Natural Ayurvedic Treatment for Chronic Liver Disease – Herbs, Diet & Lifestyle Tips

Abstract

Chronic Liver disease (CLD) includes a variety of liver disorders that lead to long-term liver damage and impaired function. Common causes include viral infection (Such as hepatitis B and C), alcohol related liver disease, Non alcoholic fatty liver disease (NAFLD), and autoimmune liver conditions. Over time, CLD can progress to severe complications like Cirrhosis, Liver failure, Portal Hypertension, and liver cancer. Symptoms typically include Fatigue, Jaundice, and abdominal pain, which can worsen as the disease advances. Early diagnosis and management are essential to slowing the disease’s progression and improving outcomes. Ayurveda can play an important role in managing CLD. In this article, we will discuss its ayurvedic aspect and its treatment.

Introduction

Chronic Liver disease (CLD) refers to the gradual decline of liver function over an extended period, typically lasting more than six months. This condition impaired essential liver functions such as the production of clotting factors and proteins, detoxification of metabolic waste and bile excretion. CLD is characterised by ongoing inflammation, liver cell damage and attempts at regeneration, which ultimately lead to fibrosis and cirrhosis. Cirrhosis represents the advanced stage of CLD, where the liver’s structure is severely disrupted, leading to the formation of scar tissue, nodules, altered blood vessels, and new blood vessel growth. The process of fibrosis and cirrhosis at the cellular level involve the activation of stellate cells and fibroblasts, which contributes to scar tissue formation, while liver regeneration depends on the activity of hepatic stem cells.

Stages of Chronic liver disease

Chronic Liver Disease Progresses in Four Stages

1. Hepatitis
2. Fibrosis
3. Cirrhosis
4. Liver Failure

Stage one – Hepatitis

This is the initial stage where inflammation occurs in the liver tissue. The liver reacts to damage or harmful substances by trying to heal itself, often through inflammation. While acute Hepatitis is a temporary reaction, chronic hepatitis happens when the injury or harmful substance persists. The Ongoing inflammation leads to excessive healing, which eventually causes scarring.

Stage Two – Fibrosis

As inflammation continues, the liver starts to develop scar tissue. This stage involves the gradual buildup of this scar tissue, which stiffens the liver and impairs its function by reducing blood flow. However, the liver is capable of regenerating some of its tissue, and if the damage slows down, fibrosis can be partially reversed.

Stage Three – Cirrhosis

At this stage, the liver’s scarring becomes severe and permanent. The liver’s ability to regenerate diminishes because there are not enough healthy cells left although cirrhosis is reversible, the progression of liver damage can still be slowed and halted with proper management. Cirrhosis begins to affect liver function, bur symptoms may not be immediately noticeable as the body tries to compensate.

Stage Four – Liver Failure

This is the final stage, where the liver can no longer perform its necessary functions for the body. At this point, the liver is in a state known as “decompensated cirrhosis.” As the liver’s functions break down, the effects are felt throughout the body, leading to severe consequences. Liver failure is a gradual process, and without a liver transplant, it is ultimately fatal.

Causes

The most common causes of chronic liver disease (CLD) include the following

1. Alcoholic Liver Disease

This encompasses a range of liver conditions resulting from excessive alcohol consumption, starting from alcoholic fatty liver (with or without inflammation), to alcoholic hepatitis (which may reverse with acute alcohol cessation), and ultimately cirrhosis (which is irreversible). Individuals with severe alcohol use disorder are particularly at risk of developing CLD, making it the most frequent cause of the disease.

2. Non-Alcoholic Fatty Liver Disease (NAFLD/NASH

Often linked with metabolic syndrome, including obesity, high cholesterol, and diabetes, NAFLD can progress to non-alcoholic steatohepatitis (NASH), leading to liver fibrosis. The metabolic syndrome risk factors worsen the condition, accelerating liver damage.

3. Chronic Viral Hepatitis

Chronic hepatitis B, C, and D are prevalent causes of CLD, particularly in regions like East Asia and Sub-Saharan Africa. Hepatitis C has several genotypes, with genotype 1a and 1b common in Europe and North America, and genotype 3 widespread in Southeast Asia. Without treatment, chronic hepatitis C may lead to hepatocellular carcinoma (liver cancer).

Genetic Causes

1. Alpha-1 Antitrypsin Deficiency is the most frequent genetic cause of CLD in children.
2. Hereditary Hemochromatosis is a disorder where excessive iron absorption occurs due to a mutation in the HFE gene, leading to iron buildup in organs and subsequent fibrosis.
3. Wilson Disease is an autosomal recessive disorder causing copper accumulation in the liver.

Autoimmune Causes

1. Autoimmune Hepatitis involves the destruction of liver tissue by the body’s immune system, often leading to cirrhosis by the time it’s diagnosed, with females being more frequently affected.
2. Primary Biliary Cirrhosis (PBC) is an autoimmune condition where the bile ducts are destroyed, leading to cholestatic jaundice and liver fibrosis. It mainly affects middle-aged women.
3. Primary Sclerosing Cholangitis (PSC), typically associated with ulcerative colitis, results in inflammation and scarring of bile ducts, reducing their size.
4. Autoimmune Hepatitis (AIH) is characterized by chronic liver inflammation, elevated autoantibodies, and is more common in women.

Other Causes of Chronic Liver Disease

1. Drugs: Medications such as amiodarone, isoniazid, methotrexate, phenytoin, and nitrofurantoin can cause liver damage.
2. Vascular Conditions: Budd-Chiari syndrome, which involves liver vein obstruction, can lead to CLD.
3. Idiopathic/Cryptogenic: Around 15% of CLD cases have no identifiable cause.

Symptoms

Signs of chronic liver disease that can be observed during a clinical examination can be categorized into those related to the disease itself, signs of decompensation, and those indicative of specific causes of liver disease. Signs Associated with Chronic Liver Disease:

1. Nail clubbing
2. Spider nevi (angiomas)
3. Gynecomastia
4.  Palmar erythema
5. Testicular atrophy
6. Feminizing hair distribution.
7. Small, irregular, shrunken liver
8. Anemia
9. Caput medusae (Dilated veins around the abdomen, often due to portal hypertension).

Signs of Decompensation:

1. Drowsiness and confusion (Encephalopathy)
2. Hyperventilation (encephalopathy)
3. Jaundice
4. Metabolic flap (asterixis)
5. Ascites
6. Peripheral edema.
7. Bruising
8. Leukonychia
9. Acid-base imbalance

Signs Associated with the Cause of Liver Disease:

1. Parotid enlargement: Swelling of the parotid glands, often due to alcohol abuse.
2. Dupuytren’s contracture: A condition of the hands often linked to alcohol use.
3. Cerebellar signs: Problems with balance and coordination, seen in alcohol-related liver disease or Wilson’s disease.
4. Peripheral neuropathy: Nerve damage, commonly seen with alcohol consumption or certain medications.
5. Increased skin pigmentation: Often observed in hemochromatosis due to excess iron.
6. Liver enlargement: Can be seen in conditions like alcohol-related liver damage, NAFLD, or hemochromatosis.
7. Kayser-Fleischer rings: Copper deposits around the cornea, characteristic of Wilson’s disease.

Diagnosis

To Diagnose Liver disease, healthcare providers begin with a physical exam, reviewing symptoms, diet, lifestyle, and medical history. They may then use various tests :

1. Blood tests: Assess liver function, Enzymes, Proteins, Bilirubin, inflammation,
2. Imaging tests: Ultrasounds, CT scan, MRI reveal shape and sign of inflammation and growth
3. Elastography: measure liver stiffness via USG or MRI
4. Endoscopy: visualizes the biliary tract with a tiny camera and may involve techniques like EUS or ERCP
5. Liver biopsy

Treatment

Treatment of chronic liver disease depends on the specific cause and stage of the disease. Common treatment includes:

Lifestyle changes

1.     Dietary adjustments
2.     Exercise
3.     Avoid Alcohol

Medication

1. Antiviral Drugs
2. Immunosuppressants
3. Diuretics
4. Liver enzyme modifiers

Ayurvedic Overview

In Ayurveda, liver disorders are grouped and termed as Yakrit Vikara. Yakrita means liver and Vikara refers to disorder.
According to Sushruta, the organ liver is formed from the blood (Rakta) during the embryonic stage. It is considered to be the main site of blood. In Ayurveda, Liver disease can be classified under two categories:

1. Yakrit Vriddhi (Enlarged Liver)
2. Mlana yakrita (Decreased function or shrinkage of liver)

Symptoms

In Yakrit vriddhi (Enlarged Liver)

1. Mala Vaivarnya (discoloration of the stool)
2. Asti shoola (pain in joints and bones)
3. Sakthi shoola (Pain in the flanks\ waist)
4. Kasa (Cough)
5. Jwara (Fever)
6. Dakshina bahu Jadya (Numbness in the right shoulder)
7. Aarti (Loss of interest)
8. Lohita Mootrata (yellow or Red discoloration of the Urine)
9. Vid Badha (Constipation)
10. Peeta Akshata (Yellow discoloration of the eyes)
11. Kamla (Jaundice)
12. Toda (Pricking sensation)
13. Daha ( Burning sensation)
14. Shotha (Oedema)

In Mlana Yakrit (Reduced Liver function) :

1. Shakrit Apravriti (Constipation)
2. Pittaalpata (Reduced biliary function)
3. Ati Trishna (Excess Thirst)
4. Avila mutrata (Turbidity of Urine )
5. Kardanma deha prabha (Loss of lustre and complexion)
6. Pandora (Anemia)
7. Adhmana (distention of abdomen)
8. Agnamandya (Loss of digestive capacity)
9. Chardi (Vomiting)
10. Avasaada (Debility)
11. Tiktodgara (Bitter regurgitation)
12. Jihwa Liptata(Coated tongue)

Causative factor

1. Madhyapana
2. Vegadharana
3. Ushna theekshana Ahara
4. Guru abhishyandi bhojana (Heavy and blocking agents)
5. Divaswapna (Day sleep)
6. Ratri Jagarana (Night Awakening)
7. Kshata (Injury)

Treatment

The line of treatment in liver disease is

Panchkarma

1. Vaman (Emesis)
2. Virechana (Purgation)

Herbs used in liver disease

1. Sharpunkha
2. Bhumi Amla
3. Laturohini
4. Kumari
5. Aragwadha
6. Bhringraj
7. Amalaki
8. Draksha
9. Guduchi
10. Punarnava
11. Patola
12. Kiratatikta
13. Bhunimba
14. Daruharidra

Ayurvedic Medications

1. Arogyavardhini vati
2. Kumaryasava
3. Tamalaki Choorna
4. Pathyakatphaladi kashaya
5. Rohitakarishta
6. Trailokyanath Rasa
7. Giloy satva
8. Punarnava mandura
9. Danti Haritaki leha
10. Kumaryasava

Herbal Remedies for Chronic Liver Disease By Planet Ayurveda

Planet Ayurveda is a GMP certified, well-known Ayurvedic company. It focuses on providing herbal supplements and treatments for various health conditions based on the principles of traditional Ayurveda. All their formulations are 100% pure, herbal, chemical free and safe to use. These formulations are prepared under the supervision of MD (Ayurveda) scholars. Planet Ayurveda provides a wide range of natural remedies, using high quality herbs that are sourced and processed with strict quality control measures. They aim at treating a variety of ailments from digestive issues to immune system support. One of their best formulations is Liver Care Pack (Double strength) for chronic liver disease.

Liver Care Pack (Double strength)

Product Description

1. Indian Echinacea capsules

This capsule is a standardised pure extract of Indian Echinacea (Andrographis Paniculata). This capsule has properties of anti-inflammatory support the immune system, helps to detox the liver, and promotes liver health. So it is used in conditions like Chronic Liver Disease.

Dosage: 2 Capsules two times a day after meals with lukewarm water.

2. Yakrit Plihantak Churna

This churna is a herbal blend of Bhumi Amla (Phyllanthus Niruri), Kalmegh (Andrographis paniculata), Bhringraj (Eclipta Alba), Sharpunkha (Tephrosia Purpurea), Kaasni (Cichorium Intybus), Katuki (Picrorhiza Kurrao) etc. This herbal powder helps to support liver function, liver regeneration, reduce inflammation, enhance digestion, and support spleen health. It helps to manage conditions like fatty liver. Hepatitis, Cirrhosis and enlarged spleen. Hence it is used in Chronic liver disease.

Dosage: Boil 1 tsp of this powder in 400 ml of water. Boil it until it remains 50 ml. Strain it and drink the water. Consume this twice a day

3. Phyllanthus Niruri Capsule

This capsule is a standardised pure extract of Bhumi amla (Phyllanthus Niruri). This capsule is hepatoprotective and helps in liver regeneration. Bhumi Amla (Phyllanthus Niruri) has properties like anti-inflammatory,  liver detoxification, and Antiviral properties, so it helps to fight against hepatitis B and Hepatitis C viruses.

Dosage: 2 capsules, two times a day with warm water after meals

4. Liver Detox Formula

This capsule is a standardised extract of Katuki (Picrorhiza kurroa), Punarnava (Boerhavia Diffusa), Kalmegh (Andrographis paniculata), Makoy (Solanum Nigrum), Haritaki (Terminalia Chebula) etc. This capsule aids in maintaining balanced hormone levels in the liver.  By cleansing and fortifying the liver, it supports the elimination of toxins from the body.

Dosage: 2 capsules two times a day after a meal with lukewarm water

5. Arogyavardhini vati

This capsule is pure extract of Haritaki (Terminalia Chebula), Bibhitaki (Terminalia bellirica), Amlaki (Emblica officinalis), Shudh Shilajit (Asphaltum), Shuddha guggulu (Commiphora mukul) etc. All herbs used in this formulation help to detoxify, help in liver regeneration, improve liver function, and have anti-inflammatory action. It also helps to improve digestion and balance liver enzymes.

Dosage: 2 tablets two times a day with lukewarm water

6. Yakrit plihari Loha

This tablet is a pure extract of Shudh parada ( Purified Mercury), Shuddha Gandhak (Purified Sulphur), Loha Bhasama (Bhasma prepared from iron), Abhrak basam (Purified Mica), Tamra Bhasam (Copper Calx), Haridra (Curcuma Longa) etc.  These Bhasams are made by processing metal and minerals in specific ways according to traditional Ayurvedic methods. It helps in strengthening the liver and helps to detoxify. It has regeneration properties so it can be used in conditions like CLD.

Dosage: 1 tablet two times a day with lukewarm water after a meal

7. Livo Plan Syrup

This Ayurvedic Syrup is a pure extract of Bhringraj (Eclipta Alba), Kalmegh (Andrographis Paniculata), Shyonak (Oroxylum Indicum), Rohitaka (Tecomella Undulata), Bhumi Amla (Phyllanthus Niruri), Pitpapda (Fumaria Indica) etc. All these herbs used in this syrup help to detoxify, regenerate the liver. This property helps the liver to prevent further progression of disease.

Dosage: 2 tsp two times a day after a meal

Conclusion

Ayurveda can play a significant role in the management and treatment of Chronic liver disease (CLD). Ayurvedic treatment can help the liver by focusing on detoxifying the liver, reducing inflammation, and promoting liver regeneration. Ayurveda helps to manage disease from its root cause. Ayurvedic Approach emphasizes the importance of improving digestion and metabolism, which can help to reduce the burden from the liver. Panchkarma therapies, classic medications, and Planet Ayurveda’s Liver Care pack (Double strength) have all these properties to heal the Liver.