How Do You Know If Your Liver Is Inflamed: Recognizing the Signs and Understanding Hepatitis

It’s a question that might niggle at the back of your mind, especially if you’ve been feeling a bit “off” lately. “How do you know if your liver is inflamed?” This query often arises when subtle, sometimes confusing, symptoms begin to surface. Perhaps you’re experiencing persistent fatigue, a strange ache in your abdomen, or noticing changes in your skin or eyes. My own journey, like many others, started with a vague sense of unwellness that took some time to pinpoint. Initially, I attributed it to stress or a busy lifestyle, a common pitfall when our bodies are trying to signal something more significant. The liver, that unsung hero working tirelessly behind the scenes, can indeed become inflamed, a condition often referred to as hepatitis. Understanding how to recognize the signs of liver inflammation is crucial for timely diagnosis and effective management, potentially preventing more serious long-term complications.

What Exactly is a Healthy Liver Doing?

Before we dive into the complexities of an inflamed liver, it’s beneficial to appreciate the sheer scope of what a healthy liver accomplishes for our bodies. This remarkable organ, nestled in the upper right quadrant of your abdomen, is essentially your body’s chemical processing plant and detoxifier. Its functions are incredibly diverse and vital for survival. For instance, it’s responsible for producing bile, which aids in the digestion of fats. Think of it like a sophisticated factory that’s constantly churning out essential substances and breaking down harmful ones. It plays a critical role in metabolism, converting nutrients from food into energy or storing them for later use. Proteins, carbohydrates, and fats – the liver handles their processing with incredible efficiency. It also manufactures key proteins necessary for blood clotting, meaning a healthy liver is indispensable for stopping bleeding.

Furthermore, the liver is a powerhouse when it comes to detoxification. It filters your blood, removing toxins, waste products, and harmful substances, including alcohol and medications. Imagine it as a highly skilled security guard, meticulously inspecting everything that passes through and neutralizing any threats. This filtering capacity is so important that even a small disruption can have widespread effects on your overall health. The liver also plays a role in immune function by producing certain types of immune cells that help fight off infections. It’s truly a multi-tasking marvel.

What Does Liver Inflammation Mean?

When we talk about a liver being inflamed, we’re referring to hepatitis. Hepatitis, in its simplest definition, means inflammation of the liver. This inflammation can be acute, meaning it comes on suddenly and lasts for a short period, or chronic, persisting for six months or longer. The causes are varied, ranging from viral infections to autoimmune conditions, excessive alcohol consumption, certain medications, and environmental toxins. It’s like your body’s internal defense system going into overdrive, reacting to an irritant or an invader within the liver tissue itself. This inflammatory response can damage liver cells, impairing their ability to perform their vital functions.

The process of inflammation involves the body sending an increased blood supply to the affected area, bringing white blood cells and other immune components to fight off whatever is causing the problem. While this is a natural and often beneficial response, chronic inflammation can lead to persistent damage and scarring, a condition known as fibrosis. If fibrosis becomes extensive, it can progress to cirrhosis, a severe and irreversible form of liver scarring that significantly hinders liver function. Understanding that inflammation is a sign of distress within the liver is the first step in recognizing when something might be wrong.

Common Causes of Liver Inflammation

To grasp how do you know if your liver is inflamed, it’s important to understand what might be causing it. The most prevalent culprits are viral infections, collectively known as viral hepatitis. These include:

• Hepatitis A (HAV): Typically spread through contaminated food or water. It’s usually an acute infection and doesn’t lead to chronic liver disease.
• Hepatitis B (HBV): Transmitted through blood, semen, and other bodily fluids. This can become chronic and is a significant cause of liver cancer.
• Hepatitis C (HCV): Primarily spread through contact with infected blood, often associated with sharing needles. Chronic HCV infection is a leading cause of cirrhosis and liver transplantation.
• Hepatitis D (HDV): This virus only infects individuals who are already infected with Hepatitis B.
• Hepatitis E (HEV): Similar to Hepatitis A, it’s often spread through contaminated water and usually resolves on its own, though it can be serious in pregnant women.

Beyond viral causes, other significant factors contribute to liver inflammation:

• Alcoholic Hepatitis: This is a serious and potentially life-threatening inflammation of the liver caused by excessive and prolonged alcohol consumption. The liver attempts to metabolize alcohol, but the byproducts are toxic, leading to inflammation and damage.
• Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH): NAFLD is characterized by the buildup of fat in the liver, which can lead to inflammation and liver cell damage (NASH). It’s strongly linked to obesity, type 2 diabetes, high cholesterol, and metabolic syndrome. This is becoming increasingly common and is a major concern for public health.
• Autoimmune Hepatitis: In this condition, the body’s immune system mistakenly attacks the liver cells, causing inflammation. The exact cause is not fully understood, but genetic and environmental factors likely play a role.
• Drug-Induced Liver Injury (DILI): Many medications, both prescription and over-the-counter, can cause liver inflammation as a side effect. This can include acetaminophen (Tylenol) in high doses, certain antibiotics, anti-inflammatory drugs, and even some herbal supplements. It’s critical to be aware of potential drug interactions and to use medications responsibly.
• Genetic Conditions: Diseases like hemochromatosis (iron overload) and Wilson’s disease (copper overload) can lead to liver inflammation and damage over time as excess substances accumulate in the liver.
• Toxins: Exposure to certain environmental toxins, such as industrial chemicals or some types of mushrooms (like the Death Cap), can cause severe liver damage and inflammation.

Recognizing the Subtle Signs: How Do You Know If Your Liver Is Inflamed?

This is the crux of the matter. The challenge with liver inflammation, especially in its early stages, is that the symptoms can be incredibly subtle and easily dismissed. Your liver doesn’t have direct pain receptors, so you won’t feel a sharp jab from an inflamed liver itself. Instead, the discomfort often arises from the stretching of its capsule or referred pain from surrounding organs. Personally, I remember feeling a dull, persistent ache in my upper right abdomen that I initially mistook for indigestion. It wasn’t a sharp pain, but a constant, nagging discomfort that just wouldn’t go away.

Here are some key indicators to watch out for:

• Fatigue and Weakness: This is perhaps the most common and often the earliest symptom. When your liver is struggling to perform its detoxification and metabolic functions, your body can feel drained. It’s not just feeling tired; it’s a profound, bone-weary exhaustion that sleep doesn’t seem to fix. You might find yourself struggling to get through the day, lacking motivation and energy for even simple tasks. This can be due to the liver’s reduced ability to process nutrients efficiently and clear toxins that can affect energy levels.
• Abdominal Discomfort or Pain: As mentioned, you might feel a dull ache or tenderness in the upper right quadrant of your abdomen, where the liver is located. This pain can sometimes radiate to your right shoulder or shoulder blade. It’s not typically a sharp, stabbing pain, but more of a persistent pressure or fullness. Sometimes, the liver can become enlarged due to inflammation, putting pressure on surrounding tissues, which leads to this sensation.
• Jaundice (Yellowing of Skin and Eyes): This is a more classic and noticeable sign of liver problems, though it usually indicates more significant inflammation or liver damage. Jaundice occurs when the liver can’t process bilirubin, a waste product from the breakdown of red blood cells, effectively. Bilirubin then builds up in the bloodstream, causing the skin, the whites of the eyes (sclera), and mucous membranes to turn yellow. It’s a stark visual cue that something is definitely amiss.
• Nausea and Vomiting: When the liver is inflamed, it can affect digestion. This can lead to feelings of nausea, a general queasiness, and sometimes actual vomiting. You might find that certain foods are harder to tolerate, or you simply feel sick to your stomach more often than usual.
• Loss of Appetite and Unexplained Weight Loss: The combination of nausea, fatigue, and impaired digestion can significantly reduce your appetite. You might find yourself not feeling hungry, even if you haven’t eaten much, and consequently, you might start losing weight without trying. This can be concerning and is a signal that your body isn’t processing nutrients as it should.
• Dark Urine: Bilirubin, which is elevated in jaundice, can also be excreted in the urine, giving it a dark, tea-like or cola-like color. This is because the kidneys are trying to help the body get rid of the excess bilirubin.
• Pale or Clay-Colored Stools: Conversely, if bilirubin isn’t reaching the intestines to give stool its normal brown color, the stools may appear pale, gray, or clay-colored. Bile, which is produced by the liver, is essential for the color and consistency of stool.
• Itchy Skin (Pruritus): Inflammation and impaired bile flow can lead to the buildup of bile salts under the skin, causing intense itching. This itching can be widespread and particularly bothersome, often occurring without any visible rash.
• Easy Bruising or Bleeding: The liver produces proteins essential for blood clotting. When the liver is inflamed and damaged, its ability to produce these clotting factors can be compromised, leading to easier bruising and prolonged bleeding from minor cuts or injuries.
• Swollen Abdomen (Ascites): In more severe or chronic cases, inflammation can lead to fluid buildup in the abdominal cavity, a condition called ascites. This can cause significant abdominal swelling, discomfort, and a feeling of fullness.
• Confusion or Cognitive Changes (Hepatic Encephalopathy): In very advanced stages of liver disease, the liver may not be able to filter toxins from the blood effectively. These toxins can then build up and affect brain function, leading to confusion, difficulty concentrating, personality changes, and even coma. This is a serious complication and requires immediate medical attention.

The Diagnostic Process: How Doctors Confirm Liver Inflammation

If you’re experiencing several of these symptoms, it’s imperative to consult a healthcare professional. Self-diagnosis is risky, and professional evaluation is key. So, how do doctors determine if your liver is indeed inflamed? It’s usually a multi-step process involving a combination of your medical history, a physical examination, and various laboratory and imaging tests. They are essentially piecing together a puzzle to understand what’s happening inside.

Medical History and Physical Examination

Your doctor will start by asking detailed questions about your symptoms, their duration, your lifestyle (including alcohol intake, diet, and any potential exposure to viruses or toxins), your medication history, and any family history of liver disease. They’ll be looking for any patterns or risk factors. The physical examination involves palpating (feeling) your abdomen to check for tenderness, enlargement of the liver or spleen, and any signs of fluid buildup. They will also visually inspect your skin and eyes for signs of jaundice and check for any unusual bruising.

Blood Tests: The Liver Function Panel and Beyond

Blood tests are crucial in diagnosing liver inflammation. The most common is the Liver Function Panel (LFP), also known as a Hepatic Function Panel (HFP) or Liver Panel. This panel measures:

• Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST): These are liver enzymes. When liver cells are damaged or inflamed, they release ALT and AST into the bloodstream, causing their levels to rise. Elevated ALT and AST levels are often early indicators of liver injury.
• Alkaline Phosphatase (ALP): This enzyme is found in the liver, bile ducts, and bone. Elevated levels can indicate liver disease, particularly issues with bile ducts, or bone disorders.
• Bilirubin (Total and Direct): Measures the amount of bilirubin in your blood. Elevated levels, as discussed, can indicate jaundice and impaired liver function.
• Albumin: This is a protein produced by the liver. Low albumin levels can indicate that the liver is not functioning properly and is not producing enough of this essential protein.
• Prothrombin Time (PT) and International Normalized Ratio (INR): These tests measure how long it takes for your blood to clot. Prolonged clotting times can signal that the liver isn’t producing enough clotting factors.

Beyond the LFP, doctors may order other blood tests to investigate specific causes of hepatitis:

• Viral Hepatitis Serology: Tests to detect antibodies and antigens related to Hepatitis A, B, C, D, and E viruses. These tests are vital for identifying viral causes of liver inflammation.
• Autoimmune Markers: Tests like antinuclear antibodies (ANA), anti-smooth muscle antibodies (ASMA), and anti-liver kidney microsomal antibodies (anti-LKM) can help diagnose autoimmune hepatitis.
• Iron Studies: For suspected hemochromatosis.
• Ceruloplasmin Levels: For suspected Wilson’s disease.

Imaging Studies: Visualizing the Liver

To get a clearer picture of the liver’s structure and any potential damage, imaging techniques are often employed:

• Ultrasound: A non-invasive test that uses sound waves to create images of the liver. It can detect liver enlargement, fatty infiltration, cysts, tumors, and changes in liver texture that might indicate inflammation or scarring.
• CT Scan (Computed Tomography): Provides more detailed cross-sectional images of the liver and surrounding organs. It can help identify the size, shape, and density of the liver and detect abnormalities.
• MRI (Magnetic Resonance Imaging): Offers highly detailed images of the liver, often providing better visualization of soft tissues and blood vessels than CT scans. It can be particularly useful in assessing the extent of fibrosis or cirrhosis.
• FibroScan (Transient Elastography): This is a specialized ultrasound technique that measures the stiffness of the liver. Increased stiffness often correlates with fibrosis or scarring, providing a non-invasive way to assess liver damage.

Liver Biopsy: The Gold Standard (Sometimes)

In some cases, a liver biopsy may be recommended. This involves taking a small sample of liver tissue using a needle inserted through the skin. The sample is then examined under a microscope by a pathologist. A biopsy can:

• Confirm the presence and extent of inflammation.
• Identify the specific cause of liver damage (e.g., inflammation, fat deposition, fibrosis, or cancer).
• Help stage the severity of the liver disease.
• Guide treatment decisions.

While a biopsy is very informative, it is an invasive procedure with potential risks, so it’s not always the first step. The decision to perform a biopsy is made based on the findings from other tests and the overall clinical picture.

Living with Liver Inflammation: Management and Lifestyle Changes

Once liver inflammation is diagnosed, the focus shifts to managing the condition and preventing further damage. The approach to treatment is highly dependent on the underlying cause, severity, and whether it’s acute or chronic. It’s a journey that often involves significant lifestyle adjustments. For me, learning to listen to my body and make conscious choices became paramount.

Dietary Considerations

A healthy diet is foundational for liver health. While there’s no one-size-fits-all “liver diet,” certain principles are generally recommended:

• Limit Processed Foods, Sugary Drinks, and Unhealthy Fats: These can contribute to inflammation and fatty liver disease. Opt for whole, unprocessed foods.
• Emphasize Fruits, Vegetables, and Whole Grains: These provide essential vitamins, minerals, and antioxidants that support liver function and combat oxidative stress.
• Include Lean Proteins: Fish, poultry, beans, and lentils are good sources of protein without excessive saturated fat.
• Healthy Fats: Sources like avocados, nuts, seeds, and olive oil are beneficial.
• Stay Hydrated: Drink plenty of water throughout the day.
• Moderate Sodium Intake: Excessive salt can contribute to fluid retention, which can be an issue in advanced liver disease.

For those with alcoholic hepatitis, complete abstinence from alcohol is absolutely non-negotiable. For NAFLD/NASH, weight loss through diet and exercise is often the most effective intervention.

The Role of Alcohol and Medications

As you might expect, if alcohol is the cause of your liver inflammation, abstaining from alcohol is the most critical step. Even moderate amounts can further damage an already compromised liver. Similarly, it’s vital to discuss all medications, including over-the-counter drugs and herbal supplements, with your doctor. Some substances can be hepatotoxic (toxic to the liver), and your doctor can advise you on safe alternatives or necessary precautions. Never start new medications or supplements without consulting your physician, especially if you have a known liver condition.

Exercise and Weight Management

Regular physical activity is beneficial for overall health and can significantly impact liver health, particularly for those with NAFLD/NASH. Exercise helps improve insulin sensitivity, reduce inflammation, and aids in weight management. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, along with muscle-strengthening activities. Even gentle exercise, like walking, can make a difference. If you are overweight or obese, even a modest weight loss (5-10% of body weight) can improve liver enzyme levels and reduce fat in the liver.

Vaccinations

For individuals at risk of or diagnosed with liver conditions, vaccinations against Hepatitis A and Hepatitis B are often recommended. This is to prevent co-infection with these viruses, which can significantly worsen existing liver disease.

Medical Treatments

Treatment strategies for liver inflammation vary widely:

• Antiviral Medications: For viral hepatitis (Hepatitis B, C, D), specific antiviral drugs can help suppress the virus, reduce inflammation, and prevent further liver damage. New, highly effective treatments are now available for Hepatitis C, often leading to a cure.
• Immunosuppressants: For autoimmune hepatitis, medications that suppress the immune system are used to reduce the attack on the liver.
• Corticosteroids: These can be used to reduce inflammation in autoimmune hepatitis, though they are often used cautiously due to potential side effects.
• Medications for NAFLD/NASH: Currently, there are no FDA-approved medications specifically for NAFLD or NASH, but vitamin E and certain diabetes medications have shown promise in some individuals. Lifestyle changes remain the cornerstone of management.
• Medications for Complications: If complications like ascites or hepatic encephalopathy develop, specific medications are used to manage these conditions.

In severe cases of irreversible liver damage, such as advanced cirrhosis, a liver transplant may be the only option.

When to Seek Medical Attention Immediately

While it’s good to be aware of the signs, some symptoms warrant immediate medical attention. These are usually indicative of acute liver failure or severe complications:

• Sudden onset of severe jaundice.
• Significant abdominal pain that is worsening.
• Persistent vomiting, especially if you can’t keep fluids down.
• Signs of bleeding, such as blood in vomit or stool, or unusual bruising.
• Confusion, disorientation, or significant personality changes (signs of hepatic encephalopathy).
• Fever accompanied by abdominal pain.

If you experience any of these, don’t hesitate. Head to the nearest emergency room or call emergency services. Prompt medical intervention can be life-saving in these critical situations.

Frequently Asked Questions About Liver Inflammation

How can I tell if my liver is just tired versus truly inflamed?

Distinguishing between a “tired” liver and a truly inflamed one can be challenging because the symptoms often overlap. A “tired” liver is a colloquial term often used to describe a liver that is overworked or struggling to keep up with demands, perhaps due to poor diet, stress, or occasional overindulgence. Symptoms might include mild fatigue or indigestion. However, when inflammation (hepatitis) sets in, the symptoms tend to be more pronounced and persistent. Persistent fatigue that isn’t relieved by rest, significant abdominal discomfort, jaundice, changes in urine or stool color, nausea, and loss of appetite are more indicative of actual inflammation. Crucially, objective medical tests, particularly blood tests measuring liver enzymes (ALT and AST), are the definitive way to tell. Elevated enzymes signal damage to liver cells, which is characteristic of inflammation.

Is it possible to have an inflamed liver without any symptoms?

Yes, it is absolutely possible, and quite common, to have an inflamed liver without experiencing any noticeable symptoms, especially in the early stages of chronic hepatitis. This is one of the reasons why regular health check-ups are so important, especially if you have risk factors for liver disease. The liver has a remarkable capacity to regenerate and compensate for damage. As a result, significant inflammation or damage can occur before the liver’s function is so impaired that symptoms become apparent. This silent progression is particularly true for conditions like chronic Hepatitis B or C, and non-alcoholic fatty liver disease (NAFLD). This is why screening tests, particularly blood tests for liver enzymes and viral hepatitis, are vital for individuals at risk.

How quickly can liver inflammation develop?

The speed at which liver inflammation can develop varies greatly depending on the cause. Acute hepatitis, such as that caused by certain viral infections (like Hepatitis A) or a severe reaction to a medication or toxin, can develop quite rapidly, sometimes within days or a few weeks of exposure. Symptoms can appear suddenly and be quite severe. On the other hand, chronic hepatitis, often caused by Hepatitis B or C, alcohol abuse, or autoimmune conditions, develops much more gradually over months, years, or even decades. In these cases, the inflammation is often low-grade and persistent, leading to slow, cumulative damage that may not become symptomatic until significant fibrosis or cirrhosis has already occurred.

Can stress cause my liver to become inflamed?

While chronic stress can negatively impact your overall health and potentially exacerbate existing liver conditions, stress itself is not a direct cause of liver inflammation (hepatitis). The primary causes of hepatitis are infections, toxins, alcohol, and autoimmune responses. However, chronic stress can lead to unhealthy coping mechanisms, such as poor diet, lack of exercise, and increased alcohol consumption, all of which can contribute to liver problems, including fatty liver disease and inflammation. Stress can also weaken the immune system, potentially making you more susceptible to infections, including viral hepatitis. So, while stress isn’t the direct culprit, it can certainly play an indirect role in liver health by influencing your lifestyle choices and overall well-being.

What is the difference between fatty liver and an inflamed liver?

Fatty liver disease, or hepatic steatosis, is a condition characterized by the excessive buildup of fat in the liver cells. In many cases, this fat buildup doesn’t cause significant harm and may even be reversible with lifestyle changes. However, in some individuals, this fat accumulation can lead to inflammation and damage to liver cells, a condition known as non-alcoholic steatohepatitis (NASH) or alcoholic steatohepatitis (ASH), depending on the cause. So, while fatty liver is the presence of excess fat, an inflamed liver (hepatitis) is specifically the inflammation of liver tissue, which can sometimes occur as a consequence of fatty liver disease. You can have fatty liver without inflammation, but NASH and ASH involve both fat buildup and inflammation.

Are there natural remedies that can help an inflamed liver?

While a healthy lifestyle is paramount, and certain dietary choices can support liver health, it’s crucial to approach “natural remedies” with caution, especially when dealing with diagnosed liver inflammation. Some herbs and supplements, like milk thistle, have been studied for their potential liver-protective properties, primarily due to their antioxidant compounds. However, scientific evidence supporting their efficacy in treating diagnosed hepatitis is often limited or inconclusive. More importantly, some herbal supplements can actually be harmful to the liver or interact negatively with prescribed medications. It is absolutely essential to discuss any natural remedies or supplements you are considering with your doctor. They can advise you on safety, potential interactions, and whether such remedies might complement your conventional medical treatment. Never replace or delay standard medical treatment for liver inflammation with unproven natural remedies.

How do I know if my liver inflammation is serious?

The seriousness of liver inflammation can range from mild and temporary to severe and life-threatening. Several factors help determine its severity. Firstly, the underlying cause plays a significant role; for example, chronic Hepatitis C can lead to severe cirrhosis over time, while Hepatitis A is usually self-limiting. Secondly, the extent of liver damage is critical. Blood tests showing very high levels of liver enzymes (ALT, AST), significantly elevated bilirubin, or prolonged clotting times can indicate more severe injury. Imaging studies like ultrasound, CT, or MRI might reveal liver enlargement, significant scarring (fibrosis), or fluid buildup (ascites), all signs of more advanced disease. Symptoms like jaundice, confusion (hepatic encephalopathy), severe abdominal swelling, or signs of bleeding are also indicators of serious liver inflammation and complications. Ultimately, a healthcare professional, based on a combination of your symptoms, medical history, and diagnostic test results, will determine the seriousness of your liver inflammation and guide the appropriate course of action.

Can an inflamed liver affect my digestion?

Absolutely. Your liver plays a central role in digestion, primarily through the production of bile, which is essential for breaking down fats in the small intestine. When the liver is inflamed, its ability to produce and secrete bile can be compromised. This can lead to a variety of digestive issues, including nausea, loss of appetite, bloating, and an intolerance to fatty foods. Bile also helps move waste through the intestines. If bile flow is impaired, this can also contribute to digestive discomfort. Furthermore, the general malaise and fatigue associated with liver inflammation can naturally decrease your desire to eat and affect how your body processes food. So yes, liver inflammation can indeed significantly impact your digestive system.

If I have an inflamed liver, do I need to avoid all fats in my diet?

Not necessarily all fats, but it’s wise to be mindful of the types and amounts of fat you consume. The key is to focus on healthy fats and limit unhealthy ones. Your liver needs healthy fats to function properly. Good sources include monounsaturated and polyunsaturated fats found in olive oil, avocados, nuts, seeds, and fatty fish (like salmon). These fats are generally easier for a compromised liver to process. What you should aim to significantly reduce or avoid are saturated fats (found in red meat, butter, full-fat dairy) and trans fats (often found in processed and fried foods). These unhealthy fats can contribute to inflammation and fatty liver disease. If you have significant bile duct issues or advanced liver disease, your doctor might advise a more restricted fat intake, but for many individuals with mild to moderate inflammation, a focus on quality over quantity is the best approach.

Conclusion

Understanding how do you know if your liver is inflamed is a critical step in safeguarding your health. The liver is a resilient organ, but it’s not immune to damage. Recognizing the subtle and sometimes obvious signs, from persistent fatigue and abdominal discomfort to jaundice and changes in bodily functions, empowers you to seek timely medical attention. The journey from experiencing symptoms to receiving a diagnosis often involves a comprehensive evaluation by healthcare professionals, utilizing blood tests, imaging, and sometimes a biopsy. While the causes of liver inflammation are varied, the implications of neglecting it can be severe. Fortunately, with proper diagnosis and management, which often includes significant lifestyle modifications like dietary changes, limited alcohol intake, and regular exercise, many individuals can improve their liver health and prevent further progression of the disease. Never hesitate to consult with your doctor if you have concerns. Your liver works tirelessly for you; it’s crucial to pay attention when it signals it needs help.