If your organs had a personality, your liver would be the strong, silent type. No matter how hard it works at filtering out toxins like alcohol and drugs, it doesn't complain until it's on the verge of collapse.
And when we say drugs, we don't mean the illegal kind. We're talking about the dozens of meds with liver-damage potential. The weight-loss aid called orlistat — aka Xenical and Alli — is the latest med that has to include liver cautions on its label.
Luckily for us and you, the liver has a remarkable ability to give itself a makeover. So if you do have a DILI (drug-induced liver injury), stopping the med and treating your liver right — no alcohol, for starters — usually will restore it to health, as long as it was in good shape to begin with.
But since the liver isn't a whiner, the trick is to spot the damage before it makes your skin itch and turns your eyeballs yellow. Some DILI-defending tips:
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* Read the fine print. You know those package inserts with the tiny type. Get out your magnifier and read it. Cautions about liver damage will make you more alert to warning signs (below).
* Don't ignore vague symptoms. Nausea, poor appetite, malaise and just not feeling great — especially shortly after starting a medication — can precede the obvious symptoms.
* Get the tests. Liver-function tests are advised even before treatment begins with some meds, such as terbinafine (e.g., Lamisil), the nail fungus drug. Don't blow them off.
Drop pounds, stop heartburn
Carrying too much fat around your middle and GERD (gastroesophageal reflux disease — think chronic heartburn) go together like walnuts and port. About half of obese people have this miserable condition, called GERD.
Extra fat hanging off the stomach pulls it down, straightening the angle where the esophagus (the tube that carries swallowed food to your stomach) joins it. When there's no angle at that juncture, stomach acid spills upward and burns the esophagus. Pressure on the stomach from deep-belly fat increases the backwash.
Losing even a little weight, since that allows the angle to return, may cure GERD.
That's what happened for 66 percent of people with GERD in a recent study. For obese women, the magic number for improving heartburn and other GI symptoms was losing just 5 percent of their body weight and taking 2 to 4 inches off their waists. Men got relief when they lost 10 percent of their weight and 4 inches from their waists.
Another reason why so many losers got better could be that they replaced most of the calories they used to spend on alcohol, chocolate, fat and other GERD triggers with lots more fruits and vegetables. They also exercised up to an hour, five days a week. And presumably they did what we tell anyone with heartburn to do: Avoid eating within three hours of bedtime. Put blocks under the head posts of your bed so you sleep at a slight downward tilt. And skip other trigger foods, too, like coffee, black pepper, spicy food, tomatoes and orange juice.
Have you had a shingles shot?
We're betting you haven't yet been vaccinated against shingles — the itchy, blistering skin rash that can spin off from chickenpox, only decades later, when you're an adult.
Maybe you've skipped it because you think you outgrew vaccinations the day you waved goodbye to the school nurse. Not true. Several adult vaccines have debuted since then. This one, Zostavax, is aimed at people between the ages of 50 and 70. The shot cuts your risk of shingles in half, and if you do get shingles, the shot makes the painful aftereffects more tolerable.
Afraid of vaccine side effects? You may be a little sore at the shot spot, but serious side effects are rare. Pass it up only if you're pregnant, allergic to gelatin or have a weakened immune system.
From where we sit, the real problem is money. But it's stopping doctors, not patients. A recent survey of 600 physicians found that money was the main reason 12 percent have stopped giving the shot. That's because getting Medicare to reimburse the $200 vaccine cost can be tricky: Only 45 percent of the doctors knew that Medicare Plan D covered some of the costs.
So if you're waiting for your doctor to offer the vaccine, don't hold your breath. Only 41 percent in the survey strongly recommended it. Boy, do we disagree. Nobody wants shingles. Yes, the shot's expensive, but it's a bargain compared to weeks of pain.