14 signs of liver damage you should know

With liver disease on the rise, especially among younger adults, you may be wondering how to spot the signs of liver damage—how can you know if your liver is struggling? You can’t live a good life without a functioning liver, so it’s important to pay attention to this critical organ.

The liver, about the size of a football, is the body’s largest internal organ. It acts as a filtration device, removing harmful substances from the blood. The liver also makes bile to help digest food and stores sugar that the body uses for energy. Furthermore, it contributes to a balanced immune system and is key to your body’s metabolism.

Let’s discuss 14 signs of liver damage, whether it can be reversed and how to properly care for your liver for optimal health.

14 signs of liver damage

There are four states of liver damage—inflammation, fibrosis, cirrhosis, and end stage liver disease (ESLD). Liver damage often goes unnoticed until cirrhosis occurs.

Recognizing the signs of liver damage early can make a big difference in your treatment and overall health. Here are 14 signs of liver damage to be aware of. 

1. Fatigue 

An underperforming liver can’t filter toxins out of the bloodstream, resulting in fatigue and a general unwell feeling.

2. Jaundice, or yellowing of the skin and eyes

Liver damage can also cause jaundice, or yellowing of the skin and eyes. This is because the liver is responsible for processing bilirubin, a yellow pigment produced from red blood cells, and excreting it into bile. When your liver isn’t functioning optimally, it’s not able to process bilirubin effectively, causing it to build up and lead to yellowing of the skin and eyes.

3. Frequent gassy sensation

When a damaged liver doesn’t secrete digestive juices to break down food, you may experience routine bloating and stool pressure.

4. Confusion

When the liver isn’t working properly due to liver damage, toxins can build up, causing brain fog. You may also be confused and disoriented.

5. Swelling in legs and ankles

A weak liver can result in swelling due to fluid retention, especially in the feet and ankles.

6. Dark urine

Urine that is darker than usual is a common sign of liver damage. The urine may be brown, orange or amber. This is due to a buildup of bilirubin in the liver, which is then excreted in urine.

7. Pale stool

When your liver is functioning properly, it releases bile salts into your stools, giving your poop a healthy brown color. If your liver isn’t producing enough bile or if the flow of bile is blocked, your stools may become pale or clay colored.

8. Loss of appetite 

Loss of appetite is a common sign of liver damage. You may not feel interested in eating food as your metabolism changes or you may feel nauseous when you eat because of digestive issues.

9. Vomiting blood

In the later stages of liver damage, you may vomit blood. This is because blood can't flow through the liver properly, which causes high blood pressure in the veins that connect the liver to the digestive organs. This can cause swollen veins in the esophagus or stomach to rupture, leading to bleeding.

Vomiting blood is a medical emergency, so seek care immediately if you notice this symptom.

10. Itchy skin

Itchy skin can occur with liver damage as bile salts build up in the blood stream and irritate nerves in the skin. Liver damage also alters the levels of certain chemicals in the blood, which can cause an itching sensation.

11. Loss of muscle and muscle weakness

Muscle weakness or loss of muscle is another sign of liver damage. This is because liver damage causes nutritional deficiencies, as the damaged liver struggles to process and administer nutrients the muscles need to stay strong.

12. Bruising easily

If you have liver damage, your liver doesn’t produce enough clotting factors, which are proteins necessary to clot blood and stop bleeding. This means you may bleed and bruise more easily.

13. Abdominal pain

Abdominal pain is a common sign of liver damage. Liver damage can cause inflammation, as well as fluid buildup, in the abdomen. The pain may be sharp and worsen when you breathe.

14. Sudden weight loss

Because liver damage often leads to malnutrition, sudden weight loss is a common sign. Liver damage can also cause a decrease in appetite, causing you to be less interested in food.

What causes liver damage?

Liver damage can be caused by a variety of factors, from infections and underlying conditions to lifestyle factors. These are the most common causes of liver damage:

• Chronic alcohol use and alcohol-related liver disease

• Viral hepatitis, particularly hepatitis B and C

• Non-alcoholic fatty liver disease (often linked to obesity, diabetes and poor diet)

• Autoimmune diseases, like autoimmune hepatitis

• Genetic disorders

• Diseases that affect your bile ducts

• Exposure to toxins or certain medications

• Chronic conditions like Wilson’s disease or hemochromatosis

Liver damage is on the rise, and lifestyle factors like diet and exercise are a big reason why.

“It’s because of our lifestyle,” said Themis Kourkoumpetis, MD, a transplant hepatologist on the medical staff at Baylor Scott & White All Saints Medical Center – Fort Worth. “We aren’t getting enough exercise, we’re drinking too much soda and we’re eating a large amount of fast food. A growing portion of our population has diabetes, high cholesterol or obesity.” 

Can liver damage be reversed?

Whether liver damage can be reversed depends on how severe it is and what’s causing it. In the early stages, the liver has an incredible ability to heal itself. Conditions like fatty liver disease or mild liver damage from alcohol use or hepatitis can often be reversed if caught in time.

Lowering alcohol intake, eating a healthier diet, losing weight or taking antiviral medication for hepatitis can help the liver regenerate. The key is making these changes early before the damage becomes too severe.

Once liver damage progresses to the advanced fibrosis or cirrhosis stages, it’s much harder to undo. While early-stage fibrosis might improve with treatment, cirrhosis can cause permanent damage that affects liver function.

At that point, the focus shifts to slowing the condition, managing symptoms and preventing complications. Medications, lifestyle changes and in severe cases, a liver transplant, might be needed. That’s why early detection and healthy lifestyle changes are so important.

“I want to inspire my patients to be proactive,” Dr. Kourkoumpetis said. “If they make good choices, the benefits to their liver can last for decades.”

Worried about your liver health? Talk to your primary care physician or find a doctor near you.