Liver Function

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

Introduction

The liver is your body’s silent powerhouse. Each day, it performs more than 500 essential functions—filtering blood, metabolizing nutrients and medications, supporting digestion, storing vitamins and minerals, and managing hormone balance. When liver function becomes impaired—even subtly—it can set off a chain of systemic imbalances that affect nearly every area of your health.

At Intercoastal Health, we use a functional medicine practitioner framework to evaluate liver function. Our approach goes beyond diagnosing overt liver disease. We identify early signs of dysfunction, investigate the root causes, and support the liver’s natural capacity to detoxify, repair, and regenerate—often before patients develop significant symptoms or clinical disease.

What Is Liver Dysfunction?

Liver dysfunction refers to any decline in the liver’s ability to carry out its essential functions. It may occur due to inflammation, fat accumulation, toxin overload, infection, medication toxicity, or scarring (fibrosis). Early signs are often overlooked until more advanced damage occurs, such as cirrhosis or liver cancer.
Conditions under the umbrella of liver dysfunction include:

• Fatty liver disease (alcoholic or non-alcoholic)
  
• Hepatitis (viral, autoimmune, or drug-induced)
  
• Cirrhosis (permanent scarring)
  
• Liver tumors and hepatocellular carcinoma
  
• Metabolic dysfunction-related liver disease (formerly called NAFLD)
  
  

Functional Role of the Liver

The liver plays a pivotal role in multiple systems, including:

• Detoxification: Neutralizes and eliminates toxins, environmental chemicals, and hormones
  
• Nutrient metabolism: Converts carbohydrates, fats, and proteins for use or storage
  
• Bile production: Required for digestion and absorption of dietary fats
  
• Hormone processing: Inactivates excess estrogens, cortisol, and thyroid hormones
  
• Vitamin and mineral storage: A, D, B12, iron, and copper
  
• Immune function: Kupffer cells filter pathogens from blood
  
• Clotting and protein synthesis: Produces albumin and clotting factors
  
  

When this vital organ is stressed, the effects can ripple across digestive, hormonal, immune, neurological, and cardiovascular systems.

Signs and Symptoms of Liver Dysfunction

The early symptoms of liver dysfunction are often vague or attributed to other causes, making it critical to listen closely to the body’s subtle signals.
Signs the Liver May Be Stressed Include:

• Fatigue or chronic low energy
  
• Right-sided abdominal or chest pain
  
• Headaches, irritability, or mood swings
  
• Nausea or loss of appetite
  
• Bitter taste in the mouth
  
• Dark circles under the eyes
  
• Yellow tongue coating
  
• Sensitivity to chemical odors (perfumes, cleaning products, smoke)
  
• Difficulty digesting fats (greasy stools, bloating)
  
• Jaundice (yellowing of skin or eyes in advanced cases)
  
• Dark urine or pale, clay-colored stools
  
• Skin issues such as rashes, acne, or itchy skin
  
  

Each may signal that your body’s detoxification systems—especially the liver—are overwhelmed or underperforming.

Laboratory Evaluation of Liver Function

At Intercoastal Health, we use comprehensive lab panels to assess early and advanced stages of liver stress. Standard liver function tests (LFTs) are just one piece of the picture. Functional interpretation also considers trends, optimal ranges, and patient symptoms.

Additional Diagnostics:

• Ultrasound: Detect fatty liver, fibrosis, or lesions
  
• MRI/CT: Detailed imaging of liver structure
  
• Elastography (FibroScan): Non-invasive fibrosis assessment
  
• Liver biopsy: When staging or unclear etiology is needed
  
  

Common Causes of Liver Dysfunction

Functional medicine emphasizes root-cause identification to treat liver dysfunction at its origin:

1. Alcohol Use
   – Excessive intake leads to fat accumulation, inflammation, and fibrosis.
   
2. Non-Alcoholic Fatty Liver Disease (NAFLD/NASH)
   – Driven by insulin resistance, obesity, poor diet, and sedentary lifestyle.
   
3. Medications & Toxins
   – Acetaminophen, certain antibiotics, antifungals, statins, environmental chemicals.
   
4. Viral Infections
   – Hepatitis B, Hepatitis C, EBV, CMV.
   
5. Autoimmune Diseases
   – Autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis.
   
6. Genetic Disorders
   – Hemochromatosis (iron overload), Wilson’s disease (copper), α-1 antitrypsin deficiency.
   
   

Functional Medicine Approach to Liver Support

1. Nutrition for Liver Health
   – Eliminate alcohol, added sugars, ultra-processed foods.
   – Emphasize detox-supportive foods: leafy greens, cruciferous vegetables, garlic, beets, turmeric, high-fiber foods.
   – Support bile flow: bitter greens, lemon water, ginger.
   
2. Targeted Supplementation
   – N-acetylcysteine (NAC) for glutathione synthesis
   – Milk thistle (silymarin) for hepatoprotection
   – Alpha-lipoic acid (ALA) as a mitochondrial antioxidant
   – Phosphatidylcholine for bile and membrane health
   – Activated B vitamins, zinc, selenium to support detox pathways
   
3. Reduce Toxin Exposure
   – Minimize unnecessary medications
   – Use clean personal care and household products
   – Filter water; avoid Teflon/aluminum cookware
   – Support elimination via sauna, movement, hydration
   
4. Movement & Circulation
   – Regular exercise to improve insulin sensitivity and liver fat metabolism
   – Gentle movement to enhance lymphatic drainage
   
   

When Liver Dysfunction Becomes Disease

Without intervention, chronic dysfunction can progress to:

• Cirrhosis
  
• Hepatocellular Carcinoma
  
• Portal Hypertension and varices
  
• Ascites
  
• Hepatic Encephalopathy
  
• Coagulopathy and hormonal imbalances
  
  

Monitoring and Follow-Up

Patients with risk factors or elevated enzymes should undergo:

• LFT panels every 3–6 months
  
• Vitamin/mineral status checks (D, B12, zinc, magnesium)
  
• Metabolic syndrome screening (glucose, insulin, lipids)
  
• Annual imaging (ultrasound or FibroScan) for fibrosis or fatty liver
  
• Cancer surveillance for high-risk groups