Liver weakness or Liver failure (Liver disease is also referred to as a hepatic disease) is any disturbance of liver function that causes illness.

The liver is responsible for many critical functions within the body and should it become diseased or injured, the loss of those functions can cause significant damage to the body.

Liver weakness or liver disease is a broad term that covers all the potential problems that cause the liver to fail to perform its designated functions.

Usually, more than 75% or three-quarters of liver tissue needs to be affected before a decrease in function occurs.

The liver is the largest solid organ in the body; and is also considered a gland because, among its many functions, it makes and secretes bile.

The liver cells have two different sources of blood supply. The hepatic artery supplies oxygen-rich blood that is pumped from the heart, while the portal vein supplies nutrients from the intestine and the spleen.

Normally, veins return blood from the body to the heart, but the portal vein allows nutrients and chemicals from the digestive tract to enter the liver for processing and filtering prior to entering the general circulation. The portal vein also efficiently delivers the chemicals and proteins that liver cells need to produce the proteins, cholesterol, and glycogen required for normal body activities.

The liver performs many important functions, including:

• Making blood proteins that aid in clotting, transporting oxygen and supporting the immune system.
• Manufacturing bile, a substance needed to help digest food.
• Helping the body store sugar (glucose) in the form of glycogen.
• Ridding the body of harmful substances in the bloodstream (especially drugs and alcohol).
• Breaking down saturated fat and producing cholesterol.

Liver weakness or Liver failure occurs when a person’s liver isn’t working well enough to perform these tasks.

Liver weakness or Liver failure can be a life-threatening emergency that requires immediate medical attention.

Causes Liver weakness or Liver failure

Many different diseases and conditions cause liver failure, including Hepatitis B and C, non-alcoholic fatty liver disease, alcohol abuse and hemochromatosis, infectious mononucleosis (Epstein Barr virus), nonalcoholic fatty liver disease (NASH) and iron overload (hemochromatosis).

Drugs for example excessive amounts of acetaminophen, and acetaminophen combination medications like Vicodin and Norco, as well as statins, cirrhosis, alcohol abuse etc.

In many cases, chronic liver failure results from cirrhosis. Cirrhosis is the scarring of the liver from repeated or long-lasting injury, such as from drinking alcohol excessively over a long period of time or chronic hepatitis infection. As scar tissue replaces healthy liver tissue, the liver loses its ability to function.

Acute liver failure is most often caused by:

• Viral infections, such as Hepatitis B.
• The overuse of allopathic drugs or toxins, like acetaminophen (Tylenol), antibiotics, antidepressants, anti-seizure medications, man-made hormones and antifungal drugs etc.
• Metabolic (biologic) or vascular (vessels that carry fluids, such as arteries) disorders, such as Wilson disease and autoimmune hepatitis.

Classic symptoms of Liver weakness or Liver failure include

• nausea,
• vomiting,
• right upper quadrant abdominal pain, and
• jaundice  {⇐click for treatment}(a yellow discoloration of the skin due to elevated bilirubin concentrations in the bloodstream).
• Fatigue,
• weakness, and
• weight loss.

However, since there are a variety of liver diseases, the symptoms tend to be specific for that illness until late-stage liver disease and liver failure occurs. Examples of liver disease symptoms due to certain conditions or diseases include:

• Gallstones. A person with gallstones may experience right upper abdominal pain and vomiting after eating a greasy (fatty) meal. If the gallbladder becomes infected, fever may occur.
• Gilbert’s disease has no symptoms and is an incidental finding on a blood test where the bilirubin level is mildly elevated.
• Cirrhosis of the liver(⇐click for treatment) will develop progressive symptoms as the liver fails. Some symptoms are directly related to the inability of the liver to metabolize the body’s waste products. Others reflect the failure of the liver to manufacture proteins required for body function and may affect blood clotting function, secondary sex characteristics, and brain function.

Symptoms of cirrhosis of the liver include the following:

• Easy bruising may occur due to decreased production of clotting factors;
• Bile salts can deposit in the skin causing itching;
• Gynecomastia or enlarged breasts in men may occur because of an imbalance in sex hormones,
• Specifically an increase in estradiol; impotence (erectile dysfunction, ED),
• Poor sex drive and shrinking testicles are due to a decrease in function of sex hormones;
• Confusion and lethargy may occur if ammonia levels rise in the bloodstream (ammonia is a waste product formed from protein metabolism and requires normal liver cells to remove it);
• Ascites (fluid accumulation within the abdominal cavity) occur because of decreased protein production;
• Muscle wasting may occur because of reduced protein production.

Additionally, there is increased pressure within the cirrhotic liver affecting blood flow through the liver. Increased pressure in the portal vein causes blood flow to the liver to slow down and blood vessels to swell. Swollen veins (varices) form around the stomach and esophagus and are at risk for bleeding.

Other symptoms include:

• jaundice  {⇐click for treatment},
• abdominal pain and swelling,
• itchy skin,
• dark urine color,
• nausea,
• vomiting,
• chronic fatigue,
• pale stool color,
• bloody stool,
• tar-colored stool,
• swelling in the ankles and legs,
• loss of appetite,
• easy bruising.

Liver failure can take years to develop. The symptoms of liver failure often look like symptoms of other medical conditions, which can make it hard to diagnose in its early stages. Symptoms get worse as patient’s failing liver continues to get weaker.

Chronic liver weakness or liver failure that occurs over many years, may cause:

• Fatigue
• Nausea
• Loss of appetite
• Diarrhea
• Vomiting blood
• Bloody stools.

As liver failure advances, symptoms become more severe. In later stages, symptoms of liver failure may include:

• jaundice  {⇐click for treatment} (yellowing of the skin and eyes)
• Extreme tiredness
• Disorientation (confusion and uncertainty)
• Fluid buildup in the abdomen and extremities (arms and legs).

Acute liver failure:

Sometimes, the liver fails suddenly, which is known as acute liver failure. People with acute liver failure may have the following symptoms:

• Bleeding
• Changes in mental status
• Musty or sweet breath odor
• Movement problems
• Loss of appetite
• General feeling of being unwell
• Jaundice

As part of its function, the liver makes bile, a fluid that contains among other substances, water, chemicals, and bile acids (made from stored cholesterol in the liver). Bile is stored in the gallbladder and when food enters the duodenum (the first part of the small intestine), bile is secreted into the duodenum, to aid in the digestion of food.

The liver is the only organ in the body that can easily replace damaged cells, but if enough cells are lost, the liver may not be able to meet the needs of the body.

The liver can be considered a chemical lab or a factory, and among its many functions include:

• Production of bile that is required in the digestion of food, in particular, fats,
• Storing of the extra glucose or sugar as glycogen, and then converting it back into glucose when the body needs it for energy,
• Production of blood clotting factors,
• Production of amino acids (the building blocks for making proteins), including those used to help fight infection,
• The processing and storage of iron necessary for red blood cell production,
• The manufacture of cholesterol and other chemicals required for fat transport,
• The conversion of waste products of body metabolism into urea that is excreted in the urine,
• Metabolizing medications into their active ingredient in the body.

The liver can be damaged in a variety of ways. Cells can become inflamed, for example, hepatitis. Bile flow can be obstructed, for example, cholestasis.

Cholesterol or triglycerides can accumulate, for example, steatosis. Blood flow to the liver may be compromised. Liver tissue can be damaged by chemicals and minerals, or infiltrated by abnormal cells, like cancer cells.

Alcohol abuse and liver disease:

Alcohol abuse is the most common cause of liver disease especially in USA, Russia and Europe. Alcohol is directly toxic to liver cells and can cause liver inflammation, referred to as alcoholic hepatitis. In chronic alcohol abuse, fat accumulation occurs in liver cells affecting their ability to function.

Cirrhosis of the liver (end-stage liver disease):

Cirrhosis (⇐click for treatment)is a late stage of liver disease. Scarring of the liver and loss of functioning liver cells cause the liver to fail. Significant amounts of liver cells need to be damaged before the hole organ fails to function.

Cirrhosis is a term that describes permanent scarring of the liver. In cirrhosis, the normal liver cells are replaced by scar tissue that cannot perform any liver function.

Acute liver failure may or may not be reversible, meaning that on occasion, there is a treatable cause and the liver may be able to recover and resume its normal functions especially with Homeopathic medication.

Liver cells may become temporarily inflamed or permanently damaged by exposure to allopathic drugs so called “medications” or narcotics/drugs. Allopathic drugs require long term use or an overdose to cause liver injury while some drugs may cause the damage even when taken in the appropriately prescribed dosage.

Taking excess amounts of acetaminophen (Tylenol, Panadol) can cause Liver weakness or Liver failure

This is the reason that warning labels exist on many over-the-counter (OTC) medications that contain acetaminophen and why prescription narcotic-acetaminophen combination medications limit the numbers of tablets to be taken in a day.

For patients with underlying liver disease or those who takes alcohol, that daily limit is lower and acetaminophen may be contraindicated in those individuals.

Statins are allopathic drugs commonly prescribed to control elevated blood levels of cholesterol. Even when taken in the appropriately prescribed dose, liver inflammation may occur. This inflammation can be detected by blood tests that measure liver enzymes. Stopping the medication usually results in the return of the liver function to normal.

Niacin is another allopathic drug used to control elevated blood levels of cholesterol, but liver inflammation with this drug is related to the dose taken. Similarly, patients with underlying liver disease may be at higher risk of developing liver disease due to medications such as niacin. Recent studies have found that niacin may not be as effective as previously thought in controlling high cholesterol. (Patients who take niacin may want to see their health care professional determine if other treatment options may be appropriate).

Other allopathic drugs may cause liver inflammation, most of which will resolve when the medication is stopped:

These include antibiotics such as nitrofurantoin (Macrodantin, Furadantin, Macrobid), amoxicillin, and clavulanic acid (Augmentin, Augmentin XR), tetracycline (Sumycin), and isoniazid (INH, Nydrazid, Laniazid). Methotrexate (Rheumatrex, Trexall), a drug used to treat autoimmune disorders and cancers, has a variety of side effects including liver inflammation that can lead to cirrhosis. Disulfiram (Antabuse) is used to treat alcoholics and can cause liver inflammation.

Infectious Hepatitis Types {⇐click for treatment}

The term “hepatitis” means inflammation, and liver cells can become inflamed because of infection.

• Hepatitis-A is a viral infection that is spread primarily through the fecal-oral route when small amounts of infected fecal matter are inadvertently ingested. Hepatitis A causes acute inflammation of the liver which generally resolves spontaneously. The hepatitis A vaccine can prevent this infection. Thorough hand washing, especially when preparing food is the best way to prevent the spread of hepatitis A. This is especially important for workers who work in the food and restaurant industries.
• Hepatitis-B is spread by exposure to body fluids (needles from drug abusers, contaminated blood, and sexual contact) and can cause an acute infection, but can also progress to cause chronic inflammation (chronic hepatitis) that can lead to cirrhosis and liver cancer. The hepatitis B vaccine can prevent this infection.
• Hepatitis C (⇐click for treatment) causes chronic hepatitis. An infected individual may not recall any acute illness. Hepatitis C is spread by exposure to body fluids (needles from drug abusers, contaminated blood, and some forms of sexual contact). Chronic hepatitis C may lead to cirrhosis and liver cancer. At present, there is no vaccine against this virus. There is a recommendation to test all people born between 1945 and 1965 for Hepatitis C antibodies to identify people who do not know that they have contracted the disease. Newer medications are now available to treat and potentially cure Hepatitis C.
• Hepatitis D is a virus that requires concomitant infection with hepatitis B to survive and is spread via body fluid exposure (needles from drug abusers, contaminated blood, and sexual contact).
• Hepatitis E is a virus that is spread via exposure to contaminated food and water.

NASH liver disease

Nonalcoholic fatty liver disease (NASH) describes the accumulation of fat within the liver that can cause inflammation of the liver and a gradual decrease in liver function.

Hemochromatosis (iron overload) is a metabolic disorder that leads to abnormally elevated iron stores in the body. The excess iron may accumulate in the tissues of the liver, pancreas, and heart, and can lead to inflammation, cirrhosis, liver cancer, and liver failure. Hemochromatosis is an inherited disease.

Wilson’s disease is another inherited disease that affects the body’s ability to metabolize copper. Wilson’s disease may lead to cirrhosis and liver failure.

Gilbert’s disease. In Gilbert’s disease, there is an abnormality in bilirubin metabolism in the liver. It is a common disease that affects up to 7% of the North American population. There are no symptoms and it is usually diagnosed incidentally when an elevated bilirubin level is found on routine blood tests. Gilbert’s disease is a benign condition and requires no treatment.

Cancers. Primary cancers of the liver arise from liver structures and cells. Two examples include hepatocellular carcinoma and cholangiocarcinoma.

Metastatic cancer (secondary cancer of the liver) begins in another organ and spreads to the liver, usually through the bloodstream. Common cancers that spread to the liver begin in the lung, breast, large intestine, stomach, and pancreas. Leukemia and Hodgkin’s lymphoma may also involve the liver.

Blood flow abnormalities. Budd Chiari syndrome is a disease in which blood clots form in the hepatic vein and prevent blood from leaving the liver. This can increase pressure within the blood vessels of the liver, especially the portal vein. This pressure can cause liver cells to die and lead to cirrhosis and liver failure. Causes of Budd Chiari syndrome include polycythemia (abnormally elevated red blood cell count), inflammatory bowel disease, sickle cell disease, and pregnancy.

Congestive heart failure, where poor heart function causes fluid and blood to back up in the large veins of the body can cause liver swelling and inflammation.

Gallstones. Normally, bile flows from the liver into the gallbladder and ultimately into the intestine to help with the digestion of food. If bile flow is obstructed, it can cause inflammation within the liver. Most commonly, gallstones can cause an obstruction of the ducts that drains bile from the liver.

Abnormalities of the opening of the bile duct into the small intestine (sphincter of Oddi) can lead to abnormalities of bile flow. The sphincter of Oddi acts as a “valve” that allows bile to flow from the common bile duct into the intestine.

Primary biliary cholangitis (PBC, formerly referred to as primary biliary cirrhosis) and primary sclerosing cholangitis can lead to progressive scarring of the bile ducts, causing them to become narrow, which results in reduced bile flow through the liver. Eventually, damage and scarring of the liver architecture occur, resulting in liver failure.

Causes and complications of Liver weakness or Liver failure

Since the liver is responsible for the functions that affect so many other organs in the body, liver disease and failure may cause complications. Acute liver failure can cause such complications as infection, electrolyte deficiencies and bleeding. Without treatment, both acute and chronic liver failure may eventually result in death.

Examples include:

Hepatic encephalopathy: Increased ammonia levels due to the liver’s inability to process and metabolize proteins in the diet can cause confusion, lethargy, and coma.

Abnormal bleeding: The liver is responsible for manufacturing blood clotting factors. Decreased liver function can cause an increased risk of bleeding in the body.

Protein synthesis or manufacture: proteins made in the liver are the building blocks for body function. Lack of protein affects many bodily functions.

Portal hypertension: Because the liver has such a great blood supply, damage to the liver tissue can increase pressure within the blood vessels in the liver and adversely affect blood flow to other organs. This can cause spleen swelling, and the development of varices or swollen veins in the gastrointestinal tract, from the esophagus (esophageal varices) and stomach to the anus (these are different than the swollen veins of hemorrhoids).

Liver weakness or Liver failure treatment

Treatment of liver failure depends on whether it is acute or chronic. For chronic liver failure, treatment includes changes to the diet and lifestyle, including:

• Avoiding alcohol or medications that can harm the liver
• Eating less of certain foods, including red meat, cheese and eggs
• Weight loss and control of metabolic risk factors, including high blood pressure and diabetes
• Cutting down on salt in the diet (including not adding salt to food)

For acute (sudden) liver failure, treatment includes:

• Intravenous (IV) fluids to maintain blood pressure;
• Medications such as laxatives or enemas to help flush toxins (poisons) out;
• Blood glucose (sugar) monitoring; glucose is given to the patient if blood sugar drops.

You may also receive a blood transfusion if you are bleeding excessively, or a breathing tube to help you breathe.

In both acute and chronic liver failure, the doctor may recommend a liver transplant. Before transplantation, doctors thoroughly screen transplant candidates to make sure a new organ might help them before placing them on organ waiting lists.

During the transplantation surgery, a healthy liver from a living or deceased donor replaces a damaged or diseased liver. Some transplant centers are able to replace a damaged liver with a portion of a healthy liver because the liver can regenerate or grow back.

Medications may irritate the liver blood vessels causing narrowing or the formation of blood clots (thrombosis). Birth control pills may cause hepatic vein thrombosis, especially in smokers.

The precise diagnosis of the liver disease involves a history and physical examination performed by a health-care professional.

Liver weakness Liver failure or liver diseases can have physical findings that affect almost all body systems including the heart, lungs, abdomen, skin, brain and cognitive function, and other parts of the nervous system. The physical examination often requires evaluation of the entire body. Blood tests help assess liver inflammation and function. Specific liver function blood tests include AST and ALT ( transaminase chemicals released with liver cell inflammation), GGT and alkaline phosphatase (chemicals released by cells lining the bile ducts), bilirubin, and protein and albumin levels. Other blood tests may be considered, including:

• Complete blood count (CBC). Patients with end-stage liver disease may have bone marrow suppression and low red blood cells, white blood cells, and platelets. As a result, patients with cirrhosis may have bleeding.
• INR blood clotting function may be impaired due to poor protein production and is a sensitive measure of liver function.
• Lipase to check for pancreas inflammation.
• Electrolytes, BUN, and creatinine to assess kidney function; and ammonia blood level assessment is helpful in patients with mental confusion to determine whether liver failure is a potential cause.
• CT scan (computerized axial tomography),
• MRI (magnetic resonance imaging), and
• Ultrasound (sound wave imaging, is especially helpful in assessing the gallbladder and bile ducts.
• A liver biopsy may be considered to confirm a specific diagnosis of liver disease. Under local anesthetic, a long thin needle is inserted through the chest wall into the liver, where a small sample of liver tissue is obtained for examination under a microscope.

In people with cirrhosis and end-stage liver disease. The liver affected by cirrhosis may not be able to metabolize the waste products, resulting in elevated blood ammonia levels and hepatic encephalopathy (lethargy, confusion, coma). A low-sodium diet and water pills (diuretics) may be required to minimize water retention.

In those people with large amounts of ascites fluid (fluid accumulated in the abdominal cavity), the excess fluid may have to be occasionally removed with a needle and syringe (paracentesis). Using a local anesthetic, a needle is inserted through the abdominal wall and the fluid is withdrawn. The ascites fluid can spontaneously become infected, and paracentesis also may be used as a diagnostic test looking for infection.

Surgery may be required to treat portal hypertension and minimize the risk of bleeding. Liver transplantation is the final option for patients whose livers have failed.

For consultation about Liver weakness or Liver failure, Hepatitis, Ascitis etc, visit our clinic.

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  Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS) ;  senior research officer Dnepropetrovsk state medical academy Ukraine; is a leading Homeopathic physician practicing in Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.

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