What is toxic liver disease?

Toxic liver disease is a liver condition caused by exposure to toxic substances, such as alcohol, certain drugs, or chemicals. It’s also called hepatotoxicity or toxic hepatitis.

In some cases, toxic hepatitis develops within hours or days of exposure to a toxin. In other cases, it may take months of regular use before signs and symptoms appear. If the liver is unable to break down the toxins that have been ingested, it leads to inflammation and liver damage.

These toxic substances can be found in the environment, in the food you eat, or in the medications you take. The symptoms of toxic liver disease tend to reduce when the body is no longer exposed to the toxin. But toxic hepatitis can permanently damage your liver, leading to irreversible scarring of liver tissue (cirrhosis) and in some cases to liver failure, which can be life-threatening.

Read: Research finds severe liver damage from supplements on the rise

What does the liver do?

The liver is a vital organ that has many functions in the body, including filtering the blood, producing bile, storing energy, and breaking down toxins. The liver is essential for good health, and any damage to it can have serious consequences.

Since the liver is responsible for filtering toxins from the blood, when it is exposed to certain toxins or too many toxins, it can become overloaded and damaged.

The liver’s main functions include:

  1. converting proteins and sugars into by-products that can be used for energy and biological processes
  2. acting as a filter to remove chemicals and drugs from the bloodstream
  3. storing vitamins, hormones and minerals, and releasing them into the body as needed
  4. producing bile, a greenish fluid that is stored in the gallbladder. Bile helps to break down fats in the small intestine.

Symptoms of toxic liver disease

Mild forms of toxic hepatitis may not cause any symptoms and may be detected only by a blood test. Stronger cases may present symptoms such as:

  • yellowing of the skin and eyes (jaundice)
  • fatigue
  • nausea
  • weight loss
  • itching
  • abdominal pain in the upper right portion of the abdomen
  • loss of appetite
  • rash
  • fever
  • weight loss
  • dark or tea-coloured urine

Causes of toxic hepatitis

The disease is usually caused by exposure to certain organic (carbon-based) chemicals or solvents, certain medications, drugs or alcohol.

Many chemicals and medications can cause liver damage, however, people respond differently to medications. While some people may have an adverse reaction to a certain drug and suffer liver damage, others may not. Excessive consumption of alcohol can cause liver damage by itself and also worsen the harmful effects of drug or chemical exposure.

Chemical-induced hepatitis

Exposure to toxic chemicals in the workplace, such as organic chemicals and solvents, is a common cause of toxic hepatitis. Exposure can occur through ingesting a chemical, breathing it in, or through contact with the skin.

Read: Can a detox help your liver?

Drug-induced hepatitis

Some prescription and over-the-counter medications may cause liver toxicity, including:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac and naproxen
  • acetaminophen (paracetamol)
  • statins (drugs that lower cholesterol)
  • anaesthetics
  • anti-seizure medications
  • antipsychotics
  • antidepressants
  • anti-rheumatic drugs
  • anti-retroviral drugs
  • anti-tubercular drugs, especially when used in combination
  • vitamin, mineral, or herbal supplements.

Other medications may be toxic for some patients, especially those who are elderly or who have viral hepatitis.

Alcohol-induced hepatitis

Alcohol abuse or dependence may cause liver damage, especially if drinking is combined with drugs or medications.

While it may seem counterintuitive that something natural can be bad for you, some common herbal supplements can cause toxic liver disease. Watch out for supplements that contain aloe vera, black cohosh, cascara, chaparral, comfrey, ephedra, or kava.

How is toxic liver disease diagnosed?

A diagnosis of toxic hepatitis is made from a combination of looking at your symptoms and medical history, a physical exam and blood tests.

Your doctor may examine your abdomen for signs of tenderness or swelling.

Blood tests are also typically part of the diagnosis process where the levels of liver enzymes and bilirubin in the blood will be analysed. Bilirubin is a waste product made from old blood cells. If blood levels of liver enzymes and bilirubin are higher than normal, it can indicate liver damage.

If liver damage is confirmed or highly likely, a liver biopsy may be carried out. This is where a small sample of tissue is removed from the liver to evaluate the type and extent of liver damage.

Magnetic resonance imaging (MRI), computed tomography (CT) or ultrasound scans may also be ordered to evaluate liver damage.

Read: How to reverse liver damage

Treatment for toxic liver disease

The first step in treating toxic hepatitis is to identify the toxin causing the damage and stopping the exposure.

This could include:

  • switching medications
  • avoiding any herbal supplement or chemical that’s toxic to your liver
  • not drinking alcohol because it puts stress on your liver.

If an overdose of paracetamol has occurred, the hospital may administer acetylcysteine, also known as N-acetylcysteine (NAC) as it can help prevent liver damage.

A liver transplant is reserved for very severe cases of liver damage.

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Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.