Toxic liver disease, or drug-induced liver injury (DILI), is damage to your liver. It’s also called hepatotoxicity or toxic hepatitis. It can cause serious symptoms or liver damage if you don’t get help.
Medications, herbal supplements, chemicals, solvents, and alcohol are all possible causes of hepatotoxicity.
What Happens in Toxic Liver Disease?
Your liver filters everything that goes into your body. It clears out alcohol, drugs, and chemicals from your blood. Then it processes the unwanted bits so you can flush them out through your urine or bile.
Sometimes, as your liver does its job of processing your blood, toxins form. They can inflame and damage your liver.
Toxic liver disease may be mild or severe. If it goes on for a while, it could cause permanent liver scarring or cirrhosis. This can lead to liver failure or even death. In some severe cases, as with acetaminophen, even short-term use can be enough to cause liver failure.
What Are the Symptoms?
You may notice:
- Fever
- Diarrhea
- Dark-colored urine
- Itching
- Jaundice, or yellowish eyes and skin
- Headaches
- No appetite
- Nausea
- Pain in your stomach
- Vomiting
- Weight loss
- White or gray stool
Symptoms may crop up hours after you come in contact with the cause. You may also feel slowly worse over days or weeks of regular exposure.
Causes
Toxic liver disease has many possible causes. Some are easier to spot than others:
Medications. Many over-the-counter (OTC) and prescription medications cancause toxic liver disease.
OTC pain relievers:
- Acetaminophen (Tylenol)
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aleve,aspirin, andMotrin.
Prescription drugs:
- Statins
- Antibiotics like amoxicillin-clavulanate or erythromycin
- Arthritis drugs like methotrexate or azathioprine
- Antifungal drugs
- Niacin
- Steroids
- Allopurinol for gout
- Antiviral drugs for HIV infection
Chemotherapy. This common cancer treatment is another possible cause. These drugs are toxins and may stress your liver.
Herbal supplements. How could something natural be bad for your liver? In fact, some common herbs could cause toxic liver disease. Watch out for supplements that contain aloe vera, black cohosh, cascara, chaparral, comfrey, ephedra, or kava.
Chemicals and solvents. Some workplace chemicals can harm your liver. Some examples are vinyl chloride, which is used to make plastics; a dry cleaning solution called carbon tetrachloride; the weed killer paraquat; and polychlorinated biphenyls.
What Raises Your Chances of Getting It?
You may be more likely to get toxic liver disease if:
- You take OTC pain relievers more than the recommended dose, with chronic alcohol use.
- You already have another liver disease, like cirrhosis, nonalcoholic fatty liver disease, or hepatitis.
- You drink alcohol while you take certain medications or supplements.
- You work in a job that uses industrial chemicals that could be toxic.
- You’re older.
- You’re female.
- You have a gene mutation that affects how well your liver works.
Diagnosis
If you notice any of the symptoms and have any of the things that can raise your odds of having toxic liver disease, see your doctor right away.
Your doctor will give you a physical exam, and go over your symptoms and medical history. Tell your doctor if you use any drugs or herbal supplements, drink alcohol, or use any chemicals at work.
Tests to diagnose toxic liver disease may include:
- Blood tests: They look for levels of liver enzymes that can show how well your liver is working.
- Ultrasound: This imaging test uses sound waves to make a detailed image of your liver.
- Computed tomography (CT) scans: This test uses a special X-ray machine that rotates around your body and sends images to a computer that creates a cross-section of your body.
- Liver biopsy: Your doctor will take a sample of tissue from your liver and look at it under a microscope to check for severe liver disease.
Treatment
Doctors have several ways to treat toxic liver disease.
Stop your exposure: This is the first step. This could include:
- Switching medications
- Avoiding any herbal supplement or chemical that’s toxic to your liver
- Not drinking alcohol because it puts stress on your liver
Symptoms often get better within a few days if you stop your exposure to the cause.
Acetylcysteine: If you think an acetaminophen overdose caused your liver disease, quickly go to the hospital to get this drug. It can help prevent liver damage.
Hospital care: At the hospital, you can also get care to treat your symptoms, like IV fluids for dehydration or anti-nausea medicine.
Liver transplant: This option is reserved for severe liver damage
Prevention
You can’t know ahead of time what drugs or chemicals could cause toxic liver disease. Here are some ways you may be able to prevent it:
- Only take the drugs you need. Take them only as your doctor instructs. Follow package directions for the recommended dosage.
- Don’t take supplements that contain herbs that could be toxic to your liver. Check the labels of any natural treatment before you take it and run it by your doctor.
- If you take more than the recommendeddose of acetaminophen, don’t drink alcohol. If you have been drinking alcohol and take the normal dose of acetaminophen, you should be fine. Ask your doctor or pharmacist if it’s safe to drink while you take any drug.
- Follow safety rules if you use any chemicals or solvents at work. Avoid or limit your exposure if you can.
- Lock up any drugs or chemicals in your home so children don’t eat them. They can get liver toxicity too. They are more at risk of liver toxicity because of their small size.
