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FAQs:

What is the Liver?

The liver is a large organ in the abdomen that performs many important bodily functions, including blood filtering. It is also considered a gland because it makes chemicals the body needs. Certain diseases and lifestyles can damage the liver, but there are many ways to protect this vital organ.

What Does the Liver Do?

The liver’s major functions are in the metabolic processes of the body. These include:

1. breaking down or converting substances from food like fats and proteins

2. extracting energy, vitamins, and minerals

3. making toxins less harmful to the body and removing them from the bloodstream

The liver does this by receiving blood with nutrients from the digestive organs via a vein known as the portal vein. The many cells of the liver, known as hepatocytes, accept and filter this blood.

The liver also manufactures an estimated 800 to 1,000 milliliters (mL)Trusted Source of bile a day, which then goes to the small intestine and helps further break down fats. Meanwhile, it also releases ammonia, a toxic by-product of the protein breakdown, through your urine in the form of urea.

What is Liver Support?

Liver support systems are extracorporeal devices that support the regeneration of a patient’s liver and buy time until a suitable donor organ is available.

Where is the Liver?

The liver is located in the upper right-hand portion of the abdominal cavity, beneath the diaphragm, and on top of the stomach, right kidney, and intestines. Shaped like a cone, the liver is a dark reddish-brown organ that weighs about 3 pounds.

How Does the Liver Regenerate?

The liver is truly an amazing organ because it has the capacity to regenerate. This means that after an injury or surgery to remove tissue, the liver tissue can grow back to a certain extent. The liver starts growing back by having the existing cells enlarge. Then, new liver cells start to multiply. In 1931, a study on rats first showed that within a week of removing two-thirds of a rat’s liver, the organ had returned to its initial weight. Other studies have confirmed these findings in rodents, and research has shown that human livers can behave similarly.

What is Fatty Liver?

Fatty liver is when there is too much fate in your liver. It’s common, particularly in people who have diabetes and are overweight. Although it might not cause any symptoms, it can lead to significant health problems. Making changes to your lifestyle is key to preventing and improving the condition.

The liver is the body’s main organ for processing food and waste materials.

A healthy liver contains very little or no fat. If you drink too much alcohol, or eat too much food, your body deals with this excess by turning some of the calories into fat. This fat is then stored in liver cells.

When fat makes up more than 5% to 10% of the total weight of your liver, you have fatty liver.

Fatty liver is becoming more common as people eat more added sugars and added fats. About 1 in every 3 Australian adults has fatty liver disease.

What Causes Liver Cancer?

Liver cancer happens when liver cells develop changes (mutations) in their DNA. A cell's DNA is the material that provides instructions for every chemical process in your body. DNA mutations cause changes in these instructions. One result is that cells may begin to grow out of control and eventually form a tumor — a mass of cancerous cells. Sometimes the cause of liver cancer is known, such as with chronic hepatitis infections. But sometimes liver cancer happens in people with no underlying diseases and it's not clear what causes it.

What is Liver Disease?

Your liver is your body’s second-largest organ (after the skin). It sits just under your ribcage on the right side and is about the size of a football. The liver separates nutrients and waste as they move through your digestive system. It also produces bile, a substance that carries toxins out of your body and aids in digestion.

The term “liver disease” refers to any of several conditions that can affect and damage your liver. Over time, liver disease can cause cirrhosis (scarring). As more scar tissue replaces healthy liver tissue, the liver can no longer function properly. Left untreated, liver disease can lead to liver failure and liver cancer.

Can Liver Disease be Prevented?

You can take steps to prevent some types of liver disease especially those affected by your diet and lifestyle. If you are at risk for liver disease, your provider may recommend lifestyle changes including:

- Avoiding or limiting alcohol.

- Avoiding foods and drinks that contain trans fats or high-fructose corn syrup.

- Carefully managing your intake of prescription and over-the-counter medications to avoid liver damage, as medications like acetaminophen (Tylenol®) are a common cause of liver injury.

- Getting regular exercise.

- Limiting consumption of red meat.

You can minimize the likelihood of contracting viral hepatitis by practicing safe sex and not sharing needles.

How Do I Know If I’m at Risk for Liver Problems?

You may be at risk for liver problems if you:

- Are exposed to chemicals regularly.

- Have overweight/obesity.

- Drink a lot of alcohol.

- Have relatives who’ve had liver disease.

- Practice poor personal hygiene, such as having unprotected sex, sharing personal items and not washing your hands often.

How Common is Liver Disease?

Overall, about 1 in 10 Americans (30 million in total) have some type of liver disease. About 5.5 million people in the U.S. have chronic liver disease or cirrhosis. Some types of liver disease are becoming more common in the U.S. because they are related to rising rates of obesity. An estimated 20% to 30% of adults have excess fat in their liver, a condition called non-alcohol rekated fatty liver disease (NAFD). This may be renamed metabolic-associated fatty liver disease (MAFLD) to reflect its relationship to metabolic syndrome and conditions like diabetes, high blood pressure, high cholesterol and obesity.

Functions of the Liver

The liver regulates most chemical levels in the blood and excretes a product called bile. This helps carry away waste products from the liver. All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood and breaks down, balances, and creates the nutrients and also metabolizes drugs into forms that are easier to use for the rest of the body or that are nontoxic. More than 500 vital functions have been identified with the liver. Some of the more well-known functions include the following:

1. Production of bile, which helps carry away waste and break down fats in the small intestine during digestion

2. Production of certain proteins for blood plasma

3. Production of cholesterol and special proteins to help carry fats through the body

4. Conversion of excess glucose into glycogen for storage (glycogen can later be converted back to glucose for energy) and to balance and make glucose as needed 

5. Regulation of blood levels of amino acids, which form the building blocks of proteins

6. Processing of hemoglobin for use of its iron content (the liver stores iron)

7. Conversion of poisonous ammonia to urea (urea is an end product of protein metabolism and is excreted in the urine)

8. Clearing the blood of drugs and other poisonous substances

9. Regulating blood clotting

10. Resisting infections by making immune factors and removing bacteria from the bloodstream

11. Clearance of bilirubin, also from red blood cells. If there is an accumulation of bilirubin, the skin and eyes turn yellow. 

When the liver has broken down harmful substances, its by-products are excreted into the bile or blood. Bile by-products enter the intestine and leave the body in the form of feces. Blood by-products are filtered out by the kidneys, and leave the body in the form of urine.

Signs of Liver Problems

The liver is a complex organ that performs a range of essential functions. A healthy liver removes waste from the blood, metabolizes fat, and synthesizes hormones. A damaged, diseased, or malfunctioning liver can lead to dangerous, even life threatening consequences.

Hepatitis refers to self-limiting or chronic inflammation of the liver. Hepatitis most commonly occurs as a result of a viral infection. However, alcohol use, exposure to toxins, certain medications, and fat deposits in the liver can also cause hepatitis.

According to the NIDDK, some people may develop symptoms of hepatitis C in 1–3 months and of hepatitis B in 2–5 months. People who have chronic hepatitis may show no symptoms for several years.

Signs of a malfunctioning liver include:

- fatigue

- weakness

- loss of appetite

- unintentional weight loss

- nausea and vomiting

- dark yellow urine

- gray stools

- discomfort in the upper right part of the abdomen

People who have advanced liver damage may experience:

- bleeding and bruising easily

- edema, which causes swelling in the lower legs, ankles, and feet

- fluid retention in the abdomen

- itchy skin

- jaundice or yellowing of the skin and eyes

- confusion or difficulty thinking

- memory loss

- personality or mood changes

Different Liver Diseases

An organ as complex as the liver can experience a range of problems. A healthy liver functions very efficiently. However, the consequences can be dangerous or even fatal in a diseased or malfunctioning liver.

Examples of liver disease include:

1. Fascioliasis: The parasitic invasion of a worm, known as a liver fluke, causes this condition. The liver fluke can lie dormant in the liver for months or even years. Fascioliasis is a tropical disease.

2. Cirrhosis: This sees scar tissue replace liver cells in a process known as fibrosis. Toxins, alcohol, and hepatitis are some of the many factors that cause this condition. Eventually, fibrosis can lead to liver failure because the functionality of liver cells becomes destroyed.

3. Hepatitis: Hepatitis is the name given to a general infection of the liver, and viruses, toxins, or an autoimmune response can cause it. An inflamed liver characterizes this condition. In many cases, the liver can heal itself, but liver failure can occur in serious cases.

4. Alcoholic liver disease: Drinking too much alcohol over long periods can cause liver damage.

5. Primary sclerosing cholangitis (PSC): PSC is a serious inflammatory disease of the bile ducts that results in their destruction. There is currently no cure, and the cause is unknown.

6. Fatty liver disease: This usually occurs alongside obesity or the harmful use of alcohol. In fatty liver disease, vacuoles of fat build up in the liver cells. Nonalcoholic fatty liver disease occurs when alcohol use is not the cause.

7. Gilbert’s syndrome: This is a genetic disorder affecting 4—16% of the population. In Gilbert’s syndrome, the body does not fully break down bilirubin. Mild jaundice can occur, but the disorder is harmless.

8. Liver cancer: The most common types of liver cancer are hepatocellular carcinoma and cholangiocarcinoma. The leading causes are alcohol and hepatitis. It is the sixth most common form of cancer globally and the third most frequent cause of cancer death around the world.

Complications of Liver Failure

Doctors will work to prevent complications, which include:

1. Cerebral edema. Fluid buildup is a problem with liver failure. In addition to your belly, it can also pool in your brain and lead to high blood pressure there.

2. Blood clotting problems. Your liver plays a big role in helping your blood clot. When it can’t do that job, you’re at risk of bleeding too freely.

3. Infections, like pneumonia and UTIs. End-stage liver disease can make you more likely to get infections.

4. Kidney failure. Liver failure can change the way your kidneys work and lead to failure.

How Liver Failure is Treated

Medication.Acetylcysteine can reverse acute liver failure caused by an acetaminophen overdose. But you have to take it quickly. There are also medications that can reverse the effects of mushrooms or other poisons.

Supportive care. If a virus causes liver failure, a hospital can treat your symptoms until the virus runs its course. In these cases, the liver will sometimes recover on its own.

Liver transplant. If your liver failure results from long-term damage, the first step may be to try to save whatever part of your liver still works. If that fails, you’ll need a liver transplant. Fortunately, this procedure is often successful.

4 Vitamins and Minerals for Liver Health

Though there isn’t much research to back up the benefits of liver detox supplements, there are several vitamins, minerals and herbal ingredients that some research suggests may support liver health. Read on for a few ingredients recommended by experts.

Vitamin E

Vitamin E is an antioxidant that may help protect liver cells from oxidative stress. Some research shows that it might also be beneficial for liver function. In fact, one review found that vitamin E could improve liver enzymes in people with nonalcoholic fatty liver disease. However, consuming high amounts of vitamin E can actually be harmful, and advises against relying solely on supplements alone to meet your needs.

Milk Thistle

Milk thistle, specifically its active compound called silymarin, is one of the most well-known supplements for liver health. It has antioxidant and anti-inflammatory properties, which may support the function of the liver. In fact, milk thistle is sometimes used as a complementary treatment for liver conditions like cirrhosis and hepatitis. According to one review of eight studies, silymarin (derived from milk thistle) improved liver enzyme levels effectively in people with nonalcoholic fatty liver disease.

Turmeric

Curcumin, the active compound in turmeric, may have antioxidant and anti-inflammatory properties and could have a protective effect on the liver. One review of four studies reported that high doses of curcumin or turmeric could improve liver enzyme levels in people with nonalcoholic fatty liver disease after eight weeks. What’s more, other research suggests that curcumin can support liver health by reducing inflammation and oxidative stress.

N-acetylcysteine

N-acetylcysteine (NAC) is a precursor to glutathione, which is an antioxidant involved in liver detoxification. NAC has been studied for its potential in treating liver toxicity caused by substances like acetaminophen (paracetamol) overdose. For instance, one 2022 review found that NAC may actually improve survival rates and reduce damage to the liver caused by acetaminophen overdose.

How to Prevent Liver Failure

The best way to prevent liver failure is to limit your risk of getting cirrhosis or hepatitis. Here are some tips to help prevent these conditions:

1. Get a hepatitis vaccine or an immunoglobulin shot to prevent hepatitis A and B.

2. Eat a proper diet from all of the food groups.

3. Maintain a heathy weight.

4. Do not drink alcohol in excess. Avoid alcohol when you are taking acetaminophen.

5. Practice proper hygiene. Since germs are commonly spread by hands, be sure to wash your hands thoroughly after you use the bathroom. Also, wash your hands before you touch any food.

6. Don't share any personal toiletry items, including toothbrushes and razors.

7. If you get a tattoo or a body piercing, make sure the conditions are sanitary and all equipment is aseptic (free of disease-causing germs).

8. Be sure to use barrier protection (condoms) when having sex.

9. If you use illegal intravenous drugs, don't share needles with anyone.

How to Keep Your Liver Healthy

Here are some tips on how to keep your liver healthy:

1. Drink Coffee

People who drink a few cups of coffee a day may be less likely to get liver diseases including cancer and scarring (fibrosis, cirrhosis). It might even slow those conditions in some people who have them. Filtered, instant, and espresso all seem to work. Still, helpful as coffee may be, it can’t take the place of a balanced diet, a healthy weight, plenty of water, and regular exercise for a healthy liver.

2. Don’t Overdo Acetaminophen

It’s in more than 600 meds, including many cold and flu drugs. Most adults shouldn’t get more than 4,000 milligrams per day. More could hurt your liver. Try not to take more than one product with acetaminophen per day, and never take more than what the package instructions recommend.

3. Practice Safe Sex

You want to protect yourself and your partner from conditions that can spread through sex, including many that could eventually hurt your liver. One, hepatitis C, infects it directly and can do serious harm over time. Most people don’t notice they have it until many years later when much of the damage has been done. Your doctor can test to see if you have it.

4. Take Your Meds Right

Though acetaminophen is the most common medication that can harm your liver, other meds can do that, too -- especially if you don’t take them as directed. It may also depend on your genes, other prescriptions, and your food. Speak to your doctor if you’re tired, nauseous, or itchy or you notice yellowish skin or eyes (jaundice) after you start a new medicine. Statins for high cholesterol and certain antibiotics (amoxicillin, clindamycin, erythromycin) are some examples.

5. Check on Your Supplements

They cause almost a quarter of all liver damage. Herbs like borage, comfrey, groomwell, and coltsfoot have “pyrrolizidine alkaloids” that can gum up the tiny blood vessels inside the organ, either over time or all at once (if you take a lot). Other herbs like Atractylis gummifera, celandine, chaparral, germander, and pennyroyal oil (used in tea) can also cause liver problems.

6. Skip Herbal Liver Remedies

Common liver remedies like milk thistle, turmeric, and astragalus don't have much research behind them. Colloidal silver, sometimes used (with little scientific support) for hepatitis C, can cause irreversible side effects like turning your skin blue. Tell your doctor about all pills, herbs, and supplements you take. First, to check on the safety of each item, but also because of how they might interact with each other.

7. Drink Only in Moderation

When you drink, your liver stops doing other things so it can break down the alcohol and remove it from your blood. If you overdo it -- more than a drink a day for women, two a day for men -- it’s really hard on the organ and could hurt it. Over time, this often leads to “fatty liver,” an early sign of disease. It also might cause bad bacteria to grow in your gut that can travel to your liver and cause damage.

8. Eat the Rainbow

That means fruits and vegetables from all the colors of the rainbow, which helps ensure you get all the nutrients and fiber you need. Avoid refined carbs like doughnuts and white bread in favor of whole-grain rice, breads, and cereals. A bit of meat, dairy, and fat can also help. But not too much, and look for “good” (monounsaturated, polyunsaturated) fats from seeds, nuts, fish, and vegetable oils.

9. Keep a Healthy Body Weight

That means working to keep a body mass index (BMI) of between 18 and 25. There are online tools to help you figure out your number. Exercise and a well-balanced diet are the best way to help maintain a good-for-you weight and lower your chances of nonalcoholic fatty liver disease. Your doctor can help you set a weight goal that will help keep your whole body well over the long term.

10. Wash Your Hands

It’s a simple, easy way to keep germs away that could infect your liver. Just a little soap and warm water will do. It’s especially important right before you prepare food and right after you change a diaper or go to the bathroom. You can spread hepatitis A in particular when you touch food or water with contaminated hands.

11. Exercise Regularly

It can help keep your BMI at the right level, which could protect against nonalcoholic fatty liver disease. But even if your BMI doesn’t change, exercise is likely to help. Why? Because it improves how your insulin works and burns triglycerides, a type of fat in your blood.

12. Avoid Toxins

These might be chemicals in cleaning products, spray cans, insecticides, and other household items. They could hurt cells in your liver if you touch, absorb, or breathe in too much of them. You can protect yourself if you wear a mask and goggles and open the windows when you use them.

13. Watch Out for Needle Risks

If you or someone you know has ever injected illegal drugs, you should get tested for hepatitis C, which can spread through blood. The same is true if you’ve had an accidental needle stick. A blood test can let you know if you’ve ever had the hepatitis C virus.

14. Check for Liver Damage

It’s especially important for your doctor to do this if you drink heavily or have a family history of liver disease. Early treatment helps, and you might not have symptoms at first. You should also get tested if you’re more likely to have hepatitis C.

15. Get Vaccinated

You can get it for hepatitis A and hepatitis B, but not for hepatitis C.  A lot of kids have been vaccinated, but many adults haven’t. Talk to your doctor about whether you need it. It might be especially important if your immune system is weak or your liver already shows some damage.

How to Find a Hepatologist

A person’s healthcare professional will typically refer them to a hepatologist if needed. Results from blood tests, imaging, scans, or physical exams, can warrant a referral to a hepatologist. The healthcare professional may also refer them to a specialist based on their symptoms, risk factors, personal, family, or medical history.

A person may also contact a local hepatologist without a referral from their doctor. However, it is best for a person to communicate with their doctors, especially if they are unsure whether their symptoms relate to the liver. Once a person receives care from a hepatologist, the hepatologist will work closely with the person’s doctor.

Sources:

Science Direct

Medical News Today

Forbes Health

WebMD

Cleveland Clinic

Johns Hopkins

Medical News Today

Healthline

Health Direct

Mayo Clinic

 

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.