Consult Dr. Anderson

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8 Mar 2016

END STAGE LIVER DISEASE TREATMENT IDEAS CONT

QUESTION: I have a 71 y.o male patient with Liver failure and d/t his age he is not a candidate for liver transplant… The Liver problem started with Wilson’s dz–> NASH–> now ascites and platelet and CBC dropping low–> they drain ascites weekly and blood transfusion happens every other week now–> Prognosis is 6-12 months maximum He has diabetes and diet is being managed by a nutritionist for past 5 months. Patient’s blood sugar is under control and he is now on vegetarian diet because the blood ammonia level is up. No jaundice yet, hence the medical doctor referred to me saying try alternative route to see if you can preserve the liver. Patient’s goal: Preserve what is left from the liver, stabilize blood and decrease amount of transfusion needed, live longer or at least more comfortable to be able to enjoy grandchildren. What would you do for liver failure?

ANSWER: These are tough as the constitution is kind of a “slowly sinking ship”… That said I have found working from cell stabilization toward specific Tx (i.e. looking at underlying causes) allows those in liver failure to be treated with the least flare up. Also, the allopathic palliative care will support your efforts.

On the first phase of cell support I’d add (one at a time) a good absorbable curcumin, then silymarin, then mixed tocopherols or tocotrienols, and some oral vitamin C. Then you are covering the ReDox compartments and the liver should love that. If tolerated then I’d add ALA both for GSH support and also for metal “shepherding” as well.

Next would be choloretics like whole beet juice and phosphatidylcholine. And if all that is OK then I’d do something to mop up more of the copper and other junk the liver will dump. DMSA can help, and liposomal EDTA or EDTA suppositories are likely best as EDTA has a very high Cu affinity.