Liver Problems -- How serious is this?

[GinaRae]

I'm wondering if it really is just a liver cleansing thing or if something more is going on and I need a specialist and possibly lose my homebirth.

I have a history of pre-e (forst two births) and PIH for the third. I thought a better diet and lifestyle would change that this time.

The MWs want me to eat enough protein and drink at least two liters per day. They've never told me how many g's to get in protein per day. One of them said as long as I am getting it three times per day and snacking on things like walnuts, I will be doing what I need to be doing.

The thing I am most non-compliant with is taking Milk Thistle and Dandelion Root and the other pill thingy to help cleanse my liver.

MY SYMPTOMS:

-- My urine is dark, especially the first half of the day, but does lighten some with more water consumation, however, still tends to show some junk in it like protein, bilirubin, leukocytes, ketones, etc. It's gotten better since I upped my water intake for a few days, still darker than pre-pregnancy.

-- I have mild to moderate headaches nearly every day. But that could be hormonal. I don't take Tylenol (because it's bad for the liver) unless I am desperate.

-- I do have general malaise nearly every day, and fatigue. I just feel ill most every day. But geez, that could be just the pregnancy I guess. Then again, it feels like my other pregnancies and I always got sick.

-- I did have hyperemesis again, which can apparently be caused by the liver

-- All over body itchies (not just soles and palms) and it tends to disappear more when I am taking Milk Thistle and Dandelion Root. It's not horrible itching that keeps me awake though, just annoying.

-- I do have upper belly pain (not right quadrant, but along the top) that seems to come and go and isn't excruciating, but hurts mostly when I am up and moving but not all the time.

-- Liver panel a couple of months ago showed my numbers were off

-- Two acupuncturists told me I have a weak liver.

NO SYMPTOMS OF:

-- No jaundice that I can see, no fever, no nausea and vomitting
-- My BP was 120/74 Friday, better than any other MW appointment so far.
-- I have no swelling, no spots in front of my eyes, no rapid weight gain. Usually by 7 months I am swelling and gaining weight quickly. My PIH and toxemia's were diagnosed around 7.5 months. I am 26/27 weeks now, so not quite there.


I guess my thing is, if I am not swelling and there's no high blood pressure... I don't know as it's anything to worry about. With pre-e (and even the PIH had some symptoms) it was different than this because I was swelling, gaining weight, had high BP, spots in front of my eyes....

In your experience, is my liver just having a hard time processing the amniotic fluids/toxins and nothing more, or should I get special tests done for things like HELLP and Choleostasis, etc.

[lorijds]

What do *you* think? Do you feel that there is something going on that needs to be checked out? What about your midwives? What are their gut feelings?

Personally, if it were me, I'd have some blood work done--complete metabolic panel, complete blood count, maybe coagulation studies? I'm not a midwife, I'm a nurse who worked for a while with a midwife. So I'm not an expert.

The reason I would get the tests done is that a) your body has shown that your liver is perhaps compromised, as evidenced by previous issues during previous pregnancies. b) you are having symptoms of liver issues again--the urine, the malaise, the upper abdominal pain, itching, etc. c) bloodwork can take the guessing out of it--if it ISN'T liver issues, wouldn't you feel better knowing that? If it is something with your liver, but your labwork isn't too bad, maybe you and your midwives would be comfortable with periodic labwork in addition to you monitoring your daily symptoms closely; then the labwork could help reinforce what your midwives know by examining you and what you know by knowing your body well.

I guess I'd encourage you to talk with your midwives and decide what is the best course of action for you and your baby to have a healthy pregnancy and birth. It shouldn't be homebirth at all costs; but neither should homebirth be abandoned at the first sign of issues. I hope your midwives and your gut can give you the guidance you need.

Since you are asking for opinions, though, I'd say go with some bloodwork and keep an open, positive mind. Don't throw in the towel, but don't ignore your body's warning signs. To me, your body is giving several signs of possible liver issues, and I wouldn't want to ignore that. However, you know your body best.

Good luck! Whatever happens, keep us posted.

[bryonyvaughn]

A liver cleansing is a very bad idea while pregnant or nursing. The liver stores fat soluble toxins it cannot break down. A liver cleanse would release the toxins into your blood which passes by the placenta before it can get excreted by your body.

That being said your numbers do not a liver cleanse. The bilirubin is evidence of your eating proteins that are doing damage to your blood cells, being carried to your liver, and doing further damage there before they are completely inactivated several days after eating the offending food.

The protein in your urine shows it's affecting your kidneys. The ketones show you are living off your fat and not able to metabolize it completely further gumming up your system. The leukocytes indicate an infection. As you didn't mention nitrites, I'd think it wasn't a UTI.

The headaches, fatigue, vomiting, itching alongside those test results just scream liver. To be honest with you if I had a client walk in with your symptoms and test results, I'd be *very* concerned. The good news is by addressing the root cause, making dietary changes alone or alongside herbal/homeopathic support, I've seen situations like yours and worse turn right around.

Originally Posted by GinaRae

...
-- I have no swelling, no spots in front of my eyes, no rapid weight gain. Usually by 7 months I am swelling and gaining weight quickly. My PIH and toxemia's were diagnosed around 7.5 months. I am 26/27 weeks now, so not quite there.

This doesn't reassure me. These symptoms can develop rapidly if the symptoms you have now is not properly addressed.

In your experience, is my liver just having a hard time processing the amniotic fluids/toxins and nothing more, or should I get special tests done for things like HELLP and Choleostasis, etc.

I think you need intervention to avoid pre-eclampsia and other complications *but* OBs aren't the ones to do it. They have little understanding of liver function, diet, and causes of pre-eclampsia, HELLP, etc. I'd think a good start would be reading about and instituting the blood type diet. At the least it will drastically reduce the ongoing damage to your liver and give it a chance to heal. After you make that change you can buy some strips and monitor your own urine. If your bilirubins are clear you're doing great. If you're spilling more you can then track down the cause. If you want help from someone trained in this area, let me know where you live. I can find folks from Chico to Salinas as well as farther into central CA.

I really don't want to scare you because I've repeatedly seen women in your condition and worse turn right around. I do want to let you know how concerned I am about your results to get you to someone who can help. Most birth attendants have very crude tools to deal with these problems. It's generally take these herbs we give everyone in your situation, drink more water, and eat more protein. Rarely is anything done to learn what specifically is causing the problem.

~BV

[GinaRae]

Lorijds, I don't know WHAT to think. I think something is wrong, but my husband feels I could be overblowing things and between him and the MWs, I am getting lost. I think the MWs feel this is also my fault for not eating/drinking/cleansing enough.

BV, I'm grateful for the long post but it confuses me. I'm supposed to be drinking Dandelion Root and lemon in my water, taking Milk Thistle and there's some other thing I would have to check the bottle.

I think this is just a light, natural way to cleanse the liver. But it could be making it worse? Or passing toxins thru the placenta? I'm a bit freaked about that.

And damaging proteins? I don't eat anything out of the norm. Can you point me to something about that?

I'd like to know about the diet you've mentioned, but unless my insurance covers it, there's no wiggle room for seeing a specialist.

It does seem like right now I am being told to eat more protein, drink more water, cleanse the liver, etc. I don't know what else to do or where to go and breaking away from the MWs to go to an OB probably won't get me anywhere.

Not sure what to do.

I DO have urine strips of my own for testing my urine though. So I can keep watch. But that doesn't do much either.

[doctorjen]

I'd be really worried with your symptoms and test results about cholestasis. I'd be getting repeat liver enzymes (blood work) and bile acids done ASAP. Cholestasis is linked to increased risk of stillbirth. Can your midwife order labs for you? If not, I'd see a doc and get those labs ordered. I think it is important, and many providers - even allopathic OBs overlook cholestasis symptoms or attribute them to more benign conditions, so don't take no for an answer.
Here's a link that talks more about cholestasis. http://www.itchymoms.com/

[bryonyvaughn]

[QUOTE=GinaRae;9025812]Lorijds,...I think the MWs feel this is also my fault for not eating/drinking/cleansing enough.

Originally Posted by GinaRae

BV, I'm grateful for the long post but it confuses me. I'm supposed to be drinking Dandelion Root and lemon in my water, taking Milk Thistle and there's some other thing I would have to check the bottle.

I think this is just a light, natural way to cleanse the liver. But it could be making it worse? Or passing toxins thru the placenta? I'm a bit freaked about that.

Ok. I misunderstood you. I thought you were doing or considering serious liver cleanses that are popular among natural health seekers. Blessed thistle is a mild liver support as is drinking lemon water. I was imagining protocols that include harsh herbs in high doses and fasting, followed by consuming things like acidic beverages (apple cider vinegar/ lemon juice, etc) and quantities of oil and or epsom salt. Those are foolish protocols in any compromised individual.

And damaging proteins? I don't eat anything out of the norm. Can you point me to something about that?

Foods contain proteins and our immune system reacts to proteins. Some proteins are similar to the proteins and sugars on our cell walls and are read by our immune system as "self" so there is no immune response. Others are read as non-self and trigger an immune response.

The lectins that trigger an immune response in a particular individual will clump blood cells. These damaged cells are carried to the liver where they are broken down. Unfortunately the released lectins have an affinity for the vessel walls of the liver and can immobilize previously healthy blood cells passing through. One meal of a "bad for you" food can result in three to five days of spilling bilirubin in your urine.

Fortunately there are foods and herbs one can take which can bind these lectins. When my nearly 6 y.o. was almost one year old he got found and ate some deadly nightshade berries. Not surprisingly his poisoning caused an anaphylactic reaction. Because of my training my first response was for the indicated homeopathic remedy. Within seconds it resolved the screaming and gut pain but didn't touch the breathing issues. I followed up with freshly juiced pineapple, a natural source of bromelain, which broke down the chains of red blood cells (rouleaux) which were clogging his lung capillaries. I was shocked by how quickly after drinking the pineapple juice his abdomen started coming up with every inhalation.

As we have different blood type markers on our cells, we can all react to different foods. My mother gets an immune response from the casein in dairy, I get an immune response to the whey, and I have a friend who can drink milk freely. Everybody's different so there is no way I can tell you what is causing your problem. That's why I suggest you find a knowledgeable clinician in your area.

I'd like to know about the diet you've mentioned, but unless my insurance covers it, there's no wiggle room for seeing a specialist.

I have no idea what sort of insurance you have. There are nutritionists, DCs, NDs, MDs, DOs, and many CAM providers trained in this. Not knowing where you live I can't guess at how reimbursable an appointment would be. As with many health payment issues, also depends on how the visit is coded.

It does seem like right now I am being told to eat more protein, drink more water, cleanse the liver, etc. I don't know what else to do or where to go and breaking away from the MWs to go to an OB probably won't get me anywhere

There is a very consumer friendly book called Live Right for Your Type about the blood type diet. The BTD is the only one I know of that addresses the issues of lectins in food. I think it's the most helpful first (and sometimes only needed) step for patients. It frees up their immune system, destresses the liver, and allows the body to repair itself. Some folks have other issues that need to be addressed individually *but* gets them in a much stronger place where their health issues are much easier to address.

I DO have urine strips of my own for testing my urine though. So I can keep watch. But that doesn't do much either.

You already have a baseline. I only do testing after changes have been made to see the result or if someone's health worsens. Otherwise I think it's just a waste of test strips... even if they are cheap.

HTH,
BV

[GinaRae]

Thanks! Clears a lot of things up. Glad the cleansing things I am doing isn't terrible.


Just trying to wrap my brain around what exactly I need to ask and expect of the MW's, as well as the rest of it.

[heartandhandsdoula]

I had cholestasis with both kids. First was induced at hospital at 38wks 2nd was induced at home at 37wks. The 2nd time my levels were much much higher than the 1st. From the second I started itching I had no fats at all. If I caved I would pay for it with even itchier skin than normal. It can be miserable if you do have it but its not too horrible if you stay away from fats.