The liver is one of the most vital organs of the body. One’s survival and quality of life depends on the well being of the liver.

It produces glucose which is vital for providing energy to the body cells for their day to day functioning. It also manufactures proteins which help the body cells to cope up with wear and tear. Clotting factors, i.e. substances which stop bleeding from any site in the body are also produced in the liver.

The Liver is also the site for manufacture of cholesterol, which serves as a reserve fuel for the body and also as a medium for transport of lipids and lipoproteins across the body for various metabolic functions.  Antibodies against various infectious agents are also made in the liver. It also serves to detoxify substances toxic to the body like alcohol. Various drugs and other chemicals are also metabolized through the liver.

Considering the so many vital functions of the liver, one cannot and should not ignore it.  Alcohol is the substance most abused and which is very harmful to the liver. To a large extent, the body tries to detoxify it but when alcohol consumed exceeds the capacity of the liver to eliminate it, the liver becomes sick. If the process continues unabated, the liver gets damaged beyond repair. 

 More than 900 drugs have been identified which can damage the liver to more or less extent in various ways. Use of some of them is unavoidable. For example, use of   Rifampicin for tuberculosis and nevarapine for HIV/AIDS is mandatory. But   use of some of the hepatotoxic drugs is avoidable.  Pain killing medicines, the NSAIDS, non steroidal anti-inflammatory drugs) like diclofenac, paracetamol, are harmful to the liver as well as the kidneys. They are misused by people ignorantly.

For a pain anywhere in the body, even if not severe, it is common to see people consuming a pill on their own. Corticosteroids are also harmful to the liver. Because of their easy availability, affordable prices and potent anti-allergy and anti-inflammatory properties, they are also used by people much. 

Some of the chemicals used in industries like arsenic, carbon tetrachloride, vinyl chloride used in plastics, organochlorine insecticides, e.t.c.  also damage the  liver.
Some herbs, certain kind of mushrooms also lead to damage of the liver.

Many of these substances may cause manifest liver disease. Here the patient may have loss of appetite, nausea, vomiting and weakness with or without frank jaundice (yellow discoloration of the eyes). Unchecked the damage may progress to liver failure, encephalopathy, coma and death.

At times, if one is exposed to any of these substances, there may be only derangement of the liver function, i.e. the hepatic enzymes may be elevated, but no clinical illness. This indicates that there has been damage to the liver cells but not severe enough to derange the function of the liver. Subsequently, if there is damage to the liver again by some hepatotoxic substance or illness like viral hepatitis, one may get florid liver damage.

Once the liver is damaged, there is no drug to correct it. The only treatment offered is palliative to cure the symptoms and maintain vital signs. Liver transplant is a procedure possible only in select centers. One needs to find a very suitable donor and then after a major surgery, immune suppressive drugs have to be taken for a long time, even for life to prevent rejection of the graft.

Hence it is wise to save the liver from any damage as far as possible. Alcohol is best avoided. Unless absolutely needed, one should not take any medicines. While consuming herbs or mushrooms, one should verify whether they are safe or not, before consuming them. 

Those working in industries should take due precautions to avoid exposure to hepatotoxic chemicals.
If in spite of these precautions and one does get any feature of liver damage, they should get their liver function tests done to assess if any damage has occurred to the liver.
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