There’s no organ in your body that works harder than your liver. It’s the largest internal organ (and gland) and is continuously working on over five hundred processes to manufacture proteins, process nutrients, produce hormones, fight infection, metabolize cholesterol and glucose, and more.
Liver damage can occur as the result of:
- alcohol abuse
- aluminum (from cookware; foods and food packaging; air pollution; anti-perspirants, deodorants, and other personal care products; fluoride in tap water)
- excess fat in the liver (“fatty liver”)
- excess iron or vitamin A
- medications: acetaminophen (Tylenol), anti-depressants, statins, antibiotics, antacids, and others (find a list here published by the U.S. National Library of Medicine) (1, 2)
- food: processed foods, excess sugar, artificial sweeteners, too many carbohydrates, high-fructose corn syrup, soda, nutrient deficiency
- chemicals used in: personal care products, agriculture, household products
- smoking cigarettes
- other underlying disease, like Crohn’s and hepatitis
- some herbs: chaparral, comfrey, kava, skullcap, yohimbe, and others (3)
The liver is astoundingly resilient and can withstand a great deal of punishment. It will tell you in subtle ways when you’re overtaxing it. Here are some signs that your liver needs special attention.
12 Telling Signs of Liver Damage
Because it’s so diverse in its function, the liver can be damaged from several sources.
Common diseases of the liver include fatty liver disease, cancer, cirrhosis, drug-induced liver disease, alcohol-related liver disease, and hepatitis.
Many of these conditions of the liver are asymptomatic at their onset.
Being cognizant and mindful of body changes will let you know that there’s damage taking place. Even given its remarkable ability to heal itself, overload can overwhelm.
1. Abdominal Swelling
Ascites is the accumulation of fluid in the abdominal cavity that most often occurs as the result of cirrhosis of the liver.
There are two major causes for the development of ascites: sodium/water retention and hypertension in the veins that pass from the intestines, pancreas, and spleen to the liver.
Inadequate blood flow and inflammation make excretion of sodium from cells more difficult and water therefore accumulates. (4)
This fluid can cause tenderness, cramping, pain, and shortness of breath. Ascites can be present with renal (kidney) dysfunction as well. (5)
2. Abdominal Pain
The liver is located below the lungs and above the stomach on the right side of the body. In addition to potential ascites, an inflamed liver can hurt.
3. Fluid Retention
As mentioned above, high blood pressure and sodium retention causes fluid to build up, even in the absence of ascites. Swelling (edema) of the lower extremities, hands, and face is common when fluid accumulates. Edema in various parts of the body can result from other conditions, such as congestive heart failure, kidney disease, lymphatic system dysfunction, and emphysema. (6)
Occasional or periodic fluid retention that occurs around the menstrual cycle or during pregnancy is common and will usually go away on its own. Edema that worsens or doesn’t go away requires close examination for the cause.
4. Upset Stomach
Everyone experiences an upset stomach now and then due to illness or something you ate. There are many conditions that can make you feel nauseous for an extended period, like pregnancy, food poisoning, viruses, vertigo, and migraines.
Nausea (sometimes followed by vomiting and/or diarrhea) that lasts for several days may be a red flag. Consider what may be causing your upset stomach and see your healthcare provider if it persists. Nausea that comes as a result of liver failure is usually experienced in conjunction with other symptoms.
Cirrhosis and liver failure affect digestion through complex interactions with the lower digestive tract. Part of what causes abdominal pain, bloating, and nausea is reduced gut motility and nutrient absorption. (7) Insulin resistance and inadequate gut bacteria resulting from liver dysfunction add complications. (8)
5. Digestive Problems
Liver damage can lead to intestinal permeability (“leaky gut“), small intestinal bacterial overgrowth (SIBO), and a general slow-down of digestion due to changes to hormone levels and bile production. (9) Changes to toilet habits, lower abdominal discomfort, and chronic flatulence can signal liver distress.
6. Fatigue and Overall Weakness
As the liver gets tired, you might, too. Fatigue almost always accompanies autoimmune hepatitis and is the most common complaint of people with liver disease. The primary reason for general malaise appears to be the disruption of neurotransmission between the liver and the brain due to liver dysfunction.
Other factors that lead to the feeling of fatigue are behavioral, social, emotional, and cognitive in nature. People who know they’re sick are more likely to act sick. Cognitive behavioral therapy can be effective in dealing with the non-physical aspects of fatigue. Although you may not feel like it, regular physical activity is essential:
“…the maintenance of physical activity is of paramount importance. The natural inclination of patients with central fatigue is to decrease physical activity. However, decreased physical activity over time will lead to cardiovascular and muscular deconditioning, which then makes physical activity even more difficult.”(10)
7. Itchy Skin
It may seem weird but liver dysfunction can make your skin itch. Cholestasis is the restriction or stoppage of bile flow from the liver.
Pruritis (skin itching) sometimes occurs along with cholestasis, depending on the magnitude of the condition. The mechanism by which it occurs isn’t fully understood.
It’s theorized that there are steroidal agents produced during the synthesis of cholesterol via an alternate pathway (departing from the normal processing by the liver) that causes irritation and pruritis. (11)
Effective treatment depends on the person. Things to try:
- castor oil
- cannabis cream (12)
- stinging nettle tea
- oatmeal baths
- capsaicin (cayenne pepper)
- apple cider vinegar (raw, organic, unfiltered)
- guava leaves
- essential oils
Bilirubin is a result of the breakdown of hemoglobin in blood cells by bile secreted by the liver.
It’s a waste product that, if it accumulates in the blood, can lend a yellowish hue to skin and/or eyes.
Jaundice is fairly common in newborn babies and is readily relieved by exposure to light.
When it occurs in adults, however, jaundice most often indicates a problem with the liver or an obstructed bile duct. (13)
9. Lack of Appetite
This goes with stomach upset and fatigue: if you’re nauseous, chances are you don’t feel much like eating.The liver is an integral part of the digestive system. If it’s beginning to fail, hormones involved in hunger will be disrupted.
Furthermore, cytokines are proteins that act as messengers between cells. They become activated as part of an immune response.
If the liver has been damaged, you can bet there’s systemic inflammation caused by cytokines that are responding to a perceived threat. Cytokines in the gastrointestinal tract and changes to the stomach’s capacity can lead to loss of appetite (and potentially, eventual malnutrition). (14)
10. Stool Changes
Bilirubin is primarily responsible for the color of your stools. Changes to the color can be caused by many factors, one of which is inadequate bile or bile duct blockage; pale or gray feces is a known sign of this.
Certain medications can also result in pale stools. Bilirubin is what gives feces its normally brown color, so liver dysfunction can cause the change to color that’s symptomatic of cirrhosis, gallstones, hepatitis, tumors, and cysts. If this continues over an extended period, it’s time to talk to a professional. (15)
11. Urine Changes
Liver dysfunction can affect the processing of bilirubin, passing it to the kidneys and excreting it through urine that passes out of the body. Because bilirubin is yellowish in color, dark urine that is brownish/goldish/orangish can be a sign of liver damage. Unusual urine color can be caused by dehydration, too much vitamin A, urinary tract infection, too much protein, eating beets, and other things. See your healthcare provider if this symptom persists.
12. Intestinal Bleeding, Constipation, and Diarrhea
If the liver is significantly damaged, you can expect your bowels (intestines) to be impacted. High blood pressure in the arteries and/or veins going in and out of the liver can cause blood vessels to rupture, with consequent gastrointestinal bleeding. Bleeding can occur at the base of the esophagus, the stomach, or in the intestines. (16) Internal bleeding is bad.
Tumors in the liver can produce hormones that act on other organs; these chemical messengers can affect digestion and cause chronic constipation. (17) Chronic diarrhea can also be a sign of liver cancer. (18)
Your liver is resilient and forgiving but it’s not invincible. Eat right, drink enough water, exercise regularly, drink alcohol in moderation (or not at all), get enough good quality sleep, and seek professional advice if you experience any of the symptoms above. Early intervention for a budding liver problem can arrest and reverse any potential damage.