Take your liver out for a run

Mind Your Body of the Straits Times dated Apr 21, 2011

Take your liver out for a run

In the last of a four-part fortnightly series on the liver, CHIA HUI JUN looks at how you can take care of the organ by maintaining a healthy lifestyle

Many people think nothing of popping a painkiller or two for pain or fever. Doctors say that it is safe if taken in proper dosages but using too much over-the-counter medication may be bad for one's liver.

Exceeding the daily recommended dosage can cause injury to the liver and, in severe cases, liver failure, said Dr Yeo Chong Meng, a consultant at Tan Tock Seng Hospital's gastroenterology and hepatology department.

In a study in 1998, paracetamol or acetaminophen accounted for almost 48 per cent of drug overdose cases seen at National University Hospital.

Dr Yeo said the maximum dose an adult can have is two 500mg tablets of paracetamol every 6hours and not more than eight tablets a day.

Ingested paracetamol is broken down in the liver into a potentially dangerous metabolite. This metabolite is detoxified by joining with a small protein substance called glutathione, also produced by the liver.

When someone overdoses on paracetamol, the liver's glutathione supply will be depleted. Thus, the potentially dangerous metabolite remains as a toxic by-product, causing liver damage.
As most medications are broken down by enzymes in the liver, the liver is more susceptible to toxicity caused by drugs.

People with liver disease have a lower threshold for drug overdose, said Dr Cheong Wei Kuen, a gastroenterologist at Mount Elizabeth Hospital.

Thoughtless use of drugs is one of a number of lifestyle habits that could affect the liver.
To maintain a healthy liver, one should also have a balanced diet and exercise regularly, as obesity and excess alcohol consumption increase one's risk of getting fatty liver disease.
When someone drinks too much alcohol, more alcohol is processed in the liver, resulting in increased amounts of intermediary compounds of alcohol breakdown.

These intermediate products will interfere with fat metabolism, causing more triglycerides to be produced in the blood, said Dr Lui Hock Foong, a gastroenterologist at Gleneagles Hospital. Trigylcerides are a form of fat stored in the liver and other parts of the body.

Exercise is like 'taking our liver out for a run', said Dr Yeo.

A study has shown that vigorous exercises may lessen the severity of fatty liver disease more effectively than moderate-intensity exercises, so high-intensity exercises like fast runs are beneficial for those with the condition, said DrBen Tan, head and senior consultant of Changi Sports Medicine Centre at Changi General Hospital.

Dr Tan recommends that those who are middle-aged, overweight or have chronic diseases and may not be able to handle vigorous exercises do moderate-intensity exercises instead. These include brisk walking or cycling at least 30 minutes per day, five days a week.

Under stress, the body releases 'stress hormones' like adrenaline, which increase inflammation in tissues, said Dr Desmond Wai, a gastroenterologist at Gleneagles Hospital.

Some studies have shown that stress worsens liver disease, such as hepatitis B, by increasing liver inflammation, said DrYeo.

Doctors also advise against risky sexual behaviour and smoking.

Having unprotected sex and multiple sex partners can put one at risk of getting hepatitis B, as the virus is spread through blood or bodily fluids like semen, Dr Yeo said. Chronic hepatitis B is one of the leading causes of liver cirrhosis and liver cancer in Singapore.

Studies have shown that smoking can increase the risk of liver cancer, especially for men and long-term smokers of 20 years or more, Dr Wai said.

Early liver damage usually has no warning signs. By the time patients experience symptoms like fatigue, weight loss, yellowing of the eye, swelling of the leg and recurrent infection, the damage is already serious, doctors said.