Now that we’ve gotten so far, some of you might be asking, “what if I eat super healthy, follow your advice, and still don’t have clear skin?” You’re right, it’s not always that simple. Sometimes our liver gets stagnated and needs our help. The health of our liver has a direct impact on the health of our skin.

Why is the liver so important for beautiful skin?

Practically everything that goes through your body gets filtered through the liver. It’s our primary detoxification organ. The liver also regulates, and removes excess hormones from the body. So our liver has a very large role in balancing our hormones.

If the liver has too many substances to breakdown at once, it can suffer from build up and get congested or sluggish at its job. A congested liver will make your skin more prone to acne.

Here’s why: if the liver slows in breaking down toxins, excess hormones, and glucose, these harmful substances get recirculated into your bloodstream, leading to hormonal imbalances and acne.

Our goal should be to make sure there are fewer toxins to process in the first place, so that the liver can work more effectively.

What can cause build up in the liver?

A diet rich in sugar, starches, and carbs – Eating the wrong foods and having too much sugar is as damaging to your liver as too much alcohol. Glucose is the primary thing that turns into fat in the liver, and when your liver stores too much fat, the result is inflammation – which then leads to acne and accelerated aging.

High stress levels – Stress triggers the release of cortisol and adrenaline into the bloodstream, and these hormones increase blood sugar. When levels of glucose (and consequently insulin) are high in the blood, the liver responds to the insulin by absorbing glucose. If too much glucose fills up the liver, the liver then becomes a storehouse for excess glucose, which then turns into fat.

Smoke and air pollution – They don’t just affect your lungs. The liver can be affected as well because it’s your body’s primary detoxification center and too much pollution can easily overwhelm our liver and cause toxic build up.

Lack of exercise – Exercise is a must because it stimulates your metabolism and also reduces fat in the liver. So giving up exercise means you’re forfeiting a part of the solution.  

Poor meal timing – Eating heavy meals late at night mean elevated insulin levels that can lead to the storage of excess fat in the liver.

Fat can start to accumulate in the liver overtime due to these lifestyle habits. Damage done by past dietary choices may also still be lingering in the liver because it was never taken care of.

In medical speak, it’s called Non-Alcoholic Fatty Liver Disease (or NAFLD for short). No, you do not have to be overweight, diabetic, or addicted to drinking to have NAFLD.

It’s quite common.

According to Harvard Health, about a third of U.S. adults have fatty liver.

Let’s take a look at popular dish in French cuisine as our analogy. Have you heard of “foie gras”? It’s a French word for a cooked delicacy made from the fatty liver of a duck or goose. In order to make foie gras, ducks and geese are force fed sugar in the form of corn and starch, and exercise is very limited. Ironically, sugars and starches comprise a large portion of the Standard American Diet (SAD) today.

Essentially, how the liver becomes fat by what is fed to these animals is unknowingly what many acne patients could be feeding themselves, leading to inflammation and possibly serious diseases inside their bodies. Sugars and starches are both broken down to glucose and processed by the liver.

However, if glucose is coming in faster than the liver can process it, the liver will store the excess as fat and the accumulation over time results in a fatty liver.

However, the causes for fatty liver are not just about diet. Research has also recognized that air pollution increases the risk for acne and fatty liver disease. So just by living in a overpopulated, congested city could increase your risk of fatty liver disease even if you are eating healthy otherwise.

However, do not be alarmed: NAFLD is not deadly.

Researchers at John Hopkins Medicine concluded NAFLD does not shorten life expectancy. More study is needed to determine if advanced NAFLD has serious consequences for the liver.

In our first lesson, I mentioned that acne was called “diabetes of the skin” by scientists in the 1950s, because acne patients often had chronically higher glucose levels that lead to increased insulin resistance over time.

And because excess glucose also gets stored in the liver as fat once the liver has more glucose than it should hold, we should not be surprised that a recent clinical study confirmed that insulin resistance is associated with non-alcoholic fatty liver.

Because this of overlap, with insulin resistance being the shared association, it’s reasonable to conclude that acne patients are also more likely to have a fatty liver than those with clear skin.

I understand how some of you are worried, and what to know if you have NAFLD?

A fatty liver is notoriously hard to detect outside of an ultrasound or liver biopsy.

Simple Fatty Liver could progress to non-alcoholic fatty liver disease if the presence of fat is in more than 5% of liver cells. Also fatty liver has nothing to do with your weight, you can be lean and still at risk.

The more cost effective way to know if you are accumulating fat in your liver is to simply look at whether you crave sugars and starches (and how much you consume them on a regular basis). Also, assess your meal timings, stress levels and whether you are getting enough exercise, as mentioned before because those factors also put you at risk. Please note that there could be no signs or symptoms associated with NAFLD.   

If NAFLD is left alone, it could lead to liver scarring and then other complications down the road. So keep your liver in check, not just for acne but for your overall health.

How do you care for your liver? 

Reduce sugars and refined carbs, because too much sugar is as damaging to your liver as too much alcohol.

Increase intake of whole grains, veggies, and lean protein. Anti-oxidants are super important for liver health! Because oxidative stress is a major contributor  to the progression of simple fatty liver to non-alcoholic fatty liver diseases, making sure you get enough daily antioxidants either through food or supplementation in critical.

Exercise stimulates your metabolism and also reduces fat in the liver. Research has shown that resistance training may be an effective way to reduce fatty liver just as aerobic activity is, even if you don’t lose much weight. Studies show that even if resistance training doesn’t make much of an impact on weight, it will make a significant difference in terms of a decline in lever fat levels.

So If you suspect you have fatty liver, studies recommend conducting 40 minute resistance training sessions, three times a week for three months to help decrease fat in the liver.

Meal timing also reduces your risk for fatty liver in a big way as medical research has proven.

The reason why meal timing is so important is because our bodies are more insulin resistant in the evening, and less able to process carb heavy meals during that time. When your body is more insulin resistant in the evening, this means the pancreas needs to pump out more insulin to deal with glucose levels. Whenever insulin increases, it also signals our liver to store more glucose, but when the liver has to go beyond its capacity to store the glucose; it turns the excess into fat.  

In recent study (by the Medical College of Wisconsin), researchers asked test subjects about meal times, skipped meals and the amount of calories consumed during each period as a percent of total daily intake.

So in this experiment The 24-hour day was divided into four intervals: 4am to 10am, 10am to 4pm, 4pm to 10pm and 10pm to 4am.

And here are the results, which are aligned with what we expected. 

Skipping morning (4am-10am) and midday (10am-4pm) meals increased the odds for fatty liver by 20%. And this was in between the 4am to 4pm time intervals. The reason for this increase is that those who skip meals during the day will compensate by overloading with food in the evening, when our bodies are the most insulin resistant.

Consuming a greater percentage of the day’s calories in the morning decreased the chances by anywhere in between 14-21%. This makes sense because our bodies are most insulin sensitive during the morning.

Eating meals late at night in the last time interval from 10pm to 4am, when our bodies are most insulin resistant, increased the probability significantly by 61%. The results from the study ultimately prove that meal timing has a big impact on acne by how it affects our liver health. Increased insulin levels at night not only increases your chances for breakouts, but also your risk for fatty liver disease.

In addition to regular exercise and correct meal timings, you can protect your liver by consuming vitamins C, E, B6 & B12, the herb milk thistle, and the mineral magnesium. Milk thistle was also mentioned in the first week as a herb that has been proven by clinical research to reduce acne.

All of these vitamins and minerals will help the body naturally produce more glutathione, which has been nicknamed “the mother of all anti-oxidants” due to its power.  

Not only does glutathione have anti-aging effects on the skin, it will help reverse the progression of fatty liver because your cells use this compound to detoxify and to protect itself from damage, as well as to repair its DNA.

If addition to those antioxidants we just went over, a compound called N-acetyl cysteine, or NAC for short, takes the spot light as our liver loving supplement for this session. NAC has powerful antioxidant effects in terms of boosting glutathione, which is the most powerful antioxidant produced inside the body, with unmatched detoxification abilities. 

According to Pharmacy Times, NAC is so powerful it’s used in hospitals to prevent liver damage from painkiller overdoses.

Research has shown that a daily dosage of NAC at 1200mg, over 8 weeks can lower acne by 50%. This supplement performed just as well as milk thistle in the same research study. Studies do not recommend going above 1200 mg per day.

As well as making sure you’re getting enough antioxidants, Keeping your body hydrated with water will also help your liver.

Water helps to flush toxins out of the liver and assists the kidneys in filtering waste products so that the liver can focus on getting rid of its own waste.

Water also helps the body metabolize stored fat in the liver. Metabolizing excess fat in the liver reduces inflammation. Because inflammation is behind the root causes of acne, keeping your body hydrated reduces your chances of getting breakouts.

Drinking water throughout the day can be a hard habit to start if you’re used to flavored drinks or coffee. So start small. Since thirst is an indication your body is already dehydrated, the key is to not wait until you feel thirsty to drink water.

Water hydrates every cell of your body, but it takes care of your internal organs first before reaching the skin. That’s why it’s critical to get more than what you feel like you need. Experts recommend to drink up to 6-8 cups of H2O a day to help keep your skin glowing.

Summary

A heathy liver means clear skin and a glowing you. The holistic way is the best way. I do not personally endorse pre-packaged “liver cleanses”, which are highly unregulated and potentially harmful.

To summarize, avoid eating meals between 10pm to 4am. Follow the time restricted eating strategy. This means all your meals must fall within a window of time of 8-12 hours.

If your doctor or medical provider approves, NAC is an optional supplement that can support liver health.

Moderate sugar like you would alcohol for your liver.

Drink water before you feel thirsty.

And last but not least, avoid over drinking.

Over drinking can damage the cells in your liver responsible for the detoxification of your entire body. On top of that, it dehydrates you making your skin look drier. Any temporary redness that you see in your skin is also a sign of inflammation as a result of over drinking. Due to these factors, over drinking on a regular basis can definitely cause wrinkles and signs of premature aging of the skin.

Too much alcohol and acne can go hand in hand because it has the capacity to increase androgen levels, like testosterone, in women. Higher androgen levels are behind hormonal imbalances that lead to clogged pores and breakouts.

When you do drink, avoid drinks with high sugar content or mixing drinks with sugary syrups. High sugar consumption triggers the body to produce more insulin, leading to higher androgen levels and greater androgen sensitivity that are behind acne.

While how much to is too much in regards to drinking can vary a lot with individuals, a good start could look like cutting it down to 1-2 drinks per week while you’re healing your acne holistically.          

Always educate yourself on what you’re putting inside your body and I hope this lesson has guided you that way. By helping your liver, not only are you stopping breakouts, but you’re also stopping accelerated aging that goes beyond the skin.