What is Hepatoxicity?

The liver is the largest glandular organ in the body. It is also the most important digestive organ in the body.


is also known as Drug induced Liver injury. The liver plays a major detoxifying role in the body. It helps in filtering and channeling out wastes from the body.

Different chemicals react differently in different people. Sometimes, medicines even in their prescribed doses can induce toxicity and damage the liver. Naturally available chemicals (e.g microcystins) or herbal remedies can also injure the liver. These chemicals are called Hepatoxins.

In the United States, about 2000 cases of acute liver failure are reported yearly. About half the cases of acute liver failure can be attributed to liver injuries sustained from chemicals and drugs. More than 900 drugs, chemicals and herbs have been found to damage the liver. Liver diseases as grave as Fulminant Liver Failure is caused by toxicity from drugs 20-40% of times.

What is the mechanism of Hepatoxicity?

The liver is a very important organ when it comes to metabolizing chemicals and drugs. As a result, the liver is susceptible to damage from these chemicals. The medicines and drugs are brought in almost undigested form the gastrointestinal tract to the liver. So they are are almost fully metabolized in the liver as 75% of the blood supplied to the liver comes directly from the gastrointestinal tract and spleen via the portal vein . Mitochondria, a cellular component is damaged in the liver cells because of certain chemicals. This cellular component is responsible for producing energy. The mitochondrial dysfunction causes oxidation and damage to the hepatic cells. The damage to the cells of the liver and the bile duct results in over accumulation of bile acids inside the liver. This causes auto digestion or self destruction of the liver cells.

How is Liver Injury due to chemicals detected?

Liver injury is mostly detected through a rise in the clinical levels of liver enzymes. Elevated levels of the following liver enzymes indicate a liver injury.

ALT Level:

An increase up to three times the upper normal limit.

ALP Level:

An increase up to two times the upper normal limit.

Total Bilirubin:

An increase up to two times the upper normal limit.

Symptoms of the above condition

The symptoms of the above condition are as follows:

  • Nausea
  • Loss of Appetite
  • Abnormal liver function test results
  • Fatigue
  • Diarrhea
  • Jaundice
  • Enlargement of liver
  • Abdominal pain

How is Hepatotoxicity treated?

Treatment is mainly by discontinuing the medication causing the toxicity. Exposure to the chemical/alcohol has to be eliminated to be able to see an improvement in the condition.

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