile components are generally a bit irritating.
When excess, these bile components can also cause some yellow
discoloration of the skin, eyes, and teeth, a condition called choleric heat
in Greek medicine. This 'heat' can be said to active the blood, and even
blood production. Thus, the liver creates rakta.

In this process, the liver and spleen have a functional relationship. The
spleen is said to store red blood cells, and can be compared
metaphorically to a "sack of rubies." The liver, on the other hand,
regulates blood sugar and sugar storage, and can be compared to a "sack
of potatoes." This is why the liver gets fatty when the diet is rich.

To recap, the liver creates heat in blood plasma (rasa) which is yellow in
color. This heat stimulates rakta, which is red in color. The spleen is pure
rakta. The function of rakta is to supply oxygen to all the cells, which keeps
metabolism strong, as a fire burning brightly.

Conclusion

The liver is called the liver because it is essential for living. Your ability
to assess and maintain liver health is essential to your well-being.
FALL LIVER DEFICIENCY

By August, your body is preparing for fall and using all available energy to
build an insulating layer of fat before the temperatures plummet mid
October. Meanwhile, sweating under the hot midday sun depletes
electrolytes. The result is that your blood will be depleted of sugars, fats,
fluids and electrolytes throughout August and September. Since the liver
is responsible for stabilizing blood sugar levels, and the kidneys maintain
electrolyte balance, this condition is called 'Vata in the liver and kidneys'.
Anxiety, insomnia, and spaciness ensue. Your body will be vulnerable to
any overexertion. Dehydration leaves your prone to indigestion. As this
condition advances, Vata in the Liver and Spleen leads to anemia (rakta
dhatu deficiency)

HOW TO EXAMINE YOUR LIVER & GALL BLADDER

One way to check your liver is to touch it. Start at the end of your floating
rib. Straighten the fingers of your right hand, put them together and make
them stiff as a board. On your next exhale wedge your fingers up &
behind your rib cage. Maintain pressure on inhale keeping mild pressure
on fingers there, supported by your left hand if necessary.

On the inhalation, the diaphragm pushes your liver down. If your liver is
swollen, as in hepatitis, you will feel the tip of the liver hit your fingers.
When the liver is swollen, it may hurt as well. You may feel referred pain at
various points in the upper abdomen.

In similar fashion you can palpate your gall bladder. Use the same
procedure as liver, but at midpoint between zyphoid process and floating
rib. If you have gall stones, you will feel tenderness during this procedure
(Murphy's Sign). You might even feel some refereed pain behind the right
shoulder blade. Some people even use this technique to wring out gall
bladder by sliding their finger over it from right to left.
Other Tips to Assess Your Liver

The liver opens in the eyes. Actually, any organ that has many blood
vessels, like the eyes, is sensitive to changes in the liver. If your eyes are
bloodshot, yellow in the corners, or stinging, your liver may be under
stress. Liver stress also causes you to feel irritated, or emotionally intense.
Liver congestion will make you feel frustrated.

Some liver pathologies can be life threatening. A medical doctor might

have your liver enzymes checked. If you suspect something is wrong with
your liver, please seek the advice of a qualified medical doctor.

DIET AND HERBS FOR HEALTHY BILE PRODUCTION

How Much Fried Food Can you Handle?

French fries & funnel cakes are a fun way to enjoy the local fair. Eat too
much though, and you start to feel queasy. This is a sign you've hit your
upper limit on fried foods. Uggh! The hot sun continues to beat down on
you as the food churns in your stomach. So, how much fried food can you
digest? How much is too much? The answer has to do with your bile.

Bile kick starts the digestion of fat. It is made in the liver and then makes
its way into the gallbladder where it is concentrated and stored.
Understanding how bile works in the body and assessing your bile
production can help you make an informed decision about funnel cakes
and fries, and support better fat metabolism.

When your french fries reach the small intestine, stored bile is released
and mixed with the fries to break up large fat globs into small droplets for
easy digestion (a process called emulsification). Fatty, fried food demands
alot of bile production from the liver. If you overdo your fry intake, there
might not be enough bile to emulsify the fat and you could end up with a
nausea and/or diarrhea. These symptoms don't exactly scream pass the
ketchup...
Bile also happens to be an important pathway for cholesterol metabolism
which is good because fatty, fried foods increase cholesterol. Stimulating
bile flow can help lower cholesterol, which is how some herb formulas
like Bitter Ghee work to help those with cholesterol problems. Stimulating
bile flow also flushes your gall bladder, preventing it from getting clogged
up with stones. In a country where 1/2 million people lose their
gallbladders annually and 1/3 of the population has high cholesterol -
these facts make bile a hot topic.

Kapha people tend to have thicker bile that gets congested in the gall
bladder, which leds to gallstones. Too much fried, fatty foods increases
the likelihood of stone formation. When bile is congested you may end up
with side effects like headaches, nausea, indigestion, constipation after
you eat a meal high in fat. Congested bile also causes poor fat digestion
and metabolism.

If you produce too much bile, it will irritate your intestines, give you
diarrhea, and also overstimulate your mind. The dosha most closely
associated with increased output of bile is Pitta. Pitta people are therefore
more prone to bile excess. Your body also tends to produce more bile in
hot summer months. So, reducing bile production is key to less irritability
when the weather is hot.

Vata tends to be deficient in bile due to dryness. Vata bile is thin.

Whether congested, too much, or too little, healthy bile production is

essential to healthy digestion of fried foods, and health in general.

What is Bile Like?

Bile (also called gall / bile acids / bile salts) is a green/yellow alkaline fluid
produced by the liver and stored in the gallbladder. If you felt it, it would
be oily and slimy to the touch. Ayurvedically, bile is hot, sharp and oily.
The tastes associated with bile are bitter, sour, pungent and salty. As
mentioned it is related to Pitta dosha and the elements of fire and water.
Bile is responsible for giving poop a cinnamon brown color. When bile
output is low, the stool color fades, turning a cardboard color. If bile
output is very low, your stool may be oily, shiny and float because it's full
of undigested fat.

Bile salts and bilirubin are the main active ingredients in bile. Bilirubin
itself is a byproduct of the breakdown and recycling of red blood cells.
Otherwise, bile is composed of 97% water, 0.7% bile salts, 0.2% bilirubin,
0.51% fats (cholesterol, fatty acids and lecithin) and 200 meq/l inorganic
salts. Bile is important for the absorption of fat soluble nutrients like
vitamins A, D, K and E.

However, as a surfactant and detergent, bile salts and acids are toxic to
cells. Bilirubin is a fiery substance that aids the inflammatory process,
thins the blood, and contributes to the breakup of mucus. When the liver
is under stress, these components of bile are released into the
bloodstream, irritating the body (a condition called choleric heat in Greek
medicine). This is why liver stress leads to increased Pitta. Bilirubin is the
substance that makes your skin and the corners of your eyes yellow,
which are cardinal signs of high Pitta.

Bile also irritates the intestines. This is why too much bile in the intestines
leads to the Pitta condition of soft stools and diarrhea, while too little
leads to constipation.

One of the liver's main functions is detoxification of the blood. The liver
excretes the "conjugated" toxins from two phases of liver detoxification
through the bile, including carcinogens, xenobiotic chemicals,
pharmaceuticals, heavy metals like mercury, aluminum and lead. Flushing
this toxic bile directly reduces Pitta dosha and refreshes the liver.

Bile is recycled and reused 4-6 times daily. Bile release is stimulated
hormonally by the release of cholecystokinin in the duodenum.
 What is the Cycle of Bile? What is the Cycle of Bilirubin?

 Produced in the liver  Hemoglobin is made from iron

for the production of red blood
 Secreted into the biliary ducts cells (RBC) in the bone
marrow.
 Stored in the gall-bladder
 Red blood cells live 120 days
 Released into the duodenum
on average.
when you eat fats
 Dead red blood cells are
 Reabsorbed by the ileum
filtered in the spleen and liver
 Transported back to liver by or broken down by white
hepatic portal circulation blood cells. Hemoglobin is
broken down into iron, or
bilirubin, or secreted in urine.

 The iron is released into the

blood for RBC production.

 Bilirubin is made into bile.

What Do You Do About Congested, Thick Bile Sludge?

Got sludge? When your gallbladder is sluggish, or there is too much
cholesterol in your bile, bile tends to thicken into a substance called biliary
sludge. Formation of sludge precedes stone formation. Once sludge or
stones start to form, the bile may be stuck in the gall bladder.

A tell tale sign of sludge or stones is waking up with spasmodic pain in the
middle of the night after indulging in a fatty meal. Congested bile may
make you nauseous and even vomit. If you experience pain in the right
and central upper abdomen (the area where your liver and gallbladder
are) there could be bile congestion. Pain may also be referred to the right
shoulder blade area. These symptoms are also symptoms of gallstones.
When this happens, take the safe route and go to the hospital to get your
gallbladder checked (usually by sonogram).
The cool, heavy and stable qualities of Kapha can lead to sludge
formation. Often there will be other signs of thick fluids as well, such as
thick saliva or mucus. The skin may be thick, pale and cool to the touch.
Individuals with congested bile may be constipated by the lack of bile flow.

To liquefy and flush bile, use cholagogues. Cholagogues are a class of

herbs and foods that increase bile production and release into the small
intestine. Cholagogues help to flush the liver and gall bladder of
congested bile. Raw beets are a cholagogue, for example, serving to thin
the bile and encourage its healthy flow. Foods with bitter taste are
especially helpful in flushing the gallbladder - so chow down on arugula
and dandelion greens. Green juices often have cholagogue properties.
Herbs like neem, kutki, guduchi, bhumyamalaki and dandelion (root and
leaves) all are all bitter cholagogues. Aloe vera gel or juice is an ideal
cholagogue. Sour taste, such as found in lemons and limes, is also a
cholagogue.

Reduce dietary consumption of oils. A little bit of healthy fats like ghee
and coconut oil are necessary to stimulate the release of bile, but chips,
fries, donuts and the like should be off the menu. Steer clear of red meat,
refined flours and sugars as these thicken fluids and make circulation
sluggish. Instead, eat a high fiber and high protein diet with lots of
vegetables, legumes and nuts. Avoid foods like pizza and sandwiches that
make you feel tired after eating them. Opt for soups and salads instead.

Favor the Kapha pacifying tastes of pungent, bitter and astringent. Some
useful pungent herb formulas include guggulu and shilajit. Grapefruits are
bitter and sour, so they make a great choice for increasing bile flow.
Vegetable juicing - especially with bitter green veggies - can also bring
Kapha back into balance. Drink hot water to help move stagnation.

What Do You Do About Deficient Bile?

Signs and symptoms of deficient bile include sluggish digestion,
constipation, fatty stools, heartburn, pale tongue, pale urine, cold and pale
skin, fatigue, difficulty digesting fat, bloating and hormone imbalance. A
blood test can be used to confirm whether your bile is low.
Deficient bile usually relates to Vata being out of balance by its rough, dry
or cold qualities. The liver may be exhausted or damaged (rough quality).
The liver is dried out due to dehydration (dryness). Or, the liver may be
cold due to poor metabolism or anemia.

Drink plenty of water as bile is primarily composed of it. If you're

dehydrated, your bile production will suffer. You'll also want to stock up
on good fats like ghee, coconut and olive oil to stimulate the production of
bile. Apple sauce is both sweet and sour, nourishing and stimulating the
liver - a win win here. Salt will help increase digestive secretions and calm
Vata. Vata should use digestives like ginger, black pepper, garlic and onion
to warm things up.

What Do You Do About Excess Bile?

Take note of any yellow discoloration in the skin or eyes as this indicates
an excess of bile. Anger and intense emotions are another cue that you're
fired up with extra bile. Diarrhea can be caused by excess bile.

To reduce bile output, avoid alcohol, spicy food, and vasodilators which
can increased blood flow through the liver. Keep your body cool, avoid the
hot mid-day sun and anything that makes you sweat. Astringent taste will
reduce bile secretion.

To reduce yellowing of the eyes, be gentle with your liver by following the
above suggestions, and avoiding caffeine and fatty foods. Coconut water,
blueberries, and other cooling, pitta pacifying foods may be helpful.

What Causes Excess Bile?

In the intestines of a healthy individual, less than .5g of bile acid remains
after re-absorption. When excessive amounts of bile remain, they enter
the colon. There, the bile stimulates water secretion and increased
peristalsis, causing chronic diarrhea. A cardinal sign of excessive bile in the
intestines is chronic soft stool or diarrhea that is not due to parasites,
food allergies, or other causes.
The presence of too much bile in the intestines is caused by several
factors:

 Overproduction of bile

 Continual bile release due to gall bladder removal

 Poor absorption of bile in the intestine

Overproduction
Hot weather causes the heart rate to increase and blood vessels to dilate,
which both exhausts the liver and leads to increased production of bile.
Hemolytic anemias such as sickle cell anemia and thalassemia can lead to
excessive production of bile. This is why individuals with these conditions
tend to be Pitta dominant.
Gall Bladder Removal
Gallbladder removal may result in continual bile release into the small
intestine, irritating it. Bile reflux can irritate the stomach and esophagus.
Poor absorption
Re-absorption of bile is affected by damage to the brush border
membrane of the small intestine. This may be due to food allergies,
parasites, Crohn's, or other conditions.

In pancreatic insufficiency, the duodenum is too acidic, causing bile salts

to precipitate out of solution, making them ineffective for fat digestion
and non absorbable by the ileum. Instead, they are eliminated through
the feces.

Bile is absorbed in the ileum. Surgical removal of the ileum (usually due to
Crohn's) results in excessive bile release into the colon.

Parasites that cause diarrhea may cause bile to be eliminated before it can
be absorbed. Imbalance in gut bacteria may also affect bile digestion,
leading to poor absorption.

Excess elimination of bile eventually depletes the bile acid pool.

Assessment of Bile
Bile Production
Location Deficiency Excess

Digestion (Anna Weak , slow digestion , Strong digestion, Poor

Vaha Srotas) Poor fat metabolism , absorption, Irritation of
Pale tongue intestines, Liver inflammation,
Red tongue

Bowel Elimination Gray stools, Yellow or green Stools,

(Purisha Vaha Constipation, Fatty Diarrhea
Srotas) stools
Bilirubin in the blood
Excessive bile production as well as liver problems can cause his levels of
bilirubin in the blood. Increased bilirubin levels could be caused by
diseases of the liver such as hepatitis or blood disorders like hemolytic
anemia.

Too much bile in the blood looks like high Pitta. Signs and symptoms
include irritability, anger, overly critical, and a yellow discoloration to the
skin and eyes.

New research indicates that bile may play a role in glucose metabolism.
Components of bile acid have been shown to lower glucose levels and
improve glycemic regulation in people with type 2 diabetes. -
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821506/

Location Bile Deficiency Bile Excess

Blood Plasma Cold, pale skin Burning mucus membranes, Yellow

(Rasa) discoloration of skin, Warm skin,
Acne

Red Blood Pale, Lack of Red complexion, Good circulation

Cells (Rakta) enthusiasm, Poor
 circulation

Nerves (Majja) Anxiety, Apathy, Intense emotions like anger and

Indecision frustration, Good discernment, Quick
decision making

Urine (Mutra Pale urine Amber or dark yellow urine

Vaha Srotas)

Sweat (Sveda Lack of sweat Excess sweat, Body odor, Yellow

Vaha Srotas) sweat stains

Your bile production affects more than you might think. Keep healthy by
keeping tabs on how it's flowing.