August 27, 2025 • 18 mins
Your liver works tirelessly behind the scenes—performing over 500 vital functions every single day—yet liver disease has quietly become one of the most overlooked health crises in America, affecting 1 in 10 adults. In this episode of The Health Pulse, we uncover why liver disease often goes undetected until it’s advanced, and what you can do to protect this extraordinary organ before it’s too late.
We walk through the progression of liver disease, from simple fat accumulation to dangerous scarring, using the vivid analogy of a garden slowly being overtaken by weeds. You’ll learn how conditions like non-alcoholic fatty liver disease, alcohol-related liver injury, and metabolic dysfunction are fueling this epidemic.
We also highlight the subtle, early symptoms—like persistent fatigue or digestive issues—that many dismiss as stress or poor diet, but may actually be your liver’s first cries for help. Most importantly, we share how simple blood tests and lifestyle interventions can detect problems early and even reverse certain forms of damage.
This episode empowers you to understand, monitor, and support your liver—the unsung hero of your health
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Disclaimer: The information provided in this podcast is for informational purposes only and should not be considered medical advice. The content discussed is based on research, expert insights, and reputable sources, but it does not replace professional medical consultation, diagnosis, or treatment. We strive to present accurate and up-to-date information, medical research is constantly evolving. Listeners should always verify details with trusted health organizations, before making any health-related decisions. If you are experiencing a medical emergency, such as severe pain, difficulty breathing, or other urgent symptoms, call your local emergency services immediately. By listening to this podcast, you acknowledge that The Health Pulse and its creators are not responsible for any actions taken based on the content of this episode. Your health and well-being should always be guided by the advice of qualified medical professionals.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Speaker 2 (00:25):
Welcome to the Deep Dive where we crack open complex
topics and really pull out thecrucial nuggets of knowledge you
need.
Today we're diving into anissue that's well, far more
prevalent, and often more silent, than many of us realize
Chronic liver disease CLD forshort and when I say prevalent I
mean really prevalent.
The American Liver Foundation,they tell us a staggering one in
(00:46):
10 adults in the US has someform of liver disease.
That makes it one of thefastest growing health concerns
worldwide.
Yet it often goes totallyunnoticed until it's well, quite
advanced.
So our mission today is prettyclear we're going to uncover
what CLD actually is, why it'sso easily missed, how doctors
diagnose it and, maybe, mostimportantly, what proactive
steps you can take forprevention and treatment.
(01:08):
Okay, let's unpack this,because your liver it's silently
doing some truly incrediblework you might not even know
about.
Speaker 3 (01:14):
And that really is the core challenge, isn't it?
What's fascinating here is howquietly this disease can advance
, often with no obvious alarmbells ringing.
The liver truly is an unsunghero.
It's got this remarkableability to repair, even
regenerate itself.
But, like you said thatresilience it has limits.
Understanding those limits,recognizing the subtle whispers
(01:35):
your body might be sending, andknowing the power of modern lab
tests for early detection that'swhere the aha moments will
really come for you.
It's all about empowering youwith the knowledge to protect
this absolutely vital organ.
Speaker 2 (01:47):
Absolutely so.
Let's start right at thebeginning.
We hear liver disease thrownaround, but what exactly is
chronic liver disease?
How does it actually damagethis organ over time?
Speaker 3 (01:55):
Yeah, good question.
Unlike a sudden injury, cld isthis insidious long-term process
.
We define it as damage lastingsix months or more.
It's not a single event.
It's more like a slow,persistent assault that starts
to wear down the liver'sincredible capacity to heal
itself.
You could think of your liverlike a really resilient garden.
(02:18):
Right, it can repair minordamage, maybe from a few weeds
popping up, but if those weedsmaybe it's excess fat, too much
alcohol, infections, toxins justkeep coming back, day after day
, year after year.
Eventually the garden getsoverwhelmed.
Healthy liver tissue startsgetting replaced by scar tissue.
That's a process calledfibrosis.
Speaker 2 (02:35):
Fibrosis.
Speaker 3 (02:36):
And that's when things really start to go wrong.
Speaker 2 (02:38):
So it's a gradual decline then, like that garden
just slowly being taken over byweeds.
Can you maybe walk us throughthose stages of decline Of?
Speaker 3 (02:45):
course.
Yeah, the progression is reallykey to understanding CLD and
it's vital because interveningearly can often change the whole
trajectory.
Typically starts with steatosis.
That's basically just excessfat building up in the liver
cells.
Yeah, think of those firstscattered weeds in our garden
analogy.
Speaker 2 (02:59):
Okay, fat buildup first.
Speaker 3 (03:01):
Right.
Then if the insult, the cause,continues, it leads to fibrosis.
That's where scar tissue startsto form and spread Like those.
Weeds are really taking rootnow, choking out the healthy
plants.
If that's left unchecked itprogresses to cirrhosis.
Now this is advanced,widespread scarring.
It severely impairs the liver'sability to function.
(03:23):
At this point our garden it'slargely overgrown, struggling to
sustain life.
Speaker 2 (03:29):
That sounds serious.
Speaker 3 (03:30):
It is, and ultimately , if it's still left untreated,
it can lead to liver failure.
That's the final stage wherethe liver, just it just can't
perform its essential jobsanymore.
Speaker 2 (03:40):
Wow.
And when the liver can'tperform, what does that actually
mean for you, for your overallhealth?
Speaker 3 (03:45):
Well, if we connect this to the bigger picture, it
really highlights just howinterconnected your entire
well-being is with this onevital organ, I mean.
The liver is a mastermultitasker.
It's responsible for over 500vital functions.
Just think about that for asecond 500.
That's incredible it is.
It detoxifies your blood,regulates your metabolism,
produces essential proteins foreverything from blood clotting
(04:06):
to hormone balance.
It's doing so much work behindthe scenes Right.
So when chronic damage occursand these critical functions
decline, it's not just a liverproblem.
It creates this cascade ofwidespread complications across
your entire body entire body.
We're talking issues rangingfrom hormonal imbalances,
digestive problems, kidneydysfunction, even a
(04:28):
significantly increased risk ofcertain cancers.
It truly is the silent linchpinof so many bodily systems.
Speaker 2 (04:35):
That really puts it into perspective how important
it is to catch this early, andto do that we need to know what
the usual suspects are right thecommon causes of CLD.
Identifying the underlyingcause sounds absolutely crucial,
because the treatmentstrategies are going to differ
dramatically depending on what'scausing it.
So what are some of the leadingcauses we should be aware of?
Speaker 3 (04:53):
Well, two of the biggest drivers right now are
actually very common in modernsociety.
First, there's non-alcoholicfatty liver disease, or NFLD,
and its more severe form or.
Nfld and its more severe form,non-alcoholic steatohepatitis,
or NASH.
Speaker 2 (05:06):
Okay, nfld and NASH.
Speaker 3 (05:08):
Right.
Nafld, as the name suggests, iswhen fat builds up in the liver
, but it's not related toalcohol use and it takes a step
further.
It involves that fat buildupplus inflammation and scarring.
Speaker 1 (05:20):
Oh.
Speaker 3 (05:20):
And this duo.
It's a huge concern becauseit's so tightly linked to really
common issues like obesity,insulin resistance, type 2
diabetes, metabolic syndromebasically, conditions related to
how your body processes energyand stores fat.
It's truly become one of thetop drivers of chronic liver
disease worldwide.
Speaker 2 (05:37):
Wow, so lifestyle factors are huge there.
And then, of course, there'sthe one people probably think of
more often alcohol.
Speaker 3 (05:43):
Precisely Alcohol-related liver disease,
or ARLD, remains a reallysignificant cause.
Chronic excessive alcoholconsumption directly damages
liver cells.
It leads to inflammation, fattydeposits and eventually
fibrosis we talked about.
Prolonged heavy drinkingsignificantly increases the risk
of cirrhosis and, down the line, liver cancer.
(06:03):
It's just a direct assault onthe liver's ability to function
and heal itself.
Speaker 2 (06:07):
Okay, so those are the two major players tied to
lifestyle, diet, alcohol.
What about other significantcauses, things that might be
less obvious to the averageperson?
Speaker 3 (06:17):
Yeah, Beyond those viral hepatitis, specifically
hepatitis B and C are majorcauses of CLD, globally Big one.
Speaker 2 (06:24):
Hepatitis B and C.
Speaker 3 (06:25):
Yep.
These viruses cause ongoinginflammation in the liver.
If it's left untreated it canprogress to fibrosis, cirrhosis
or even hepatocellular carcinoma.
That's a type of liver cancer.
Then you've got autoimmunehepatitis.
This is where your body's ownimmune system mistakenly attacks
healthy liver cells.
Speaker 2 (06:43):
Your own immune system, wow.
Speaker 3 (06:45):
Yeah, leading to chronic inflammation and damage.
This often requiresimmunosuppressive therapy,
basically medications to calmdown that overactive immune
response, to prevent progression.
We also see several genetic andmetabolic disorders, for
instance hemochromatosis.
That's a condition where thebody absorbs too much iron.
Speaker 2 (07:02):
Too much iron.
Speaker 3 (07:02):
Exactly Leads to excess iron storage that damages
the liver over time.
Then there's Wilson's disease,which involves abnormal copper
accumulation in the liver andother organs, and alpha-1
antitrypsin deficiency, a rarerinherited disorder linked to
both liver and lung damage.
Speaker 2 (07:19):
Okay, so quite a few other potential causes.
Speaker 3 (07:21):
And finally, there are other, less common causes,
things like medication-inducedliver injury Think long-term use
of certain common painrelievers, maybe some
antibiotics.
Also toxin exposure fromenvironmental chemicals, even
some herbal supplements, believeit or not and various bile duct
diseases that obstruct the flowof bile.
So yeah, this raises animportant question, doesn't it?
Speaker 2 (07:41):
With so many potential causes, how can you
possibly know if your liver isat risk, especially if it's
silent?
That is the million-dollarquestion, isn't it?
Because, as we keep saying, cldis so silent in its early
stages, it makes early diagnosisincredibly challenging.
Many people are only diagnosedafter significant damage has
already happened, but there areoften overlooked early stage
(08:02):
symptoms.
Things people might just brushoff, like persistent fatigue,
just feeling tired all the time,or maybe a mild nagging
abdominal discomfort or bloating, maybe a loss of appetite,
unexplained weight changes ornausea and digestive issues,
especially after eating high-fatmeals.
The problem is, these symptomsare so nonspecific, aren't they?
They're easily mistaken foreveryday weight changes or
nausea and digestive issues,especially after eating high fat
meals.
The problem is, these symptomsare so nonspecific, aren't they?
They're easily mistaken foreveryday stress, maybe a poor
(08:25):
diet, other minor things.
And here's where it gets reallyinteresting, because what might
seem like just being tired orhaving a sensitive stomach, that
could actually be your livertrying to tell you something.
Speaker 3 (08:36):
Exactly.
It's those subtle, easilydismissed cues that make it so
tricky.
Now, as chronic liver diseaseprogresses maybe into fibrosis
or even cirrhosis, the symptomsunfortunately become much more
noticeable and more severe.
They signal more advanceddamage, Things like jaundice,
that unmistakable yellowing ofthe skin and eyes that's due to
(08:56):
elevated bilirubin.
Speaker 2 (08:58):
Right, I've heard of jaundice.
Speaker 3 (08:59):
Yeah, and it's often accompanied by dark urine and
pale stools, which indicateimpaired bile flow.
You might also notice swellingin the legs and abdomen that's
called edema and the sites dueto fluid retention.
Easy breathing or bleeding canhappen because the liver isn't
making enough clotting factors.
Okay, there's also persistentitching, often called
cholestatic pruritus, caused bybile, salt buildup under the
(09:21):
skin and even confusion ormemory problems.
That's known as hepaticencephalopathy.
It happens when toxins build upin the bloodstream and start
affecting the brain.
Speaker 2 (09:30):
Wow, that sounds scary.
Speaker 3 (09:31):
It can be, and because those early CLD symptoms
are so subtle and easilydismissed.
Regular liver function testingis just incredibly crucial.
Especially for anyone with riskfactors like diabetes, obesity,
a history of heavy alcohol useor viral hepatitis.
Speaker 2 (09:51):
It's often the most reliable way to catch the
problem before it becomes afull-blown crisis.
So if you're experiencing anyof those risk factors, or maybe
some of the subtle symptoms, howdo doctors actually figure out
what's going on beneath thesurface?
What's the diagnostic processactually like?
Speaker 3 (10:03):
Well, the detective work almost always kicks off
with a simple blood draw,specifically a panel of liver
function tests or LFTs.
Speaker 2 (10:11):
LFTs okay.
Speaker 3 (10:11):
These are our initial insights into the liver's
health.
Think of them like a dashboardfor your liver.
They give us clues if there'sinflammation, if bile is flowing
properly or if the liver isstruggling with its vital
synthesis jobs For instance,enzymes like ALT and AST.
They're classic markers thattell us if liver cells are being
damaged.
Speaker 2 (10:29):
ALT and AST got it.
Speaker 3 (10:30):
We also check levels of bilirubin to see how well
bile is flowing, and proteinslike albumin to gauge the
liver's manufacturing capacity,its ability to make things
Beyond that.
Doctors might run specificblood panels to check for viral
hepatitis infections or maybeautoimmune markers if they
suspect an autoimmune condition.
Speaker 2 (10:48):
That makes sense.
Blood tests is the first sortof alarm system.
What comes next if those testsraise concerns?
Speaker 3 (10:54):
So, building on those initial blood tests, imaging
tests provide a vital visualpicture of your liver's health.
What does it actually look like?
Ultrasound is often thefirst-line imaging choice.
It's non-invasive, prettycommon and can detect issues
like fatty liver, signs offibrosis or even cirrhosis.
A particularly valuablenon-invasive test is something
(11:14):
called FibroScan or transientelastography.
It actually measures liverstiffness to estimate the degree
of scarring, all withoutneeding any incision.
Speaker 2 (11:24):
Oh, interesting Measures stiffness.
Speaker 3 (11:26):
Exactly.
In more complex cases, though,or if there's a need to detect
complications likehepatocellular carcinoma, liver
cancer, then MRI or CT scanswon't be used.
They give more detailedpictures.
Now, while these non-invasivemethods are really excellent for
screening and monitoring,sometimes the ultimate
confirmation, the gold standardcomes from a liver biopsy.
Speaker 2 (11:49):
A biopsy.
Speaker 3 (11:49):
Yeah, when other tests are inconclusive, a biopsy
provides really detailedinformation about inflammation,
the extent of fibrosis and helpspinpoint the specific causes of
the liver damage.
Speaker 2 (12:02):
Right, and for someone who wants to be
proactive, I understand.
There are even ways now to getsome initial insights into your
liver health right from home.
Speaker 3 (12:09):
That's right, and that convenience factor is huge
for preventative health, isn'tit?
Speaker 2 (12:12):
Definitely.
Speaker 3 (12:13):
There's increasing availability of comprehensive
at-home liver testing kits.
These can offer basic liverfunction panels, screening for
viral hepatitis, even someautoimmune and metabolic liver
markers.
It just makes tracking yourliver health much more
accessible.
It can be a really great firststep for a lot of people.
Speaker 2 (12:30):
That's a fantastic development for empowering
individuals for sure.
So OK, once chronic liverdisease is diagnosed, the
journey doesn't stop there,right.
Regular lab testing becomesabsolutely essential to track
disease progression, monitor howwell treatments are working and
prevent serious complicationslike cirrhosis and liver cancer.
Speaker 3 (12:50):
What kind of function indicators we talked about
earlier ALT, ast, bilirubin,albumin.
Over time Rising enzymes cansignal active inflammation or
maybe worsening fibrosis.
Declining protein levels mightindicate the liver is losing its
(13:11):
synthetic capacity, its abilityto make stuff.
Speaker 1 (13:13):
Okay.
Speaker 3 (13:14):
They also keep a close eye on your prothrombin
time or PTINR.
That measures blood clottingability.
If those values get elevated,it can suggest more advanced
liver disease.
And because the liver andkidneys are so interconnected,
serum creatinine andelectrolytes are often checked.
That assesses kidney function,which can definitely be affected
in advanced liver disease.
Speaker 2 (13:33):
Okay, tracking the disease itself.
And beyond that, what aboutmonitoring for those serious
complications you mentioned,like cancer?
Speaker 3 (13:40):
That's the second crucial part of monitoring
absolutely.
For example, alpha-fetoproteinor AFP.
It's a blood marker usedalongside imaging tests to
screen for hepatocellularcarcinoma liver cancer,
especially in patients whoalready have cirrhosis.
Ammonia levels get checked ifsymptoms of hepatic
encephalopathy, that confusionor memory issues start to
(14:02):
develop.
That indicates a buildup oftoxins affecting the brain and a
platelet count can reveal lowplatelets.
That might indicate somethingcalled portal hypertension,
which is a common and seriouscomplication of cirrhosis, where
blood pressure in the liver'sportal vein system gets
abnormally high.
Speaker 2 (14:18):
It sounds like a lot of ongoing management,
definitely, but also a lot ofways to stay ahead of the curve,
hopefully.
What does treatment andmanagement actually look like
once CLD is diagnosed?
How?
Speaker 3 (14:28):
do you tackle it?
Well, it's a highlypersonalized approach.
It's always based on theunderlying cause and, of course,
the stage of the disease howfar along is it?
But the core focus it's alwayson treating that underlying
cause to try and slow or haltthe progression.
So for NAFLD and NAJ, thetreatment really centers on
significant lifestyle changes.
We're talking sustained weightloss, regular exercise, tight
(14:51):
blood sugar control.
Speaker 2 (14:56):
Sometimes medications to improve insulin sensitivity
are also considered.
Ok Lifestyle first for fattyliver disease.
Speaker 3 (14:58):
Exactly With alcohol-related liver disease.
Complete alcohol cessation isabsolutely critical,
non-negotiable, really toprevent further damage.
If it's viral hepatitis B or C,antiviral medications can
suppress or even eliminate theinfection, which reduces
inflammation and stopsprogression.
Speaker 2 (15:15):
That's good news.
Speaker 3 (15:16):
Yeah.
For autoimmune hepatitis, thoseimmunosuppressive therapies
like corticosteroids are used tocalm the immune system down and
slow the disease progression.
And for those genetic disorders, specific therapies are
available, like medications toremove excess iron for
hemicrobitosis or coprotelationtherapy for Wilson's disease.
Speaker 2 (15:35):
So it really depends on the root cause, but lifestyle
sounds like it plays a massiverole across the board, right?
Speaker 3 (15:41):
What are the key lifestyle and dietary changes
people really need to be awareof?
Speaker 2 (15:45):
Oh, lifestyle and dietary changes are profoundly
impactful almost universallybeneficial, really, regardless
of the specific cause.
Maintaining a balanced dietrich in protein, healthy fats,
while rigorously avoiding addedsugars, highly processed foods
and refined carbohydrates that'skey.
Speaker 3 (16:03):
Avoid the junk food.
Speaker 2 (16:04):
Pretty much.
And here's a fascinatinginsight While sodium restriction
is often recommended,especially to manage fluid
buildup like ascites, the realgoal is often to also reduce
insulin stimuli from thoseprocessed carbs and sugars that
plays a central role ininflammation and fluid retention
too.
It's not just about the saltshaker.
Speaker 3 (16:23):
Ah, interesting.
Reduce insulin stimuli Exactly.
And, of course, avoidingalcohol entirely and staying
physically active are criticalfor reducing insulin resistance
and fat accumulation in theliver.
Now, in very severe cases, whenthe liver is significantly
damaged, advanced interventionsmight be needed.
Things like endoscopictreatments for complications or
even a liver transplant might benecessary.
Speaker 2 (16:43):
Right Transplant as a last resort.
Speaker 3 (16:45):
But what's truly fascinating here, I think, is
the sheer power you have.
Through consistent lifestyleadjustments you can directly
influence your liver health andpotentially even reverse early
damage.
It's quite empowering.
Speaker 2 (16:58):
It really is.
This deep dive has absolutelyhighlighted the power of being
informed and proactive.
Chronic liver disease, as we'veheard, is often silent in its
early stages, making it so easyto miss, but it can lead to
serious, even life-threatening,complications if it's left
undetected.
The good news, though and thisis truly important is that early
(17:18):
diagnosis, getting the propertreatment and regular monitoring
it can slow or even reverseliver damage in many cases.
Your liver is workingincredibly hard for you every
single day, often without awhisper of complaint, and now,
hopefully, you know some of thekey things to look out for and
how you can actively support it.
Speaker 3 (17:37):
Exactly, and you know , given how vital and incredibly
adaptable your liver is, itkind of makes you wonder,
doesn't it, what other subtlesignals our bodies might be
sending us that maybe we're notyet equipped to fully understand
, and it shows how preventativeknowledge truly empowers us to
live healthier, longer lives.
It's just a powerful reminder.
I think that taking control ofyour health often begins with
simply asking what's reallygoing on beneath the surface.
(17:57):
Simply asking what's reallygoing on beneath the surface.
Speaker 2 (18:00):
That's a really profound thought to end on.
Thank you so much for joiningus on this deep dive into
chronic liver disease.
We really hope thisconversation helps you take
control of your health journeyand encourages you to keep
learning.
Speaker 1 (18:17):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
Stay informed, stay healthy andwe'll catch you in the next
episode.
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Speaker 2 (00:25):
Welcome to the Deep Dive where we crack open complex
topics and really pull out thecrucial nuggets of knowledge you
need.
Today we're diving into anissue that's well, far more
prevalent, and often more silent, than many of us realize
Chronic liver disease CLD forshort and when I say prevalent I
mean really prevalent.
The American Liver Foundation,they tell us a staggering one in
(00:46):
10 adults in the US has someform of liver disease.
That makes it one of thefastest growing health concerns
worldwide.
Yet it often goes totallyunnoticed until it's well, quite
advanced.
So our mission today is prettyclear we're going to uncover
what CLD actually is, why it'sso easily missed, how doctors
diagnose it and, maybe, mostimportantly, what proactive
steps you can take forprevention and treatment.
(01:08):
Okay, let's unpack this,because your liver it's silently
doing some truly incrediblework you might not even know
about.
Speaker 3 (01:14):
And that really is the core challenge, isn't it?
What's fascinating here is howquietly this disease can advance
, often with no obvious alarmbells ringing.
The liver truly is an unsunghero.
It's got this remarkableability to repair, even
regenerate itself.
But, like you said thatresilience it has limits.
Understanding those limits,recognizing the subtle whispers
(01:35):
your body might be sending, andknowing the power of modern lab
tests for early detection that'swhere the aha moments will
really come for you.
It's all about empowering youwith the knowledge to protect
this absolutely vital organ.
Speaker 2 (01:47):
Absolutely so.
Let's start right at thebeginning.
We hear liver disease thrownaround, but what exactly is
chronic liver disease?
How does it actually damagethis organ over time?
Speaker 3 (01:55):
Yeah, good question.
Unlike a sudden injury, cld isthis insidious long-term process
.
We define it as damage lastingsix months or more.
It's not a single event.
It's more like a slow,persistent assault that starts
to wear down the liver'sincredible capacity to heal
itself.
You could think of your liverlike a really resilient garden.
(02:18):
Right, it can repair minordamage, maybe from a few weeds
popping up, but if those weedsmaybe it's excess fat, too much
alcohol, infections, toxins justkeep coming back, day after day
, year after year.
Eventually the garden getsoverwhelmed.
Healthy liver tissue startsgetting replaced by scar tissue.
That's a process calledfibrosis.
Speaker 2 (02:35):
Fibrosis.
Speaker 3 (02:36):
And that's when things really start to go wrong.
Speaker 2 (02:38):
So it's a gradual decline then, like that garden
just slowly being taken over byweeds.
Can you maybe walk us throughthose stages of decline Of?
Speaker 3 (02:45):
course.
Yeah, the progression is reallykey to understanding CLD and
it's vital because interveningearly can often change the whole
trajectory.
Typically starts with steatosis.
That's basically just excessfat building up in the liver
cells.
Yeah, think of those firstscattered weeds in our garden
analogy.
Speaker 2 (02:59):
Okay, fat buildup first.
Speaker 3 (03:01):
Right.
Then if the insult, the cause,continues, it leads to fibrosis.
That's where scar tissue startsto form and spread Like those.
Weeds are really taking rootnow, choking out the healthy
plants.
If that's left unchecked itprogresses to cirrhosis.
Now this is advanced,widespread scarring.
It severely impairs the liver'sability to function.
(03:23):
At this point our garden it'slargely overgrown, struggling to
sustain life.
Speaker 2 (03:29):
That sounds serious.
Speaker 3 (03:30):
It is, and ultimately , if it's still left untreated,
it can lead to liver failure.
That's the final stage wherethe liver, just it just can't
perform its essential jobsanymore.
Speaker 2 (03:40):
Wow.
And when the liver can'tperform, what does that actually
mean for you, for your overallhealth?
Speaker 3 (03:45):
Well, if we connect this to the bigger picture, it
really highlights just howinterconnected your entire
well-being is with this onevital organ, I mean.
The liver is a mastermultitasker.
It's responsible for over 500vital functions.
Just think about that for asecond 500.
That's incredible it is.
It detoxifies your blood,regulates your metabolism,
produces essential proteins foreverything from blood clotting
(04:06):
to hormone balance.
It's doing so much work behindthe scenes Right.
So when chronic damage occursand these critical functions
decline, it's not just a liverproblem.
It creates this cascade ofwidespread complications across
your entire body entire body.
We're talking issues rangingfrom hormonal imbalances,
digestive problems, kidneydysfunction, even a
(04:28):
significantly increased risk ofcertain cancers.
It truly is the silent linchpinof so many bodily systems.
Speaker 2 (04:35):
That really puts it into perspective how important
it is to catch this early, andto do that we need to know what
the usual suspects are right thecommon causes of CLD.
Identifying the underlyingcause sounds absolutely crucial,
because the treatmentstrategies are going to differ
dramatically depending on what'scausing it.
So what are some of the leadingcauses we should be aware of?
Speaker 3 (04:53):
Well, two of the biggest drivers right now are
actually very common in modernsociety.
First, there's non-alcoholicfatty liver disease, or NFLD,
and its more severe form or.
Nfld and its more severe form,non-alcoholic steatohepatitis,
or NASH.
Speaker 2 (05:06):
Okay, nfld and NASH.
Speaker 3 (05:08):
Right.
Nafld, as the name suggests, iswhen fat builds up in the liver
, but it's not related toalcohol use and it takes a step
further.
It involves that fat buildupplus inflammation and scarring.
Speaker 1 (05:20):
Oh.
Speaker 3 (05:20):
And this duo.
It's a huge concern becauseit's so tightly linked to really
common issues like obesity,insulin resistance, type 2
diabetes, metabolic syndromebasically, conditions related to
how your body processes energyand stores fat.
It's truly become one of thetop drivers of chronic liver
disease worldwide.
Speaker 2 (05:37):
Wow, so lifestyle factors are huge there.
And then, of course, there'sthe one people probably think of
more often alcohol.
Speaker 3 (05:43):
Precisely Alcohol-related liver disease,
or ARLD, remains a reallysignificant cause.
Chronic excessive alcoholconsumption directly damages
liver cells.
It leads to inflammation, fattydeposits and eventually
fibrosis we talked about.
Prolonged heavy drinkingsignificantly increases the risk
of cirrhosis and, down the line, liver cancer.
(06:03):
It's just a direct assault onthe liver's ability to function
and heal itself.
Speaker 2 (06:07):
Okay, so those are the two major players tied to
lifestyle, diet, alcohol.
What about other significantcauses, things that might be
less obvious to the averageperson?
Speaker 3 (06:17):
Yeah, Beyond those viral hepatitis, specifically
hepatitis B and C are majorcauses of CLD, globally Big one.
Speaker 2 (06:24):
Hepatitis B and C.
Speaker 3 (06:25):
Yep.
These viruses cause ongoinginflammation in the liver.
If it's left untreated it canprogress to fibrosis, cirrhosis
or even hepatocellular carcinoma.
That's a type of liver cancer.
Then you've got autoimmunehepatitis.
This is where your body's ownimmune system mistakenly attacks
healthy liver cells.
Speaker 2 (06:43):
Your own immune system, wow.
Speaker 3 (06:45):
Yeah, leading to chronic inflammation and damage.
This often requiresimmunosuppressive therapy,
basically medications to calmdown that overactive immune
response, to prevent progression.
We also see several genetic andmetabolic disorders, for
instance hemochromatosis.
That's a condition where thebody absorbs too much iron.
Speaker 2 (07:02):
Too much iron.
Speaker 3 (07:02):
Exactly Leads to excess iron storage that damages
the liver over time.
Then there's Wilson's disease,which involves abnormal copper
accumulation in the liver andother organs, and alpha-1
antitrypsin deficiency, a rarerinherited disorder linked to
both liver and lung damage.
Speaker 2 (07:19):
Okay, so quite a few other potential causes.
Speaker 3 (07:21):
And finally, there are other, less common causes,
things like medication-inducedliver injury Think long-term use
of certain common painrelievers, maybe some
antibiotics.
Also toxin exposure fromenvironmental chemicals, even
some herbal supplements, believeit or not and various bile duct
diseases that obstruct the flowof bile.
So yeah, this raises animportant question, doesn't it?
Speaker 2 (07:41):
With so many potential causes, how can you
possibly know if your liver isat risk, especially if it's
silent?
That is the million-dollarquestion, isn't it?
Because, as we keep saying, cldis so silent in its early
stages, it makes early diagnosisincredibly challenging.
Many people are only diagnosedafter significant damage has
already happened, but there areoften overlooked early stage
(08:02):
symptoms.
Things people might just brushoff, like persistent fatigue,
just feeling tired all the time,or maybe a mild nagging
abdominal discomfort or bloating, maybe a loss of appetite,
unexplained weight changes ornausea and digestive issues,
especially after eating high-fatmeals.
The problem is, these symptomsare so nonspecific, aren't they?
They're easily mistaken foreveryday weight changes or
nausea and digestive issues,especially after eating high fat
meals.
The problem is, these symptomsare so nonspecific, aren't they?
They're easily mistaken foreveryday stress, maybe a poor
(08:25):
diet, other minor things.
And here's where it gets reallyinteresting, because what might
seem like just being tired orhaving a sensitive stomach, that
could actually be your livertrying to tell you something.
Speaker 3 (08:36):
Exactly.
It's those subtle, easilydismissed cues that make it so
tricky.
Now, as chronic liver diseaseprogresses maybe into fibrosis
or even cirrhosis, the symptomsunfortunately become much more
noticeable and more severe.
They signal more advanceddamage, Things like jaundice,
that unmistakable yellowing ofthe skin and eyes that's due to
(08:56):
elevated bilirubin.
Speaker 2 (08:58):
Right, I've heard of jaundice.
Speaker 3 (08:59):
Yeah, and it's often accompanied by dark urine and
pale stools, which indicateimpaired bile flow.
You might also notice swellingin the legs and abdomen that's
called edema and the sites dueto fluid retention.
Easy breathing or bleeding canhappen because the liver isn't
making enough clotting factors.
Okay, there's also persistentitching, often called
cholestatic pruritus, caused bybile, salt buildup under the
(09:21):
skin and even confusion ormemory problems.
That's known as hepaticencephalopathy.
It happens when toxins build upin the bloodstream and start
affecting the brain.
Speaker 2 (09:30):
Wow, that sounds scary.
Speaker 3 (09:31):
It can be, and because those early CLD symptoms
are so subtle and easilydismissed.
Regular liver function testingis just incredibly crucial.
Especially for anyone with riskfactors like diabetes, obesity,
a history of heavy alcohol useor viral hepatitis.
Speaker 2 (09:51):
It's often the most reliable way to catch the
problem before it becomes afull-blown crisis.
So if you're experiencing anyof those risk factors, or maybe
some of the subtle symptoms, howdo doctors actually figure out
what's going on beneath thesurface?
What's the diagnostic processactually like?
Speaker 3 (10:03):
Well, the detective work almost always kicks off
with a simple blood draw,specifically a panel of liver
function tests or LFTs.
Speaker 2 (10:11):
LFTs okay.
Speaker 3 (10:11):
These are our initial insights into the liver's
health.
Think of them like a dashboardfor your liver.
They give us clues if there'sinflammation, if bile is flowing
properly or if the liver isstruggling with its vital
synthesis jobs For instance,enzymes like ALT and AST.
They're classic markers thattell us if liver cells are being
damaged.
Speaker 2 (10:29):
ALT and AST got it.
Speaker 3 (10:30):
We also check levels of bilirubin to see how well
bile is flowing, and proteinslike albumin to gauge the
liver's manufacturing capacity,its ability to make things
Beyond that.
Doctors might run specificblood panels to check for viral
hepatitis infections or maybeautoimmune markers if they
suspect an autoimmune condition.
Speaker 2 (10:48):
That makes sense.
Blood tests is the first sortof alarm system.
What comes next if those testsraise concerns?
Speaker 3 (10:54):
So, building on those initial blood tests, imaging
tests provide a vital visualpicture of your liver's health.
What does it actually look like?
Ultrasound is often thefirst-line imaging choice.
It's non-invasive, prettycommon and can detect issues
like fatty liver, signs offibrosis or even cirrhosis.
A particularly valuablenon-invasive test is something
(11:14):
called FibroScan or transientelastography.
It actually measures liverstiffness to estimate the degree
of scarring, all withoutneeding any incision.
Speaker 2 (11:24):
Oh, interesting Measures stiffness.
Speaker 3 (11:26):
Exactly.
In more complex cases, though,or if there's a need to detect
complications likehepatocellular carcinoma, liver
cancer, then MRI or CT scanswon't be used.
They give more detailedpictures.
Now, while these non-invasivemethods are really excellent for
screening and monitoring,sometimes the ultimate
confirmation, the gold standardcomes from a liver biopsy.
Speaker 2 (11:49):
A biopsy.
Speaker 3 (11:49):
Yeah, when other tests are inconclusive, a biopsy
provides really detailedinformation about inflammation,
the extent of fibrosis and helpspinpoint the specific causes of
the liver damage.
Speaker 2 (12:02):
Right, and for someone who wants to be
proactive, I understand.
There are even ways now to getsome initial insights into your
liver health right from home.
Speaker 3 (12:09):
That's right, and that convenience factor is huge
for preventative health, isn'tit?
Speaker 2 (12:12):
Definitely.
Speaker 3 (12:13):
There's increasing availability of comprehensive
at-home liver testing kits.
These can offer basic liverfunction panels, screening for
viral hepatitis, even someautoimmune and metabolic liver
markers.
It just makes tracking yourliver health much more
accessible.
It can be a really great firststep for a lot of people.
Speaker 2 (12:30):
That's a fantastic development for empowering
individuals for sure.
So OK, once chronic liverdisease is diagnosed, the
journey doesn't stop there,right.
Regular lab testing becomesabsolutely essential to track
disease progression, monitor howwell treatments are working and
prevent serious complicationslike cirrhosis and liver cancer.
Speaker 3 (12:50):
What kind of function indicators we talked about
earlier ALT, ast, bilirubin,albumin.
Over time Rising enzymes cansignal active inflammation or
maybe worsening fibrosis.
Declining protein levels mightindicate the liver is losing its
(13:11):
synthetic capacity, its abilityto make stuff.
Speaker 1 (13:13):
Okay.
Speaker 3 (13:14):
They also keep a close eye on your prothrombin
time or PTINR.
That measures blood clottingability.
If those values get elevated,it can suggest more advanced
liver disease.
And because the liver andkidneys are so interconnected,
serum creatinine andelectrolytes are often checked.
That assesses kidney function,which can definitely be affected
in advanced liver disease.
Speaker 2 (13:33):
Okay, tracking the disease itself.
And beyond that, what aboutmonitoring for those serious
complications you mentioned,like cancer?
Speaker 3 (13:40):
That's the second crucial part of monitoring
absolutely.
For example, alpha-fetoproteinor AFP.
It's a blood marker usedalongside imaging tests to
screen for hepatocellularcarcinoma liver cancer,
especially in patients whoalready have cirrhosis.
Ammonia levels get checked ifsymptoms of hepatic
encephalopathy, that confusionor memory issues start to
(14:02):
develop.
That indicates a buildup oftoxins affecting the brain and a
platelet count can reveal lowplatelets.
That might indicate somethingcalled portal hypertension,
which is a common and seriouscomplication of cirrhosis, where
blood pressure in the liver'sportal vein system gets
abnormally high.
Speaker 2 (14:18):
It sounds like a lot of ongoing management,
definitely, but also a lot ofways to stay ahead of the curve,
hopefully.
What does treatment andmanagement actually look like
once CLD is diagnosed?
How?
Speaker 3 (14:28):
do you tackle it?
Well, it's a highlypersonalized approach.
It's always based on theunderlying cause and, of course,
the stage of the disease howfar along is it?
But the core focus it's alwayson treating that underlying
cause to try and slow or haltthe progression.
So for NAFLD and NAJ, thetreatment really centers on
significant lifestyle changes.
We're talking sustained weightloss, regular exercise, tight
(14:51):
blood sugar control.
Speaker 2 (14:56):
Sometimes medications to improve insulin sensitivity
are also considered.
Ok Lifestyle first for fattyliver disease.
Speaker 3 (14:58):
Exactly With alcohol-related liver disease.
Complete alcohol cessation isabsolutely critical,
non-negotiable, really toprevent further damage.
If it's viral hepatitis B or C,antiviral medications can
suppress or even eliminate theinfection, which reduces
inflammation and stopsprogression.
Speaker 2 (15:15):
That's good news.
Speaker 3 (15:16):
Yeah.
For autoimmune hepatitis, thoseimmunosuppressive therapies
like corticosteroids are used tocalm the immune system down and
slow the disease progression.
And for those genetic disorders, specific therapies are
available, like medications toremove excess iron for
hemicrobitosis or coprotelationtherapy for Wilson's disease.
Speaker 2 (15:35):
So it really depends on the root cause, but lifestyle
sounds like it plays a massiverole across the board, right?
Speaker 3 (15:41):
What are the key lifestyle and dietary changes
people really need to be awareof?
Speaker 2 (15:45):
Oh, lifestyle and dietary changes are profoundly
impactful almost universallybeneficial, really, regardless
of the specific cause.
Maintaining a balanced dietrich in protein, healthy fats,
while rigorously avoiding addedsugars, highly processed foods
and refined carbohydrates that'skey.
Speaker 3 (16:03):
Avoid the junk food.
Speaker 2 (16:04):
Pretty much.
And here's a fascinatinginsight While sodium restriction
is often recommended,especially to manage fluid
buildup like ascites, the realgoal is often to also reduce
insulin stimuli from thoseprocessed carbs and sugars that
plays a central role ininflammation and fluid retention
too.
It's not just about the saltshaker.
Speaker 3 (16:23):
Ah, interesting.
Reduce insulin stimuli Exactly.
And, of course, avoidingalcohol entirely and staying
physically active are criticalfor reducing insulin resistance
and fat accumulation in theliver.
Now, in very severe cases, whenthe liver is significantly
damaged, advanced interventionsmight be needed.
Things like endoscopictreatments for complications or
even a liver transplant might benecessary.
Speaker 2 (16:43):
Right Transplant as a last resort.
Speaker 3 (16:45):
But what's truly fascinating here, I think, is
the sheer power you have.
Through consistent lifestyleadjustments you can directly
influence your liver health andpotentially even reverse early
damage.
It's quite empowering.
Speaker 2 (16:58):
It really is.
This deep dive has absolutelyhighlighted the power of being
informed and proactive.
Chronic liver disease, as we'veheard, is often silent in its
early stages, making it so easyto miss, but it can lead to
serious, even life-threatening,complications if it's left
undetected.
The good news, though and thisis truly important is that early
(17:18):
diagnosis, getting the propertreatment and regular monitoring
it can slow or even reverseliver damage in many cases.
Your liver is workingincredibly hard for you every
single day, often without awhisper of complaint, and now,
hopefully, you know some of thekey things to look out for and
how you can actively support it.
Speaker 3 (17:37):
Exactly, and you know , given how vital and incredibly
adaptable your liver is, itkind of makes you wonder,
doesn't it, what other subtlesignals our bodies might be
sending us that maybe we're notyet equipped to fully understand
, and it shows how preventativeknowledge truly empowers us to
live healthier, longer lives.
It's just a powerful reminder.
I think that taking control ofyour health often begins with
simply asking what's reallygoing on beneath the surface.
(17:57):
Simply asking what's reallygoing on beneath the surface.
Speaker 2 (18:00):
That's a really profound thought to end on.
Thank you so much for joiningus on this deep dive into
chronic liver disease.
We really hope thisconversation helps you take
control of your health journeyand encourages you to keep
learning.
Speaker 1 (18:17):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
Stay informed, stay healthy andwe'll catch you in the next
episode.
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