6 Things You Need to Know About Liver Disease

Liver disease affects an estimated 100 million Americans and is one of the leading causes of death in the United States. In its advanced stages, liver disease can lead to cirrhosis (severe liver scarring), liver failure and liver cancer.

Despite its increasing prevalence, liver disease and its causes are misunderstood. We asked Steven Lidofsky, MD, PhD, director of hepatology at University of Vermont Medical Center, to help set the record straight about liver disease. Below he shares six things you might not know. 

1. There Are Many Forms of Liver Disease

“There’s still a myth that liver disease is caused by alcohol use,” says Dr. Lidofsky. “In reality, there are many conditions that affect the liver, and most are not related to drinking.” 

The most common type of liver disease is metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD). This condition causes fat to build up in the liver and is associated with obesity and poor metabolic health. MASLD is thought to affect more than 25% of U.S. adults.

Alcohol-associated liver disease is caused by heavy drinking, defined by the National Institutes of Health (NIH) as having 15 or more drinks in a week for men and 8 or more drinks in a week for women.

Liver disease can also be caused by viral infections like Hepatitis B and C. The Centers for Disease Control and Prevention (CDC) recommends that all adults be screened for these conditions at least once (and more frequently if they have other risk factors, like sharing and reusing needles or syringes).

2. Liver Disease Is on the Rise 

As the global obesity epidemic has grown over the past few decades, MASLD has become significantly more prevalent. Research indicates that more than half the adult population worldwide will have the disease by 2040.

Alcohol-related liver disease has also surged, particularly in younger adults, which researchers attribute to increased alcohol consumption during COVID-19. 

3. Many People Don’t Know They Have Liver Disease

Dr. Lidofsky calls MASLD a “silent disease,” because most patients are asymptomatic and may not be aware that there’s anything wrong.

“You can go for years without experiencing symptoms,” he says. “Most people find out that they have a liver condition during routine health screenings or testing for another condition.”

4. Most Liver Disease Is Treatable

Most forms of liver disease are treatable, particularly when caught early. Your condition may not even require medication - many cases of liver disease can be reversed through lifestyle changes.

“Patients with MASLD can often improve their condition by managing their weight, eating a healthier diet and increasing physical activity,” says Dr. Lidofsky.

Those with alcohol-associated liver disease should quit drinking to prevent permanent liver damage. Medication is used to cure Hepatitis C and suppress Hepatitis B to undetectable levels.

5. Liver Disease Puts You at Risk of Cardiovascular Disease

MASLD is one of several metabolic conditions – including high blood pressure, high cholesterol and diabetes – associated with serious heart conditions. Recent studies show that adults with MASLD are at significantly higher risk of heart failure than those without liver disease. 

6. Some Over-the-Counter Supplements Can Cause Liver Damage

Many people incorporate herbal or nutritional supplements into their diets without realizing that they may be harming their health.

“Supplements aren’t regulated by the U.S. Federal Drug Administration (FDA) and many of them contain ingredients that are toxic to the liver,” says Dr. Lidofsky. Herbal and dietary supplements now account for 20% of cases of liver damage in the U.S, according to the NIH and the American Association for the Study of Liver Disease. The supplements most often to blame are multi-ingredient nutrition products such as those used for weight loss, green tea extract and anabolic steroids used in body building.

While some cases of supplement-related liver injury may be mild, the condition can also be severe and lead to permanent damage or liver failure. Check with your doctor.