Liver Dysfunction

Authored by Chris McDermott, APRN, practicing with autonomous authority in Florida

Introduction

Your liver is a vital organ that silently supports hundreds of metabolic processes every day. From detoxification and digestion to vitamin storage and hormone metabolism, the liver is foundational to whole-body health. Yet liver dysfunction can progress quietly, often going undetected until symptoms become more severe or irreversible damage occurs.
At Intercoastal Health, we take a proactive, functional medicine approach to liver dysfunction, focusing on early detection, root-cause resolution, and liver-supportive care. Through biomarker testing, personalized nutrition, lifestyle changes, and detoxification strategies, we help patients address the underlying contributors to liver impairment and optimize long-term liver function.

What Is Liver Dysfunction?

Liver dysfunction refers to any disturbance in the liver’s ability to perform its essential functions. This can range from mild inflammation to significant impairment in detoxification, protein synthesis, and nutrient metabolism.
The liver’s primary roles include:

• Filtering toxins, drugs, and environmental chemicals
  
• Synthesizing bile to aid in digestion
  
• Regulating blood sugar, cholesterol, and fat metabolism
  
• Storing vitamins (A, D, B12) and minerals (iron, copper)
  
• Producing clotting factors and albumin
  
• Assisting in hormone breakdown and conversion
  
  

When the liver becomes overwhelmed or damaged, these processes can falter, contributing to both localized and systemic health concerns.

Signs and Symptoms of Liver Dysfunction

Liver dysfunction often presents with non-specific symptoms, especially in early stages. These symptoms may be subtle and easily attributed to other causes, which is why regular lab testing and clinical evaluation are essential.
Common Signs and Symptoms Include:

• Fatigue and weakness
  
• Nausea and vomiting
  
• Loss of appetite
  
• Bitter taste in the mouth
  
• Headaches, mood irritability, or poor concentration
  
• Itchy skin or yellow tongue coating
  
• Dark circles under the eyes
  
• Sensitivity to chemical odors (perfumes, cleaning products, smoke)
  
• Difficulty digesting fats (bloating, gas, or oily stools)
  
• Jaundice (yellowing of skin and eyes in advanced cases)
  
• Dark urine or pale stools
  
• Abdominal pain or fullness, especially in the upper right quadrant
  
  

Diagnosing Liver Dysfunction: Functional Biomarkers and Imaging

At Intercoastal Health, we use both standard and functional ranges for lab interpretation. We also assess trends over time, understanding that liver function may decline subtly before crossing into abnormal values.

1. Liver Function Tests (LFTs)

2. Additional Diagnostics

• Ultrasound: To evaluate liver texture, size, and fat infiltration
  
• CT/MRI: For detailed imaging of liver structure and mass detection
  
• Elastography (FibroScan): Non-invasive tool to assess liver stiffness (fibrosis)
  
• Hepatitis Panel: To detect viral hepatitis A, B, or C
  
• Autoimmune Markers: ANA, SMA, and anti-LKM1 to assess for autoimmune hepatitis
  
• Iron and Copper Panels: To evaluate for hemochromatosis or Wilson’s disease
  
  

Common Causes of Liver Dysfunction

Functional medicine emphasizes root-cause identification to treat liver dysfunction at its origin. Some causes are reversible with appropriate intervention, while others require long-term management.

1. Alcohol Consumption
   
   • Chronic alcohol use leads to fat accumulation, inflammation (alcoholic hepatitis), and fibrosis
     
   • AST:ALT ratio >2 is often indicative of alcoholic liver disease
     
2. Non-Alcoholic Fatty Liver Disease (NAFLD) and NASH
   
   • Strongly associated with obesity, insulin resistance, high-fructose diets, and sedentary lifestyle
     
   • NASH includes inflammation and potential progression to cirrhosis
     
3. Toxin Exposure
   
   • Environmental toxins (e.g., pesticides, heavy metals, industrial solvents)
     
   • Overuse of acetaminophen, certain antibiotics, antifungals, and statins
     
4. Autoimmune Liver Disease
   
   • Autoimmune hepatitis and primary biliary cholangitis involve immune attack on liver or bile ducts
     
5. Genetic and Metabolic Disorders
   
   • Hemochromatosis (iron overload)
     
   • Wilson’s disease (copper accumulation)
     
   • Alpha-1 antitrypsin deficiency
     
6. Infectious Causes
   
   • Viral infections: Hepatitis B, C, CMV, Epstein-Barr virus
     
   • Parasitic infections (geographically specific)
     
     

Functional Medicine Management of Liver Dysfunction

At Intercoastal Health, our goal is to restore and preserve liver health by reducing inflammatory triggers, removing toxic burdens, supporting detoxification pathways, and optimizing mitochondrial and metabolic function.

1. Nutrition for Liver Repair
   
   • Emphasize anti-inflammatory, antioxidant-rich foods: leafy greens, cruciferous vegetables, beets, garlic, turmeric, ginger
     
   • High-fiber foods: flaxseeds and legumes
     
   • Support bile flow: lemon water, dandelion greens, bitter herbs
     
   • Limit or eliminate processed sugars, alcohol, trans fats, refined carbohydrates, high-fructose corn syrup, and soda
     
2. Targeted Supplementation
   
   • N-acetylcysteine (NAC): Precursor to glutathione
     
   • Milk thistle (silymarin): Supports hepatocyte regeneration
     
   • Alpha-lipoic acid (ALA): Mitochondrial antioxidant
     
   • Phosphatidylcholine: Membrane integrity and bile composition
     
   • Vitamin D and zinc: Correct common deficiencies
     
   • Activated B vitamins: Methylation and detox support
     
3. Lifestyle and Detoxification Support
   
   • Minimize chemical exposures (cleaning products, cosmetics, plastics)
     
   • Use air and water filters
     
   • Engage in regular physical activity
     
   • Support lymphatic movement: sauna therapy, dry brushing, hydration
     
   • Optimize sleep: liver detoxification is heightened during early sleep cycles
     
4. Medication and Supplement Review
   
   • Discontinue hepatotoxic medications when possible (under supervision)
     
   • Ensure appropriate dosing—more is not always better in liver disease
     
     

Conditions Associated with Liver Dysfunction

If left unaddressed, liver dysfunction may progress to serious complications:

• Cirrhosis
  
• Hepatocellular Carcinoma (liver cancer)
  
• Portal Hypertension
  
• Ascites
  
• Hepatic Encephalopathy
  
• Coagulopathy
  
• Hormonal imbalances (estrogen, testosterone, cortisol metabolism)
  
  

Monitoring and Follow-Up

Functional medicine involves ongoing surveillance and trend analysis rather than one-time testing. Patients with signs of liver dysfunction should be monitored regularly:

• Reassess liver enzymes and bilirubin every 3–6 months
  
• Check vitamin and mineral status (D, B12, zinc, magnesium)
  
• Screen for metabolic syndrome markers: fasting glucose, insulin, triglycerides
  
• Annual ultrasound or elastography for those at risk of fibrosis or fatty liver
  
• Cancer screening for high-risk populations (viral hepatitis, cirrhosis)