Your liver not only acts as a filter for your blood, but it also produces hormones, stores energy, and makes compounds that allow your gut to digest food. And those are just a few of its many essential duties.
Considering your liver’s outsize role in keeping you hale and healthy, you’d think even small problems with it would stand out. But that’s not the case, says Bruce Bacon, MD, a professor of internal medicine and chair of gastroenterology at the St. Louis University School of Medicine.
“Hepatitis C used to be called the ‘silent epidemic’ because many people who had it weren’t aware of it,” Bacon explains. By the time you’re showing signs or symptoms of liver problems—whether due to hepatitis, fatty liver disease, or something else—chances are good that cirrhosis has already set in, he says.
Cirrhosis is a type of serious liver deterioration that results from a long-standing disease or injury, says Jamile Wakim-Fleming, MD, a liver disease expert at Cleveland Clinic. Think of cirrhosis as arthritis of your liver; once it settles in, you’re in trouble. Patients with liver cirrhosis are at significant risk for liver cancer and may eventually require a transplant, Wakim-Fleming says.
Fatty liver disease—which often goes hand in hand with obesity—is the most common cause of liver issues, Bacon says. “Some estimates suggest up to 25 million people have fatty liver disease,” he adds. The various forms of hepatitis, as well as excessive drinking, are other common causes of liver problems, he says.
Drinking in moderation, sticking to a healthy diet, and getting plenty of exercise is your best defense against liver problems, Wakim-Fleming says. Bacon also recommends regular checkups with your doctor, which can allow him or her to spot blood markers of unrecognized or impending liver issues. There are also a handful of common symptoms associated with liver disease. If you experience any of these, get yourself to a doctor on the double.
Feeling sore, swollen, or achy in the “right upper quadrant” of your abdomen is a sign your liver might be in peril, Bacon says. While your liver spans most of your abdominal cavity, it’s shaped like a wedge, and its fat end is housed on your right side. If it’s damaged or inflamed, you may feel it there, he says.
Yellow eyes or skin (jaundice)
When your body breaks down old blood cells, one of the byproducts created is a yellowish compound called bilirubin. While a healthy liver has no problem disposing of bilirubin, a diseased liver allows bilirubin to build up in your blood, which can turn your skin and eyes yellow, Wakim-Fleming explains. This is jaundice. “Dark urine and light feces are also signs of jaundice,” she adds.
Arthritis-like joint pain, nausea, vomiting, fatigue, and loss of appetite are all interrelated symptoms of liver disease—particularly autoimmune hepatitis, Wakim-Fleming explains. Autoimmune hepatitis is a condition in which your immune system mistakenly attacks the cells and tissues of your liver, and it’s more common in women than men, according to the National Institutes of Health.
If your liver is not properly cleaning your blood, you could have clotting issues near the surface of your skin, Wakim-Fleming says. These sorts of clotting issues can result in “spider angiomas,” or large skin blemishes that resemble spiders or asterisks, she explains. “They’re common on the chest and torso,” she adds
A diseased liver can allow too much copper to build up in your blood and brain, Wakim-Fleming says. “This can lead to Alzheimer’s-like confusion,” she says. She adds that this sort of confusion is associated with advanced-stage liver disease, meaning it’s unlikely to be the first (or only) symptom you experience if your liver is in trouble.
An oversize belly or swollen ankles coupled with skinny, weak arms and legs could result from fluid imbalances caused by a diseased liver, Wakim-Fleming says. This muscle wasting can also show up above your cheeks and around your temples, she says. But again, these are late-stage liver disease symptoms—and not something you’re likely to notice one day out of the blue.