The liver is the largest internal organ in the human body and a metabolic all-rounder of astonishing complexity. Weighing about one and a half kilograms, it performs tremendous work every day without us even noticing. It lies protected beneath the right rib cage and carries out its countless tasks so quietly and efficiently that we often only become aware of its existence when something goes wrong. Yet the liver is involved in virtually every metabolic process and is absolutely essential for our survival.

The functions of the liver

The range of tasks the liver performs daily is impressive. It filters the entire blood volume approximately three hundred times a day, sorting nutrients, waste products, and potential toxins. As the body's central detoxification center, it breaks down medications, alcohol, and toxic substances that would otherwise harm the organism. Simultaneously, it produces bile, essential for the digestion of fats in the small intestine, and stores important vitamins such as A, D, E, K, and B12, as well as minerals like iron and copper. The liver regulates blood sugar levels by storing glucose as glycogen and releasing it as needed. It produces clotting factors, without which even a minor injury could become catastrophic, and synthesizes vital proteins such as albumin. Furthermore, it breaks down hormones and regulates their levels in the blood, thus maintaining overall metabolic balance.

Regenerative capacity and its limits

One of the liver's most astonishing properties is its remarkable regenerative capacity. It can repair damage and even regrow to its original size after partial removal—a capability unmatched by any other internal organ to this extent. However, this regeneration has its limits, which must be respected. When the liver is subjected to chronic stress, it begins to replace functional tissue with scar tissue. This process, called fibrosis, progresses with continued stress and ultimately leads to cirrhosis—an irreversible condition in which the liver can no longer adequately perform its functions.

The problem of our time

In recent decades, a new liver disease has reached epidemic proportions: non-alcoholic fatty liver disease, internationally known as NAFLD. Approximately 25 to 30 percent of the Western population is affected, and the rate rises to as high as 80 percent in overweight individuals. What makes this disease unique is that, unlike alcohol-related liver damage, fatty liver disease is caused by diet and lifestyle. This finding is both alarming and encouraging, because what is caused by lifestyle can also be improved through lifestyle changes. Fatty liver disease is not inevitable, but a challenge that you can actively address.

Non-alcoholic fatty liver disease, known internationally as NAFLD, is now the most common liver disease in Western industrialized countries. It affects people of all ages, including children, and its prevalence is increasing in parallel with the rise in obesity and metabolic syndrome in the population. The disease often begins harmlessly and unnoticed, but can lead to serious liver damage if it progresses. Understanding the different stages is important to assess the urgency of intervention.

The stages of fatty liver

It begins with simple fatty liver, medically known as steatosis. At this stage, more than five percent of the liver cells contain fat deposits. The liver still functions normally, there are usually no symptoms, and this condition is completely reversible. Many people live with simple fatty liver for years without knowing it. However, if the burden persists, the next stage can be reached: fatty liver hepatitis, also called NASH (non-alcoholic steatohepatitis). Here, inflammation is added to the fatty deposits, directly damaging liver cells. Blood tests often show elevated liver enzyme levels, and the risk of progression increases significantly. In the next stage, fibrosis, scar tissue begins to form. The liver tries to repair damaged tissue, but instead of functional liver cells, only connective tissue is produced. Liver function becomes increasingly impaired. The final stage is cirrhosis, in which extensive scarring has destroyed the liver's structure. This condition is irreversible and can lead to liver failure, fluid retention, bleeding from esophageal varices, and liver cancer.

Why does fatty liver develop?

The development of non-alcoholic fatty liver disease is closely linked to the modern lifestyle. The main cause is a chronic imbalance between energy intake and energy expenditure. When more calories are consumed than the body burns, the excess energy must be stored somewhere. While adipose tissue is the primary storage site, the liver also stores fat when overloaded. Excessive consumption of sugar and saturated fats is particularly problematic, as they directly contribute to fat storage in the liver. Insulin resistance and metabolic syndrome play a key role, as they adversely affect fat distribution in the body. Lack of exercise exacerbates the problem because muscles, a major energy consumer, are depleted. A genetic predisposition can also increase the risk, although it rarely leads to the disease on its own. The liver is central to metabolism, and anything that burdens the metabolism also burdens the liver. Fructose, or fruit sugar, is particularly problematic because it is metabolized almost exclusively in the liver and promotes fat storage especially effectively.

Symptoms and early detection

The insidious thing about fatty liver disease is that the early stages practically never cause any symptoms. The liver has no pain receptors, and as long as it can perform its functions, the body sends no warning signals. Sometimes there are nonspecific indications such as general fatigue, a dull pressure in the upper right abdomen, or elevated liver enzyme levels that might be detected during a routine blood test. However, many people have no symptoms whatsoever and only discover their fatty liver disease by chance. This lack of early warning signs makes preventative screenings for those with risk factors so important. The good news is that simple fatty liver disease and even NASH can completely reverse itself. The liver has a remarkable capacity for regeneration, and with the right treatment, it can recover.

Diet is the most important factor for liver health and the area where you have the greatest direct influence. What you eat directly affects whether fat is stored or broken down in the liver, whether inflammatory processes are amplified or suppressed, and whether the liver receives the nutrients it needs for its many functions. A liver-friendly diet doesn't have to be complicated or restrictive – it largely corresponds to what we generally understand as a healthy diet.

The basic principles

For those who are overweight, a moderate calorie deficit is the most effective way to reduce liver fat. Research consistently shows that even a five to ten percent weight loss can significantly improve or even completely cure fatty liver disease. This isn't about crash diets or extreme restrictions, but rather a sustainable reduction in calorie intake that can be maintained long-term. The Mediterranean diet has proven particularly beneficial for the liver in numerous studies. It emphasizes the consumption of plenty of vegetables, olive oil as the primary fat source, regular fish consumption, nuts, and as few processed foods as possible. This diet provides ample antioxidants, anti-inflammatory substances, and healthy fats while being low in sugar and saturated fats. A particularly important principle is minimizing fructose, or fruit sugar. Unlike other sugars, fructose is metabolized almost exclusively in the liver and strongly promotes fat storage. Therefore, avoid soft drinks, which often contain large amounts of fructose or high-fructose corn syrup, as well as fruit juices, which provide concentrated fructose without the slowing-down fiber of whole fruit. Whole fruit in moderate amounts, however, is safe, as the fiber slows down fructose absorption and the total amount per serving is manageable.

liver-protecting foods

Some foods have proven particularly beneficial for liver health. Surprisingly, coffee is one of them. Epidemiological studies consistently show that regular coffee consumption reduces the risk of liver fibrosis and cirrhosis, with two to three cups a day showing significant effects. The exact mechanisms are not yet fully understood, but coffee contains a variety of bioactive substances beyond caffeine. Green tea is rich in catechins, especially EGCG, which has been shown in studies to reduce liver fat. Olive oil, with its monounsaturated fatty acids, is gentle on the liver and should be a primary source of fat. Fatty fish such as salmon, mackerel, or herring provide omega-3 fatty acids with anti-inflammatory properties. Cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts contain substances that support the body's detoxification enzymes. Nuts are rich in vitamin E and healthy fats and have been associated with better liver health in studies.

What you should avoid

Sugar and refined carbohydrates are the main enemies of a healthy liver. Trans fats, often hidden in processed foods, directly damage the liver. Excessive consumption of saturated fats, such as those found in fatty meats or fried foods, promotes inflammation and fat storage. Highly processed foods usually combine several of these problematic components and also contain additives whose long-term effects on the liver are not always known. And of course, you should be critical of alcohol – even in cases of non-alcoholic fatty liver disease, alcohol is harmful and can accelerate the progression of the condition.

Most people know that alcohol damages the liver. But the details – how much is too much, what exactly happens in the liver, and when the damage becomes irreversible – are less well known. A sound understanding helps people make informed decisions about their own consumption, instead of relying on vague fear or unreflective ignorance.

How the liver processes alcohol

Alcohol is broken down almost exclusively in the liver, as it is the only organ with sufficient quantities of the necessary enzymes. The enzyme alcohol dehydrogenase first converts ethanol into acetaldehyde – a toxic intermediate responsible for many of alcohol's unpleasant effects. Another enzyme then converts acetaldehyde into harmless acetate, which the body can use as an energy source or excrete. These processes generate oxidative stress in the liver, deplete resources like NAD+ needed for other vital metabolic processes, and, with regular consumption, the resulting intermediate products directly damage liver cells. The liver's capacity to break down alcohol is limited: it can process approximately seven to ten grams of alcohol per hour, roughly equivalent to a small beer. Anything beyond that continues to circulate in the bloodstream and exerts its effects throughout the body while the liver works overtime.

Where are the limits?

For women, a maximum of ten to twelve grams of alcohol per day is considered low-risk, which corresponds to about a small glass of wine or a quarter liter of beer. For men, the threshold is twenty to twenty-four grams per day, or about a glass of wine or half a liter of beer. At least two to three alcohol-free days per week should also be observed to allow the liver time to regenerate. Above these limits, the risk of liver damage increases significantly. It's important to know that the threshold is lower for women because hormonal and enzymatic differences make the female liver more sensitive to alcohol. This is not solely a matter of body size or weight, but rather of biochemistry.

Stages of alcohol-related liver damage

Alcoholic fatty liver disease can develop after just a few days of regular alcohol consumption. The liver stores fat because alcohol breakdown takes priority, disrupting normal fat metabolism. This initial stage is completely reversible with abstinence – the liver usually recovers within a few weeks. Alcoholic hepatitis is an inflammation of the liver caused by alcohol, which can be acute and severe. It manifests as jaundice, fever, upper abdominal pain, and a general feeling of illness. In severe cases, it can be life-threatening. With continued alcohol consumption or repeated damage, alcoholic cirrhosis eventually develops – the end stage with permanent scarring of the liver tissue. This condition is no longer curable; its progression can only be slowed.

Regeneration is possible

The liver can recover from alcohol-related damage if action is taken promptly. After a few weeks of abstinence, liver function tests often improve significantly. Alcoholic fatty liver disease can completely regress within four to eight weeks. Even after years of regular consumption, substantial recovery is possible, as long as cirrhosis has not yet developed. This regenerative capacity should be seen as an encouragement, not as a license for further consumption. The combination of alcohol, obesity, and fatty liver disease is particularly risky. These three factors exacerbate each other, and the progression of liver damage is significantly accelerated. Anyone who already has non-alcoholic fatty liver disease should be especially cautious about alcohol consumption.

Exercise has a direct impact on liver health, regardless of whether the scale shows any change. This finding is particularly important because many people become frustrated and give up when they don't lose weight despite exercising. But even without visible weight loss, regular physical activity improves liver function and reduces liver fat. The liver benefits from exercise on multiple levels, and these effects begin relatively quickly.

How exercise helps the liver

Physical activity activates the release of fatty acids from the liver and their combustion in the muscles. When you exercise, your muscles need energy, and some of it is mobilized from the liver's fat reserves. At the same time, exercise improves insulin sensitivity throughout the body. Since insulin resistance is one of the main causes of fat storage in the liver, improved insulin sensitivity directly counteracts fatty liver disease. Regular physical activity also lowers inflammatory markers throughout the body, including in the liver, which can slow the progression from simple fatty liver to the inflammatory NASH. At the cellular level, exercise improves the function of mitochondria, the powerhouses of cells. More efficient mitochondria mean better energy utilization and a reduced tendency for fat storage.

What the studies show

The scientific evidence is clear: eight to twelve weeks of regular exercise can reduce liver fat by twenty to thirty percent, even if body weight remains the same. This means that the body redistributes fat and relieves the burden on the liver, even if the scale doesn't show any change. Both endurance and strength training are effective, with the combination of both potentially yielding the best results. High-intensity interval training, also known as HIIT, shows particularly strong effects in some studies with a shorter time investment. Ultimately, however, the best form of training is the one you actually do regularly.

The practical recommendations

Official recommendations suggest at least 150 minutes of moderate activity per week, or alternatively, 75 minutes of vigorous activity. Moderate activity means you get slightly out of breath but could still carry on a conversation – brisk walking, leisurely cycling, swimming at your own pace. Vigorous activity makes you breathe more heavily and makes speaking difficult – jogging, fast cycling, aerobics classes. Strength training is also recommended on at least two days per week. This isn't about bodybuilding, but about maintaining and building muscle mass, which, as active tissue, constantly consumes energy and thus relieves the burden on the liver. An often underestimated factor is reducing sedentary time. Prolonged sitting, regardless of physical activity, is a risk factor for metabolic disorders. Regular movement breaks – getting up and walking around briefly every thirty to sixty minutes – can make a difference.

The beginning

If you haven't been very active so far, start where you are. Daily walks of ten to fifteen minutes are a good start. Gradually increase the duration over weeks and months. The best exercise is the kind you actually do – whether that's swimming, cycling, dancing, gardening, or going to the gym. The important thing is to do it regularly and with a certain level of endurance. Don't forget strength training: muscle mass consumes glucose and fatty acids, thus relieving the burden on the liver and improving overall metabolism. Two sessions per week with basic exercises for the major muscle groups will already make a measurable difference.

Detox products, liver cleanses, detox programs – the market for these is huge and continues to grow. Juice cleanses, special teas, dietary supplements, and programs promise to detoxify the liver and rid it of accumulated toxins. But does the liver really need external detoxification? The scientific answer is clear: No. The concept of detox as a marketing category is based on fundamental misunderstandings about how the liver works.

The truth about detoxification

The liver is the body's own detoxification organ. It possesses a sophisticated system of enzymes that works in two phases. In phase one, toxins are activated or modified through chemical reactions. In phase two, these intermediate products are bound to water-soluble molecules so they can be excreted via the kidneys or intestines. This process occurs continuously and automatically as long as the liver is healthy and sufficient nutrients are available for the enzymes to function. The liver doesn't need juices, pills, or expensive programs for this. It does its job on its own, around the clock, without a break.

What detox products can't do

There is no scientific evidence that detox diets, juice cleanses, special teas, or corresponding supplements improve or accelerate liver detoxification. Most of the so-called toxins that such products are supposed to remove aren't even mentioned because they don't exist or the liver has already eliminated them on its own. What these products often achieve is a placebo effect, because you feel like you're actively doing something for your health. Some people experience short-term weight loss during a juice cleanse, but this is usually water loss and quickly returns. The calorie reduction during a cleanse can indeed help the liver—but not because of any detox effect, but simply because fewer calories mean less strain. The most guaranteed effect is an empty wallet.

What the liver really needs

Instead of external detoxification programs, the liver primarily needs less strain. This means less alcohol, fewer highly processed foods, fewer unnecessary medications, and, where possible, less excess weight. In addition, good basic nutrition is essential: a balanced diet that provides all the necessary nutrients so that the detoxification enzymes can do their job. Certain vitamins and minerals are indispensable as cofactors for these enzymes, but they are obtained through a normal, balanced diet, not through special detox supplements. Dietary fiber also helps, as it binds bile acids and metabolic waste products in the intestines and promotes their elimination. Drinking enough water helps the kidneys excrete the waste products processed by the liver. But all of this is not a detox program, but simply a healthy lifestyle.

If supplements at all

There are some substances with some scientific evidence for liver-protective effects. Milk thistle, which contains the active ingredient silymarin, may have a protective function in cases of existing liver damage, although the research is not conclusive. Omega-3 fatty acids have shown positive effects in studies on fatty liver disease. Vitamin E can be considered under medical supervision for certain liver conditions. However, none of these substances can replace a healthy lifestyle and can even be harmful if used incorrectly or in the wrong dosage. Prevention through lifestyle is and remains the most effective and safest way to maintain liver health.

The liver is the body's central metabolic factory and therefore also the main site where medications are metabolized and broken down. Almost all drugs pass through the liver, where they are chemically modified and prepared for excretion. In most cases, this process is unproblematic, but some medications can strain the liver or, under certain circumstances, even damage it. An awareness of these connections helps to minimize risks without succumbing to excessive fear of necessary medications.

Common potentially liver-damaging medications

Paracetamol is one of the most commonly used painkillers and is safe in normal doses. However, in cases of overdose, it is the most frequent cause of acute liver failure in Western countries. The maximum daily dose of four grams should not be exceeded, and with regular alcohol consumption, the safe limit is lower because alcohol increases the liver's sensitivity to paracetamol. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac rarely cause liver damage, but liver function should be checked occasionally with chronic use. Certain antibiotics, particularly those in the fluoroquinolone group or the combination of amoxicillin and clavulanic acid, can, in rare cases, cause liver damage. Statins, prescribed for high cholesterol, can elevate liver enzyme levels, although severe liver damage is rare, and regular monitoring is recommended. Anabolic steroids, which are unfortunately still misused in the fitness and bodybuilding world, are highly damaging to the liver and can even cause liver tumors.

The underestimated risk of dietary supplements

It is often overlooked that even seemingly harmless, natural dietary supplements can put a strain on the liver. High doses of green tea extract have led to severe liver damage in several cases, which is why concentrated extracts should be used with caution, while regular green tea is safe. Kava kava, a plant with relaxing effects, is banned in some countries due to proven hepatotoxicity. High doses of vitamin A can directly damage the liver. Various weight-loss supplements often contain problematic or even undeclared substances. The label 'natural' does not automatically mean 'harmless,' and a healthy dose of skepticism is advisable when it comes to dietary supplements.

Practical recommendations

You should only take medication when it is truly necessary, and it should be dosed as prescribed. Self-medication should be limited, and if you are unsure, consult a doctor or pharmacist. Regular monitoring of liver function is advisable when taking medications that can strain the liver long-term. Drug interactions deserve special attention: The combination of alcohol and paracetamol is particularly dangerous because alcohol intensifies paracetamol's toxic effects on the liver. Exercise caution with dietary supplements, especially high doses or exotic products. If you already have liver disease, extra care is required. Many medications may need to be dose-adjusted, and your doctor should always be informed about your liver status.

Besides fatty liver and alcohol, viral infections are a major cause of liver disease. The various hepatitis viruses differ significantly in their transmission routes, course, and treatability. A basic understanding helps in assessing risks and taking appropriate preventative measures. The three most important are hepatitis A, B, and C, although other, rarer forms also exist.

Hepatitis A

The hepatitis A virus is transmitted via the fecal-oral route, meaning through contaminated water or food. Infections occur primarily when traveling to countries with lower hygiene standards, but can also be transmitted through imported food or certain sexual practices. The course of the illness is typically acute, with symptoms such as nausea, fatigue, loss of appetite, and often jaundice. The good news is that hepatitis A almost always heals completely and does not become chronic. Having had the infection once confers lifelong immunity. There is an effective vaccine, which is recommended before traveling to risk areas and for certain occupational groups. Permanent liver damage from hepatitis A is very rare.

Hepatitis B

The hepatitis B virus is transmitted through blood, sexual contact, and from mother to child during birth. Unlike hepatitis A, hepatitis B can become chronic, with the risk depending heavily on the age of infection. In adults, about five to ten percent of infections become chronic, while in newborns, this figure can reach up to ninety percent. Chronic hepatitis B significantly increases the risk of cirrhosis and liver cancer. Since 1995, hepatitis B vaccination has been part of the standard immunization program for infants in Germany, so younger generations are generally protected. For older people who have not been vaccinated, catch-up vaccination may be advisable, especially if they have certain risk factors. If a chronic infection is present, antiviral medications can suppress viral replication and slow the progression of the disease, although a complete cure is usually not possible.

Hepatitis C

Hepatitis C is primarily transmitted through blood. Historically, blood transfusions were a major source of infection before testing became available. Today, the most common route of transmission is the sharing of needles during intravenous drug use. Unlike hepatitis B, hepatitis C becomes chronic in 75 to 85 percent of cases—a surprisingly high percentage. Left untreated, the chronic infection often leads to cirrhosis and liver cancer over decades. The medical revolution came around 2015 with the introduction of direct-acting antiviral drugs, known as DAAs. These can completely cure hepatitis C in over 95 percent of cases—a remarkable success story of modern medicine. However, a vaccine against hepatitis C does not yet exist.

Should you get tested?

Testing for hepatitis B and C is advisable if risk factors are present. These include blood transfusions before 1990, any history of intravenous drug use, tattoos or piercings obtained under potentially unhygienic conditions, multiple sexual partners, and origin from regions with a high prevalence of hepatitis. Both infections can remain asymptomatic for decades and may only be detected when liver damage is advanced. A simple blood test can provide clarity and, in the case of hepatitis C, pave the way for a cure.

The liver often suffers silently, making its presence known only at a late stage. Since early stages of liver disease usually cause no symptoms, blood tests are the most important tool for early detection. Elevated liver enzyme levels are frequently the first and only indication that something is wrong. Regular monitoring of liver enzyme levels can uncover problems before they develop into serious illnesses, giving you the opportunity to take early action.

Understanding the most important liver values

GOT and GPT, also known as AST and ALT, are enzymes found inside liver cells. When liver cells are damaged, these enzymes are released into the bloodstream and can be detected there. GPT is more specific to the liver, while GOT is also found in the heart and muscles. Elevated levels can indicate fatty liver disease, hepatitis, alcohol-related liver damage, or drug-related liver damage. GGT, short for gamma-GT, is an enzyme found in the liver and bile ducts and is particularly sensitive to alcohol and biliary tract problems. It is often the first value to rise with regular alcohol consumption and is therefore sometimes called an 'alcohol marker'. Alkaline phosphatase, abbreviated AP, is elevated in biliary tract diseases but can also rise in bone problems, which complicates interpretation. Bilirubin is a breakdown product of the red blood pigment hemoglobin, which is processed in the liver and excreted via bile. Elevated bilirubin levels occur when bile flow is impaired or liver damage is severe, causing the characteristic yellowing of the skin and eyes known as jaundice. Albumin is an important protein produced by the liver. Low albumin levels indicate impaired liver function and are a sign of severe liver damage.

What elevated values ​​mean

Slightly elevated liver enzyme levels can have many causes and are not automatically a cause for panic. However, they are a warning sign that should be taken seriously. Fatty liver disease is the most common cause of slightly elevated ALT (GPT) levels. Regular alcohol consumption often first manifests as an increase in GGT (Gamma-glutamyl transferase). Certain medications can temporarily raise liver enzyme levels without causing permanent damage. A hepatitis infection should always be ruled out when liver enzyme levels are elevated. In many cases, elevated liver enzyme levels can be normalized through lifestyle changes when the underlying cause is treated.

When should you have your liver function tested?

If you have risk factors for liver disease—such as being overweight, regular alcohol consumption, diabetes, or taking medications that can strain the liver—regular checkups are advisable. A liver function test can also be helpful for nonspecific symptoms like persistent fatigue or discomfort in the upper right abdomen. As part of a general health checkup, liver function should be checked occasionally, even without specific risk factors. The DoctorBox Liver Check allows you to easily determine important liver values ​​from the comfort of your own home. A simple finger prick is all it takes for the blood sample; the analysis is performed in a certified laboratory, and you receive the results online with easy-to-understand explanations. This gives you an initial overview of your liver health without having to wait for a doctor's appointment.

The liver is a silent organ. It works tirelessly, filtering, processing, storing, and detoxifying without complaint. This characteristic is both a blessing and a curse: a blessing because you're unaware of its work in everyday life, a curse because problems often go undetected for a long time. That's why it's so important to give your liver the attention it deserves – not through expensive detox programs, but through sound knowledge and a lifestyle that supports it rather than burdening it.

What you should take away from this article

Fatty liver disease has become a widespread health problem, affecting up to 30 percent of the population. Its main causes are overeating, excessive sugar consumption, and lack of exercise – all factors you can influence. In its early stages, fatty liver disease is completely reversible, and even a five to ten percent weight loss can bring about dramatic improvement. This isn't about crash diets, but rather sustainable, moderate changes. Exercise directly affects liver fat, even independently of weight loss. Regular physical activity reduces liver fat, improves insulin sensitivity, and lowers inflammatory markers. You don't have to become a competitive athlete – consistent moderate activity is sufficient. Alcohol deserves respect, even if you don't have alcohol-related liver disease. Even moderate amounts put a strain on the liver, and in the case of existing fatty liver disease or other risk factors, alcohol exacerbates the damage. Alcohol-free days and mindful consumption are not restrictions, but rather acts of care for your liver. Detox products are marketing, not medicine. The liver detoxifies itself – it doesn't need juices, pills, or detox programs. What she needs is less stress and good basic nutrition through a balanced diet.

Early detection is crucial

Because liver diseases often remain asymptomatic for a long time, regular checkups are important, especially if risk factors are present. A simple blood test can detect elevated liver enzyme levels long before irreversible damage occurs. Knowing your liver enzyme levels allows you to take timely action.

What you can start today

The liver has a remarkable capacity for regeneration. Give it the chance to use this ability. Reduce sugar, especially soft drinks and fruit juices. Exercise regularly, even if it's just daily walks. Consume alcohol mindfully and not as a habit. Keep an eye on your weight, especially your waist circumference. And have your liver function checked occasionally to know where you stand. These measures cost little, are not restrictive, and can maintain your liver health for decades. Your liver works for you every day—it's only fair to work for it, too.