By Joseph J. Carter, L.Ac.
In a world where environmental chemicals, pharmaceutical drugs, alcohol, and other damaging agents take a daily toll, there is a great need for therapies that protect the liver from injury and facilitate its recovery after it has been harmed.
From the Western scientific viewpoint the liver is the primary site for the biotransformation of everything that enters the body through the walls of the alimentary canal and for most foreign compounds that enter the body via the skin and lungs. The vast majority of these biotransformations are accomplished by complex enzyme systems encapsulated within the endoplasmic reticulum of the liver’s cells. These enzyme systems provide the catalysts that allow useful compounds to be made available to the cells of the body. They are also the body’s main detoxifiers as they transform harmful substances into forms that can be eliminated by the body. These same enzymes can wreak havoc on the liver’s own cells when they are released from the endoplasmic reticulum, a process which occurs when liver cell membranes are damaged due to exposure to injurious substances. The standard measures of liver function and liver damage are SGPT (ALT) and SGOT (AST) 1evels. These are, in fact, measures of the specific liver enzymes that are released into the bloodstream following damage to the liver.
Modern herbal researchers, guided by traditional herbal knowledge and insight, have shown that there are natural plant compounds that are liver protective in nature. It is theorized that these compounds help ensure the integrity of the liver cell membranes and thus protect liver cells from their own powerful enzyme systems through three possible mechanisms. Some of the compounds may compete with toxic substances for available binding sites on the liver cell membrane. Some compounds encourage hepatic circulation, thus limiting the liver’s exposure to toxins. Finally, other compounds encourage more rapid recovery of liver cells after damage by improving liver metabolic function.
Whatever the mechanisms, these natural plant compounds have been shown to reduce the impact of many toxic substances. Laboratory experiments demonstrating the effectiveness of these protective compounds usually rely on countering poisonous substances such as carbon tetrachloride (CCI4), alcohol, and amanita toxin. Some of this research will be mentioned below in our discussion of the herbs that make up Health Concerns’ herbal formula, Ecliptex [now Rehmannia & Milk Thistle formula (2021)]. It should also be noted that many of the materials shown to have liver protective effects are also useful for reducing the impact of viral hepatitis. The same or similar mechanisms of action may well be involved. Of the herbs that make up Ecliptex, one, Silybum, comes to us from European folk medicine, while the rest come from the vast Chinese herbal materia medica.
SILYBUM
Silybum marianum (Milk Thistle) has long been used in Europe for the treatment of liver disorders. Historical records show that the fruits of Silybum were used by the Greeks some 2,000 years ago. The folk uses of Silybum encouraged modern pharmacological researchers in Germany to investigate the herb for possible bioactive components. What they found are a class of molecules called flavolignans. The different flavolignans of Silybum are collectively termed “silymarin”.
The injected silymarin has been shown to protect rats from the deadly effects of alpha-amanitin, the lethal component of Amanita phalloides, the Death Cap fungus. Amanita toxin is one of the most powerful liver toxins known; yet when silymarin is administered before ingestion of the toxin it prevents liver damage. When given up to 24 hours after the toxin is administered, it greatly reduces mortality and the amount of liver damage. It is theorized that silymarin competes with amanita toxin for binding sites on the liver cell membrane, and thus protects the membrane and the whole liver cell by excluding the toxin and preventing the breakdown of the cell membranes with the concomitant release of liver enzymes.
Other research with Silybum shows that it stimulates liver cell protein synthesis by increasing the activity of ribosomal RNA. This leads to higher regenerative capability for liver cells. Thus, Silybum is not only protective, but leads to more rapid recovery for liver cells after they are damaged.
The remarkable effects of silybum spurred further research into plant materials with possible liver protective properties. In this search the highly developed Chinese herbal materia medica was found to be a true treasure house.
Among Chinese herbs, two categories of herbs contain many of the liver protective agents. They are Yin and Blood Tonic herbs and the Blood Vitalizing herbs.
YIN AND BLOOD TONICS
Looking to the Yin and Blood Tonic herbs with liver protective action, we find Lycium fruit (Gou Qi Zi), Ligustrum (Nu Zhen Zi), and Eclipta (Han Lian Cao).
Lycium fruit is the sweet red fruit of Lycium chinensis. Traditionally, Lycium fruit is thought to nourish the Kidney and Liver Yin, to nourish the Blood, and to strengthen the Kidney Essence. It has been used primarily for the treatment of eye problems, for treating impotence, and as one of the primary tonics of Chinese herbalism. Modern research has shown that extracts of Lycium fruit both prevent damage to liver cells exposed to CCL4, and hasten their recovery from exposure as measured by liver function tests and histological examination. Other research has shown that Lycium fruit improves immunological function by increasing reticuloendothelia phagocytosis and encouraging lymphocyte production.
Ligustrum is the whole seed of Ligustri lucidi. Traditionally, Ligustrum is thought to tonify the Liver and Kidney Yin and to preserve the Kidney Essence. Ligustrum has been used to treat premature graying of the hair, weakness of the back and knees, and other signs of aging such as hearing loss and failing vision. Modern research has shown the Oleanolic Acid fraction of Ligustrum to lower the concentration of SGPT in rats exposed to CCI4, and Ligustrum has been used successfully in the treatment of acute icteric hepatitis. Ligustrum also has immune system enhancing effects, having been shown to increase leukocytes depressed by cancer therapies and to promote lymphoblast transformation.
Eclipta (Han Lian Cao) is the above ground parts of Eclipta alba and/or Eclipta prostrata. Traditionally, it has been thought to nourish the Liver and Kidney Yin, and to cool the Blood to stop bleeding. Eclipta has been used to treat tinnitus, premature graying of the hair, and various kinds of bleeding. In the Ayurvedic system of medicine, preparations of Eclipta are used to treat cirrhosis of the liver. According to modem research, an ethyl acetate of Eclipta gave even better protection than silybin (one of the bioactive flavolignans of Silybum marianum) in liver cells exposed to CCI4. That same Eclipta extract also has a significant anti-amanita toxin effect. Leading pharmacological researcher, Hildebert Wagner of Germany, considers Eclipta to be one of the most promising liver protective compounds.
BLOOD VITALIZING HERBS
The Blood Vitalizing herbs with proven liver protective action are Tang Kuei (Dang Gui), Tien Chi (Tian Qi/San Qi), Curcuma (Yu Jin), and Salvia (Dan Shen).
Tang Kuei is the root of Angelica sinensis. Traditionally, Tang Kuei is thought to nourish the Blood, to activate the blood circulation, to act as an analgesic and an anti-spasmodic, to moisten the intestines and colon, to regulate the female reproductive organs, and to detoxify the blood. Tang Kuei is considered the supreme women’s herb due to its regulation of the blood and female reproductive organs. It is extensively used for nourishing the Blood, activating the blood flow, improving the skin tone, regulating menstruation, and treating abdominal pain. While commonly considered both a Yin and Blood Tonic and a Blood Vitalizing herb, its use in Ecliptex falls into the Blood Vitalizing category. This is due to the fact that in this formula it is combined with other Blood Vitalizing herbs and not with Qi Tonic herbs, such as Ginseng and Astragalus, with which it is usually combined if its Yin and Blood nourishing are to be tapped. Modern research has shown Tang Kuei to have a protective effect on rat livers exposed to CCI4. It has been shown to increase the oxygen consumption of murine livers, possibly due to a generalized increase in the liver’s metabolic rate.
Tien Chi (Tian Qi/San Qi) is the root of Panax Pseudoginseng. Traditionally, Tien Chi is thought to both stop bleeding and to disperse static blood. It is commonly used for stopping various types of bleeding arid for resolving blood clots when there is traumatic injury. Modern research has shown Tien Chi to be hemostatic, hemolytic and to promote blood circulation. The saponin components of Tien Qi, saponin A and B, have been shown to lower the SGPT concentration in patients with chronic hepatitis.
Curcuma (Yu Jin) is the tuberous root of Curcuma longa. Traditionally, it is thought to invigorate the Blood and break up Congealed Blood, to dredge the Liver and purge the Gall Bladder, and to help circulate Qi. It has been used in the treatment of hepatitis, jaundice, sharp pains, and spontaneous bleeding. Modern research has shown Curcuma to increase the secretion and excretion of bile. Derivatives of Curcuma called curcuminoids have been shown to reduce SGPT and SCOT levels 50-80% in rat liver cells exposed to CCI4. Curcumin, one of the curcuminoids, has also been shown to be liver protective in vivo using CCI4 induced liver damage in mice.
Salvia (Dan Shen) is the root of Salvia miltiorrhizae. Traditionally Salvia is thought to dispel Blood stasis and activate Blood circulation. Salvia is commonly used in formulas for blood stasis accompanied by heat as may occur in endometriosis, uterine cancers, angina pectoris, irregular menstruation, tubal pregnancy, and skin ailments such as acne, boils and sores. In modem research Salvia has been shown to inhibit the development of cirrhosis of the liver in animals subject to alcohol in their diet and injections of CCI4. SGPT activity of the animals receiving Salvia was significantly less than that of animals not receiving Salvia. Salvia has also been shown to improve hepatic circulation and to enhance the regeneration of liver tissue after injury.
In addition to the Yin and Blood Tonics and the Blood Vitalizing herbs mentioned above, there are four additional herbs in Ecliptex that have each shown liver protective action. They are Licorice
(Gan Cao), Plantago (Che Qian Zi), Bupleurum (Chai Hu), and Schisandra (Wu Wei Zi).
By combining ancient wisdom about plant products that treat the liver and modern research about how these plant products protect the liver’s physiological function, Health Concerns has developed the liver protective formula ECLIPTEX. May you and your patients use it in good health.
*References are from; “Economic and Medicinal Plant Research”, vol. 2 Wagner, Hikino and Farnsworth. 1988 Academic Press Limited, and; “Progress in Clinical and Biological Research”, vol. 213 by Cody, Middleton, and Harborne. 1986 Alan R. Liss, Inc.
Health Concerns does not participate in animal experiments.
Joseph Carter, L.Ac. is a graduate of The Academy of Chinese Culture and Health Sciences. He specializes in Gynecology and Immunology in his private practice.
ENVIRONMENTAL HERBAL FORMULAS Ecliptex is a combination of herbs that protects liver function and helps repair liver damage including that which occurs from hepatitis. A combination of Yin tonics and Qi and Blood circulating herbs offers the best protection for the liver’s function of detoxifying ingested substances. Sylibum, Schisandra, Lycium fruit, Ligustrum, and Eclipta tonify the Yin. Bupleurum, Salvia, Tien-chi, Curcuma, and Tang-kuei promote circulation of Qi and Blood. Eclipta and Sylibum are especially effective in treating liver damage.
Clear Air combines herbs that ventilate the lungs with herbs that dispel phlegm and stop cough, in order to cleanse the lungs of accumulated contaminants from smoking or air pollution. This formula is a variation of the classical formula, Ding Chuan Tang and is also appropriate for asthma, cough with phlegm, and bronchitis. Observe cautions if the patient has high blood pressure or tachycardia. Monitor the patient for sleeplessness or heart palpitations because the formula contains Ma Huang (ephedra).