In this article, the reader will get a clear idea of the importance of the Liver in our body, its functions, preventive measures and diagnostic methods.
Table of contents
- Why is the Liver the Most Important organ in Our Bodies?
- How Widespread Is Liver Disease? Look At The Statistics.
- Which risk factors are most commonly associated with liver disease?
- To Look Out For: Symptoms Of Liver Damage?
- Understanding Liver Disease: The Different Stages and What You Need To Know
- Simple Steps for Optimal Liver Health
- Overview of diagnostic methods
- Understanding ALT and AST: How Liver Damage Is Detected Through Blood
- Should You Buy A Self-Test Kit? Here Are Some Pros And Cons To Consider.
- Take-Home Points
The Liver is a vital organ with many essential functions, including breaking down toxins, aiding digestion, and storing essential nutrients.
Liver disease is a significant health problem worldwide that can be caused by excessive alcohol consumption, obesity, and Chronic liver inflammation.
Symptoms of liver disease can include jaundice, fatigue, nausea and vomiting, abdominal pain, loss of appetite, weight loss, dark urine, or pale stool.
It is vital to eat a healthy diet, exercise regularly, maintain a healthy weight, limit alcohol consumption, and avoid exposure to toxins.
Diagnostic methods most commonly used to examine liver diseases are blood tests, imaging tests, liver biopsy, endoscopic procedures and self-blood tests.
Why is the Liver the Most Important organ in Our Bodies?
The Liver is situated in the upper abdominal cavity, just below the diaphragm on the right side of our body.
Liver tissue is composed of numerous lobules, small units of liver cells with many canals carrying blood and bile running through them.
To explain the significance of the Liver in our body, we first need to understand the Primary Functions of the Liver.
The Liver synthesises proteins, detoxifies various metabolites, produces digestive enzymes, helps metabolise nutrients, regulates red blood cells (RBCs), stores glucose.1
Blood from the digestive organs flows via the portal vein to the Liver, bringing nutrients, medication and toxins.
These substances are then processed, stored, modified to some extent, detoxified and either passed back into the blood or eliminated in the bowel. In this way, the Liver clears the toxins from our bodies.2
The Liver plays a crucial role in all metabolic processes in the body.
In fat metabolism, the liver cells break down fats and produce energy.3 Bile is necessary for the breakdown and absorption of fats.
In the metabolism of carbohydrates, the Liver helps to ensure that the sugar level in your blood (blood glucose) stays constant.4
How Widespread Is Liver Disease? Look At The Statistics.
Liver disease is a significant public health problem in Europe and worldwide.5 It is the fifth most common cause of death in the European Union (EU) and the third most common cause of death in the WHO European Region.
Approximately 2 million deaths occur annually from liver diseases, with cirrhosis and viral hepatitis/hepatocellular carcinoma each contributing 1 million fatalities.
Cirrhosis is the 11th most common cause of death worldwide, and liver cancer is the 16th leading cause; they account for 3.5% of global mortality.6
Alcohol consumption is a significant risk factor on a global scale, with over 75 million people suffering from alcohol-use disorders and at risk of its resulting liver disease.
Obesity/overweight (2 billion adults) and diabetes (400 million) are further linked to non-alcoholic fatty liver disease and hepatocellular carcinoma.7 There remains a high prevalence of viral hepatitis.
Chronic infection with the Hepatitis B virus and Hepatitis C virus is a primary cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma.
According to ECDC data in 2017, 4.7 million people were living with chronic hepatitis B virus infection and 3.9 million people with Hepatitis C infection in EU/EEA countries and the UK.
In the EU/EEA, deaths attributed to the hepatitis B virus and hepatitis C virus are estimated to account for around 55% of liver cancer deaths and 45% of all deaths due to cirrhosis and other chronic liver diseases.
At the same time, drug-induced hepatic injury continues to rise as a significant source of acute hepatitis.8
Which risk factors are most commonly associated with liver disease?
The Main Risk factors which are most commonly associated with liver disease are:
- High Consumption of alcohol is a toxin to the Liver. It can cause a wide range of liver damage, from fatty liver disease to cirrhosis.9
- Chronic liver inflammation and damage caused by hepatitis B and C can lead to cirrhosis and liver cancer.
- Non-alcoholic fatty liver disease can progress to more severe conditions such as non-alcoholic steatohepatitis (NASH) or cirrhosis.
- Obesity increases the risk of hepatic inflammation and fibrosis progression, leading to NASH-related cirrhosis.10
- Herbal supplements such as kava and comfrey correlate with Liver damage.
- Hemochromatosis (an excess of iron in the body) and Wilson’s disease (a disorder that prevents the body from adequately metabolising copper) can lead to Liver damage.
To Look Out For: Symptoms Of Liver Damage?
The symptoms of liver damage vary from mild to severe, and they can often go unnoticed until it is too late.
The most common symptoms of Liver damage are fatigue, nausea, vomiting, abdominal pain, loss of appetite, weight loss, dark urine, and pale stool.11
Jaundice: this happens due to increased bilirubin in the blood, which causes skin and eyes to turn yellow.
Fatigue: A state of exhaustion characterised by extreme tiredness and energy depletion.
Nausea and Vomiting: An increase in toxins in the blood or digestive issues caused by liver inflammation can cause nausea and vomiting.
Abdominal Pain: Inflammation or enlargement of the Liver causes abdominal pain.
Loss of appetite: Loss of appetite or inability to absorb nutrients properly can cause weight loss.
Dark urine: Blood bilirubin may cause dark urine.
Pale stool: The lack of bile in the stool can be caused by liver damage.
Understanding Liver Disease: The Different Stages and What You Need To Know
There are four stages of liver disease Hepatitis (inflammation), Fibrosis(scarring), Cirrhosis(Severe scarring), and Liver failure.
Early diagnosis of liver disease will help you assess any liver-related issues.
It is important to recognise the stages of liver disease and to be aware of the signs and symptoms at each stage. Knowing the stages of liver disease can help you identify potential issues early and take action to prevent further damage.
Stage 1: Inflammation
The Liver handles the toxic waste that enters our bodies. When the Liver cannot handle or remove toxins from the body, the body reacts with inflammation, swelling the organ. As inflammation is a sign of viral hepatitis or immune hepatitis, alcoholic fatty Liver or non-alcoholic fatty Liver, it is crucial to see a doctor as soon as possible.
Stage 2: Scarring
When the Liver is left untreated, inflammation can cause scarring to the Liver. Scarred tissue does not function as well as healthy tissue, making the organ less efficient. This is referred to as Fibrosis.
Stage 3: Cirrhosis
The 3rd stage of liver disease, Liver Cirrhosis, is characterised by severe scarring and an inability to heal. This process can take decades, providing ample opportunity to act before things become critical.
Stage 4: Liver Failure or End-stage liver disease (ESLD)
This is the final stage. It can take years for the Liver to reach this stage when it stops functioning completely, as it cannot heal itself. There are two types of liver failure. The acute form occurs within 48 hours after the poison is absorbed in the body or after a drug overdose. The chronic condition evolves when alcohol poisons your Liver – the most common cause of liver transplantation.
Simple Steps for Optimal Liver Health
Maintaining a healthy liver is very important as the Liver is one of the most important organs which performs major functions in our body.
Other than taking medicines or getting surgery or transplantation, we can take care of the Liver by following these very simple tasks:
- Maintaining a healthy diet can help you keep your Liver healthy and clean.12
- Doing regular physical activities can help you keep your Liver healthy.
- You can keep your Liver healthy by keeping your weight according to BMI (Body Mass Index) standards.
- Consumption of alcohol is a significant cause of liver diseases, so avoid high alcohol consumption.
- You can take some preventive measures to avoid liver dysfunction, for example, getting a vaccination against Hepatitis A and B etc.
Overview of diagnostic methods
Research has shown that early detection and prompt treatment of liver problems can significantly reduce the risk of liver failure or cancer.
A blood test can help to recognise major liver problems by checking the AST and ALT ratios. Moreover, a self-blood test for the Liver is a simple procedure you can do in the comfort of your home.
Imaging tests like Ct scan, MRI scan, and Ultrasound scan for the Liver are frequently performed to examine the Liver’s physiological status.13
Liver biopsy is also an effective diagnostic method but an invasive method in which a needle is inserted into your Liver. A small quantity of liver cells is taken and sent to a lab to check the development of scarring in the Liver, which happens in the second and third stage of liver disease.14
The endoscopic procedure is done in the final stage of liver disease to check the development of cirrhosis in the Liver.
Understanding ALT and AST: How Liver Damage Is Detected Through Blood
AST and ALT are enzymes found in many tissues in the body but are most abundant in the Liver.
When the Liver is damaged, ALT and AST enzymes leak from the Liver into the bloodstream. This results in a raised concentration of ALT/AST in the blood.
- ALT (alanine aminotransferase) is an enzyme that breaks down fats in the Liver. As a result of these chemical reactions, your Liver produces bile, which breaks down food and toxins and fights infection.15
- AST (aspartate aminotransferase) is an enzyme that plays a vital role in many metabolic processes in our body.16
AST is found in the blood at higher levels when there is damage to the liver cells, while ALT is found in the blood at higher levels when there is inflammation of the Liver.
The concentration of these liver enzymes can be measured with a simple blood test which can give important information about your Liver’s health.17
If you experience symptoms of liver dysfunction or other diseases, your healthcare provider will first check the concentration of liver enzymes.
Increased ALT and AST and their ratios are used in clinical practice to diagnose specific diseases.18
For example, the De Ritis ratio also referred to as the AST/ALT ratio was first proposed for hepatitis diagnosis and is commonly applied for distinguishing between fatty liver conditions.
Furthermore, the AST/ALT ratio is a reliable predictor of non-liver diseases such as cardiovascular disease, certain cancers, and type 2 diabetes mellitus.18
Should You Buy A Self-Test Kit? Here Are Some Pros And Cons To Consider.
A liver self-test is an easy, fast and inexpensive method for assessing liver function.
Pros of the Liver Home Test
- It is easy to use. You can perform the analysis by yourself at home.
- There is no need to send a sample to a laboratory.
- Self-testing is relatively inexpensive. Usually, it is much more cost effective than traditional methods of testing.
- The results are available within minutes.
Cons of the Liver Home Test
- The liver function self-test is not 100% accurate. There is a slight chance that the test will give a false positive or false negative result.
- It is impossible to control if someone collects the sample properly at home. People should always strictly follow the instructions for use.
- Rapid tests are unable to quantify the concentration of liver enzymes. It is only possible with laboratory analysis.
- AST/ALT self-tests for the Liver may only be available in some areas.
- The self-blood test for the Liver is invasive.
- The insurance may not cover the test, so you must bear the cost. At your physician, you might get it for free.
- Liver Function Home Test (ALT and AST)20.71 € incl. VAT
You should always purchase the test kit from a reputable source. Reliability and testing experience can differ significantly between various brands.
- The Liver is a vital organ which deals with some significant functions in our body.
- Maintaining a healthy liver in your body is simple. Follow a well-balanced and healthy diet, avoiding toxin intake, alcohol intake etc.
- The symptoms of liver dysfunction vary from mild to severe, and they can often go unnoticed until it is too late.
- Fatigue, nausea, vomiting, abdominal pain, loss of appetite, weight loss, dark urine, and pale stool are symptoms of liver dysfunction.
- There are four stages of liver disease: Stage 1 – Hepatitis (Inflammation), Stage 2 – Fibrosis (Scarring), Stage 3 – Cirrhosis (Severe scarring), and Stage 4 – Liver failure.
- Aspartate transaminase (AST) and alanine aminotransferase (ALT) are biomarkers that the Health care provider checks first in case of any symptoms or dysfunctions in your body.
- Advancement of medical technology, getting a self-blood test for the Liver is now possible.
- Self-test for the Liver has pros and cons. Consider them before buying any self-tests.
- Saxena R, Theise ND, Crawford JM. Microanatomy of the human liver-exploring the hidden interfaces. Hepatology. 1999 Dec;30(6):1339-46. doi: 10.1002/hep.510300607. PMID: 10573509.
- Menche N. (ed.) Biologie Anatomie Physiologie. Munich: Urban & Fischer/ Elsevier; 2012.
- Pschyrembel W. Klinisches Wörterbuch. Berlin: De Gruyter; 2014.
- Schmidt R, Lang F, Heckmann M. Physiologie des Menschen: mit Pathophysiologie. Heidelberg: Springer; 2011.
- Jewell J, Sheron N. Trends in European liver death rates: implications for alcohol policy. Clin Med (Lond). 2010 Jun;10(3):259-63. doi: 10.7861/clinmedicine.10-3-259. PMID: 20726458; PMCID: PMC5873553.
- “The Burden of Liver Disease in Europe: A Review of Available Epidemiological Data.” Journal of Hepatology, vol. 58, no. 3, 2013, pp. 593–608. https://doi.org/10.1016/j.jhep.2012.12.005.
- Mokdad, A. A., et al. “& Naghavi, M.(2014). Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis.” BMC medicine 12.1: 145.
- Monitoring of responses to the hepatitis B and C epidemics in EU/EEA countries – 2020 data (2022) European Centre for DiseasePreventionandControl.Availableat:https://www.ecdc.europa.eu/en/news-events/monitoring-responses-hepatitis-b-and-c-epidemics-eueea-countries-2020-data (Accessed: February 10, 2023).
- Pimpin, Laura, et al. “Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies.” Journal of hepatology 69.3 (2018): 718-735.
- Majid B, Khan R, Junaid Z, Khurshid O, Rehman SH, Jaffri SN, Zaidi B, Zehra J, Batool S, Altaf S, Jatoi A, Safina F. Assessment of Knowledge About the Risk Factors of Chronic Liver Disease in Patients Admitted in Civil Hospital Karachi. Cureus. 2019 Oct 20;11(10):e5945. doi: 10.7759/cureus.5945. PMID: 31799087; PMCID: PMC6860746.
- Newton, Julia L., and David EJ Jones. “Managing systemic symptoms in chronic liver disease.” Journal of hepatology 56 (2012): S46-S55.https://doi.org/10.1016/S0168-8278(12)60006-3
- Mega A, Marzi L, Kob M, Piccin A, Floreani A. Food and Nutrition in the Pathogenesis of Liver Damage. Nutrients. 2021 Apr 16;13(4):1326. doi: 10.3390/nu13041326. PMID: 33923822; PMCID: PMC8073814.
- Hall P, Cash J. What Is the Real Function of Liver ‘Function’ Tests? (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609680/) Ulster Med J. 2012; 81(1):30-36.
- Lala V, Goyal A, Bansal P, Minter, DA. Liver Function Tests. (https://www.ncbi.nlm.nih.gov/books/NBK482489/) StatPearls. Updated July 4, 2020.
- Ida M. Washington, Gerald Van Hoosier, in The Laboratory Rabbit, Guinea Pig, Hamster, and Other Rodents, 2012
- Otto-Ślusarczyk D, Graboń W, Mielczarek-Puta M. Aminotransferaza asparaginianowa–kluczowy enzym w metabolizmie ogólnoustrojowym człowieka [Aspartate aminotransferase–key enzyme in the human systemic metabolism]. Postepy Hig Med Dosw (Online). 2016 Mar 16;70:219-30. Polish. doi: 10.5604/17322693.1197373. PMID: 27117097.
- Nidhi Raval, … Rakesh K. Tekade, in Biomaterials and Bionanotechnology, 2019
- Giannini EG, Testa R, Savarino V. Liver Enzyme Alteration: A Guide for Clinicians. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC545762/) CMAJ. 2005;172(3):367-379.