UNC Health Care
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5 Steps to a Healthy Liver

About 4.9 million adults in the United States have liver disease, according to the Centers for Disease Control and Prevention, and more than 40,000 people die from it each year.

The problem is getting worse; death rates for chronic liver disease and cirrhosis increased by 31 percent between 2000 and 2015 among people ages 45 to 64.

Those statistics are certainly alarming, but UNC REX Healthcare gastroenterologist Tanvir Haque, MD, says all of us can keep our livers healthy by following some simple steps.

1. Avoid risky behaviors and get vaccinated.

Hepatitis C, which affects up to 4 million people in the U.S., is a leading cause of cirrhosis, a scarring and hardening of the liver. Cirrhosis can lead to serious complications, including liver cancer or end-stage liver disease, which can only be reversed by getting a liver transplant.

There is no vaccine available for hepatitis C. In the U.S., the primary mode of transmission for hepatitis C is blood exposure through the sharing of needles used to inject illegal drugs, so this is a risky behavior that should be avoided, Dr. Haque says. Fortunately, hepatitis C is a curable infection, so it is also important to get screened for it, particularly for those who are at higher risk. This includes people with a history of injection or intranasal drug use, people who received a blood transfusion before 1992, people who have undergone long-term hemodialysis, and anyone born between 1945 and 1965 (roughly the baby-boom generation).

Hepatitis B also increases risk for serious illness; an estimated 15 to 25 percent of people with hepatitis B go on to develop liver cancer, cirrhosis or liver failure. Fortunately, hepatitis B infection can be prevented by avoiding risky behaviors—such as having sex with someone who has hepatitis B, having multiple sex partners or sharing syringes to inject drugs—and by getting vaccinated.

“Everyone should talk with their health care provider about being vaccinated for hepatitis B,” Dr. Haque says.

2. Don’t drink too much alcohol.

Excessive alcohol consumption is another common cause of cirrhosis, accounting for about 48 percent of cirrhosis deaths in 2013. Alcohol-related liver disease is also the cause of more than 1 in 3 liver transplants in the U.S.

But how much alcohol is too much?

Among healthy people who do not have liver disease, one alcoholic drink a day for a woman, or two for a man, is considered to be a safe level of alcohol consumption, Dr. Haque says.

“But don’t think it’s OK to drink more than this during the weekend if you didn’t drink during the week,” he adds. “Your liver needs time to process the alcohol, and you will overwhelm it if you binge.”

For people who have been diagnosed with liver disease, it’s best to avoid alcohol, Dr. Haque says.

3. Be wary of unintentional overdoses.

Another growing threat to liver health is drug-induced liver injury, which can be caused by both prescription and over-the-counter medications. Sometimes this happens when people unintentionally take excessive doses of common drugs such as acetaminophen (Tylenol), Dr. Haque says.

For example, sometimes people with a cold may take two or three over-the-counter medications at the same time that all include acetaminophen. While taking any one of these at a time as directed is safe, combining two or more runs the risk of a liver-damaging overdose.

“You should always read the label of any medication you take, to see what’s in it and to make sure you don’t exceed the recommended dosage,” Dr. Haque says. Ask your doctor or a pharmacist if you’re not sure.

4. Exercise and eat a healthy diet.

An estimated 30 percent of people in the U.S. have nonalcoholic fatty liver disease, according to the American Liver Foundation; its incidence has more than doubled over the past 20 years. NAFLD is a buildup of extra fat in liver cells that is not caused by alcohol. It’s the most common form of liver disease in children.

NAFLD may cause the liver to swell, which can lead to cirrhosis, liver cancer or liver failure. It tends to develop in people who are overweight or obese or have diabetes, high cholesterol or high triglycerides. However, NAFLD can also happen in people who don’t have any of these risk factors.

The best way to avoid NAFLD, Dr. Haque says, is to maintain a healthy weight, exercise, and eat a healthy diet that’s high in protein and fiber. You should also reduce the amount of sugar in your diet.

5. Take a coffee break.

Multiple studies have found that drinking coffee reduces the risk of cirrhosis and liver cancer, Dr. Haque says.

Furthermore, these benefits come from all types of coffee, both regular and decaf, no matter how it is made. This includes instant coffee, drip coffee, pour-overs and espresso-based coffee drinks. So if you feel like having a cup of joe, go right ahead!


If you’re struggling with digestive problems, talk to your doctor or find a gastroenterologist near you.