Towards a healthy liver

January 2011    View PDF    Ask a question    En español

Next to your skin, your liver is the largest organ in your body. It’s also one of the hardest working and can even re-grow its own tissue. It can work when a large portion of it is removed or diseased. The things that you eat, drink, breathe and take in through your skin all get filtered through your liver. It’s also where your body stores vitamins, releasing them as you need them. In all, your liver performs hundreds of tasks throughout a day.

Your liver filters alcohol and toxins from your blood. It breaks down many drugs into forms that are easier for your body to use. It changes the food you eat into energy and gives out chemicals that aid your brain and central nervous system. It also helps to maintain your body heat to clot your blood.

Many substances can be toxic to your liver. Alcohol, street drugs, smoke, toxic fumes, some herbs and even some prescription and non-prescription drugs can harm your liver. Infections can harm it as well, such as hepatitis viruses and bacteria. Since the liver performs so many essential jobs, any of these toxins can cause it to not work properly. This, in turn, can hurt almost all of your body’s other systems.

A healthy liver is essential to a healthy life. You can do many everyday things to keep your liver healthy. Not putting yourself at risk for liver diseases can help. Simple changes in your diet can go a long way in helping your liver to work well and recover from illness. This publication describes these and many other ways to promote a healthy liver.

You’ll see over the next few pages many ideas to consider when taking care of your liver. Consult your doctor when starting or changing your diet, exercise routine, medicines or supplements.

Your liver …

  • Stores vitamins, minerals and sugars for energy
  • Makes new proteins
  • Helps digest food
  • Cleans the blood
  • Helps your blood to clot
  • Controls cholesterol and fats
  • Clears alcohol and toxins
  • Helps control body heat
  • Maintains hormones
  • Helps fight infections

Get informed

Read up on liver disease and how to prevent it. This publication is a good starting point and reliable sources can be found on the internet. Your doctor or an experienced nutritionist can also advise you on a liver health plan.

Another way to learn about health issues is by talking to others with similar concerns. Consider joining a support group. Online “Ask the Experts” forums and bulletin boards may also help. These can be found through your doctor’s office, local health care organization or internet search engine.

Make lifestyle changes

Making changes in your diet can go a long way in helping your liver work well. Eating a healthful diet can also help the liver recover from illness, and is sometimes an important part of treatment. Check the US Food Guide Pyramid at

Alcohol is rather difficult for the liver to process. Some people are more sensitive to it than others. It can be an issue depending upon how much and how often a person drinks. Stopping or cutting back will give your liver a chance to work better. Some experts suggest no more than 1–2 drinks a day, but for people with liver disease, it’s recommended to not drink alcohol at all. Consider the alcohol content of the many liquid cold and flu products. As well, drinking alcohol with acetaminophen and other medicines can be toxic to your liver.

What we breathe is also filtered by the liver. Two ways to preserve your liver’s health are to avoid smoking and stay away from toxic fumes and liquids. Smoking may increase the risk of liver cancer. Fumes from everyday items like hair sprays, cleaning products, bug sprays and paint thinners can also damage your liver. Wear a mask or gloves or open windows to air out your living spaces. Also, look around your home or work for any signs of chemicals that may cause liver damage.

Liver damage is common in people who are injection drug users. This can pass viruses and bacteria from person to person. Street drugs are also often impure. Limiting or not using street drugs will help protect your liver, and don’t share your works with others. This also holds true for syringes for taking steroids or diabetic meds.

Safer sex and good hygiene can prevent infections that affect the liver. Finding out more about your sex partner’s sexual history can also help. (Read Project Inform’s publication, Sex and Prevention Concerns for Positive People.) Also, don’t share personal items like toothbrushes, razors, manicure tools or other items that may have blood on them.

Get a vaccine

Two of the most common infections of the liver are hepatitis A and B. Both are preventable. Your doctor can test you to see if you’ve been exposed to them before. If you haven’t, getting vaccinated can prevent a good deal of harm to your liver. The vaccines are given as 2–3 shots and are available on their own or combined as one.

Keep up with your health care

Many people don’t know they have liver disease. You can get tested by your doctor to find out if your liver is working properly. Let your doctor know if you have any risk factors for liver disease.

Make sure you get regular check-ups and blood work done. Liver function tests will check for changed levels of chemicals in your body. These will show whether your liver is working well or if there’s an infection or other problem that needs to be addressed. It can be useful to keep track of your test results over time as well.

If you have chronic liver disease like hepatitis B or C, specialists such as a hepatologist or gastroenterologist can help you. Infectious disease specialists may also help. Depending upon your level of disease, you may want to consider using a medical team for treatment.

Other conditions you have, like diabetes, may affect how well your liver works. Treating these other conditions properly will help your body in general and also help support your liver to work as well as it can.

Know the symptoms and causes

Your liver can continue to do its job even when there’s damage being done. So it’s important to know the possible symptoms of liver disease. Report them to your doctor as soon as possible. Liver disease can often be corrected if found early.

Symptoms may not appear in everyone. When they’re present, they can include fatigue, nausea, loss of appetite, stomach pain, changes in memory or behavior, swelling and itching of the skin. More severe symptoms include yellowish coloring of the skin or eyes (jaundice), dark urine and changes in stool.

Inflammation in the liver, called hepatitis, upsets how well your liver works. It refers to damage caused by viruses, bacteria, alcohol, legal and illegal drugs, among others. Left untreated, hepatitis can lead to liver scarring, cancer, failure, transplant and even death. For these reasons it’s important to help prevent disease in the first place.

Eat well and exercise

Eat a balanced diet with a range of fresh fruits and vegetables, lean meats, whole grains and foods with fiber. Cut down on fatty foods or foods with a high amount of sugar or salt. Excess fat, sugar and salt can stress your liver, like fried foods, fast food, processed cheeses and meats, and many boxed and frozen processed foods. Eating smaller meals more often can aid your liver to work less.

Drink lots of water and other fluids to flush toxins from your body. Eight glasses of water a day is recommended for most people. Also, get regular exercise and reduce stress in your life. Both help promote a healthy body, which in turn helps your liver do its work.

Getting a proper amount of protein and keeping a normal body weight is essential. Good sources of protein include lean meat, fish, eggs, poultry, beans, nuts and dairy products. However, getting too much protein can stress your liver. Being overweight or having diabetes can put you more at risk for a serious liver disease called non-alcoholic steatohepatitis (NASH).

Fruits, vegetables and meats should be washed well before using. Be careful with any food if you don’t know its source. Do not eat raw or undercooked fish or shellfish like sushi, oysters, shrimp or clams if you have a weaker immune system. Someone with an already damaged liver doesn’t need to fight an additional battle.


Tell your doctor about all the medicines you take—both prescription and over-the-counter meds like pain or flu medicines. Make a list of them and take it in during your next check-up. Liver function tests will help monitor your liver health while you take these and other drugs.

If you ever wonder what’s in a medicine or product, read the label or ask your doctor or pharmacist. These can help you avoid dangerous side effects and drug interactions.

Some common pain relievers can be hard on the liver if used too often. Some prescription drugs, including HIV meds, can also stress the liver. Acetaminophen can be very toxic, especially when taken with alcohol. If you have liver disease, NSAIDs like Advil (ibuprofen) can also be dangerous to take.

Aspirin can lower a person’s platelet count. People with liver disease often experience a swelling of the spleen. This can destroy platelets faster than the body can make them. Taking aspirin will add to this problem.

Vitamins and herbs

Tell your doctor, pharmacist or trained nutritionist about all of the supplements you take. You could write up a list of them or take them in a bag with the product boxes or labels. Include vitamins, herbal teas and remedies, nutrition supplements, over-the-counter items and other products you take. Many of these can have side effects and interact with each other and many medicines. This could end up hurting your liver..

Some people think taking more vitamins and minerals than necessary will give them better health including those labeled “natural”. However, that can actually be harmful. Avoid high doses of vitamins A, D, E and K. As well, taking iron supplements may be hard on your liver. It may be wise to avoid iron-fortified foods or iron-coated cooking utensils.

Virtually no well-done study has proven which herbs help the liver. In fact, studies are not required to show the safety of herbal products as are prescription meds. A few supplements are thought, but not proven, to help the liver. Some of them include artichoke, astragalus, California poppy, chamomile, dandelion, garlic, ginkgo biloba, licorice root, milk thistle, peppermint and soybean. A list of herbs that can harm the liver are found in the box on this page.

Another herb called milk thistle could alter the blood levels of HIV drugs because it uses a liver protein called p450 which is also used by HIV meds. Another common herb, St. John’s Wort, greatly lowers the blood levels of some HIV meds and it’s recommended that it not be used with an HIV regimen. In the end, we just don’t have proof what kind of reactions will happen with different herbal products.

Several groups of people should avoid using herbs unless OK’d by their doctor. These include infants, pregnant and nursing women, and people with liver disease, organ transplants, serious medical conditions or those scheduled for surgery.

Herbs to avoid (possible toxicity)

  • Blue-green algae
  • Borage
  • Bupleurum
  • Chaparral
  • Comfrey
  • Dong Quai
  • Ephedra (some forms)
  • Germande
  • Jin Bu Huan
  • Kava
  • Mistletoe
  • Pennyroyal
  • Sassafras
  • Shark Cartilage
  • Skullcap
  • Valerian

Other resources that may help

HCV Advocate

Consumer Lab

Herbal products, recreational drugs and HIV meds

Sex and Other Prevention Concerns of Positive People

Strategies for Maintaining Your General Health