Doctor tells what tests need to be taken before starting to take a potentially dangerous drug
Most of the medications we take to treat various diseases, as well as most dietary supplements to prevent health problems, are transformed in the liver in one way or another. Therefore, it is the liver that takes on the entire burden of processing drugs, neutralizing possible toxic intermediate metabolites and risks of overdose.
Some drugs, if taken without medical supervision, can gradually destroy and kill the liver. How, explained to “Doctor Peter” Ekaterina Pustovit is a gastroenterologist, hepatologist, and head of the department at the ABIA clinic.
Can drugs kill the liver?
This question sounds fatal. The answer is yes, but don’t get scared ahead of time. Remember the famous phrase of Paracelsus: “Everything is poison, everything is medicine; the dose determines both”? In fact, this statement originally had a different message, but today let the simplified version remain, so that we do not get immersed in idle discussions about the benefits and harms of medicinal substances.
Considering the metabolic activity of the liver in relation to biochemical processes, it can be said that there are no drugs that could not damage the organ under certain conditions. Any drug, even one that seems completely safe at first glance, can harm the liver. This could be homeopathy, vitamins or dietary supplements, not to mention more serious drugs.
Damaged immediately or gradually
Some drugs cause acute liver damage, changes occur almost immediately. Depending on the susceptibility of the organ, problems can occur even with the first pill. But most often this occurs within the first 90 days of taking it.
Treatment with drugs for more than a year can lead to chronic and sometimes irreversible damage to hepatocytes – liver cells. Therefore, any drugs should be taken on the recommendation of a doctor and under his strict supervision.
Severity of damage
How much damage the organ will undergo will depend on:
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from the properties of the drug itself – dosage form, dose, route of administration, etc.;
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from the individual qualities of the patient – genetic predisposition, comorbidity (many chronic diseases and medications taken), age, gender, food preferences and bad habits (alcohol).
The incidence of drug-induced liver injury is not precisely known.
It is clear that there is an increase in drug-induced liver damage due to uncontrolled use of dietary supplements and weight loss products. Today, many chemicals are known with proven hepatotoxic effects.
The expert is sure that we still don’t know much about liver problems, because even green tea, if consumed in excess, can lead to an increase in AST and ALT levels.
The most dangerous drugs
The most dangerous are:
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hormonal drugs,
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antibiotics,
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lipid-lowering drugs.
Not to mention the “heavy” special drugs for the treatment of infectious, oncological or autoimmune diseases.
In 1978, scientists proposed dividing substances:
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to obligate hepatotoxicants, which predictably damage liver cells in absolutely everyone;
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damaging to the organ only in predisposed people – idiosyncratic.
Symptoms of liver damage can vary from no complaints at all to a combination of fatigue, fever, loss of appetite, weight loss, nausea, vomiting, abdominal pain, itching, rash, jaundice, and changes in urine and stool color.
How to determine if the liver is suffering?
Early diagnosis of liver damage caused by drugs is prognostically important, so it is better to take AST, ALT, total and direct bilirubin, alkaline phosphatase tests before starting to take a potentially dangerous drug, with repeated monitoring of these indicators two weeks after starting to take the drug, and then every month for the entire period of treatment with a course prescription.
If signs of liver damage are detected, the potentially dangerous drug should be discontinued immediately, if possible.
Regression of clinical symptoms after drug withdrawal is a clear diagnostic sign of its hepatotoxicity for a given patient. Regression can be long-term (more than 1 month), therefore dynamic monitoring of AST and ALT, alkaline phosphatase and bilirubin levels is necessary.
How to prevent damage
To prevent drug-induced liver damage when prescribing a potentially hepatotoxic drug and to treat already formed liver damage, hepatoprotective drugs are used. The choice of treatment regimen (outpatient or inpatient), drugs for therapy, dosage and duration of treatment is determined by the attending physician.
Remember that any drug or dietary supplement, even one that seems completely safe at first glance, can cause severe liver damage., and do not self-medicate – it is dangerous.
Liver Helpers on Your Table
We told you earlierthat adding certain foods to your daily diet will help your liver and digestive system as a whole. Experts from the Rospotrebnadzor portal “Healthy Nutrition” named such helpers on your desk.
Pumpkin
Its pulp contains substances with a hepatoprotective effect. According to experts, they participate in the construction of the cell membrane of hepatocytes – liver cells, in the exchange of cholesterol and the protection of lipids in the cell membrane from oxidation. These are vitamin A (carotenoids), phospholipids, unsaturated fatty acids omega-3 and omega-6.
Pumpkin is also rich in fiber, which has a mild choleretic and anti-inflammatory effect.
This vegetable will be useful for the liver both baked and boiled. By the way, it will also like pumpkin juice or seeds.
Beet
It is rich in vitamins A, B group (B1, B2, B6, folic acid) and phosphorus, which serve as building material for liver cells.
Fiber stimulates the bile ducts and helps with bile stasis.
Red berries (cherry, raspberry, cranberry)
Red berries contain a lot of carotene (vitamin A), ascorbic acid and dietary fiber – pectin, cellulose.
“All these substances stimulate the growth and regeneration of hepatocytes when the liver is damaged as a result of diseases such as viral hepatitis, alcoholic liver disease, and fatty hepatosis,” says Rospotrebnadzor.
