We are often told that too much alcohol is bad for us, and you may have wondered when sipping a glass of wine or beer how alcohol affects your liver.

Your liver can cope with drinking a small amount of alcohol. However the liver can only handle a certain amount of alcohol at any given time, so if you drink more than the liver can deal with by drinking too quickly, or drinking too much over a short period of time, the liver cells (hepatocytes) struggle to process it. When alcohol reaches the liver, it produces a toxic enzyme called acetaldehyde which can damage liver cells and cause permanent scarring, in addition to other organs such as the stomach lining causing gastritis or peptic ulcer disease.

If you continue to drink excessively, either through binge drinking or by having multiple drinks on a daily basis, the consequences include destruction of liver cells, a build-up of fat deposits in your liver (fatty liver), or liver inflammation (alcoholic hepatitis), permanent scarring (cirrhosis) or even liver cancer.

Guidelines for low risk weekly alcohol consumption suggest up to 11 standard drinks in a week for women, and up to 17 standard drinks in a week for men. Drinking no more than six standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion. Drinking more than six standard drinks on any one occasion is regarded as binge drinking. Remember it is the amount of alcohol – not the type – is what matters.

AskAboutAlcohol.ie is a HSE website that provides dedicated information about alcohol risk and offers support and guidance to anyone who wants to cut back on their drinking. Keep in mind that alcohol can have varying effects on you depending on; age, gender, mental health, drug use and medical conditions, so balance a glass of your preferred alcoholic beverage  with some thought about the associated risks.

Research has demonstrated that more than 70% of Irish over-50’s are either overweight or obese. Of those classed as obese, approximately 30% will have fatty liver disease, putting them at high risk of liver scarring (cirrhosis), liver failure and liver cancer.

If you carry any excess weight around your middle, it can cause insulin resistance which often leads to fatty liver disease. Measure your middle and keep it at a healthy circumference. Men should maintain a waist of less than 102cm (40 inches) and women, less than 88cm (35 inches). Exercising and eating a diet that’s low in fat and high in fibre, vitamins, antioxidants and minerals will help you maintain a healthy weight and liver.

Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount.  Guidelines recommend 150 to 300 minutes (2 ½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1 ¼ to 2 ½ hours) of vigorous intensity physical activity each week. Aim to start with a brisk 30 minute walk each day.

Fad diets that make your weight yoyo can put excessive stress on your liver. Avoid any products that promise large amounts of weight loss in an unrealistically short period of time. Aim to lose weight at a healthy rate of ½ -1kg per week. Liver cleansing and detox diets should also be avoided. Contrary to popular belief, no particular diet is liver cleansing, but a healthy diet improves well-being.

• A blood test is the best way to keep a keen eye on the levels of cholesterol and glucose in your blood – all of which are associated with fatty liver disease. Too much glucose can be an indication that you have impaired glucose tolerance or diabetes – in both cases you’ll need to carefully control your blood sugar levels through diet, medications and/or weight loss.
• Have you ever experimented with intravenous drugs? Did you have a blood transfusion, or organ transplant prior to 1992? If so, make sure you get tested for hepatitis C.
• Do you complain of chronic fatigue? Check your iron levels (serum ferritin). Haemochromatosis is a genetic condition very common in Irish people that causes slow gradual iron accumulation in the liver and other organs. Once diagnosed, treatment is very simple and regular ferritin blood checks can help to keep the condition under control.

• Practice safer sex and protect yourself from hepatitis B. Unlike hepatitis B, hepatitis C is not classified as a sexually transmissible infection, but if there is a chance of blood to blood contact, you should practice safer sex.
• Less commonly, toothbrushes, razors and other personal care items can also transmit hepatitis B or C, so don’t borrow, or share yours with anyone. Household contacts of people living with chronic hepatitis B should be offered the hepatitis B vaccine. There is no vaccine for hepatitis C.
• If you currently use intravenous drugs, don’t share needles. Take advantage of a needle exchange program.
• Body art, piercings, and tattoos are all forms of self-expression. However, inadequately sterilised tools, reused needles or contaminated inks could expose you to hepatitis B or C infections. Because piercing and tattoo equipment can come into contact with blood, it is important to ensure your service provider takes the proper infection control precautions between clients.

With easy access to health information via the internet, you may be tempted to self-diagnose and treat your own health problems. But by not consulting a doctor, you may be putting yourself at risk for potentially hazardous side effects that can result when certain medications and/or supplements are combined.

As the main organ that detoxifies most drugs, herbal remedies and vitamins, the liver is vulnerable to the toxic consequences of self-medicating. In recent years, herbal remedies such as kava have made headlines for their harmful effects on the liver, yet it is only one of many herbal remedies that can cause liver toxicity. There have also been concerns about the potential for accidental over-dosing with paracetamol when several products containing this drug (i.e. cold remedies and pain medication) are taken at the same time.

People may not realise that any medication – herbal or pharmaceutical – undergoes important chemical changes when processed by the liver. While the original product might not be considered harmful, the resulting by-products may be toxic to the liver. Also, the interaction of one medication with other medications, or when combined with alcohol, may cause complications for otherwise healthy people.

Those who already have liver problems have to be especially careful and may not be able to take even the most ordinary over-the- counter remedies to treat common ailments like headaches or colds. Always consult your doctor or pharmacist before taking new medication.