10 Signs of Having Liver Damage–Always Being Tired or Bad Breath Could be a Signal

March 21, 2019 Updated: March 21, 2019

Usually associated with alcohol over-use, liver problems are becoming more pronounced than ever in society these days, with conditions like fatty liver disease and cirrhosis becoming more and more common. In fact, some 80 to 100 million Americans are affected by non-alcoholic fatty liver disease (NFLD), according to Mayo Clinic, so it’s really important to keep an eye out for warning signs and try and nurture your liver health when you are healthy.

In order to help you do this, we have complied 10 common signs that may indicate liver damage:

1. Eyes and skin turning yellow

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One of the early signs of liver damage is jaundice, a disease that turns the skin, the whites of the eyes, tongue, and fingernails noticeably yellow. Jaundice is when there’s too much bilirubin in the blood and is caused by problems with the liver’s filtering function, which results in bilirubin accumulating—first in the bloodstream and then in the skin, giving it a yellowish color.

Jaundice is very common in newborn babies, as bilirubin is removed via the placenta during gestation. After birth, newborns have to get rid of excess bilirubin on their own, but their organs are still too immature to be filter properly. Jaundice in adults is rare and usually signifies liver problems, especially in those who drink too much alcohol over a long period of time, which can seriously damage the liver.

2. Constant fatigue

Tired Work
(B-D-S Piotr Marcinsk/Shutterstock)

Medical scientists have yet to figure out exactly why bad livers make people feel tired all the time, but frequent, severe exhaustion has been associated with liver problems. One important factor is that the liver supplies the body with energy by converting glucose into glycogen and storing it for later use. A compromised liver is less able to facilitate this process when the body desperately needs energy, which could explain how liver diseases might cause symptoms of low-energy.

3. Loss of appetite

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People with liver damage may not feel like eating anything as a result of a problem with their bile production. Bile is a greenish-brown fluid produced by the liver and stored in the gallbladder, whose primary job is to break down fats into fatty acids to be absorbed and utilized by the body. When the liver fails to produce enough bile, food will not be digested properly, which often leads to loss of appetite and weight loss—arguably one of the least healthy ways to lose weight.

Along with diarrhea, nausea, and fatigue, such loss of appetite is among the first symptoms of liver failure and means the liver is losing or has lost its ability to function. It’s a life-threatening condition that deserves urgent medical attention.

4. Sleep disruption

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Traditional Chinese Medicine holds that something called “qi,” or “life energy,” moves through the body’s organs in a 24-hour cycle, alternating at its peak points in one particular organ every two hours. The window from 1am to 3am, according to this theory, is assigned to the liver, and waking up during that period at night means you may have issues with your liver.

Whether you subscribe to Traditional Chinese Medicine or not, waking up in the early morning can indeed be a sign of liver problems, and sleep disturbances are commonly seen in liver cirrhosis patients. The liver is responsible for the processing of melatonin, an important natural hormone that regulates the circadian rhythm. A damaged liver may have trouble breaking down melatonin, resulting in increased daytime fatigue followed by nighttime alertness when it finally gets around to deactivating the melatonin still circulating in the system.

5. Bleeding easily

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When the body bleeds, it activates a complex system of plasma proteins known as coagulation factors—proteins that work together to form clots and prevent further blood loss. The liver is responsible for producing most of these specialized proteins, some of which require vitamin K for synthesis. The liver also produces the bile salts essential for intestinal absorption of this vitamin.

People with damaged livers will bleed or bruise more easily, because they not only have too few blood clotting proteins, but also have problems absorbing vitamin K sufficiently. When clotting is poor, even a slight injury to a blood vessel may lead to severe blood loss, which can mean even a nosebleed, which may not be life-threatening, can still seem pretty scary.

6. Changing color of urine and stool

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The most common cause of darkening urine is dehydration, which can be remedied by drinking more water. But if you are drinking enough fluid and your urine remains dark, it may indicate a liver problem. An ill-functioning liver can cause bilirubin to built up in the system, which may end up being excreted through the kidneys, changing the color of urine.

One should be more alerted if dark urine is accompanied by pale stool. A healthy, well-functioning liver releases bile into the stool, giving it its normal brown color. Stool appearing grey, pale, yellow, or clay-colored very likely means there’s a problem with bile production.

7. Red palms

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Red palms, also known as palmar erythema (PE), is a condition where the lower part of your hands turns reddish. Sometimes the redness extends all the way to the fingers. The condition itself is actually harmless and can be the result of unusual hormone changes which bring more blood to the surface—and that’s why it occurs more often in pregnant women.

PE is associated with several forms of liver disease. In fact, about 23 percent of people who have cirrhosis of the liver also experience PE. Other liver diseases associated with PE include Wilson’s disease, which occurs when there’s too much copper in the body, and hemochromatosis, which occurs when there’s too much iron in the body.

8. Bad breath

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Fetor hepaticus, also known as “breath of the dead,” is commonly associated with liver failure. Its unique sweet, musty smell is distinct from other kinds of bad breath. While most forms of bad breath arise from processes in the mouth, such as bacteria breaking down food remains, fetor hepaticus is caused by volatile compounds, which are produced as a result of liver damage, entering the lungs from the blood.

Although it’s not a particularly accurate method of diagnosis, there are actually doctors who smell patients’ breath in order to detect liver failure. In a 2009 study, researchers from the Catholic University of Leuven in Belgium took breath samples from 52 patients with liver cirrhosis and 50 healthy participants. They analyzed these samples to determine if they belonged to liver cirrhosis patients. In the end, they were able to accurately classify 94 of the 102 breath samples.

9. Terry’s nails

(Wikimedia Commons)

Nails that are predominately white with only a narrow, reddened or dark rim near the tip is a condition known as Terry’s nails. Although it can occur with normal aging, Terry’s can also be a warning sign of underlying medical conditions, most notably: cirrhosis, chronic kidney disease, and congestive heart failure. In fact, about 80% of cirrhosis patients have Terry’s nails.

10. Sensitive skin

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Another early sign of liver problems is increased skin sensitivity. Liver disease patients may find their skin becomes itchy, flaky, or oversensitive to the touch. In some cases, they also notice the appearance of veins through the skin. The exact reason
 why liver disease causes itchy skin remains unknown, but it has been thought that certain substances accumulate in
 the blood as a result of liver disease, including bile acids, which may play a role in this type of itch—although no evidence has shown it.

Keeping the skin moisturized will help provide short-term relief, but skin sensitivity will probably worsen if there is an underlying liver problem, until it is addressed.

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice.

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