Liver extract

Category

Herbs & Supplements

Synonyms

Alkaline phosphatase isoenzymes, aqueous liver, bovine liver extract, crude liver extract, cyanocobalamin, hydrolyzed liver extract, hydroxocobalamin, iron, LEx, liquid liver extract, liver, liver concentrate, liver extract lysate, liver factors, liver fractions, liver glandular products, liver hydrolysate, liver substance, purified liver extract, raw liver, Solcohepsyl®, Solcohepsyl® extralysate, subcellular liver fractions, vitamin B12.

Note: Although liver extract contains many constituents, such as vitamin B12, this monograph focuses on liver extract research.

Background

Liver extract and desiccated (dried) liver have been marketed as iron supplements for over a century. The extract is processed cow or pig liver that may either be a freeze-dried brownish powder or a concentrated liquid that has had most of the fat and cholesterol removed.

Preliminary clinical studies indicate that liver extract may be helpful in treating hepatic (liver) dysfunction. In addition, liver extract seems to work synergistically with interferon in treating hepatitis C and other viral infections. More research is needed in these areas.

Laboratory studies indicate that liver extract may have some effects that could be useful in treating certain forms of cancer, such as the ability to direct migration of metastasizing cells and the inhibition of DNA, RNA, and protein formation. More research is needed in these areas to quantify liver extract's properties.

Some concern has been raised about the safety of liver extract, as it is made of animal liver, which may be infected with parasites, bacteria, or prion diseases. Although there are currently no available reports of diseases such as bovine spongiform encephalitis (BSE, or "mad cow disease") being transmitted by liver extract, the U. S. Food and Drug Administration (FDA) still cautions against the use of any animal organ extract. It is not clear how the processing of liver extract affects the transmission of these organisms.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Pernicious anemia: Ingestion of liver increases red blood cell counts, and liver extract (by mouth or by injection) has the same effect. Both liver and liver extract have high vitamin B12 content. Today, pernicious anemia is typically treated with vitamin B12 injections.
Grade: A

Chronic fatigue syndrome: An injectable solution of bovine liver extract containing folic acid and cyanocobalamin has been an advocated treatment of chronic fatigue syndrome. Preliminary study indicates that patients with chronic fatigue syndrome positively reacted to intramuscular bovine liver extract. Additional study is needed to make a firm recommendation.
Grade: C

Chronic hepatitis (hepatitis C): Hepatitis impairs liver function; liver extract has shown liver stimulatory and protective effects. The combination of liver extract and interferon may increase patients' response to interferon therapy alone. However, additional study is needed.
Grade: C

Hepatic disorders: Liver extract seems to stimulate liver function. In two studies, liver extract increased the liver function of patients with impaired liver function. More research is needed to compare liver extract to other hepatostimulatory treatments.
Grade: C

Surgical uses (urological operation adjunct): Liver extract may help maintain liver function during urological surgery. More research is needed to define the importance of this normalization of liver function.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Allergies, anemia, antioxidant, antiviral, blood clots, cardiovascular disease, celiac disease, corneal abrasions/ulcers, deficiency (vitamin B12), detoxification, drug addiction, enhanced muscle mass/strength, gastric acid secretion stimulation, hematopoiesis (stimulation of blood cell production), hepatoprotection, herpes simplex virus type 1, influenza virus infection, malabsorption (familial selective B12), methylmalonic aciduria, multiple sclerosis, obstetric and gynecological disorders, physical endurance, poisoning, renal failure (uremia), rheumatoid arthritis, stamina enhancer, tonic, tuberculosis, wound healing.

Dosing

Adults (18 years and older):

There is no proven safe or effective dose for liver extract. A dose that has been used is 500 milligrams of liver extract 1-3 times per day. As an injection, 2 milliliters of liver extract has been administered daily for up to five days, although injections should only be given under the supervision of a qualified healthcare professional, including a pharmacist.

Children (younger than 18 years):

There is no proven safe or effective dose for liver extract in children, and use is not recommended.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to liver extract or its constituents. Liver extract therapy has caused severe anaphylactic shock. Symptoms of sensitivity may include itching, slight flushing, tachycardia, cough, nasal and ocular discharges, and localized to generalized urticaria ("hives"), weakness, faintness, nausea, vomiting, bronchospasm, asthmatic reaction, substernal pain, collapse, rigor, profound shock, and rarely, death.

Side Effects and Warnings

Few adverse effects have been reported for liver extract, including anaphylactic shock and blood clotting changes. However, raw liver may contain liver flukes or the bacterium Vibrio fetus. The U. S. Food and Drug Administration (FDA) cautions against the consumption of any dietary supplement made from animal glands or organs, especially from cows and sheep from countries with known cases of bovine spongiform encephalitis (BSE, or "mad cow" disease) or scrapie. It is thought that these extracts may contain viable prions that could infect humans. It is not clear how the processing of liver extract affects the transmission of these organisms. Currently, there are no available reports of transmission of BSE through liver extract.

Other possible adverse effects of liver extract may include itching, slight flushing, tachycardia (fast heart rate), cough, nasal and ocular (eye) discharges, urticaria ("hives"), weakness, faintness, nausea, vomiting, bronchospasm, asthmatic reaction, substernal pain, collapse, rigor, profound shock, and rarely, death.

Use cautiously in patients taking antacids or with acid reflux as liver extract may increase gastric acid or pepsin output. Also use cautiously in patients with compromised immune function as liver extract may inhibit lymphocyte proliferation. Use cautiously in hepatopathic patients with reduced human growth hormone metabolic clearance rate, as liver extract may tend to normalize its metabolism.

Use cautiously in patients with clotting disorders as liver extract may stimulate production of red blood cells, affect blood clotting, or improve hemoglobin concentration in patients with impaired hepatic function.

Avoid liver extract in patients with iron metabolism disorders or iron shortage disorders, such as hemochromatosis (a metabolic disorder that causes increased absorption of iron).

Pregnancy and Breastfeeding

Liver extract is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Raw liver may be a possible source of Vibrio fetus septicemia in humans, although there are no available reports of liver extract causing Vibrio fetus septicemia.

Interactions

Interactions with Drugs

Liver extract may increase gastric acid and pepsin outputs. Study results are unclear and caution is advised.

Liver extract may affect blood clotting and may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Liver extract may improve plasma cholesterol levels in patients with impaired hepatic function. Patients taking any cholesterol-lowering medications should use cautiously, as dosing adjustments may be necessary.

Liver extract may reversibly inhibit thymidine and uridine incorporation into DNA and RNA during cell growth and dose-dependently catalyze the removal of O6-methylguanine.

Liver extract may tend to normalize the metabolic clearance rate of human growth hormone in hepatopathic patients. Caution is advised in patients taking human growth hormones. Monitoring may be necessary

Liver extract inhibits lymphocyte proliferation. Caution is advised when combining liver extract with immunomodulating drugs.

Liver extract may increase the antiviral activity of interferon. It may also inhibit herpes simplex virus type-1 and influenza virus type A when used in combination with other antiviral agents.

Liver extract may have a high content of heme iron and antioxidant superoxide dismutase.

Interactions with Herbs and Dietary Supplements

Liver extract may increase gastric acid and pepsin outputs. Study results are unclear and caution is advised.

Liver extract may affect blood clotting, which may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Liver extract may improve plasma cholesterol levels in patients with impaired hepatic (liver) function. Patients taking any cholesterol-lowering herbs, such as red yeast rice, should use cautiously, as dosing adjustments may be necessary.

Liver extract may interact with herbs used as cancer therapies. Although not well studied in humans, caution is advised.

Liver extract may tend to normalize the metabolic clearance rate of human growth hormone in hepatopathic patients. Caution is advised in patients taking herbs or supplements similar to human growth hormones. Monitoring may be necessary.

Liver extract inhibits lymphocyte proliferation. Caution is advised when combining liver extract with immunomodulating herbs.

Liver extract may increase the antiviral activity of interferon. It may also inhibit herpes simplex virus type-1 and influenza virus type A when used in combination with other antiviral herbs.

Liver extract may have a high content of heme iron and antioxidant superoxide dismutase. Liver extract and vitamin B12 may have a therapeutic effect in patients with liver diseases and rheumatoid arthritis.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ashley Brigham, PharmD (Northeastern University); J. Kathryn Bryan , BA (Natural Standard Research Collaboration ); James Ceurvels, PharmD (Northeastern University); Nicole Giese, MS (Natural Standard Research Collaboration); Juliann Goodfriend, PharmD (Northeastern University); Jason Mahoney, BA (Natural Standard Research Collaboration); Audrey Nealon, PharmD (Northeastern University); Rebecca Strauss, PharmD (Northeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Kenneth Triptow, PharmD (Drake University); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Ebinuma H, Saito H, Tada S, et al. Additive therapeutic effects of the liver extract preparation mixture adelavin-9 on interferon-beta treatment for chronic hepatitis C. Hepatogastroenterology 2004;51(58):1109-1114.

Fukuda Y, Sawata M, Washizuka M, et al. [Effect of liver hydrolysate on hepatic proliferation in regenerating rat liver]. Nippon Yakurigaku Zasshi 1999;114(4):233-238.

Ito H, Miyazaki M, Nishimura F, Nakajima N. Haptotactic migration of pancreatic cancer cells induced by bioactive components in bovine liver extract. J.Surg.Oncol. 1998;68(3):153-158.

Kaslow JE, Rucker L, Onishi R. Liver extract-folic acid-cyanocobalamin vs placebo for chronic fatigue syndrome. Arch.Intern.Med. 1989;149(11):2501-2503.

Kondoh K, Imaide Y, Uchida M, et al. [Effect of the administration of liver extract after surgical operations in urology]. Hinyokika Kiyo 1986;32(1):163-167.

Lewis CJ. Letter to Reiterate Certain Public Health and Safety Concerns to Firms Manufacturing or Importing Dietary Supplements that Contain Specific Bovine Tissues. 11-14-2000.

Nappi R. [Clinico-statistical findings on the effectiveness of the combination of iron, liver extract and vitamin B in anemias in obstetrico-gynecological disorders]. Arch.Ostet.Ginecol. 1979;84(3-4):99-109.

Pegg AE, Roberfroid M, von Bahr C, et al. Removal of O6-methylguanine from DNA by human liver fractions. Proc.Natl.Acad.Sci.U.S.A 1982;79(17):5162-5165.

Preziosi P, Nistico G, Marano V. Double-blind study of a total liver extract in patients with hepatic dysfunction. Int.J.Clin.Pharmacol.Biopharm. 1975;11(3):210-215.

Saito H, Ebinuma H, Tada S, et al. Enhancing effect of the liver extract and flavin adenin dinucleotide mixture on anti-viral efficacy of interferon in patients with chronic hepatitis C. Keio J.Med. 1996;45(1):48-53.

Su HL, Huang MH, Yu CL, et al. The mechanisms of inhibitory effects of liver extract on lymphocyte proliferation: II. Inhibition of DNA, RNA, and protein synthesis and their relationship to the effects of metabolic inhibitors. Clin.Exp.Immunol. 1988;72(2):228-232.

Taira N, Yoshifuji H, Boray JC. Zoonotic potential of infection with Fasciola spp. by consumption of freshly prepared raw liver containing immature flukes. Int.J.Parasitol. 1997;27(7):775-779.

Tonutti E, Visentini D, Bizzaro N, et al. The role of antitissue transglutaminase assay for the diagnosis and monitoring of coeliac disease: a French-Italian multicentre study. J Clin Pathol 2003;56(5):389-393.

Tonutti E, Visentini D, Bizzaro N, et al. The role of antitissue transglutaminase assay for the diagnosis and monitoring of coeliac disease: a French-Italian multicentre study. J Clin Pathol 2003;56(5):389-393.

Yokochi S, Ishiwata Y, Saito H, et al. Stimulation of antiviral activities of interferon by a liver extract preparation. Arzneimittelforschung. 1997;47(8):968-974.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.