If you’re a healthy individual, you might not think twice about your liver — and for good reason: The only time this organ seems to attract any attention is when it stops working.

Still, because the liver plays a vital role in your health, it makes sense to educate yourself about it, especially if you have a history of liver issues.

Here are answers to nine common questions about the liver.

1. What does my liver do?

As one of the hardest-working organs in your body, the liver performs hundreds of functions, according to UPMC. Not only does it clear toxins from your blood, it also produces bile, which is used for digestion, and provides you with more energy than the most superfood-loaded smoothies. Indeed, scientists once considered it not only the center of the body but also the most critical organ, says Anurag Maheshwari, MD, a gastroenterologist and liver disease specialist at The Center for Liver and Hepatobiliary Diseases at Mercy Medical Center in Baltimore. “This was before anybody knew what the heart did, but even with that knowledge, the liver remains one of the most important organs of the body, as you can’t live without it.”

2. How can I keep my liver healthy?

The simple answer is to follow a healthy lifestyle. That includes eating whole, nutritious foods and exercising regularly. But there are even more critical strategies for keeping your liver healthy, including reducing your alcohol intake; keeping your body mass index (BMI), which takes into account your height and weight, under 30; and keeping diabetes under control (even preventing diabetes in the first place, if possible), Dr. Maheshwari says. These habits help the liver function as it should, notes the American Liver Foundation.

3. How does being overweight or obese affect my liver?

By eating healthy and exercising regularly, you’ll have an easier time keeping your BMI in a healthy range. (Calculate your BMI here.) Anything between 25 and 29 is overweight, and anything over 30 is considered obese, according to the Centers for Disease Control and Prevention (CDC). (Yet note that BMI is not a perfect measure, and ranges and their implications for health vary by population, according to Harvard University.) Obesity in particular is linked to fatty liver disease, which, in turn may contribute to scarring, or cirrhosis of the liver, and liver failure, according to the Mayo Clinic. If weight is an issue, strive to lose 10 percent of your current weight, which can benefit liver health, Maheshwari says.

4. What’s the best diet to follow for liver health?

This is a question Maheshwari gets asked almost daily. While there’s no liver diet per se — though calorie control is helpful if you need to lower your BMI — he recommends the Mediterranean diet, which is rich in fruit and vegetables. The reason? Not only is calorie control easier on this diet because of the focus on naturally lean plant-based foods, this diet also helps regulate glucose levels. Excess glucose is converted to fat in the liver, which can play a role in the development of fatty liver disease.

Here are additional recommendations from the American Liver Foundation:

Choose high-fiber foods, including fresh fruit and vegetables, whole-grain breads, and rice and cereals.
Skip foods high in saturated fat, sugar, and salt. That includes fried foods.
Drink lots of water to help prevent dehydration and allow your liver to function optimally.
Talk with your doctor about alcohol intake.

5. How can alcohol harm the liver?

As for alcohol, the CDC recommends a maximum of two drinks a day for healthy men and one drink a day for healthy women. And if you aren’t a drinker, don’t start. Maheshwari points to a study published in the September 2018 journal The Lancet that examined the effects of alcohol intake on chronic disease risk and premature death. “The study found that there was an incremental increase in mortality and cancer with incremental amounts of alcohol, which is why they concluded that any amount of alcohol is detrimental to the body,” he says. “Zero drinks is the safest number.”

Maheshwari recommends abstaining from alcohol if you have liver issues. If abstinence isn’t possible, limit your alcohol to no more than four to six drinks a week and no more than two in a 24-hour period. That’s the amount of time the liver can safely metabolize alcohol. If you drink more than that, especially if you try to bank all of your drinks into one or two nights, your liver will suffer.

6. What symptoms will I notice if my liver isn’t working right?

Spotting problems in the liver can be tough, namely because symptoms don’t typically show up until it’s too late, and many problems with this organ may mimic unrelated health issues. “Liver disease tends to be a silent killer, and lack of symptoms doesn’t mean the problem isn’t serious,” Maheshwari says.

In general watch for these warning signs, he adds:

Urine that’s the color of iced tea
Yellowing (jaundice) of your eyes
Stools that look like clay
Itching that won’t subside with lotion and keeps you up at night
Ankle swelling
Abdominal swelling
Chronic fatigue

7. Should I get my liver tested even if I’m healthy?

You may benefit from getting your liver even if you're healthy, especially if you have certain risk factors — for example, if you drink alcohol regularly or have a family history of liver disease. Ask your primary care doctor whether you need what’s called a hepatic, or liver, function test, which is part of a complete metabolic panel, or CMP. This panel checks several body functions, liver included, through a blood test. While there’s no age-based guideline for this screening, it often coincides with the time you get your first physical, says Maheshwari.

Just know that getting an abnormal reading on your liver doesn’t mean you definitely have a problem. “Lots of little things like viruses, chemicals, and toxins can alter a liver test,” Maheshwari says. If it does come back abnormal, you’ll need to work with your physician to see if there is an issue.

8. Should I be tested for hepatitis C?

Hepatitis C, a contagious liver disease spread mainly through contact with the blood of somebody who’s infected with the virus, used to be a much bigger problem. While it still is a concern, the novel treatment developed in 2014 have allowed physicians to cure large numbers of patients, Maheshwari says. But that doesn’t mean you should ignore it.

According to guidelines released by the CDC in 2020 all adults over the age of 18 should undergo a hepatitis C screening at least once in their life, unless risk is less than 0.1 percent. The CDC also recommends a screening for pregnant women unless they, too, have a less than 0.1 percent risk. However, more frequent testing may be necessary if you have risk factors for hepatitis C.

Those risk factors include:

Using injection drugs currently or in the past, even if was only once many years ago
Having human immunodeficiency virus (HIV) infection
Having certain medical conditions, including people who have received maintenance hemodialysis and those who have persistently abnormal levels of alanine aminotransferase, an enzyme in liver cells
Receiving a blood transfusionor organ transplant before July 1992
Receiving blood from a donor who later tested positive for hepatitis C
Being treated for a blood-clotting problem before 1987
Being the son or daughter of a mother with hepatitis C
Working as a healthcare, emergency medical, or public safety employee who’s been exposed to the blood of somebody with hepatitis C (through needlesticks, sharps, or mucosal exposures)
Having multiple sexual partners

9. What’s my prognosis if I’m diagnosed with some type of liver disease?

Because the liver is a resilient organ, outcomes from liver diseases, especially when spotted early, like nonalcoholic fatty liver disease, hepatitis C, and genetic diseases (such as Wilson’s disease and hemochromatosis), are generally good. “The liver has a greater capacity to regenerate and repair than any other organ,” Maheshwari says.

Treating problems early is vital, though. Take, for instance, hepatitis C, which can be cured in 95 percent of patients when caught early, thanks to relatively newer treatment options — but cure rates drop below 90 percent when the disease is diagnosed later, according to the University of Michigan Health Lab. If problems linger, the liver can be damaged to a point that is irreversible. Because issues can be tough to spot, getting that liver checked regularly is key.