Texas Liver Care is committed to empowering patients with knowledge about liver and metabolic health. Understanding your condition, treatment options, and lifestyle strategies can help you make informed decisions and improve long-term outcomes. Our education resources are designed for patients, caregivers, and the public.
What it is:
A condition in which fat builds up in the liver due to metabolic factors such as excess weight, insulin resistance, or high cholesterol. The more severe form, MASH (formerly NASH), involves inflammation and liver cell injury. When metabolic risk factors occur together with regular alcohol use, this is sometimes called MetALD (metabolic and alcohol-related liver disease).
Risks:
Often silent, MASLD can gradually progress to fibrosis (scarring), cirrhosis, or even liver cancer. It is now one of the most common causes of liver disease worldwide.
Management:
The foundation of treatment is healthy weight reduction through nutrition, physical activity, and behavioral support. Managing diabetes, blood pressure, and cholesterol is essential. Limiting alcohol intake is important, particularly when both metabolic and alcohol factors are present. New medications are emerging for patients with more advanced disease.
TLC Tip:
Even a 7–10% weight loss can significantly reduce liver fat and inflammation. Small, steady steps make a big difference.
What it is:
Liver injury caused by excessive or prolonged alcohol use. It includes a spectrum ranging from fatty liver to alcohol-associated hepatitis and cirrhosis. When alcohol use occurs alongside metabolic risk factors such as excess weight, diabetes, or high cholesterol, it is sometimes called MetALD (metabolic and alcohol-related liver disease).
Symptoms:
Fatigue, loss of appetite, jaundice, and swelling can occur, but damage often progresses silently for years before symptoms appear.
Management:
The cornerstone of treatment is complete alcohol cessation. Supportive care, balanced nutrition, and management of complications (such as ascites or encephalopathy) are key. For advanced disease, liver transplantation may be considered when medical therapy alone is insufficient.
Support:
Recovery requires both medical and behavioral support. Counseling, medications for alcohol use disorder, and peer programs such as Alcoholics Anonymous (AA) or SMART Recovery can make long-term sobriety achievable.
TLC Tip:
No matter how far the disease has progressed, liver healing begins the moment alcohol use stops and compassionate help is available.
What it is:
A viral infection that causes liver inflammation and, if untreated, can lead to cirrhosis or liver cancer. Many people live with chronic Hepatitis C for years without realizing it.
Symptoms:
Most people have no symptoms early on. When they occur, they may include fatigue, nausea, abdominal discomfort, or yellowing of the eyes and skin (jaundice).
Management:
Modern antiviral medications can cure over 95% of people with Hepatitis C usually with just 8 to 12 weeks of pills and minimal side effects. Early treatment prevents long-term liver damage.
Screening:
Everyone should be screened at least once in adulthood, and more often for people with prior injection drug use, transfusions before 1992, or other risk factors.
TLC Tip:
If you’ve ever tested positive for Hepatitis C antibodies, you need a confirmatory HCV RNA test to know if you still have the virus.
What it is:
A viral infection that attacks the liver. Most adults clear the infection on their own, but some people develop chronic Hepatitis B, which can lead to cirrhosis or liver cancer over time.
Symptoms:
Usually none at first. Some people experience fatigue, loss of appetite, nausea, dark urine, or yellowing of the eyes and skin (jaundice).
Management:
Regular blood tests and imaging to monitor liver health. Antiviral therapy may be started if the virus is active or liver damage is present. Lifelong follow-up is important even if you feel well.
Prevention:
Vaccination is safe and highly effective. Practice safe sex, avoid sharing needles or razors, and ensure all household and sexual contacts are vaccinated.
TLC Tip:
If you’ve ever been told you have “surface antigen positive” or “carrier state,” don’t ignore it, schedule ongoing care with a liver specialist.
What it is:
Advanced scarring of the liver that results from long-standing injury, such as viral hepatitis, alcohol use, or fatty liver disease. As cirrhosis progresses, normal liver function declines and blood flow through the liver becomes restricted.
Complications:
May include portal hypertension, varices (enlarged veins prone to bleeding), ascites (fluid buildup), hepatic encephalopathy (confusion due to toxins), and liver cancer.
Management:
Care involves guideline-based surveillance, low-sodium nutrition, avoidance of alcohol, appropriate medications, and evaluation for liver transplantation when indicated. Early recognition and coordinated care improve survival.
TLC Tip:
Even in advanced disease, careful management and consistent follow-up can prevent many complications and maintain quality of life.
What it is:
A complication of liver scarring in which blood flow through the liver becomes restricted, causing increased pressure in the portal vein, the main vessel that carries blood from the intestines to the liver.
Symptoms:
Often silent until advanced. Can cause varices (enlarged veins that may bleed), fluid buildup in the abdomen (ascites), or splenomegaly.
Management:
Focuses on reducing portal pressure and preventing bleeding with medications (such as non-selective beta-blockers), endoscopic banding of varices, and regular monitoring.
TLC Tip:
Even if you feel well, routine endoscopy and medication adherence are vital to prevent life-threatening bleeding events.
What they are:
A group of immune-mediated liver conditions in which the body’s immune system mistakenly attacks liver cells or bile ducts. These include Autoimmune Hepatitis (AIH), Primary Biliary Cholangitis (PBC), and Primary Sclerosing Cholangitis (PSC).
Symptoms:
Fatigue, itching, jaundice, and abdominal discomfort are common. Some people have no symptoms until liver tests become abnormal.
Management:
Treatment may include immunosuppressive therapy (such as steroids or azathioprine), medications to improve bile flow, and management of itching and fatigue. Ongoing monitoring helps prevent complications like cirrhosis or bile duct cancer.
TLC Tip:
Because these conditions are lifelong, regular follow-up with a hepatologist and maintaining liver-healthy habits can make a major difference in outcomes.
Find resources for managing Autoimmune & Cholestatic Liver Diseases
What it is:
Liver cancer refers mainly to two types:
Risk factors:
Cirrhosis from any cause, chronic Hepatitis B or C, alcohol-associated liver disease, and fatty liver disease (MASLD) all increase the risk.
Screening:
People at risk should undergo imaging (e.g. ultrasound, CT or MRI) and alpha-fetoprotein (AFP) testing every 6 months to detect tumors early, when curative treatment is most effective.
Management:
Treatment depends on stage and liver function. Options include surgical resection, liver transplantation, local ablation or embolization, and systemic therapies such as targeted or immunotherapy.
TLC Tip:
Regular surveillance is your best defense, most liver cancers can only be cured if found early.
Pre-transplant:
Evaluation includes detailed blood work, imaging, cardiac testing, nutrition assessment, and psychosocial support to ensure each patient is ready for surgery and recovery. Maintaining sobriety (when applicable), optimizing nutrition, and keeping appointments are crucial parts of readiness.
Post-transplant:
Care involves lifelong follow-up with your transplant team, use of immunosuppressive medications to prevent rejection, and close monitoring for infection, kidney function, and cancer screening. Nutrition, vaccination, and medication adherence remain essential.
TLC Tip:
Liver transplant is not an endpoint, it’s the start of a new phase of care that requires teamwork, vigilance, and long-term support.
What it is:
Liver damage that occurs when a medication, supplement, or herbal product harms liver cells. Both prescription and over-the-counter products can cause it, including common pain relievers, antibiotics, or “natural” remedies.
Symptoms:
Often silent at first. Possible signs include fatigue, nausea, itching, dark urine, or yellowing of the eyes and skin (jaundice).
Management:
The key is early recognition and stopping the offending drug. Most people recover fully with medical supervision, though severe cases may require hospitalization. Always discuss any new medication or supplement with your care team.
TLC Tip:
Bring an updated list of all medicines and supplements to every visit, prevention starts with awareness.
What it is:
An inherited disorder causing the body to absorb and store too much iron, which can accumulate in the liver, heart, and pancreas and lead to organ damage over time.
Symptoms:
Many have no symptoms for years. Fatigue, joint pain, and darkened skin may appear later.
Management:
Treatment involves regular blood removal (phlebotomy) to reduce iron levels. Family members should be screened because the condition is genetic. Limiting alcohol and avoiding iron or vitamin C supplements also help protect the liver.
TLC Tip:
Simple blood tests for iron and ferritin can detect overload early, ask about screening if liver tests or family history suggest risk.
What it is:
A rare genetic disorder where the body can’t properly remove copper, leading to buildup in the liver, brain, and other organs. Other inherited liver diseases include alpha-1 antitrypsin deficiency and various metabolic enzyme disorders.
Symptoms:
Fatigue, behavioral or mood changes, tremors, or jaundice. In children and young adults, it may mimic other liver conditions or neurological illness.
Management:
Treatment removes excess copper through chelating medications and dietary adjustment. Lifelong monitoring is needed to prevent recurrence. Family screening and genetic testing are essential.
TLC Tip:
If several relatives have unexplained liver disease or neurologic symptoms, ask your provider about genetic testing, early detection saves lives.
What they are:
Liver diseases that affect infants, children, and adolescents, including biliary atresia, metabolic and genetic disorders, viral hepatitis, and autoimmune hepatitis.
Symptoms:
Jaundice lasting beyond the newborn period, pale stools, poor growth, fatigue, or abdominal swelling.
Management:
Children require specialized pediatric hepatology care for diagnosis, nutrition, and monitoring. Some may need early surgery or liver transplantation. Ongoing family education and support are vital for long-term outcomes.
TLC Tip:
Early referral to a pediatric liver specialist gives children the best chance for recovery and healthy growth.
There is no single “perfect” diet for liver or metabolic health, each person’s needs, goals, and preferences are unique. Our philosophy centers on personalized, sustainable nutrition and realistic lifestyle change to support healthy weight, optimal metabolism, and long-term liver wellness.
Low-Carbohydrate / High-Fat (Ketogenic)
Can promote weight loss and better blood sugar control for some patients. Should emphasize healthy fats (olive oil, nuts, avocado) and be medically supervised if liver disease is advanced.
Small, consistent changes, such as reducing sugary drinks, adding daily movement, or prioritizing sleep, often create the biggest long-term improvements in liver and metabolic health.
Find resources on Nutrition, Weight Wellness & Lifestyle
What Are They
Liver tests are simple blood measurements that show how well your liver is working and whether inflammation, scarring, or bile flow problems may be present. They are among the most important tools for detecting and monitoring liver disease, often before symptoms appear.
Common liver-related blood tests include:
Why It Matters
Regular monitoring helps your care team:
Following your results over time, not just single numbers, provides the clearest view of your liver’s health and stability.
Interpreting Results
Ask your provider to review your results in plain terms:
Your care team will also consider other factors, like age and metabolic health, to put your results into context.
Preparing for Testing
TLC Tip
Keep a personal record of your liver test result. Watching trends over time helps you and your provider make informed, proactive decisions about your liver care.
What Are They
Modern liver imaging provides a detailed, non-invasive view of your liver’s health.
Why It Matters
Imaging is central to modern liver care. It helps:
Regular imaging allows your hepatology team to fine-tune your care plan, catching issues early and personalizing your treatment for better outcomes.
Interpreting Results
Your provider will review key values and findings with you:
Preparing for Testing
Most tests require no special preparation beyond avoiding food and drink for a few hours.
TLC Tip:
Ask your provider to explain your FibroScan® and Doppler findings in plain language. These measurements can track your progress over time and help visualize the benefits of healthy habits or therapy.
What It Is
The Model for End-Stage Liver Disease (MELD) score estimates how urgently a patient may need a liver transplant. It is calculated from key lab values such as bilirubin, creatinine, sodium, INR, albumin, and other clinical factors that reflect overall liver and kidney function. A higher MELD score indicates more advanced liver disease and greater medical urgency. MELD scores are updated automatically through transplant centers and reviewed regularly by your care team to reflect your current health status.
Why It Matters
The MELD score is central to transplant evaluation and organ allocation in the United States. It helps ensure that donated livers are offered first to those in greatest need.
In some cases, patients receive a MELD exception, additional points granted for conditions not fully captured by lab results (such as liver cancer or specific metabolic disorders). These exceptions help ensure appropriate transplant priority when labs don’t tell the whole story.
TLC Tip
Keep your MELD-related labs current and discuss changes promptly with your hepatology team. Even modest lab shifts, or approved MELD exceptions, can influence transplant eligibility and priority. Staying informed helps you stay ready.
What It Is
People living with liver conditions are more vulnerable to serious infections, so staying up to date on vaccines is an important part of liver care. Vaccines help prevent illnesses that can worsen liver disease, cause flare-ups, or complicate transplant eligibility.
Key recommended vaccines include:
Your care team may tailor timing based on your diagnosis, immune status, and any upcoming procedures or transplant evaluations.
Why It Matters
Liver disease can weaken your body’s ability to fight infections, and infections can accelerate liver injury. Vaccinations help:
TLC Tip
Bring your vaccine record to every visit so your care team can confirm protection, schedule boosters, and document progress in your chart — keeping you fully protected year-round.
What It Is
Pain is common in people with liver conditions, from muscle aches and arthritis to post-procedure discomfort. However, many pain medicines are processed by the liver or affect blood flow, fluid balance, or bleeding risk. Careful selection and dosing are essential to avoid harm.
Acetaminophen (Tylenol®) is usually the safest first-line option up to 2,000 mg (2 g) per day, as long as alcohol is avoided and other medicines containing acetaminophen aren’t used simultaneously.
NSAIDs (such as ibuprofen, naproxen, and diclofenac) should be avoided in cirrhosis due to the risk of kidney injury, fluid retention, and bleeding.
Opioids and sedatives require close monitoring and should only be used under specialist guidance, as they may worsen confusion or breathing in advanced liver disease.
Why It Matters
Uncontrolled pain can harm quality of life, but inappropriate pain medication can worsen liver function or trigger serious complications. Understanding safe options allows for symptom relief without compromising liver safety. Your care team can help design a personalized plan using:
• Adjusted doses of safer medications.
• Non-pharmacologic methods (heat, stretching, physical therapy).
• Topical or nerve-targeted treatments that minimize systemic exposure.
TLC Tip:
Never start a new pain, supplement, or herbal product without consulting your provider or pharmacist, even “natural” options can cause liver injury or interact with medications.
What It Is
Home cooking allows you to take control of ingredients, portion sizes, and preparation methods, all of which are essential for liver and metabolic wellness. Meals made from whole foods, such as vegetables, fruits, lean proteins, whole grains, and healthy fats, help the liver repair itself, regulate blood sugar, and reduce inflammation.
Cooking at home doesn’t have to be complicated, even small changes make a difference. Try using olive oil or avocado oil instead of butter, seasoning with herbs and spices instead of salt, and choosing baked or grilled foods over fried. Preparing meals ahead of time and eating mindfully can help prevent overeating and promote steady energy throughout the day.
TLC Tip
Plan meals around fiber-rich plant foods and limit added sugars and processed snacks. Over time, these simple habits can lead to meaningful improvements in liver health, energy, and overall well-being.
What it is
Pregnancy affects nearly every organ system, including the liver. While most pregnancies proceed normally, certain liver-related conditions can appear or worsen during pregnancy. Early recognition and coordinated care between your hepatologist and obstetrician are key to protecting both maternal and fetal health. Some liver changes in pregnancy are normal, such as mild elevation in liver enzymes or gallbladder changes due to hormones, but others require immediate attention. These include:
Why It Matters
Liver disorders during pregnancy can affect both mother and baby, influencing delivery timing, medication safety, and even postpartum recovery. Proactive care can:
If you have chronic liver disease, pre-pregnancy evaluation allows your care team to:
TLC Tip
Schedule a pre-pregnancy consultation with both your hepatologist and OB-GYN (preferably maternal-fetal medicine). Collaborative care ensures safe monitoring and a healthy delivery for you and your baby.
What it is
Travel can be safe and rewarding for people with liver or metabolic conditions, but it requires extra preparation. Changes in climate, food, and medical access can affect medication use and disease stability. With careful planning, most individuals can travel confidently and safely.
Before you Travel
During Travel
Returning Home
TLC Tip
Carry a one-page summary from your hepatologist listing your diagnosis, medications, allergies, and emergency contact numbers. This helps ensure proper care if you need urgent evaluation while away.
What it is
Living with liver disease can affect more than just the body, it often impacts mood, thinking, sleep, and relationships. Depression, anxiety, irritability, and “brain fog” (mild confusion, poor focus, or forgetfulness) are common in chronic liver disease and after liver transplantation. These symptoms may stem from both biological factors and psychological stress (coping with illness, medications, or lifestyle changes).
The good news: emotional and cognitive symptoms are treatable, and addressing them early can improve quality of life, adherence to medication, and long-term liver outcomes.
Why It Matters
Addressing mental health isn’t a luxury, it’s part of comprehensive liver care.
Recognizing Common Signs
If these symptoms persist or interfere with daily life, talk to your care team, support is available and effective.
Treatment & Support Options
TLC Tip
Emotional well-being is part of liver health. If you notice changes in your mood, sleep, or focus, don’t wait, ask your hepatology team about counseling, support groups, or mental-health referrals. Getting help early protects both your mind and your liver.
What it is
Managing liver or metabolic disease takes more than medical treatment, it also requires stability in the essentials of daily life. Reliable access to housing, transportation, healthy food, and financial or legal support can make a major difference in recovery, adherence, and overall well-being.
Why it matters
When social needs are unmet, stress rises and medical care often becomes harder to sustain. Connecting early with social workers and community resources helps patients stay consistent with appointments, medication, and healthy routines.
TLC Tip
If you’re struggling with transportation, insurance, food insecurity, or other social challenges, tell your care team. Texas Liver Care can help link you with community programs and patient navigators who understand your situation and can coordinate practical support.
