Your liver is the second largest organ in your body, behind only your skin. The liver is also the largest gland. It makes and secretes chemicals that are used by other parts of your body to perform key processes. Your liver sits just under your ribcage on your right side. It’s about the size of a football and weighs on average about 3.5 pounds.

The liver is essential for life. It performs more than 500 vital functions that keep your body healthy and working properly. These functions include storing nutrients; removing toxins, waste products and worn-out cells from your blood; filtering and processing chemicals in food, alcohol and medications; and producing bile, a fluid that helps in digestion.

Liver disease is any disorder that negatively impacts the healthy performance of your liver. There are many disorders that fall under this umbrella. They include:

• Viral infections, such as hepatitis.
• Diseases associated with consuming too many toxins, including alcohol-related liver disease and fatty liver disease.
• Inherited diseases, such as hemochromatosis, Wilson disease and alpha-1 antitrypsin deficiency.
• Conditions that occur when your immune system mistakenly attacks your liver, such as autoimmune hepatitis, primary sclerosing cholangitis and primary biliary cholangitis.
• Liver cancer (hepatocellular carcinoma), a condition in which the cells in your liver develop abnormally and grow out of control.
• Cirrhosis, a condition in which your liver is severely scarred and permanently damaged.

Without treatment, these conditions can ultimately lead to liver failure, when large parts of your liver become damaged and can’t function anymore. At this point, you may require a liver transplant, when your diseased liver is removed and replaced with a healthy liver from a donor.

Certain factors increase your risk for liver disease. The most well-known is heavy drinking, which is defined by the Centers for Disease Control and Prevention as more than eight alcoholic drinks per week for women and more than 15 drinks per week for men.

Other risk factors include:

• A family history of liver disease.
• Diabetes or high cholesterol.
• A job that exposes you to blood and other body fluids.
• Being overweight or obese.
• Taking certain supplements or herbs, especially in large amounts.
• Mixing certain medications with alcohol.
• Taking more than the recommended dose of certain medications.
• Sharing needles for drug use.
• Having unprotected sex.

Each liver disease has its own signs and symptoms, but some common ones to be aware of include jaundice, a yellowing of the skin and whites of the eyes; bleeding or easy bruising; swelling of the legs or ankles; pain in the abdomen; itchy skin; dark urine; pale, bloody or black stools; a buildup of fluid in the belly, called ascites; and fatigue.

To diagnose liver disease, your doctor will review your history and symptoms and perform a thorough physical examination. The doctor will also recommend certain tests, bloodwork to measure liver enzymes. Abnormal levels may indicate problems with your liver function.

Your doctor may also use imaging tests, such as ultrasound, MRI or CT, to look for signs of damage, scarring or tumors in your liver. Another test your doctor may suggest is a liver biopsy, during which a needle is used to remove a small sample of liver tissue for analysis.

Treatment depends on the type of disease and how far it has progressed. In general, treatment for includes medications and lifestyle changes. Medications may include antiviral drugs to treat hepatitis, steroids to reduce inflammation, antibiotics and other medications to target specific symptoms. An organ transplant is a last resort for liver failure.

While not all diseases can be prevented, you can help keep your liver healthy by making some key lifestyle choices, such as:

• Eat a liver-friendly diet rich in fruits and vegetables, lean proteins, whole grains and fiber.
• Exercise regularly.
• Limit alcohol consumption.
• Avoid smoking and using drugs.
• Maintain a healthy weight.
• Practice safe sex.
• Don’t take more than the recommended dose of medications.
• Drink more water to help remove toxins and flush liver tissues
• Visit a doctor annually for a physical and bloodwork.

October is Liver Awareness Month. Follow these suggestions and live with a healthier liver.

Patti DiPanfilo

Iron is a mineral your body needs to stay healthy and function properly. Iron is a major component of hemoglobin, a protein in red blood cells that carries oxygen from your lungs to the rest of your body. Iron is also used to make certain hormones such as erythropoietin (EPO), which signals the bone marrow to make more red blood cells.

Normally, your intestines absorb the right amount of iron from the food you eat. Sometimes, the body absorbs more iron than it needs, which is a condition called hemochromatosis. Your body has no natural way to rid itself of this excess iron, so it is stored in your joints and organs, such as your liver, heart and pancreas. Without treatment, hemochromatosis causes iron overload, which can seriously damage those organs.

Too much iron in the heart can cause an arrhythmia or heart failure. Excess iron in the liver can lead to cirrhosis, liver cancer or liver failure. Too much iron in the pancreas can result in the development of diabetes.

Hemochromatosis is relatively common, affecting more than 1 million Americans. There are two main types: primary and secondary.

Primary hemochromatosis, also called hereditary hemochromatosis, is usually caused by genetic factors. It typically results from mutations to the HFE gene, which controls how much iron you absorb from food. The gene mutation that most commonly causes hemochromatosis is C282Y. You are more likely to develop the disorder if you inherit two copies of the C282Y mutation, one from each parent.

Secondary hemochromatosis, which is much less common, develops due to other medical conditions, such as certain types of anemia and liver disease. It can also develop as a result of receiving numerous blood transfusions.

Symptoms typically develop after age 40 once iron has built up to a toxic level. In general, women develop symptoms about 10 years later than men, usually after menopause. The reason for the difference is that women lose blood, and therefore iron, from childbirth and menstruation. However, it begins to accumulate once they enter menopause.

Some of the more common symptoms of hemochromatosis include joint pain, fatigue, bronze or gray skin color, pain in your abdomen due to an enlarged liver, loss of sex drive, erectile dysfunction, hair loss, memory fog, abnormal heartbeat and unexplained weight loss.

Diagnosing hemochromatosis can be challenging because its symptoms are common to other conditions. Visit your doctor if you are experiencing symptoms, have one of the conditions associated with excess iron in the organs or have a family member who has hemochromatosis.

To make a diagnosis, your doctor will first ask about your symptoms as well as your personal and family medical history. He or she will perform a physical exam, which includes listening to your body with a stethoscope and tapping on your abdomen to check for an enlarged liver.

Your doctor will likely order blood tests, including a transferrin saturation test, which shows how much iron is attached to transferrin, a protein that carries iron in your blood. Another blood test is the serum ferritin, which measures the amount of ferritin, a protein that stores iron, in your blood. You doctor may order a blood test to look for the C282Y mutation as well.

If your doctor suspects liver damage, he or she may perform a liver biopsy. He or she will take a small sample of liver tissue through a needle and look at it under a microscope to see if there’s any liver damage. In some cases, you doctor can accurately evaluate the health of your liver from an MRI scan.

Hemochromatosis can be treated safely and effectively by removing blood, and therefore excess iron, from your body on a routine basis. This process is called phlebotomy, and it’s just like donating blood. The amount of blood removed and the frequency of treatment depend on your age and overall health, as well as the severity of your condition. The goal of phlebotomy is to reduce your iron level to normal.

If you have a condition that excludes you from treatment with phlebotomy, such as anemia or heart complications, another treatment may be recommended to remove the iron from your body. Chelation therapy uses medication that binds to the excess iron and allows it to be expelled from your body through your urine or stool.

If you have hemochromatosis, you should eat a healthy, well-balanced diet. Your doctor may recommend avoiding raw shellfish, iron and vitamin C supplements (vitamin C helps your body absorb iron from food) and limiting alcohol. If you have liver disease, particularly cirrhosis, you should stop drinking alcohol.

If you have a first-degree relative – parent, sibling or child – with hemochromatosis and are between 18 and 30 years old, you should be screened for the condition regularly. This way, if the condition is present, it can be discovered in its early stages, before iron overload causes organ damage. Hemochromatosis screening may include blood testing and genetic testing.

Patti DiPanfilo

May is Hepatitis Awareness Month. Although awareness may already be high due to a current mysterious pediatric outbreak that has affected more than 500 children in 20 countries and more than 180 kids in the US over the past six months.

Hepatitis is an inflammatory condition of the liver, and when your liver is inflamed, its ability to function can be compromised. Hepatitis is most commonly caused by a viral infection, although there are other causes as well. We’re concentrating on viral hepatitis in this blog.

There are five known types of viral hepatitis classified as hepatitis A, B, C, D and E. In the US, the most frequently diagnosed, affecting an estimated 4.4 million Americans, are hepatitis A, B and C.

Each of these conditions is caused by a different virus: the hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV). Hepatitis A. B and C have similar symptoms but are spread in different ways and can affect the liver differently.

Regarding the current outbreak: The Centers for Disease Control and Prevention is investigating cases with unknown causes in 36 states and territories. Though most children have recovered, at least five have died and 16 needed a liver transplant. As of May 20, the illness of one Florida child under 10 was under investigation, but state officials said there are no confirmed cases.

The most common symptoms of hepatitis include: dark urine, yellowing of the skin or whites of the eyes (jaundice), clay-colored stool, low-grade fever, loss of appetite, fatigue and aching joints. You may also feel sick to your stomach or have stomach pain. If you experience any or a combination of these symptoms, contact your doctor right away.

To diagnose hepatitis, your doctor will perform a physical exam and review of your symptoms. The doctor will use blood tests to check for the presence of the virus and may also use liver function tests to see how your liver is working, an abdominal ultrasound to look for liver damage or enlargement, or a liver biopsy to sample any abnormal areas of your liver and study them under a microscope.

Hepatitis A is usually a short-term illness that doesn’t lead to a chronic, or long-lasting, infection. The hepatitis A virus is found in the stool and blood of people who are infected. Hepatitis A, which is highly contagious, is commonly spread by eating contaminated food or drink. It can also be spread through close personal contact with someone who is infected, such as during oral or anal sex.

There is no cure for hepatitis A. Treatment typically consists of rest, adequate nutrition and fluids. In rare cases, people with hepatitis A require hospitalization. This type of hepatitis normally resolves within two months without having any long-term effects, and you will have lifelong immunity afterward.

Hepatitis B is spread through contact with body fluids such as blood, vaginal secretions and semen containing the hepatitis B virus (HBV). Your risk for getting hepatitis B increases if you inject drugs or if you have sex or share razors with someone who has it.

Some people with hepatitis B, particularly those who get infected as adults, are able to clear the virus from their bodies without treatment. For others, short-term hepatitis B progresses into a chronic, lifelong infection that over time can result in serious health problems such as liver damage, cirrhosis, liver cancer and even death.

When treatment for hepatitis B is needed, there are several medications available and others in development. However, people who start hepatitis B treatment may need to take medication indefinitely because these medications do not lead to a cure.

Hepatitis C is one of the most common causes of liver disease in the US and used to be the primary reason for liver transplants. The infection is chronic in 75 to 85 percent of people who have it, and 1 to 5 percent experience life-threatening complications, such as liver failure.

Hepatitis C is spread by coming into contact with the blood of a person who is infected with the hepatitis C virus (HCV). This can happen if you share drug injection equipment; have sex with someone who is infected; or share personal items such as razors, nail clippers or toothbrushes with an infected person. In addition, about 6 percent of infants born to infected mothers will get hepatitis C.

Treatment is recommended for all people including children 3 and older and pregnant women with hepatitis C. Treatment involves taking medication for a course of eight to 12 weeks. The cure rate with this therapy is more than 90 percent with few side effects.

To help prevent hepatitis, there are vaccines against hepatitis A and B, but there is no vaccine available for hepatitis C.

By Patti DiPanfilo

Here’s a heads up, Baby Boomers! The US Preventive Service Task Force and the Centers for Disease Control and Prevention recommend we all get tested for hepatitis C. That’s because adults born between 1945 and 1965 are five times more likely to have been exposed to the hepatitis C virus than the rest of the population. One out of every 30 Boomers has been exposed.

These statements scream two big questions: What’s the deal with hepatitis C and why are Baby Boomers so highly at risk? First things first.

Hepatitis C is a viral infection that attacks the liver. It can lead to serious problems such as cirrhosis (scarring), liver cancer and liver failure. Hepatitis C is the main reason people need liver transplants, and the incidence is increasing in the US.

The virus is spread through the blood or body fluids of an infected person. Exposure to the virus most often occurs from reusing infected needles, and less commonly through sex and from mother to baby. Some people caught it from tainted blood transfusions or organ transplants prior to 1992, when screening was initiated.

If you’re carrying the virus, you probably don’t know it. Most of the time, there are no outward symptoms to alert you. In a few cases, though, people might notice a loss of appetite, nausea, fatigue, and a slight yellowing of their eyes and skin, as well as dark urine.

A simple blood test can tell you if you carry antibodies for the hepatitis C virus. Having antibodies means you’ve been exposed to the virus at some point. (About 20 percent of people who have been exposed successfully fight it off.) If you test positive for antibodies, a follow-up test will tell you if you are currently infected. If so, there are new treatments out there that can wipe out the virus in nearly 100 percent of cases.4

So, why are Baby Boomers at risk? The answer is: No one knows for sure. The prevailing thought used to be that it was due to a high-risk lifestyle, which created a stigma for people who had hepatitis C. However, recent research has put the kybosh on that theory.

In a study published in early 2016 in The Lancet Infectious Diseases, researchers say the hepatitis C epidemic can be traced to hospital transmissions caused by the practice of reusing needles in medical settings.

During their study, the researchers found that 1948 to 1963 saw the greatest expansion of hepatitis C virus infection, which suggested that the epidemic had its roots in World War II, when battlefield medical procedures helped spread the virus. After the war, there was a ton of new technology developed, but knowledge of the risks didn’t develop as quickly.

Prior to 1950, physicians typically used glass and metal syringes that were washed and reused. In most cases, they were disinfected, but traces of blood could remain, as on other medical equipment. Disposable needles became popular between 1950 and 1960, but by that time, the drug culture was emerging. And as noted earlier, blood products and organs weren’t carefully screened for viruses until 1992.

The researchers in this study concluded that medical practices, not lifestyle choices, are actually behind the high hepatitis C rates in the Baby Boomer population. Their hope is to eliminate the stigma attached to hepatitis C and encourage people in this generation to go ahead and get tested. Will you?