The importance of bile for healthy arterial flow (Pt. 1)

We have seen the key role the liver plays in digestion and detoxification: the liver is a digestive organ, makes bile and cholesterol  and it is the body’s major detoxification organ. By breaking down complex chemicals, alcohol, toxins, bacteria and parasites, the liver converts these into less toxic substances. But the liver has hundreds of other functions, each of them connected with different parts of the body. According to Andreas Moritz, author of the book “The liver and gallbladder miracle cleanse”, the liver “With its intricate labyrinth of veins, ducts and specialized cells feeds  the 60 to 100 trillion cells of the body…. supply(ing) these cells with a constant stream of nutrients, enzymes and hormones.” (1)

To perform all of these functions the liver needs to be completely unobstructed. But what happens when this is not the case? Gallstones are a hazard to all these vital tasks because they obstruct bile flow, leading to high levels of toxicity in the liver and ultimately to liver diseases. According to the author, “Liver congestion is among the leading health problems” (1) and in his opinion it is not something that  conventional medicine  considers, not until advanced liver cell destruction shows up as elevated liver enzymes in the blood.

The good news is that it takes many years for this congestion to happen, which means there are many things we can do to prevent this. In this blog, we will look once again at the liver and the gallbladder. We will give special attention to the importance of bile and how it can be key to the health of our heart. We will also look at how the liver influences the entire circulatory system, and how the “Heart and Body Extract” can help keep our liver and gallbladder work properly.

The liver has many jobs

“The liver is the largest gland in the body, weighing up to 3 pounds…It can also be the most complex and active organ in the body.”  (1) A healthy liver receives and filters 3 pints of blood per minute. Most of the filtered waste products leave the liver via bile. The liver also produces 1-1.5 quarts of bile every day. This ensures that all the activities in the liver and in the rest of the body run smoothly and efficiently.

The liver is also responsible for hundreds of other different functions,  the main ones are:

  • Manufacture of cholesterol, an essential building material  of organ cells
  • Manufacture of bile
  • Production of hormones and proteins that affect the way the body functions, grows and heals
  • Manufacture of new amino acids
  • Conversion of existing amino acids into proteins: These proteins are the main building blocks of the cells, hormones , neurotransmitters, genes and so forth
  • Break down of old, worn-out cells and the nitrogen part of amino acids, the byproduct of which in both cases is uric acid, which is excreted through urine
  • Recycling of protein and iron
  • Storage of vitamins and nutrients
  • Growth and functioning of every cell in the body

Reduced bile availability is the source of almost all health problems

In order to perform all of its functions, the liver needs these 1-1.5 quarts of bile per day, anything less than that, as it is the case of gallstones, will dramatically compromise our health (1). Bile availability is so important that the author asserts “Almost all health problems are a direct or indirect consequence of reduced bile availability.” (1)

But, what is bile exactly? “Bile is a “yellow/green aqueous solution…(made up of) bile acids, cholesterol, phospholipids (mainly phosphatidylcholine) and the pigment biliverdin (bili = bile, verdi = green).” (2)

Bile has a key role in digestion.  “Without sufficient bile, food remains undigested or partially digested. For example, to enable the small intestines to digest and absorb fat and calcium from food, the food must first combine with bile. When fat is not absorbed, calcium is not absorbed either, leaving the blood in a deficit. The blood subsequently takes its extra calcium from the bones. Most bone density problems (osteoporosis) actually arise from insufficient bile secretion and poor digestion of fats, rather than from not consuming enough calcium.” (1)

Bile is antimicrobial and antibacterial

This detergent and emulsification ability that allows bile to solubilize fats “also confers potent antimicrobial properties on bile and gives it an important role in the body’s physicochemical defense system.” (2) Bile primarily exerts its antibacterial effects on cell membranes, cells then become shrunken and empty after exposure to bile. “Bile salts at high concentrations can rapidly dissolve membrane lipids and cause dissociation of integral membrane proteins ….This nearly instantaneous solubilization results in the leakage of cell contents and cell death” This antibacterial role bile plays explains why many substances are mixed into bile.” (2) This is the case of:

Immunoglobulin A and mucus, which are secreted into bile to prevent bacterial growth and adhesion.

Tocopherol, which may prevent oxidative damage to the biliary and small intestinal epithelium

Many endogenous substances (endobiotics) may be secreted in bile and undergo enterohepatic cycling (recycling). These include lipovitamins (particularly the biologically active forms of vitamin D 2), water-soluble vitamins (particularly vitamin B 12, folic acid and pyridoxine), all estrogenic steroids, progesterone, testosterone, corticosteroids and essential trace metals. Many other substances like antimicrobials and drugs are also mixed into bile and undergo this enterohepatic cycling. (2)

Bile also functions as an excretory fluid by eliminating substances that cannot be efficiently excreted in urine because they are insoluble or protein bound, like it is the case of cholesterol. (2)

Other jobs bile has are:

  • To maintain normal fat levels in the blood
  • To help maintain proper acid/alkaline balance in the intestinal tract
  • To keep the colon from breeding harmful microbes
  • To feed the body’s cells in the right amounts

Enterohepatic circulation: Bile recycles itself

One of the lesser known extremely important functions of bile is to deacidify and cleanse the intestines. (1) Bile performs this very important role by going from the liver to the intestines in a circular motion up to 10 times a day, (2-3 times for each meal). (3) This is actually where bile recycles itself and as it does it cleanses itself and the intestines. This is what is known as ‘enterohepatic circulation’ (2) and it is of great importance for the health of our digestive system in regards to “microbial defense, maintaining intestinal barrier integrity, setting the microbiome, optimizing detoxification, inhibiting inflammation, promoting fat and fat soluble nutrient uptake, and the regulation of glucose and lipid homeostasis throughout the body.” (3)

It is also the reason why the many toxic substances we mentioned above are usually ‘dumped’ into bile in order to be detoxified too.

While the majority of bile in our body is recycled and put back in use by this process known as ‘enterohepatic circulation’, a small amount of bile is lost in stool everyday. This loss is “compensated by an equal daily synthesis of bile acids by the liver, (which allows) the size of the bile salt pool to be maintained.” (2)

Bile is synthesized in the liver, stored in the gallbladder and secreted into the duodenum

The gallbladder is not essential for bile secretion but it facilitates its storage in preparation for fat digestion. The liver is where bile is synthesized. After synthesis, bile leaves the liver and enters the duodenum at a junction regulated by the ‘sphincter of Oddi’ (2)

Half of this hepatic bile is then diverted to the gallbladder where water and electrolytes are removed and bile is acidified. The other half bypasses the gallbladder and enters the duodenum in order to undergo the continuous recycling we mentioned before (enterohepatic cycling). (2)

When food enters the small intestine, acid and partially digested fats stimulate secretion of two hormones that are important for the secretion and flow of bile: ‘secretin’ and ‘cholecystokinin’. Secretin stimulates biliary duct cells to secrete bicarbonate and water to expand the volume of bile. Cholecystokinin (cholecysto = gallbladder, kinin = movement) stimulates contractions of the gallbladder and the common bile duct. As a result, the gallbladder contracts, the sphincter of Oddi relaxes, and up to 80% of the gallbladder contents are discharged into the duodenum. (2)

Bile acids are 50% of the content in bile

Bile acids constitute approximately 50% of the organic components of bile. They are synthesized in the liver from cholesterol by a multienzyme process.  “All bile acids are conjugated with either glycine or taurine before secretion….for this reason both taurine and glycine conjugates are often called ‘bile salts’.” (2) Conjugation is a process by which a substance is bound to an acid in order to deactivate it and make it water soluble, thereby facilitating their excretion (1). Bile acids then “promote concentration of bile” (2)

Bile acids emulsify fats and act as ‘lipid carriers’

“Bile acids play an essential role in digestion by emulsifying and solubilizing fats. Bile acids are secreted into bile…and mix with phosphatidylcholine and cholesterol. When bile enters the small intestine, phosphatidylcholine is hydrolysed and absorbed and cholesterol precipitates from solution enhancing its elimination. …Bile acids…have (a) detergent action on particles of dietary fat, which causes fat globules to break down or be emulsified into minute, microscopic droplets…. Emulsification greatly increases the surface area of fat, making it available for digestion by lipases, which cannot access the inside of fat droplets.” (2) This is a very key aspect of fat digestion, it basically means that without bile, even if we are supplementing with digestive enzymes, fats cannot be completely digested.

“Bile acids also function as ‘lipid carriers’ in that they can solubilize lipids …and thus allow their transport in an aqueous environment, which is critical for the absorption of fats and fat-soluble vitamins… In addition, … the ability of bile acids to act as detergents also allows them to interact with bacterial membrane lipids thereby conferring potent antimicrobial properties on bile. ” (2)

“Decreased concentrations of bile acids in bile may also result in bile being supersaturated with cholesterol and may lead to the formation of gallstones.” (2)

Gallstones prevent bile from flowing in sufficient amounts 

“The gallbladder is a sac-like organ that expands to the size and shape of a small pear when full” (2). A normal gallbladder generally holds about 2 fluid ounces of bile. Also, the gallbladder adds mucus to bile, which turns it into a thick, mucus-like substance with a different consistency than that from the liver. Its high concentration makes bile the powerful digestive aid that it is.

The muscular walls of the gallbladder contract and eject bile when acidic foods and most protein foods enter the duodenum from the stomach. This is even more the case if the food is high in fat. The body uses the bile salts contained in bile to emulsify the fat and facilitate its digestion. Once the bile salts have done their job and left the emulsified fat for intestinal absorption, they travel on down the intestine. Most of them are reabsorbed in the small section of the small intestine (ileum) and carried back to the liver. Once in the liver the bile salts are collected again in the bile and secreted into the duodenum.

Diminished bile salts concentration in the bile causes gallstones and leaves large amounts of fats undigested, this is hazardous to the intestinal environment. Gallstones in the gallbladder may contain cholesterol, calcium, pigments such are bilirubin, bile salts, water mucus, toxins, bacteria, and sometimes dead parasites.

“Gallstones  in the liver and gallbladder continuously block the liver’s bile ducts, …thus prevent(ing) the necessary amounts of bile from reaching the intestines” (1). Lack of sufficient bile will interfere with:

  • The digestion of food
  • Elimination of waste
  • Detoxification of harmful substances in the blood
  • Maintenance of the nervous and endocrine systems and all other parts of the body

Gallstones are ‘sticky’ hardened bile

As we have seen in previous blogs, gallstones are a lifestyle problem. Food toxins and food chemicals, heavy metals, drugs, etc all can add up and increase toxicity in the body. These toxins have to be detoxified in the liver,  and leave the liver via bile. Too many of these toxins will not only overload the liver’s detoxification abilities, but also the  bile system. Bile then can become ‘sticky’ and saturated with its unabsorbed constituents. Since they cannot be filtered, they begin to harden, which is what gallstones are.

In the same way, a diet high in processed carbohydrates will force the liver to manufacture extra cholesterol. In normal circumstances cholesterol is dissolved in bile, but when there is too much, it can precipitate out of the bile solution and come out as crystals, causing gallstones.

“Because these stones are congealed clumps of bile or organic matter, they are practically ‘invisible’ to x-rays, ultrasonic technologies and CT. Only when excessive amounts of cholesterol-based stones, or other clumps of fat, block the bile ducts of the liver may an ultrasound test reveal what is generally referred to as ‘fatty liver’…A dilation of bile ducts caused by larger and denser stones or by clusters of stones may be detected more readily through magnetic resonance imaging (MRI)” (1). In the case of the gallbladder, tests can more easily detect these hardened stones with X rays or ultrasound. (1)

Gallstones can cause diseases of the gallbladder and bile ducts

Gallstones can be very painful, condition known as ‘biliary colic’. Gallstones can also cause irritation and inflammation of the lining of the gallbladder and bile ducts, condition known as ‘cholecystitis’. Ulceration of the tissues between the gallbladder and the duodenum or colon is also common and is known as ‘fistula formation and fibrous adhesions’.

Gallstones can cause many diseases of the liver

“A healthy liver and immune system  are perfectly able to destroy viral material…however, when large amounts of gallstones are present, the liver becomes congested and toxic.” According to the author Andreas Moritz, all liver diseases are preceded by extensive bile duct obstruction caused by gallstones. Gallstones distort the liver lobules, subsequently, blood circulation to and from these lobules and the cells of which they are composed, becomes increasingly difficult. Under these conditions, the liver cells have to cut down bile production and nerve fibers become damaged. Prolonged suffocation due to the presence of stones eventually damages or destroys liver cells and their lobules. Fibrous tissue gradually replaces damaged cells, causing  further obstruction and an increase in pressure  on the liver’s  blood vessels. If the regeneration of the liver cells does not keep pace with this damage, liver cirrhosis is imminent.

As opposed to liver cirrhosis, liver failure can be reversed once the cause for blockage is removed, whether it is alcohol, drugs or gallstones. Liver failure occurs when cell suffocation is so severe that the liver’s vital functions cannot be carried on. Once the cause is removed, cells grow again and the liver can return to normal.

Acute hepatitis results when whole groups of liver cells begin to die off. Because gallstones harbor large quantities of viral material, this can invade and infect liver cells, causing cell degenerative changes. As gallstones increase in number and size and as more cells become infected and die, entire lobules begin to collapse and blood vessels begin to develop kinks. This greatly affects blood circulation to the remaining liver cells. The extent of the damage that these changes have on the liver and its overall performance largely depends on the degree of obstruction caused by the gallstones in the liver bile ducts. Cancer of the liver only occurs after many years of progressive occlusion of the liver bile ducts.” (1)

When the movement of bile through the bile channels (canaliculi) is blocked, and the liver cells can no longer conjugate and excrete bile pigment (bilirubin) there is a buildup in the bloodstream of both bile and the substances from which it is made. As ‘bilirubin’ begins to build up in the blood, it stains the skin, causing the characteristic color.

Gallstones can also harbor many live viruses. Some of these break free and enter the blood, condition  known as ‘chronic hepatitis’.

What other consequences can we find for the presence of gallstones?

The liver loses its ability to detoxify any harmful substances in the blood: chloroform, alcohol , drugs, etc. The presence of these toxins can cause the body to develop hypersensitivity to these toxic substances. Many allergies stem from such conditions of hypersensitivity

The liver cannot deliver the proper amounts of nutrients and energy to the right places in the body at the right time. This upsets the delicate balance in the body, known as ‘homeostasis’,  leading to disruption of its systems and stress on its organs. A clear example of such a disturbed balance is an increased concentration of the endocrine hormones estrogen and aldosterone in the blood. These hormones, produced both in men and women, are responsible for the correct amount of salt and water retention. These hormones may not be sufficiently broken  down  and detoxified. Their high concentration in the blood causes  tissue swelling and water retention  which causes toxins and harmful waste matter to accumulate in various parts of the body and further congests the pathways of circulation and elimination.

Gallstones interfere with digestion and increase toxicity

Gallstones in the liver and gallbladder drastically reduce the secretion of bile, which weakens the ability of pancreatic enzymes to digest carbohydrates, proteins and fats, and prevents the small intestine from absorbing fats, calcium and vitamin K. Vitamin K, as we have seen, is used by the liver to produce the compounds responsible for the clotting of the blood.  In case of poor vitamin K absorption, hemorrhagic disease, heart disease, osteoporosis and cancer may occur.

Calcium is also essential for bone and teeth, coagulation of the blood, muscle contraction and some other vital activities. Poor bile secretion can undermine the uptake of calcium, vitamins A, E and D. Vitamin A in low levels can damage the epithelial cells of all the organs, blood vessels, and lymph vessels. Vitamin A is also important for eyesight and to reduce microbial infection.

What is more, and as we have seen in previous blogs, undigested food tends to ferment in the small and large intestines. In order to speed up the process of decomposition, they attract a great number of bacteria. The breakdown products and the  excretions produced by these bacteria are very toxic, all of which irritates the mucus lining (the body’s main line of defense against disease causing agents). These toxins also impair the body’s immune system, mainly located in the intestines. When the small and large intestines are burdened with a great amount of toxins, different digestive disorders  can occur like Crohn’s disease and ulcerative colitis.

All of these situations we have listed can lead to complex diseases such as congestive heart failure. This will be explained fully in part 2.

References:

(1) Moritz, Andreas. The Liver and Gallbladder Miracle Cleanse: An All-natural, At-home Flush to Purify and Rejuvenate Your Body. Berkeley, CA: Ulysses, 2007. Print.

(2) http://femsre.oxfordjournals.org/content/29/4/625.full

(3) https://hackyourgut.com/2016/11/11/the-most-important-thing-to-know-if-you-have-ibs/

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