The incidence of liver disease is rising globally. With rapid urbanization, dietary and lifestyle changes have added to the risk of developing liver disease early. The encouraging news is that when caught and treated early, the liver can regenerate completely. With the rapid rise in the use of social media, there is a huge amount of “misinformation” available, and it is very important to negate these misconceptions to save lives.One of the biggest myths among people is that liver disease is only caused by alcohol and that teetotalers do not get liver disease. It is, in fact, the commonest question I get asked routinely: “Doctor, I have never had a drink in my entire life. How did I get Liver Disease?” While routinely consuming excess alcohol is a known cause of liver disease, a larger number of patients today are suffering from Metabolic Associated Steatotic Liver Disease (previously called Non-alcoholic Fatty Liver Disease). In fact, fatty liver disease has overtaken alcohol as the commonest cause of liver failure in my practice, necessitating liver transplantation. This condition is closely linked to obesity, diabetes, a high-calorie diet, and lack of physical activity (all describing the lifestyle of a software professional in Bangalore). Surprisingly, even patients who appear fit may develop fatty liver due to undiagnosed metabolic risk factors.Another misbelief is that liver disease is easily diagnosed because the patient will develop symptoms early. But in reality, the liver can sustain damage to the extent of 60–70% before physical symptoms appear. In fact, once a patient presents with symptoms like jaundice, fluid accumulation in the abdomen, or internal bleeding, it essentially means that the liver disease has progressed to severe fibrosis or even cirrhosis, and reversal of the disease may then not be possible. This is the reason why liver disease is termed the “silent killer,” and this “silent progression” makes regular health check-ups crucial, especially for high-risk individuals, to diagnose, prevent, and treat liver disease.This is also the reason why a normal liver function test should not falsely reassure a patient that all is well. While blood tests are an important part of investigating liver disease, they become abnormal only at later stages. Serious conditions like steatohepatitis (fatty liver damage) can progress to advanced stages of liver damage without showing up in a blood test. This is why we experts recommend combining a blood test with a clinical consultation, in addition to imaging studies like ultrasound and FibroScan, for a more early and accurate diagnosis.A fad nowadays is to try “natural” or “herbal remedies” for every disease, including liver disorders. The belief that herbal or traditional remedies are safer and have no side effects is flawed. While most of these may be inherently safe, many unregulated supplements have entered the market which have been linked to drug-induced liver injury, sometimes leading to complete liver failure. “Natural” does not always mean harmless, and self-medication without consulting an expert can and will do more harm than good.One of the other dangerous myths among people, which makes them lose hope, is that once liver disease sets in, it is irreversible. While this is true for advanced stages of liver disease like cirrhosis, most early stages of liver disease, including fatty liver and early-stage fibrosis, are completely reversible, provided they are diagnosed in time. A tailored regimen of a healthy diet, regular exercise, and some medications is all that is required to completely reverse liver disease in its early stages. It is only when liver disease progresses to late fibrosis or cirrhosis that reversal becomes impossible. Once complications of cirrhosis set in, the only way to treat it is through a liver transplant operation. This is the main reason why we advise patients to maintain a healthy lifestyle along with regular health checks and consultations with specialists to both diagnose and treat liver disease early.Finally, the social media popularity of “detox” diets and “juice cleanses” has made people believe that they can cure all the damage to the liver. In reality, the liver is itself the body’s biggest and main detoxifying organ, and there is no scientific evidence that such diets or cleanses in any way improve the functioning of the liver. In some cases, extreme dietary practices like prolonged fasting or pure juice diets may even worsen liver health. This is why the body needs a well-balanced lifestyle comprising a healthy diet with carbohydrates, proteins, fiber, and healthy fats, combined with regular exercise, to maintain health. “Short cuts” to health rarely work.In conclusion, liver disease is most often preventable and completely reversible when diagnosed early. Dispelling the myths around liver health is the first step toward bringing awareness. The importance of vaccination against Hepatitis B, maintaining a healthy lifestyle, avoiding unnecessary medications or supplements, and undergoing regular screening is the cornerstone of not only good liver health but also overall body health. A well-informed approach can go a long way in protecting this vital organ.
