How to Tell if Your Liver is Struggling: Key Signs and Symptoms

Written By Jaclyn P. Leyson-Azuela, RMT, MD, MPH

Published OnJuly 17, 2025

How to Tell if Your Liver is Struggling: Key Signs and Symptoms

Liver health is vital yet it is often overlooked. Recognizing how to know if your liver is struggling can help you act early. This will guide you through key symptoms, causes, and when to seek help. If you’ve been feeling off and can’t quite put your finger on it, you might want to check your liver. It might be telling you something about its function.

This article provides highlights of any sign of liver trouble so you can take action early. Thus, preventing any serious consequences from happening. These early signs could make a difference when it comes to protecting your long-term health. Let’s expose how to recognize when your liver needs your support. Your well-being starts from the inside out.

Key Insights:

Jaundice and itchy skin are major signs of liver disease
Persistent fatigue may be due to toxin buildup
Dark urine and pale stools indicate bile flow problems
Non-alcoholic fatty liver disease (NAFLD) is linked to poor diet and obesity
Early-stage liver issues can often be reversed with lifestyle changes
Blood tests and imaging are diagnostic tools that are essential for diagnosing liver problems
Watch out for signs like nausea, right upper abdominal pain, and vomiting

What are the early warning signs of liver problems?

You might be wondering: “How do I know if my liver is struggling?” Pay attention to your body. Early signs are subtle but important.

Your liver works silently but powerfully. When it's struggling, it doesn't always shout, sometimes it whispers. Spotting early signs can help you take action before serious damage occurs. Common early symptoms include:

Persistent fatigue that doesn’t go away even after rest
Mild pain or discomfort in the upper right abdomen
Unexplained nausea or vomiting
Loss of appetite
Dark-colored urine
Itchy skin
Yellowing of eyes or skin (jaundice)

These early symptoms may be mistaken for other issues, which is why liver disease is often called “silent” or asymptomatic. You should not ignore these signs, especially if you have the risk factors like alcohol consumption, family history, or obesity.

What kind of pain indicates liver issues?

If you’re wondering where the liver pain shows up, it is usually felt on the upper right side of your belly, just under your ribs.

The liver pain often feels like a dull pressure or ache. It may radiate to your back or right shoulder. This discomfort can get worse after eating, especially after eating meals rich in fat. Unlike sharp pain coming from kidney stones or gas, the liver pain is more of a nagging or persistent ache.

You should see a doctor if:

The pain persists longer than usual and worsens over time
It commonly comes along with jaundice, fatigue, or unusual bowel changes
You feel bloated or noticed some swelling in your abdomen

Don’t ignore these chronic or recurrent right-sided pain. It can be a warning that your liver is already struggling.

Is persistent fatigue a sign of liver struggling?

Yes, if the fatigue is persistent and sticks around no matter how much sleep you get may be a sign that your liver is struggling.

When your liver isn’t functioning well, toxins start building up in your blood. This will place extra pressure on your body that will drain your energy. You may feel:

Tired for no reason
Mentally foggy
Low motivation to do basic tasks
Weak or even sore muscles

If the fatigue you’re experiencing does not improve even with ample rest, and it comes along with other symptoms like loss of appetite, itchy skin, or nausea, don’t wait for them to progress. Your liver may need help.

How do liver problems affect your skin and eyes?

If you’re asking, “How do I know if my liver is not working?”, one of the clearest signs is in your skin and eyes.

Jaundice, which is the yellowing of the skin and whites of the eyes, is a strong sign. It happens when bilirubin, a yellow pigment, builds up in the blood because your liver can’t break it down properly.

When jaundice occurs, it often comes with any of the following:

Itchy skin, particularly on the arms, back, or hands
Spider angiomas–these are spider-looking blood vessels visible under the skin
Palmar erythema (redness on your palm)
Skin that’s dry, bruises easily, or flaky

These symptoms often tell you that something is wrong with your liver. And you need to get it checked before it escalates even further. It usually signals that the liver cannot process toxins properly and it cannot remove these wastes effectively.

What is jaundice and why does it occur with liver disease?

Jaundice is the build up of bilirubin, resulting in yellowish discoloration of your eyes and skin. It happens, as discussed, because the liver could no longer properly process bilirubin as a toxic waste.

Normally, your liver processes bilirubin from the old red blood cells. But when your liver is not working properly, this process slows down or probably even stops. So the toxic waste accumulates as a result and gets deposited under the skin or in the eyes. As this happens, itchiness in the skin and even yellowish discoloration occurs.

Why does liver disease cause itchy skin?

Skin itchiness from liver disease is due to the buildup of bile salt in the blood. The function of the liver is to remove these substances. But when it can’t, they stay in the blood and these substances get deposited in the skin.

Characteristics of liver disease-related skin itchiness:

Often feels deeper compared to most allergies or skin itchiness
They are hard to relieve
It is worst on the hands and feet, and also at night
No visible rash can be seen

If you are constantly scratching your skin, without any rash, you might want to start checking your liver for signs of struggle.

Can liver issues cause digestive problems?

Yes. The liver helps digest food and filter toxins. When it's not working, digestion suffers.

Direct signs that your liver is struggling include:

Feeling sick or queasy especially after a high-fat meal
Nausea or vomiting without any clear or apparent cause
Pale or clay-colored stools
Dark urine even when you’re hydrated
Unexplained bloating

These signs point to disrupted bile production and toxin filtering, which are the two of the liver’s main jobs.

Why do liver problems lead to nausea and loss of appetite?

Your liver helps in processing nutrients as well as detoxifies the body. When it gets inflamed or damaged, toxins build up and nutrients get inadequately processed. This will make you feel:

Full quickly even after a small meal
No desire to eat even your favorite foods
Queasy in the mornings
Easily nauseated by rich or fatty foods

This isn't just your regular indigestion. If you have these symptoms with the presence of jaundice or fatigue, make an appointment with your doctor.

What do pale stools and dark urine indicate about liver health?

Your stool color changes when bile flow is blocked. Pale, gray, or clay-colored stools mean less bile is reaching your gut.

In the same manner, even when you are drinking enough fluids, you still have dark-colored urine. This means bilirubin has been building up in your body.

What kind of fatigue is associated with liver struggling?

If you're dragging all day, even after a good night's sleep, your liver might be struggling.

Liver-related fatigue feels:

Persistent or constant that is not relieved by adequate rest
Physically and mentally tired, which affects both your energy and focus
Like you’re running empty all the time.

This is the kind of fatigue that is entirely different from the usual tiredness you feel because the liver has failed to regulate your energy properly.

You may also notice:

Muscle weakness
Brain fog
Mood changes (irritability, anxiety)

Fatigue is one of the most common signs that the liver is struggling, even before jaundice appears or pain is felt.

When should you seek medical attention for liver symptoms?

If you notice any of the following symptoms, it would be wise to see your doctor. Some signs of liver problems can be reversed when it’s caught early.

Seek help if you have:

Yellow skin or eyes
Dark urine or pale stools
Swelling of the abdomen or legs
Ongoing nausea or vomiting
Chronic fatigue
Confusion
Pain (dull ache) on the right upper abdomen
Severe itching without rash

These symptoms can indicate serious liver damage like hepatitis or cirrhosis. Your doctor will run some tests or imaging to check for your liver health.

What are the common causes and risk factors for liver disease?

Liver problems don’t occur overnight. They are caused by long-term habits, exposure, or hidden medical issues. Major causes of liver disease include:

Chronic alcohol use
Hepatitis infection (A, B, or C)
Fatty liver disease
Autoimmune liver disease
Inherited conditions (e.g., hemochromatosis)

Risk factors to develop these liver diseases include:

Obesity
Type 2 diabetes mellitus
High cholesterol or triglyceride levels
Family history of liver disease
Unprotected sex or injectable drug use
Certain medications or herbal supplements

What role does alcohol play in liver damage?

Alcohol is a major cause of liver disease. It directly damages liver cells and can lead to:

Fatty liver (early, reversible stage)
Alcoholic hepatitis (inflammation of liver)
Cirrhosis (permanent scarring and loss of function)

Heavy drinking over months or years increases your risk. Women and people with poor nutrition often have increased odds of developing liver damage.

How does non-alcoholic fatty liver disease develop?

Non-alcoholic fatty liver disease (NAFLD) happens when fat builds up in your liver, even if you don’t drink alcohol.

It is often associated with:

Obesity
Insulin resistance or type 2 diabetes
Poor diet, especially high in sugar and fat
Lack of physical activity

NAFLD can progress silently over the years, which could then develop into non-alcoholic steatohepatitis and ultimately to cirrhosis if it remains untreated. Early weight loss and dietary changes can make a big difference.

What are the genetic and autoimmune causes of liver disease?

Some people are born with liver risks. Inherited and autoimmune conditions include:

Hemochromatosis (increase in iron that get deposited in tissues)
Wilson’s disease (copper buildup in the body)
Autoimmune hepatitis (your immune system is attacking the liver)
Primary biliary cholangitis (bile ducts are destroyed)
Alpha-1-antitrypsin deficiency (missing protein damages liver cells)

These are rarer but serious. They often require lifelong management. If you have a family history or unexplained symptoms, screening can help.

Quick Summary Box

Liver problems can start quietly with subtle symptoms like tiredness or itchy skin.
Serious signs include jaundice, dark urine, and pale stools.
Alcohol, poor diet, and viruses are common liver stressors.
Testing and early lifestyle changes can protect your liver long term.

Frequently Asked Questions

Q: What are the first signs of liver damage?

A: Fatigue, nausea, loss of appetite, and mild right-abdomen discomfort. Jaundice and dark urine are more advanced signs.

Q: Can liver disease be cured or reversed?

A: It depends on the cause and stage. Early fatty liver can often be reversed. Cirrhosis is generally permanent but can be managed.

Q: What tests are used to check liver function?

A: Blood tests like ALT, AST, bilirubin, albumin, and INR. Imaging like ultrasound or MRI may be used.

Q: What foods are bad for your liver?

A: Processed foods, sugar, trans fats, and alcohol are harmful.

Q: How can I naturally improve my liver health?

A: Eat whole foods, maintain a healthy weight, exercise, avoid toxins and limit alcohol.

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