Liver health

Caring for the liver includes knowing what can help the liver and knowing what can damage it.

Activities that help the liver

Eating nutritious foods

Good nutrition helps people with their overall health, especially because liver disease affects digestion and the metabolism, absorption and storage of nutrients. Eating well gives people the energy and nutrients they need to feel well, helps their immune system to function well and helps their liver regenerate or maintain itself. Eating well means choosing a variety of foods each day, including protein and plenty of fruits and vegetables, and limiting foods high in fat and sugar.

Exercising

Being active is part of staying healthy. Obesity and steatosis (fat build-up around the liver) can make liver problems worse. Light to moderate exercise can boost energy, reduce stress and prevent weight gain. Exercise does not have to be strenuous or complicated; people can build gradually to exercising for 15–30 minutes, three times per week. Finding physical activities that people enjoy and that are simple to do will make exercising easier. Ten minutes of activity here and there adds up!

Physical activity is recommended for all people with hepatitis C, except those with decompensated cirrhosis or other metabolic complications.

Getting vaccinated for hepatitis A and B

Hepatitis A and B can also harm the liver, but the good news is that there are vaccines to prevent both hepatitis A and B infections. If a person does not have hepatitis A or B, or hasn’t had these infections in the past, they can get vaccinated. If a person has hepatitis B, it is possible to get treatment. Hepatitis A will usually go away on its own.

Activities that can injure the liver

People with advanced liver injury (cirrhosis) may want to avoid or reduce activities that further injure their liver.  

Drinking alcohol

Alcohol can increase injury to the liver and the likelihood of developing liver cancer. People with advanced liver injury (cirrhosis) may want to stop or reduce their alcohol use.

If a person wants to make this change in their life, they may need to try different strategies to discover what works for them. Here are some suggestions:

• Set a goal to reduce drinking that seems manageable and try to stick to it.
• Space out alcoholic drinks with non-alcoholic drinks such as water, juice or pop.
• Switch to smaller drinks or drinks with lower alcohol content (a 3% beer instead of a 5% beer, for example).
• Water down hard alcohol by mixing it with juice, soda pop or water.
• Seek support through a support group, addiction treatment or counselling.

Some people find that the best approach is to stop drinking altogether. Some people are able to do this on their own, while others find that some sort of support group works best.

For some people, recovering from a drug or alcohol addiction can be a lifelong process. Many people may go back to alcohol or drug use (also known as relapsing) from time to time. If this happens, it is important to remember that it is a normal part of recovery.

Smoking cigarettes

Cigarette smoking injures the liver. If a person smokes and drinks alcohol, this can cause greater injury to the liver. Smoking can also cause heart disease, lung cancer and breathing problems. Like alcohol, nicotine is highly addictive and it can be hard to cut back on smoking. The Canadian Cancer Society has a smoker’s helpline website (smokershelpline.ca) that offers resources and support for quitting smoking, and most provinces and territories do too.

Taking over-the-counter painkillers

Painkillers are generally divided into two categories. The first category includes the analgesic (painkilling) and antipyretic (fever reducing) drug called acetaminophen, the active ingredient in Tylenol. The second category consists of non-steroidal anti-inflammatory drugs (NSAIDs), the most common of which are ibuprofen and acetylsalicylic acid, the active ingredients in Advil and Aspirin. Each category of drug can provide pain and fever relief, and the NSAIDs also have anti-inflammatory properties.

People with hepatitis C or cirrhosis may use painkillers to manage side effects and symptoms, but they should never exceed the allowable or recommended dose. Both categories of drugs have been shown to have liver-toxic effects when more than the recommended dose is taken. It is also possible to overdose on Tylenol. To learn more about how to prevent a Tylenol overdose, see Pain medications.

Healthcare providers can offer additional information on how to manage pain and can recommend the best choice for each person.

Using street drugs

There is not a lot of information about how street drugs affect the liver. Some people may decide to change their drug use when they find out they have hepatitis C or start treatment or after they are cured by decreasing or stopping their drug use or using less harmful drugs.

Resources for service providers

• Hepatitis C Basics – eduCATIE online course
• Common hepatitis C drugs available in Canada for adults – CATIE website

Resources for clients

• Understanding Cirrhosis of the Liver: First Steps for the Newly Diagnosed – CATIE booklet