As the largest internal organ, the liver has both digestive and non-digestive functions essential for life. As part of the digestive system, it helps promote the proper breakdown of food through bile action and converts nutrients from your food into substances the body can use. Outside of the digestive system, the liver is responsible for making protein, converting stored energy into usable energy, filtering toxins and contaminants from the blood, and processing potentially harmful substances like drugs or alcohol. 

Liver health is essential for a myriad of functions. When your liver is not performing those functions adequately, the signs and symptoms can occur slowly and often sneak up on you. For this reason, it is important to promote liver health before problems arise, taking into account the many risk factors that we now know and understand. Having your liver checked regularly, combined with health-promoting practices and natural supplements, is the ideal way to care for your liver. 

If you have concerns about your liver, it is important to discuss them with your doctor. Most doctor visits last only about ten minutes, so you want to make the most of your time. Knowing the essential questions will help you get answers and guidance for the best approach to optimize liver health.

The best questions to focus on should include

♦ How is my liver doing?
♦ Are there liver function tests we can do?
♦ What are my treatment options?
♦ How can I improve liver health?

Getting these answers is a good start. Additional visits may be required, depending on your test results. Should you be looking for supplemental information about your liver’s health, below are the top questions to address as you continue to explore options for better liver health. 

1. What factors contribute to poor liver health?

The top factors leading to poor liver function are:

♦ Poor diet and excessive weight gain, which causes fat to accumulate in the liver and damages liver cells.

♦ High alcohol consumption, which includes drinking more than 2 servings per day and binge drinking.

♦ Viral infection, most commonly associated with risky lifestyle choices and behavior.

♦ Overuse of certain medications and exposure to chemicals or toxins.

♦ Genetic conditions that cause the liver to accumulate metals, such as iron and copper, or form defective protein, such as alpha-1-antitrypsin. 

Excessive drinking

2. What are the signs and complications of poor liver health?

The signs of poor liver health will vary depending on the underlying cause, but there are general symptoms to bring to your doctor’s attention. 

Abdominal pain, especially in the right upper quadrant
Gassiness or abdominal distention 
♦ General signs of poor digestion, including frequent heartburn or indigestion
Fatigue, poor sleep, and cloudy mentation
♦ Nausea, vomiting, or loss of appetite 
♦ A tendency to bruise easily or prolonged bleeding time
♦ Swelling, in the legs and ankles, or morning facial swelling
♦ Itching or various rashes, especially on the palms

Without early identification and treatment, liver health can deteriorate. As this occurs, signs of a more serious condition may be identified, such as:

♦ Gastrointestinal bleeding
♦ Muscle loss
♦ Yellowing of the skin or eyes 
♦ Spider-like blood vessels 
♦ Itching and rashes
Severe fatigue, weakness, and loss of mental capacity

In order to understand the symptoms, it is important to understand the process of how your liver stops doing the things it is supposed to. As the liver becomes sick, it becomes swollen and tender, and overtime, it accumulates scar tissue, eventually turning hard. Since a lot of blood passes through the liver, liver health impacts the flow of blood. Poor liver health may force the blood to flow through other channels, and patients may present with internal bleeding. 

A healthy liver makes protein, so without adequate protein production, fluids shift in the body, making it swollen. A healthy liver contains the bile it makes within the digestive system; otherwise, bile seeps into the bloodstream and turns the sclera and skin a yellowish color. A healthy liver clears nitrogen waste and other toxins; otherwise, they accumulate in the brain and make thinking and concentration difficult. It is important to act preventatively to maintain a healthy liver.

The longer you live without intervention, the worse your liver health can get. The range of complications can vary from moderate to severe and can include any of the following:

♦ Poor digestion
♦ Bleeding
♦ Swelling in the legs and abdomen
♦ Enlargement of the spleen
♦ Infections
♦ High blood pressure, specifically in the veins that supply the liver
♦ The buildup of nitrogen waste and toxins

3. What tests are there to check liver health?

Your doctor can perform liver function tests to check the overall health of your liver, starting with a liver function panel to measure proteins and enzymes produced by the liver, as well as a blood count. The following blood tests measure liver health:

♦ Liver enzymes, such as ALT, AST, and alkaline phosphatase
♦ Albumin
♦ Bilirubin
♦ Platelets
♦ Prolonged bleeding time

In addition to the initial chemistry panel and blood count, your doctor should also consider checking the following:

♦ Vitamin D
♦ Prealbumin
♦ Lipid panel
♦ Viral infections
♦ Ultrasound

Ultrasound imaging of the liver should be done, especially if any of the initial tests return abnormal. An ultrasound of the liver is relatively inexpensive, noninvasive, and carries no risk of radiation.

Patient consulting with her doctor

4. What can I do to help improve liver function?

The best approach to promoting healthy liver function is through dietary and lifestyle changes. Your doctor can provide careful surveillance and treatment of complications as they arise, but ultimately, proper liver health is best achieved through lifestyle modification. 

Diet: The best evidence for what constitutes a healthy liver diet is the Mediterranean diet (MD), which is rich in healthy fat (mono- and polyunsaturated), fresh vegetables, fruit, and legumes, as well as fish. It is also lower in animal products, especially red and processed meat, dairy, and simple sugar or refined flour. There is also an emphasis on local and fresh produce, with an element of conviviality to food tradition, meaning that eating is done as a family and community, not individually.

Time-restricted eating: There is emerging evidence that restricting the amount of time spent in the fed state can help the liver clear toxins and lipids and kick-into a fasting mode, where it has more time to metabolize energy and recover. The liver stores energy and can create energy from fat, but it will not utilize its resources until you give it a reason to. Fasting allows the liver time to put these resources to work, turnover biological tissue, and regenerate.

Meal planning: Few of us plan our meals, but it may be the single most important intervention we can make to improve overall health. Prepping for meals takes time and requires fresh produce, the use of cookware, and then the clean-up, so it is understandable why most of us prefer going out or eating on the run. But it turns out that this poor eating habit is perhaps responsible for much of our health problems as a society. Although there is no easy fix, start by taking lunch with you to work, and include fruit, vegetables, nuts, and seeds for snacks.

Exercise: Ideally, you want 15 to 30 minutes of physical activity a day, with the goal of breaking a sweat or at least raising your resting heart rate. If schedules do not allow for this, then small changes to your daily routine can help increase your activity level, such as taking the stairs instead of the elevator, walking around the block after lunch, parking further away, and walking to work. 

Alcohol moderation: Alcohol is processed by the liver very similarly to sugar; additionally, alcohol is a toxin that needs to be broken down enzymatically. Moderation is a key to maintaining normal liver function; in many cases, avoidance of alcohol is the only solution to prevent further complications

Weight loss: Regardless of the method, a small reduction in your body mass index can have a significant impact on your liver. Most studies show that losing just 5-7% of your body weight can really help jumpstart your liver to better health. 

5. What are treatment options for liver damage?

There are medications that can treat viral infections, help digestion, and address various symptoms, but the only treatment currently available to promote liver health is diet and lifestyle. You only have one liver, and transplantation of another one is very high risk with a difficult chronic course.

The potential risks and side effects of medical management of poor liver health include:

♦ Accelerated liver damage
♦ Electrolyte imbalance and dehydration
♦ Kidney damage
♦ Infections and bacterial overgrowth
♦ Fatigue and sleepiness

Therefore, natural supplements have a definite advantage over current medical options for the promotion of liver health. The ingredients found in LiverMD® were individually selected for their clinical effectiveness and naturally support optimal liver function. It is best used preventatively, but it can also help maintain residual liver function and slow down the progression of chronic conditions.

Enlarged Spleen

LiverMD® was created to be the most effective liver health supplement available on the market today. It is designed to address the growing epidemic of poor liver health affecting over 100 million Americans.

In combination with the dietary and lifestyle modification noted above, our formula of patented ingredients is an effective way to provide natural and safe everyday care for your liver. 

Vitamin E: This clinically studied vitamin has been shown to effectively prevent uncontrolled cell division in the liver. Our liver health formula specifically contains EVNolMax®️, a supercharged complex version of vitamin E, with a full spectrum of tocotrienols and tocopherols for better absorption and bioavailability. 

Milk thistle: This herb, specifically its key compound silybin, has been used for centuries to promote proper liver health. 1MD Nutrition incorporated a highly bioavailable form of silybin into our formula, called Siliphos®, for more effective liver support. Silybin has been shown to strengthen liver cells, protect the liver, and promote the optimal breakdown of toxins. 

N-Acetylcysteine: NAC, an amino acid that replenishes glutathione, the primary antioxidant in the body, helps support detoxification in the liver. Glutathione fights oxidative stress, which helps support liver health and function.

Alpha-lipoic acid: ALA has the ability to protect the liver from oxidative stress and has been shown to help sensitize insulin receptors, which can help slow down the progression of liver damage from chronic conditions. 

Zinc: Deficiency in this micronutrient is commonly observed in patients with chronic liver conditions, but it is essential and plays a significant role in thousands of enzymatic reactions. Its replenishment can improve healing by inhibiting cellular breakdown.

Selenium: This essential trace mineral is a natural antioxidant that helps promote a healthy environment for your liver. In combination with other compounds, such as zinc and ALA, it also promotes the healing of liver cells. 

Final Thoughts

The liver is an essential organ responsible for metabolic and digestive health as well as proper detoxification of the body. These important functions expose the liver to potentially harmful substances, which can hurt the liver over time. In combination with healthy lifestyle choices and regular exercise, LiverMD®️ provides enhanced protection for liver cells and supports liver function. 

Dr. David Kahana


Dr. David Kahana is board certified in Pediatrics and Gastroenterology through the American Board of Pediatrics (ABP), as well as Medical Nutrition through the National Board of Physician Nutrition Specialists.