DEAR DR. GOTT: Could you provide information on an enlarged liver? My doctor says there is nothing that can be done about it. I don’t drink alcohol now and never have.
I also have a herniated disc in my neck C2-5. Is the surgery risky or can I live a normal life without surgery?
DEAR READER: Generally speaking, an enlarged liver is not a disorder within itself but an indication of an underlying problem that may include congestive heart failure, liver disease, such as amyloidosis (abnormal protein accumulation in the liver), Wilson’s disease (the accumulation of copper in the liver), hemochromatosis (iron overload), fatty liver disease unrelated to alcohol, hepatitis A, B or C, infectious mononucleosis, cancer, and still more. Risk factors for enlargement may include the ingestion of large doses of medication and OTC vitamins/ herbs/supplements, poor dietary choices, being overweight, and the excessive consumption of alcohol.
The lower edge of a healthy liver generally extends to the lower portion of the ribs on the right side. It is firm in texture and generally cannot be palpated below the edge of the ribs unless a person is taking a deep breath or if it is enlarged. Diagnosis can often be made simply by a physician palpating the abdomen during examination, through blood tests that determine liver enzyme levels, magnetic resonance imaging (MRI), ultrasound, computerized tomography (CT), or through actual liver biopsy.
Treatment will depend on the cause. This makes it important for your physician or hepatologist to get to the bottom of the problem so the correct steps can begin as soon as possible. You may simply be taking large doses of a particular medication that is the lone culprit. For example, some cholesterol-lowering medications can cause liver values to rise on blood testing. In order for a physician to be assured a person’s liver is not being compromised in an attempt to lower those levels, periodic lab testing should be ordered. Or, you may have read a magazine article on the virtues of black cohosh taken for hot flashes and symptoms of menopause, among other things. And, were that the case, it is an easy fix.
On the home front and while waiting for any test results that may have been ordered, I recommend you review your diet and make changes if appropriate, follow recommended dosing for any vitamins, herbs or other over-the-counter supplements you may be taking and discontinue smoking if appropriate. You don’t indicate whether you work or are retired. Should you be exposed to insecticides, aerosol cleaners, or other toxic chemicals at work or because of other reasons, be sure to wear a mask and gloves and limit that exposure. Some seemingly harmless and possibly helpful supplements such as kava, valerian, the black cohosh, and others can adversely affect the liver so be sure to provide your physician with a complete listing of everything you take, no matter how insignificant they may appear.
With regard to your herniated disc, your orthopedic specialist is your best judge of whether surgery should be performed or not. I am sure no doctor worth his salt would perform the procedure unless he or she felt it would greatly enhance your quality of life and because you do not indicate if your daily living is compromised, I cannot offer a worthwhile opinion.
Readers who would like related information can order my Health Report “Vitamins & Minerals” by sending a self-addressed, stampede number 10 envelope and a $2 US check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
