Understanding Liver Failure. Plus: How Do I Know If My Liver Is Healthy?

  • 10 Mins Read
  • Health Conditions
  • Written by: Reshma Pathare
Liver health and liver failure
  • Liver failure is the loss of liver function, and if left untreated, it can be fatal.
  • Abdominal pain, vomiting, pale dark urine, fatigue, loss of appetite, and sleepiness are some of the symptoms of liver failure.
  • Acetaminophen overdose, mushroom poisoning, autoimmune disease, viral infection, industrial toxins, metabolic disorder, sepsis, and shock can cause acute liver failure.
  • Excessive alcohol consumption, high levels of body fat, infection from unclean needles, and unsafe sex are among the top causes of chronic liver failure.
  • There are certain signs of a healthy liver, too, and they indicate that the liver is working well.
  • Since symptoms of liver damage are sometimes unclear, one should know the signs of a healthy liver as well, to ascertain if the liver is working as it should.

Do you know which hard-working organ sits in the upper-right portion of our abdomen? It’s the liver, and it helps us live!

The liver is an extremely vital organ and performs a variety of functions, mainly associated with metabolism and toxin filtration. The liver tissue faces a lot of stress daily, and it has the ability to self-repair.

But sometimes, this stress can get too much for the liver to handle; that’s when liver failure symptoms may appear. The top causes of liver failure are bad lifestyle choices, e.g. heavy alcohol consumption; a viral infection; overdose of some medicine(s); the eating of poisonous mushrooms; or a medical condition called hereditary hemochromatosis.

You must know about both healthy liver signs and liver damage causes to ensure that this vital organ doesn’t develop any irreversible conditions such as liver cirrhosis, which might lead to liver failure.

Liver failure

In the human body, the liver is a leading solid organ. The liver performs many functions, including:

  • Bile manufacturing, bile is most necessary for assisting the digestion of food.
  • Clearing the bloodstream from harmful substances like drugs and alcohol.
  • Saturated fat
  • Manufacturing proteins that help to clot the blood, transport oxygen, and support the immune system.

Liver failure is the term for a condition when the liver is too unwell to fully do its work, such as producing bile, filtering toxins out of the body, and regulating blood sugar levels.

While the liver doesn’t produce the hormone insulin, which comes from the pancreas and controls blood sugar, the liver can respond to high levels of insulin — this indicates a high level of sugar in the blood — by absorbing some of that sugar and storing it as glycogen, to be released later when the body needs sugar. The liver’s chief job is processing all kinds of toxins and waste materials from our food and drink and getting it excreted.

As is evident, if these extremely important processes are hampered, your overall health will suffer. Untreated liver failure could even become fatal.

Acute liver failure is a life-threatening condition, where sudden massive death of liver cells occurs. This may cause complications like excessive internal bleeding. It may cause a sudden hospitalization. Patients suffering from liver failure face a poor quality of life and are at an increased risk of dying due to liver failure.

Signs and symptoms

Here are some symptoms and signs of liver failure:

  • Fluid retention: Cirrhosis, a condition in which scar tissue replaces good liver tissue, is the most prevalent symptom of liver illness, occurring in 50% of patients. Fluid accumulation can lead to abdominal distension and limb edema. This occurs when your liver veins have high blood pressure or your liver is unable to produce albumin, a protein that keeps blood from leaking into tissue.
  • Skin and eyes became pale yellow (jaundice): This symptom results in darker urine and a yellowish tint to your skin or eyes. Bilirubin, a pigment formed when red blood cells break down, builds up in your system, causing it to look. Bilirubin is absorbed and converted into bile by a healthy liver. Your body then eliminates it through feces.
  • Mental confusion: Hepatic encephalopathy is a disorder caused by a build-up of excess toxins in the brain. It ensues because the liver fails to clear blood from harmful chemicals and toxins. This condition may affect the mood, speech, sleep, and behavior of the patient.
  • Easily bleeding: The portal vein connects the liver to the other digestive organs, including the gall bladder and intestine. The portal vein is where around 25% of your blood is cycled by your liver. Cirrhosis can damage the portal vein functioning and allows for an increased risk of bleeding. You may vomit blood, have blood in your feces, or experience rectal bleeding.

Blood is diverted to your spleen, which enlarges in an attempt to relieve congestion. In your esophagus and stomach, varicose veins can form, and these enlarged veins can readily bleed.

Clotting proteins in the blood is one of the many healthy liver signs. However, a sick liver cannot, resulting in additional hemorrhage. Prothrombin is one of the clotting factors. Due to liver dysfunction production of prothrombin decreases. Because of that blood clotting time increase and continue bleeding occurs.

  • Sleeplessness: Cirrhosis of the liver causes sleep-wake disorders, which are linked to a lower quality of life. Insomnia (difficulties getting asleep and staying asleep, or unrefreshing sleep), excessive daytime sleepiness, and sleep-wake inversion are the most prevalent problems (disturbances of circadian rhythmicity). Due to abdomen pain, there is a disturbance in sleep. The patient can not get enough sleep.
  • Nausea: The patient has an unexpected urge of vomiting. nauseous feeling for a long time.
  • Vomiting: Blood in vomit.
  • Pain in the upper right abdomen: The liver is situated on the upper right side of the abdomen below the lungs. That side of the abdomen pains a lot.
  • Diarrhea: Frequently having a pale dark color of stools/motion.
  • Fatigue: The patient may feel lethargic, have low energy, or bad mood.
  •  Loss of appetite: The patient finds eating a well-balanced diet difficult. Patients lose their appetite and find difficulty in coping with eating. Malnutrition is frequent in alcoholic hepatitis patients. Large doses of alcohol reduce hunger, and heavy drinkers acquire the majority of their calories from it.

Risk factors for liver failure

The risk of liver failure can increase due to poor lifestyle choices or other medical conditions. The following are some of the factors that may raise the risk and be the reason of liver failure symptoms:

  • Heavy alcohol consumption

Alcohol is one of the most common liver damage causes. This may be what you have already heard many times. The liver is responsible for the breakdown (metabolism) of alcohol. Frequent heavy consumption of alcohol increases the load on the liver. This may be harmful to the liver and may cause liver diseases and ultimately liver failure.

  • Obesity

Morbid obesity is one of the risk factors for liver failure. Obesity alone can cause a severe condition with all of the symptoms of alcoholic hepatitis, as well as cirrhosis and liver failure. Obesity is a prime cause of non-alcoholic fatty liver disease which may progress to liver failure.

  • Type 2 Diabetes

Diabetes patients have a high risk of liver disease. Medicines used for diabetes treatment are metabolized in the liver. They put a load on the liver functions.

  • Body piercings and tattoos or the use of shared needles to inject drugs

A tattoo or piercing is a risk of exposure to the virus in the body fluid. Sharp needles for injecting drugs may have the risk of hepatitis virus exposure.

  • Exposure to the blood and body fluids of others

If you come to contact with the blood and body fluid of a patient with Hepatitis A virus can cause hepatitis A virus transmission, which increases the risk of liver failure.

  • Having sexual intercourse without protection
  • Liver illness in the family
  • Toxic exposure to some substances

Liver failure diagnosis

The doctor diagnoses liver dysfunctions based on your symptoms, medical history, blood tests (liver function test), urine tests, abdominal imaging, and CT scan of the abdomen or liver.
A biopsy of your liver tissue can be used to diagnose liver disease and examine for symptoms of liver damage. A liver biopsy is often performed with a long needle injected through the skin to remove a tissue sample for testing.

Liver function test

When you have symptoms of liver dysfunction your doctor will recommend you some liver function tests. This blood test includes some enzyme tests like alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT), protein tests such as albumin, prothrombin test, and bilirubin test. With help of these tests, your doctor comes to know if your liver functions are good or if you have any liver disorder.

Causes of acute liver failure

1. Acetaminophen overdose

Acetaminophen is the other name for paracetamol. Taking too much acetaminophen commonly causes liver damage. Acetaminophen toxicity is common due to the wider availability of medicine and the general impression of its safety. Many products contain acetaminophen in combination with other ingredients, including opioids and diphenhydramine. Acute liver failure may occur because of a large dose of paracetamol.
In case you or someone accidentally or intentionally take large doses of paracetamol, go to the hospital as quickly as possible. Early treatment may prevent liver failure.

2. Prescribed drug-induced liver damage

When doctors prescribe you medicines for any other health condition. The prescribed medicines can induce liver damage. Medicines like antibiotics, NSAIDs, anti-epileptics, anti-tuberculosis, over-the-counter drugs, weight loss medicines, anticonvulsants, and herbal dietary supplements can cause liver failure. Such medicines hurt the liver.

3. Viral infections

Hepatitis A, hepatitis B, hepatitis E, herpes virus, Epstein Barr virus, and cytomegalovirus are some viral infections that can cause acute liver failure.

4. Autoimmune disease

Autoimmune hepatitis is a disorder in which your immune system attacks and destroys liver cells, producing inflammation and injury, which can lead to liver failure.

5. Vascular diseases

Budd-Chiari syndrome is a rare disease that can affect the veins in the liver. In this disease, liver veins get narrowed and blocked. That’s why there is less blood supply to the liver and your liver functions get interrupted and cause acute liver disease.

6. Mushroom poisoning

The most prevalent mushroom that causes hepatotoxicity is Amanita phalloides. A patient with a recent mushroom consumption and a history of severe gastrointestinal symptoms like abdominal cramping, vomiting, and diarrhea should be suspected of the diagnosis. Normally symptoms appear after 6 to 12 hr of consumption. Because there is no blood test to confirm mushroom intake, the diagnosis of mushroom poisoning is done clinically.

7. Shock

Impaired blood flows to the liver because of sepsis and shock can cause acute liver failure. Extreme physical activity in heat may trigger ALF.

8. Metabolic disease

A rare inherited disorder called Wilson’s disease, the accumulation of copper in your liver, brain, and other vital organs causes Wilson’s disease. Over-deposition of copper in the liver may cause acute liver failure.

9. Industrial toxins

An industrial toxin that can cause acute liver failure is carbon tetrachloride. It’s a chemical that’s used in refrigerants and solvents for waxes, varnishes, and other materials. Some other chemicals also may cause acute liver failure.

10. Fatty liver during pregnancy

In some pregnancies, the fat started to deposit on the liver. This rare condition can cause acute liver failure. Mother should not consume alcohol during pregnancy, because that increase fat deposition in the liver and liver cell may get affected.

11. Cancer

The beginning or spread of cancer to your liver can cause liver failure. A high amount of alcohol consumption may cause scars (fibrosis) and that will lead to liver cancer.

12. Alcohol

Alcohol-related liver disease (ALD) is caused by consuming more alcohol than the liver can process, causing the organ to be damaged.
The chemical reaction that occurs as the liver breaks down the alcohol generates a toxin that damages liver cells. Even if you don’t get drunk, consuming too much alcohol consistently causes liver damage. When the liver suffers too much damage, it affects the entire body. ALD can be both preventable and lethal.

How can anyone prevent liver failure?

Liver failure is usually an exacerbated outcome of other liver diseases. Hence, minimizing the risk of other liver diseases or preventing their progression can help prevent liver failure. Liver failure may be reduced by these preventive actions mentioned below:

  •  Reduce alcohol consumption.

One drink a day for women and up to two drinks a day for men is good for healthy adults. Drink alcohol in moderate amounts. Overconsumption may cause liver diseases.

  •  Get vaccinated for hepatitis A and hepatitis B.

If you are at high risk of getting hepatitis virus or you have recently been infected, you need to talk to your doctor about getting hepatitis A and hepatitis B vaccines.

  • Use medicines wisely.

Prevent overdose of acetaminophen and follow doctor indications before taking medicines. Avoid mixing medicines and alcohol. Talk to your physician before taking any herbal supplements with prescribed drugs.

  •  Keep monitoring your physical health

Yearly physical examination with screening for liver functions, obesity, high cholesterol, high blood pressure, and diabetes.

  • Maintain your lifestyle, diet, and healthy weight.

Obesity may cause nonalcoholic fatty liver disease. Change your lifestyle and diet for maintaining a healthy weight.

  • Avoid contact with people’s blood and body fluid.

Hepatitis A can be spread by intentional or accidental needle sticks or improper cleanup of blood.

  • Keep your food hot and safe.

Always wash your hands before and after handling or eating food. Make sure you are eating cooked and hot food. Use bottled water but if not possible use boiled water.

  • Have safe sex. Avoid risky behavior.

If you are having tattoos or body piercings be cautious about safety and hygiene when you select a shop. Use condoms during sex.

Liver failure diagnosis, test


The doctor diagnoses liver dysfunctions based on your symptoms, medical history, blood tests (liver function test), urine tests, abdominal imaging, and CT scan of the abdomen or liver.

A biopsy of your liver tissue can be used to diagnose liver disease and examine for symptoms of liver damage. A liver biopsy is often performed with a long needle injected through the skin to remove a tissue sample for testing.

Liver function test

When you have symptoms of liver disease, your doctor will recommend some liver function tests. This blood test includes some enzyme tests like alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT); and protein tests such as albumin, prothrombin test, and bilirubin test.

With the help of these tests, your doctor comes to know if your liver functions are good, or if you have any liver disorder.


Liver failure is a life-threatening disease with a high mortality rate. Liver failure is the last stage of all liver diseases. Vomiting, abdominal pain, blood in stool, pale yellowish colored eyes and nails, fatigue, loss of appetite, and change in speech, mood, and behavior all are a sign and symptoms of liver failure.

There are some diagnostic tests like blood tests, urine tests, and liver imaging. All these tests doctors can help in the diagnosis of your liver disease. There are several causes of liver failure such as an overdose of acetaminophen, alcohol, viral infections, metabolic disease, mushroom poison, autoimmune disease, shock, industrial toxins, and vascular disease.

To reduce the risk of liver failure and make your liver healthy avoid overdosing on acetaminophen, and alcohol, get vaccinated, healthy diet, and have regular exercise. After reading so far, we hope that you’ve found an answer to the question of how to know if your liver is healthy? If you or anyone have symptoms of acute liver failure don’t wait immediately consult your doctor and start treatment.


As we know liver failure is the last stage of liver disease. There are several causes of liver failure but you can reduce the risk of liver failure by some preventive measures.