January 20, 2019

How Do I Know if I Have Liver Damage?

Drugs and alcohol can put an enormous strain on the largest organ in your body: your liver. The liver carries out a number of important functions. These have been summarized in a report by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), titled “Alcohol’s Effects on the Liver”:

filtering bad toxins out of the blood
synthesizing cholesterol
metabolizing and storing sugars
processing fats
storing vitamins
assembling proteins for use in the liver and elsewhere

Damage to the liver compromises and impairs these critical functions, which are indispensable to staying alive and being healthy. The end result can be nothing short of multiple organ failure and death. On its own, this fact should be incentive enough to get professional help for a drug or alcohol problem. Your liver is simply too precious to risk. This article will illustrate why, by:

identifying the substances that are especially hard on your liver
contextualizing the risks and dangers of chronic liver disease
describing the signs and symptoms of liver damage

Drugs That Are Hardest on the Liver

Among substances that are hardest on the liver, alcohol is at the top. “A large proportion of heavy drinkers develop serious alcoholic liver disease,” according to the same NIAAA report cited above. Certain factors—genetic heredity, gender, diet and co-occurring liver illness—may influence susceptibility. (For example, the American Liver Foundation says women are more likely to suffer liver damage than men.) Still, there is no denying that alcohol is toxic, and its metabolism exposes the liver to these toxins and greater inflammation. Over time, chronic drinking only escalates this liver injury, leading to fibrosis and cirrhosis.

While alcohol is probably the worst, most common offender implicated in damaging the liver, there are other drugs that can cause liver damage. If you are using any of these drugs listed by the National Institute on Drug Abuse, you may be at higher risk of liver damage:

- Heroin
- DXM
- Inhalants
- Steroids

Additionally, Tylenol (acetaminophen) is notorious for taking a toll on the liver.

Assessing Your Risks of Liver Damage

Chronic heavy drinking and/or drug use can significantly raise one’s risks of liver damage.

In the case of alcohol, how much you drink is the biggest risk factor for liver damage or liver disease. Heavy drinking even for just a few days significantly increases your prospects of fatty liver disease, an article in Medical News Today, “10 Health Risks of Chronic Heavy Drinking,” stated. Over time, too, chronic drinking alters the liver’s metabolism of fat, so that excess fat builds up in the liver. In the longer term, alcoholic hepatitis can develop, followed by cirrhosis— a terminal condition.

Just how common is liver damage among alcoholics and heavy drinkers? Research has concluded that about 20 percent of alcoholics and heavy drinkers develop fatty liver disease— and often without any detectable symptoms except for an enlarged liver. (Fatty liver disease is the first stage of alcohol-related liver disease, followed by alcoholic hepatitis, then cirrhosis.)

The rate and prevalence of chronic liver disease in the U.S. has dramatically increased in recent years— so much so that the Centers for Disease Control (CDC) report that chronic liver disease is one of three leading causes of the declining life expectancy, right up there with opiate and drug overdoses. Death rates for chronic liver disease increased by an average 7.9 percent annually between 2006 and 2016 among men between the ages of only 25 and 34. The increase was even higher among women in the same age group: 11.4 percent per year. Researchers speculated that alcohol use was one explanation for the rise in prevalence of liver disease.

Signs and Symptoms of Liver Damage

What, then, are signs and symptoms of liver damage to be mindful of? If you regularly drink and/or use drugs and are experiencing one or more of the following symptoms, you may benefit from consulting your doctor regarding the health of your liver:

Vision problems – Blurry vision, myopia, seeing floating spots, dry eyes, and color blindness can all be indications of a deficiency in blood flow through the liver, which is caused by inflammation of the liver. One of the most common causes of liver inflammation: alcoholism.
Exhaustion – This has been noted as the most common symptom of liver damage, and it is one that can significantly compromise the quality of daily life. What causes this level of fatigue? The speculation is that liver damage leads to changes in brain chemistry and hormone levels, especially corticotropins, serotonin, and noradrenaline, and in turn these changes reduce energy levels, producing tiredness and low motivation.
Jaundice – Your skin and the whites of your eyes may turn yellow (or jaundiced) due the buildup of a yellowish substance in the liver known as bilirubin. (Liver damage can hamper the liver’s ability to process bilirubin.) Bilirubin is an antioxidant produced through the breakdown of bile. Excessive amounts of bilirubin can be toxic, however, leading to seizures and neurological impairments among other issues. An article in Medical Daily attributes jaundice to these “common causes of liver damage”: excess alcohol, excess ecstasy abuse, hepatitis, cancer, and exposure to toxins and infections.
Changes in your stool and/or urine – Damage to the liver can also manifest itself as changes to stool and/or urine. Urine may become dark yellow because of increased levels of bilirubin in the blood. Your stool may change in both color and consistency, becoming unusually pale and/or displaying a thick, tar-like consistency. Blood in your bowel movements may also occur. If you are experiencing either chronic constipation or alternating constipation and diarrhea (the symptoms of irritable bowel syndrome (IBS), these can be symptoms of liver damage.
Itchy skin, also known as “pruritus” – The itchiness will probably not be reserved to one area of the body, but instead will be widespread. The itching may or may not accompany changes to your skin’s appearance. In some cases, the skin may be rough or red. Liver disease is one of a number of causes of itchy skin— but if the condition has come on suddenly and lasted more than two weeks, the Mayo Clinic recommends seeing a doctor to determine its causes.
Swelling in legs or abdomen – This condition may also have multiple causes, but cirrhosis of the liver is the most common explanation. The swelling occurs because of fluid retention on account of higher levels of albumin and proteins in the blood and fluid (which the damaged liver is not able to eliminate). In some cases of abdomens that are swollen because of liver damage, the affected person appears pregnant.
Bruising easily – If you’re someone who bruises easily, this may be on account of a liver that is not producing the proteins necessary for blood clotting, or has slowed down in this production.
Pain/tenderness in the upper right corner of the abdomen or the lower right part of the rib cage – This pain is often described as a throbbing or stabbing pain which can only be relieved with a pain medication. But these abdominal pain symptoms can also arise because of drug abuse.
Nausea – In fact, vomiting that continues without explanation can be a very clear sign that someone is suffering from liver problems.
Loss of appetite – This symptom, typically accompanied by rapid weight loss, is usually an indication that liver damage has progressed into full-blown liver disease. Once liver damage has reached this point, the person suffering may not be able to eat or keep food down, and will need intravenously administered nutrients in order to stay alive. At this stage, there is little that can be done to repair the liver, and a transplant is the only hope of eluding a terminal outcome.
Excessive sweating – When your liver is damaged, the organ has to work harder to fulfill its functions, and as a result produces more heat, raising your body’s overall temperature. In an effort to cool itself down and excrete more of the toxins that your liver is no longer able to eliminate, your body sweats more.
Encephalopathy – This condition, characterized by mental confusion and memory, is what happens when the toxins that your liver is no longer able to flush out build up and travel to the brain. Other symptoms can include mood changes, disorientation, sluggish movement, drowsiness, and coma. Encephalopathy can be fatal— so if you are experiencing any of these symptoms, get immediate medical help.

Asymptomatic Liver Damage

If you are not experiencing any of the above symptoms, keep in mind that as many as 50 percent of people with liver damage do not experience any real symptoms, the University of Iowa Hospitals and Clinics warns. At most, someone with liver damage may find they are fatigued, lack motivation and occasionally itch in places. (These are the most common signs of liver damage.)

Moreover, in the absence of treatment, liver damage can progress to liver disease, at which point there is little medical recourse in the form of a cure, beyond a transplant.

What this means is that if you have a drinking problem or are using drugs, it never hurts to be proactive and consult a liver specialist. They can administer a simple blood test to check whether your liver enzymes are in the normal range (or not).

Can You Reverse Drug or Alcohol-Related Liver Damage?

The good news for anyone with drug or alcohol-related liver damage is that your liver is amazingly resilient and, with a sustained period of abstinence from drugs or alcohol, can often repair itself from even severe damage. In other words, you can reverse drug or alcohol-related liver damage.

The same positive prognosis can be true for anyone who wants to quit drinking or using drugs but doesn’t think they can on their own. With drug or alcohol treatment, you can successfully stay sober and give your liver a second chance at health. That begs the question: why would you not get treatment for an addiction problem?

For more information related to drugs, alcohol and liver damage, check out the following articles: