The gut-liver axis is fast becoming the center stage of functional medicine, highlighting its critical role in everything from detoxification to immunity. This bidirectional communication system between the gut and the liver, mediated by the portal vein and immune signaling pathways, is being re-evaluated for its profound impact on metabolic health, autoimmunity, and even mood disorders.
Why does this matter? The liver processes nutrients absorbed by the gut and detoxifies harmful substances.
But here’s the kicker: a compromised gut (leaky gut and dysbiosis) floods the liver with endotoxins like lipopolysaccharides (LPS). Over time, this overload can trigger liver inflammation, steatohepatitis or non-alcoholic fatty liver disease, and impaired detoxification.
Research reveals that balancing the gut microbiome can ease this burden, preventing liver-related dysfunction.
For example,
Elevated levels of Escherichia coli, a Proteobacteria species with potent LPS in its cell membrane, is associated with non-alcoholic fatty liver disease (NAFLD), newly renamed as metabolic dysfunction-associated steatotic liver disease (MASLD).*
An overgrowth of E coli responds well to a dietary strategy that lowers colonic pH, such as through the use of supplemental lactulose in low doses and an increase in high-fiber whole foods. Additionally there are several herbal antimicrobials, such as pomegranate peel, oregano, thyme, clove and garlic, that can effectively drive down E coli levels.
As these interventions can trigger a temporary increase in the LPS load, using binders alongside the treatment is important.
Interventions that lower colonic pH, such as through the use of supplemental lactulose and increasing high-fiber whole foods or herbal antimicrobials may be needed to drive down levels.
Akkermansia muciniphila, a keystone species, strengthens the gut lining and reduces systemic inflammation, indirectly benefiting liver health.
Butyrate-producing bacteria like Faecalibacterium prausnitzii produce short-chain fatty acids (SCFAs) that regulate inflammatory responses, protecting both the gut and the liver.
Testing your gut microbiome will reveal individual microbial imbalances and inform a target strategy that can then be addressed accordingly. (more on that here)
In the meantime, here are some general actionable interventions:
1. Include more resistant starch in your diet. Add green banana powder or potato starch powder to your smoothies or shakes. Eat more foods such as soaked oats, cooked and cooled potatoes, rice, black beans or rye bread. This helps feed butyrate-producing microbes, supporting gut-liver harmony.
2. Generally include more fiber-rich plant foods in your diet as this lowers colonic pH, making the environment inhospitable to potentially problematic bacteria.
3. Include polyphenol-rich foods, like berries, dark cacao, and green tea as these help modulate gut bacteria, reducing LPS translocation to the liver.
The takeaway: Your liver isn’t working alone. By nurturing your gut, you’re directly supporting one of the most hard-working organs in your body. After all, a healthy gut is a healthy liver, and vice versa.
Links to studies:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11223324/
https://pubmed.ncbi.nlm.nih.gov/23055155/
Be well.
