The Liver – Your Body's Greatest Multitasker

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What does the liver do?

The liver is the body’s greatest multitasker. Below is an overview of its most important jobs:

Digestion. Everything you eat or drink gets digested by the stomach and intestine, absorbed into the blood, and passed on to the liver. The liver processes this blood into nutrients and filters out toxins to be flushed out of the body in the form of urine or stool.

Sugar regulation. Your liver helps your body balance blood sugar levels. When the liver processes a meal, it removes sugar from the blood and stores it in the form of glycogen. If your blood sugar gets too low, your liver converts the glycogen into glucose and releases it back into the bloodstream.

Blood metabolism. Many blood products, such as albumin, clotting factors, and substances to help regulate blood volume, are produced in the liver. It regulates blood levels of amino acids for use in protein synthesis and other metabolic processes. The liver “recycles” the blood, breaking down old or damaged blood cells and processing hemoglobin to recycle the iron. A byproduct of this process is bilirubin, which passes out of the body as waste. The liver also produces blood for fetal development during pregnancy.

Immune response. The liver has a variety of immune cells that are responsible for detecting, killing, or clearing various pathogens. It also houses immune cells that help control inflammation.

Production. Your liver produces bile, which helps break down fats and waste products in the small intestine during digestion. It also produces cholesterol and special proteins that help carry fats through the body.

Chemistry. The gut produces ammonia, a toxic byproduct of protein digestion. Your liver converts ammonia into urea, which is less toxic and eventually excreted.

Storage. The liver stores essential nutrients like glucose, iron, vitamins and minerals, and glycogen and releases them as needed.

Causes of liver disease

Infection
Viruses and parasites can infect the liver, causing swelling and inflammation. The most common liver viruses are Hepatitis A, B, and C. These viruses cause liver damage and can be spread through blood or semen, bad food or water, or close contact with an infected person. Liver parasites are generally more common in other parts of the world, but liver flukes, spread by contaminated water or eating raw or undercooked fish do exist in certain regions of the US.

Immune system conditions
In autoimmune diseases, the immune system, the body’s defense mechanism, turns on healthy tissue. Autoimmune hepatitis attacks the liver itself while primary biliary cholangitis, and primary sclerosing cholangitis affect the bile ducts.

Genetics
Certain genetic mutations inherited from one or both parents can cause liver disease. Some genetic liver diseases include Hemochromatosis, Wilson's disease, and Alpha-1 antitrypsin deficiency. Genetics can also predispose a person to certain types of liver cancer.

Cancer
Primary liver cancer originates in the liver. The most common type occurs in the liver itself but cancer can also start in the bile ducts or the liver’s blood vessels. Secondary liver cancer occurs when cancer spreads from other parts of the body, most often the colon or rectum, followed by breast, lung, stomach, or pancreas.

Alcohol abuse
Alcoholic liver disease (ALD) results from heavy alcohol use. The long-term damage causes a type of permanent scarring called cirrhosis.

Obesity and/or unhealthy diet
Excess consumption of fats, red or processed meats, sugar, salt, fried foods, and refined carbohydrates causes fat to build up in the liver, resulting in nonalcoholic fatty liver disease.

Toxins
Certain herbal supplements, including turmeric, green tea extract, garcinia cambogia, black cohosh, and ashwagandha, can be toxic to the liver. Some prescription medications can cause liver damage, especially when used for a long period of time. Certain chemicals in every day products, such as fabrics, food packaging, and cooking and cleaning products, can be harmful to the liver and other organs.

Symptoms of Liver Disease

Symptoms of liver disease vary greatly and are not necessarily noticeable early on. If you notice one or more of the following symptoms, be sure to address it with your doctor:

• Yellowing of the skin and the whites of the eyes, called jaundice, is due to a buildup of bilirubin
• Chronic fatigue
• Belly pain and swelling, particularly in the upper right abdomen
• Edema (swelling) of the legs and ankles due to fluid retention
• Bleeding easily and unexplained bruising
• Pale, clay-colored, or dark and tarry stools and dark urine
• Pruritus (itchy skin) as a result of bile buildup
• Digestive issues such as nausea, vomiting, or loss of appetite
• Skin rashes
• Ascites – fluid buildup in the abdomen which causes a swollen belly and potential shortness of breath
• Brain fog, confusion, memory problems, and personality changes
• Spider veins
• Blotchy red palms
• Clubbed fingers and nails
• Hair loss
• Vomiting blood, which can indicate bleeding in the digestive tract
• Problems with balance and coordination
• Enlarged veins called varices in the esophagus, stomach, and/or abdomen

Keeping your liver healthy

Given how hard your liver works, it’s smart to take a few steps to help keep it healthy, including:

• Maintain a healthy weight – obesity is a risk factor for non-alcoholic fatty liver disease (NAFLD)
• Eat a balanced diet, drink lots of water, watch your cholesterol, and avoid eating raw or undercooked shellfish
• Exercise regularly to help reduce liver fat
• Avoid exposure to toxins from cleaning and aerosol products, insecticides, chemicals, and additives
• Don’t smoke
• Drink sparingly and responsibly.
• Avoid the use of illicit drugs – intravenous drug use is associated with hepatitis A, B, and C
• Use only clean needles for tattoos and body piercings
• Don’t share personal hygiene items like razors, toothbrushes and nail clippers
• Practice safe sex to reduce your risk of hepatitis B and hepatitis C
• Wash your hands with soap and warm water before preparing food and immediately after using the bathroom, changing diapers, or touching pets
• Follow directions on all medication and tell your doctor about any over-the-counter medicines, supplements, and natural or herbal remedies you take
• Get vaccinated for hepatitis A and B (there’s no vaccine against the hepatitis C virus)

This article first appeared in the June 2025 edition of the HealthPerks newsletter.