Don’t ignore your Liver when you have SIBO!

It has been a couple months since I wrote a blog and I am so happy that my return post will be all about the liver! There are so many different SIBO protocols, but most fail to address the liver.

You may know a little bit about the liver. You may associate liver problems with alcoholism. But, you do not have to be a drinker to have liver inflammation. 

Working with SIBO clients, I see my fair share of liver dysfunction. Most of the time the liver is inflamed and congested, which can leave you susceptible to SIBO. In this post, I will lay out why liver issues can prevent healing.

What is the Liver’s Role?

Let’s get to know the liver! The liver is the organ most well known for its role in detoxification. The liver is responsible for eliminating waste, chemicals and toxins from the body. Other roles of the liver include: storing nutrients, producing bile and processing cholesterol.

The main problem that I am typically seeing in my clients is congestion and/or inflammation in the liver. When you have breakdowns in liver function, digestion takes a hit.

In the modern world, the liver faces new challenges. The increase in toxic exposures from pollution, pesticides, drugs, heavy metals, chemicals in our products and processed foods have made the livers job tougher than ever before! Plus, imbalances in the gut can also put additional stress on the liver. SIBO can drive liver dysfunction.

When your gut is imbalanced, you will produce higher levels of endotoxins. The liver is responsible for eliminating these toxins. If the endotoxin burden is high, your liver can easily become overwhelmed, which leads to liver inflammation and congestion.

The liver’s main defense to help eliminate toxins is glutathione, an antioxidant that packages up toxins and making them less reactive and harmful. Long standing gut issues and high endotoxin levels will deplete glutathione levels leading to lots of inflammation in the liver.

Endotoxins inhibit bile salt and phase 3 transport proteins, which causes bile salts and toxins to accumulate in liver cells. This accumulation of bile acid and toxins cause inflammation and damage to liver cells. Hindering the flow of bile not only causes toxins to build up, but it has a huge effect on digestion, motility and microbial balance in the small intestines.

Poor bile flow is a huge problem in the SIBO space. You can not have a healthy gut without proper bile flow.

Poor bile flow increases risk of SIBO for 2 main reasons. First, bile is an antimicrobial and it helps keep bacteria levels low in the small intestines. Poor bile flow leads to more bacterial growth in the small intestines.

Second, bile also stimulates motility. Poor bile flow slows down motility leaving more time for food and fibers to sit in the gut to be fermented by SIBO bugs. I see many of my clients have improvement in symptoms from just increasing bile flow!

If the liver is overwhelmed by toxins, the cells will try to protect themselves and start dumping toxins back into the blood stream to recirculate in the body and cause inflammation elsewhere.

What are the signs and symptoms of liver issues?  

The symptoms that can indicate a need for liver and gall bladder support are pale stools, fatty stools, blood sugar instability and severe die off reactions. On labs, I look for elevations in the liver enzymes (ALT/AST) and bilirubin levels. A history of gallstones or build up in the gall bladder could also be indicative of a congested liver and gall bladder

Have you ever had die off symptoms? Die off is another sign that your liver is overwhelmed by the toxin burden. I describe die off in more depth in this post. Many try to push through die off symptoms, but this is a mistake. You need to use die off as a sign that your liver needs more help and you need to slow down on any supplements or antibiotics that are driving the symptoms.

A history of environmental toxin exposures like mold or heavy metals could also leave your liver congested and in need of support.

How to Give Your Liver Some Love

Bind toxins from the gut

As described above, endotoxins from the gut can deplete glutathione and hinder bile flow leaving the liver susceptible to congestion. The end goal is to balance out the gut and seal the gut lining so that the endotoxin load in the liver decreases.

My clients often benefit from endotoxin binders that can lower the endotoxin burden on the liver. Binders will bind to endotoxins in the gut which prevents them from being absorbed into the body and ensures that they get excreted out in your poop. With less influx of endotoxins, liver congestion and inflammation will reduce.

There are a number of binders that you can use. A couple options are immunoglobulin formulations like SBI, activated charcoal and clay. Definitely discuss with your provider what binder might be right for you!

Increase Glutathione Levels

Glutathione is pivotal to helping the liver detox toxins. There are a number of ways that you can increase glutathione levels through your diet. Here is a list:

• Eat enough protein (0.5 grams per body weight in lbs)
• Get enough glycine in your diet. Collagen or Gelatin are great sources if tolerated.
• Increase polyphenol rich foods. A good rule of thumb for this is to eat 5-9 servings of fruits and veggies daily. Use herbs and spices liberally.
• Eat enough carbs. Insulin signaling is needed to produce glutathione. Dipping too low in carbs could lead to lower glutathione levels.
• Eat Magnesium rich foods. Or you can supplement

If your diet is really limited,  you may want to supplement with liposomal glutathione to help increase glutathione levels to help open up your detox pathways.

Increase Bile Flow

Bile flow will ensure that toxins are taken from the liver cells and excreted through the bile into the small intestines. Here are strategies that can increase bile flow:

• Bitter herbs can increase bile flow. Milk thistle, dandelion, myyrh and gentian are all good examples. 
• Daily movement is crucial to increasing bile flow. Stay active as much as possible
• Eat enough choline rich foods needed for the production of bile. Found in eggs, liver and beef.
• Green tea can increase bile flow. (only drink if you tolerate caffeine)
• Optimize Circadian Rhythms can help regulate bile production and flow

Limit environmental toxin exposure

Reducing toxins from household cleaners, food, beauty products, hygiene products and more can help reduce back ups in the liver. Here are some tips when it comes to reducing toxins:

• Avoid using plastic containers (use glass water bottles and storage containers)
• Buy organic food when possible
• Filter your water
• Buy non-toxic household products when possible such as detergents and household cleaners
• Buy non-toxic hygiene and beauty products like make-up, body wash, shampoo, conditioner, nail polish, hair products, sunscreen and skin care products
• The Environmental Working group has a great app to help you choose better non-toxic options for you and your family.

Treat any heavy metal or mold toxicities

If you have tried the above and your liver is still inflamed or struggling. You may want to explore the possibility of heavy metal or mold toxins. Working with a provider to rid the body of these inflammatory toxins is critical for SIBO and liver repair.

Bottom Line:

If the liver is inflamed, your detoxification and digestion will take a hit. Liver support during SIBO healing can be very helpful!

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