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September 7, 2021


Michael Kuefner, PhD (BMS)
Liver Health And The Endocrine System: How Does Liver Health Affect Our Hormones?

Fact Checked By Michael Kuefner, PhD (BMS)
 September 7, 2021

Endocrine System

Our livers have a multitude of functions.

They play a fundamental role in regulating metabolism, secrete bile acids for digestion, storing excess fats, and much, much more.

However, one lesser-known function of the liver is its role in the human endocrine system.

For example, hypo- and hyperthyroidism and other thyroid diseases are commonly associated with poor liver health.

Liver diseases such as hepatitis, liver cancers, cirrhosis, and alcoholic liver disease can cause issues with hormone signaling as well (1).

Other endocrine-related pathologies are related to altered liver function as well, including adrenocortical dysfunction, or deficiencies in adrenaline/adrenal function, and sex hormones like estrogen and testosterone.

This article will discuss the relationship between the liver and endocrine system along with some ways to improve liver health in the context of endocrine/hormonal signaling.


Liver health and adrenal insufficiency

Individuals who experience liver failure have a high incidence and risk for adrenal insufficiency, a disease where the body cannot produce adequate amounts of cortisol, or primary stress response hormone.

Interestingly, the severity of adrenal dysfunction is highly correlated to how severely one’s liver is damaged, indicating the liver is highly involved with cortisol signaling (2).

Adrenal insufficiency is particularly common in individuals who have liver disease and has a prevalence rate between 33-65% in people who have undergone acute liver failure (3).

This percentage rises to 92% in people given liver transplants, which is particularly frightening and these individuals usually require corticosteroids to alleviate adrenal dysfunction (4).

Other studies have been conducted on patients with Addison’s disease, which is a disease characterized by adrenal dysfunction (and insufficient production of cortisol and aldosterone).

These studies have shown that elevated liver enzymes (such as serum aminotransferases) are associated with Addison’s disease and that providing corticosteroids to treat this normalizes these liver enzymes, further highlighting the connection between the liver and hormone levels throughout the body (5).

One question you may be asking is ‘Why is proper adrenal health important?’

The first answer to this is cortisol release.

This hormone is the primary stress hormone, and increases sugar release into the bloodstream when it is necessary (i.e., when the body doesn’t have sufficient amounts of nutrients around to keep it fueled).

Besides this, cortisol provides the brain with sugars when necessary, and functions in fight-or-flight situations as well.

Besides cortisol, aldosterone is another hormone released by the adrenal gland and is the master regulator of salt and water in our body.

This means that it regulates our blood pressure as well – along with other things like nutrient deficiencies like sodium or potassium (eat your bananas!).

Overall, the adrenal system is vastly important for everyday health, and insufficiencies bring about many, many times severe issues like Addison’s disease.

The liver is just one piece of the puzzle when it comes to keeping the adrenal system functioning properly.

Liver Health and Sex Hormones – estrogen, testosterone, and more

The liver is a sex hormone-responsive organ, meaning that it will undergo significant changes in response to alterations in sex hormone levels in the body.

Individuals with decreased testosterone levels and increased estrogen levels have decreased liver function, and the ratio of estrogen:testosterone has been found to increase with declining liver function as well (6).

Moreover, testosterone, dihydrotestosterone, and dehydroepiandrosterone levels in the plasma of people with liver diseases (such as cirrhosis) are reduced, and the degree to which they are reduced is highly corrected with how poor liver dysfunction is (7).

To put this more clearly, the lower your testosterone levels are, the worse your liver is functioning.

Studies have also observed that alcohol-induced liver damage has similar effects on sex hormones in men and women.

In men with alcoholic cirrhosis low testosterone levels and higher estradiol levels have been observed, suggesting that alcohol abuse and poor liver health are associated with fewer sex hormones (7).

Similar results have been seen in women as well – in post-menopausal women with alcoholic liver disease, higher estradiol levels were observed.

Sex hormones, specifically estrogen, are important in males and females because they bind to the estrogen receptors in the liver and regulate numerous metabolic processes.

Clinical studies have even reported that the binding of estrogen to these receptors may be beneficial for preventing the accumulation of abdominal fat in men (8).

In females, estrogen plays a role in regulating the amount of fat deposited into the liver.

This is significant as too much fat in the liver (commonly called fatty liver disease) results in numerous health complications (8).

The importance of estrogen in the context of liver health is highlighted by studies on postmenopausal vs premenopausal women.

Specifically, postmenopausal women typically have higher plasma LDL-C (the ‘bad’ cholesterol) compared to premenopausal women, suggesting that estrogen may regulate lipid deposits into the liver (9).

How to optimize liver health in the context of endocrine signaling?

This is a tricky question, but one particular well-studied, natural liver-support supplement likely benefits the endocrine system and our hormone signaling as well.

This natural substance is the beetroot.

Beetroot is used as a liver support supplement due to its anti-inflammatory and antioxidant capabilities.

However, beetroot extracts also provide dietary nitrates and, thus, increase nitric oxide levels.

Nitric oxide plays a primary role in anabolic hormones and is a major mediator of hormones released in response to exercise (such as stress hormones, pituitary hormones, and more).

Specifically, increased cortisol secretion in response to exercise (to fuel the body with more glucose when necessary) has been observed with increased nitric oxide levels (10).

Concluding Remarks

Amongst its numerous other functions, the liver plays a substantial role in hormonal regulation.

This role is important for daily activities, our fight-or-flight response, and sexual activity.

Maintaining a well-balanced diet, limiting alcohol consumption, and some natural-based liver support supplements are just a few ways to keep your liver functioning properly and keep your hormones at a healthy level.