The liver is a hardworking organ that plays a vital role in digestion, detoxification, immunity and metabolism. Indeed, the largest internal organ in the human body is also one of the most important, which is why a well-functioning liver is crucial for good health.

Family medicine specialist Dr Chow Suet Yin explains the essential services performed by the liver, and what happens if these functions fail.

1. Detoxification

Trendy detox diets often appear online, claiming various health benefits. But if the liver is the primary organ responsible for dealing with toxins, why turn to fads to get the job done?

“The liver produces its own enzymes to break down metabolic waste and convert substances that can be secreted in urine and faeces,” Chow explained.

“Without this function, waste substances like bilirubin would build up in the body, leading to problems like jaundice. Eventually, this buildup would affect brain function, which could lead to a coma.”

2. Digestion

The liver produces bile, a digestive fluid that helps to break down fat so it can be absorbed.

Bile also helps store fat-soluble vitamins A, D, E and K. Without it, the human body would be unable to absorb these vitamins, which could lead to deficiencies that affect different aspects of health.

These include impaired vision from low levels of vitamin A; weakened bones from insufficient vitamin D; muscle weakness from lack of vitamin E; and poor blood clotting without vitamin K.

3. Immunity

Among its many other functions, the liver produces a concentration of Kupffer cells. These help to filter and remove harmful pathogens like viruses and bacteria, which can enter the liver from the gastrointestinal tract.

By helping to prevent inflammation and infection, Kupffer cells play a vital role in protecting the liver, allowing it to perform its various functions.

4. Metabolism

Your body’s ability to store energy and manage blood sugar levels is also regulated by the liver, which stores glycogen, a form of glucose, that can be released for energy when needed.

Another important metabolic function is the development of proteins that help with blood clotting, and albumin, which is essential for maintaining blood volume.

Given these metabolic functions, poor liver health could result in low energy, dysregulation of blood sugar levels, easy bruising, and swelling in the abdomen and legs, Chow highlighted.

Lifelong liver?

Much has been said about the liver being the only organ that is capable of self-regeneration. While that is good news, there are limitations.

“Unhealthy lifestyle habits are the leading cause of poor liver health and fatty liver disease,” said Chow, who outlined the main culprits as follows:

• excessive alcohol intake;
• diets that are very high in saturated fats, sugar, and processed food;
• obesity, which is related to diet and lack of exercise; and
• the impact of certain medications, supplements, and traditional or herbal remedies.

While early symptoms of liver disease are non-specific, more obvious signs appear as its condition deteriorates.

“Fatty liver is the initial stage of liver disease and it is not associated with any symptoms,” Chow noted. “Only a scan will reveal the fat deposits that have built up in the liver.

“This progresses to inflammation and subsequently scarring: by this time, you may have symptoms such as fatigue and abdominal pain that comes and goes.

“Without intervention, scar tissue will build up from the liver’s ongoing attempts to heal itself, advancing to fibrosis. At this stage, liver functions are impacted, leading to more severe symptoms, such as abdominal pain from an enlarged liver or fluid buildup in the abdomen.”

The next stage of liver disease is known as cirrhosis, in which the damage to the liver and its blood vessels becomes irreversible.

“When the liver becomes cirrhotic, you are likely to have symptoms such as jaundice and find yourself more prone to bruising or bleeding. As liver functions continue to worsen, you may even vomit blood and experience confusion or weakness.

“Moving forward, the damaged cells can become cancerous, leading to liver cancer, or progress to liver failure,” she cautioned.

As liver damage has its roots in unhealthy lifestyle habits, the key to turning things around is to adopt healthier habits. Chow recommends:

• eating more good fats from sources like olive oil, avocado, fatty fish, seeds and nuts;
• consuming salt and sugar in moderation;
• cutting back on processed foods, saturated fats, and substances like alcohol;
• staying active and maintaining a healthy weight, as among those who are overweight, a 5-10% reduction in weight can reverse fatty liver;
• getting adequate sleep, as the liver works hardest while we are at rest

Chow also advises caution with supplements and traditional remedies, as these may have an impact on liver functions, and advocates going for annual screenings to help monitor your liver health and allow for early intervention.