What Are the Warning Signs of Liver Failure?

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Liver failure is when the liver loses its ability to perform its essential roles. Liver failure can be broken down into two categories, acute liver failure and chronic liver failure.

Acute liver failure happens suddenly. It is typically due to a virus, medication, or an autoimmune disease. Chronic liver failure happens slowly over time and can be caused by several different conditions.

When the liver is damaged, people usually will experience warning signs to let them know that something is not quite right. This article discusses the warning signs of liver failure.

liver pain

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Signs of Liver Damage

The liver handles over 500 functions within the body. Its functions can be broken down into four main categories. They are digestion, cleaning the blood, immune support, and blood clotting.

The signs of liver damage will start when the liver cannot carry out one of its jobs. These signs will vary from person to person.

No Appetite

People with liver failure can experience poor digestion and increased toxins in the bloodstream. This leads to nausea, which decreases appetite.

There are two hormones, leptin and ghrelin, that control hunger. Leptin reduces hunger, whereas ghrelin increases hunger.

In liver failure, levels of ghrelin do not increase as they should before mealtimes. This will cause a poor appetite and less food will be eaten. In the meantime, leptin production increases in liver failure. With more of this hormone, people with liver failure will have less of an appetite.

Inconsistent Sleep

Poor, inconsistent sleep is a common symptom of liver failure.

A 2018 study reported inconsistent sleep is often due to changes in how the body processes both the hormone melatonin and glucose (the body's main sugar), as well as how it regulates body temperature and the production of ghrelin.

People with liver failure are unable to adequately process medications. Therefore, it's important to look for medication-free ways to help improve sleep.

Poor Memory

The liver is an important organ for so many reasons. One of its jobs is to clear out toxins from the blood. If these toxins, like ammonia, aren't removed, the nervous system can be affected, leading to decreased brain function and poor memory.

When there is a loss of brain function, it's called hepatic encephalopathy (HE). This condition can occur suddenly or slowly over time.

Itchy Skin

Itchiness is a symptom of liver failure that only some people will experience. The itching can be in a single spot, like the hand or foot. Or the itching can be all over the body.

Experts haven't narrowed down the main reason for itchy skin in people with liver failure. Whether this symptom arises seems to depend on the cause of your liver failure.

A healthcare provider will be able to prescribe medications to treat itchy skin caused by liver failure. Using creams and lotions can also help relieve the itch temporarily .


Jaundice, or yellowing of the eyes and skin, is caused by a buildup of bilirubin in the blood. Bilirubin is a reddish-yellow waste product found in the blood. Excessive bilirubin in the blood can be caused by inflammation or changes in the liver cells or blocked bile ducts. 

In a healthy liver, bilirubin is adequately removed. But in people with liver failure, the liver can't keep up with the bilirubin production, which then causes the yellowing of the skin and whites of the eyes.

Jaundice can be the first symptom of liver disease, and in some people, it is the only symptom.


One of the warning signs of liver failure is bleeding.

The liver is a crucial player in clotting. It makes almost all of the body's clotting products. If the liver is not working as it should, the blood will not be able to clot when needed. This can cause unexplained or excessive bleeding.

Fluid Retention

Fluid retention around the midsection, medically known as ascites, is a sign of liver failure. The fluid collects in your abdomen and can become painful or make it difficult to move around.

Ascites fluid is one of the signs of liver failure caused by a condition called cirrhosis. Cirrhosis is a liver disease that causes significant scarring of the liver. It is often brought on by long-term heavy alcohol drinking, hepatitis, or nonalcoholic fatty liver disease.

Sudden Change in Weight

Weight loss can be blamed on malnutrition or a lack of appetite. When the liver doesn't work properly, it can cause people with liver disease to lose weight.

On the other hand, some people with liver disease can gain weight. Sudden weight gain usually is due to fluid retention.

Red Palms

Red palms, also called palmar erythema, is a condition in which the palms of the hands become red. In some instances, the fingers can also become red.

This is a sign of many different conditions, including liver failure. In one study, it was found to occur in 23% of people with liver cirrhosis.

Enlarged Breasts

Men who have liver failure from cirrhosis may experience gynecomastia, which is breast enlargement.

The cause of breast enlargement in men with liver failure is twofold. The first potential cause is when the liver is failing and it cannot appropriately break down hormones. An increase in certain hormones can cause gynecomastia.

The second cause is related to chronic high alcohol consumption, which causes liver failure. Alcohol also contains a product that imitates estrogen in the body. It stops testosterone production allowing the levels of estrogen to be higher than testosterone levels.

Dry Eyes and Mouth

Another warning sign of liver failure is dry eyes and mouth. Sometimes called primary biliary cholangitis, it is an autoimmune condition that causes the bile ducts in the liver to slowly die.

In a 2012 study, 30%–50% of patients with primary biliary cholangitis suffered from dry mouth and eyes. The study also noted that it was primarily females who reported these symptoms.

Early Signs of Liver Issues

One of the earliest signs of liver problems is jaundice. The yellowing of the eyes and skin is a telltale sign that the liver is not functioning properly. Other early signs include:

  • Discomfort below the right side of the ribs
  • Diarrhea
  • Nausea
  • Fatigue
  • Loss of appetite

Liver Damage Causes

A variety of conditions and diseases can cause liver damage. Here are the most common causes of liver damage:

  • Hepatitis: Hepatitis is liver inflammation; it can be brought on by a viral infection, alcohol consumption, or autoimmune disease.
  • Tylenol (acetaminophen): Tylenol can cause liver damage when it is not taken as prescribed.
  • Wilson's disease: This is a rare genetic condition in which the liver stores extra copper in the system and damages the liver and eventually other organs.
  • Cancer: Liver cancer or cancers that have spread to the liver can cause damage to the organ.
  • Cirrhosis: Cirrhosis causes liver scarring, which replaces healthy liver tissue and slows down blood flow through the liver.

Risk Factors for Liver Damage

Factors that can increase your risk for liver damage are:

When to See a Healthcare Provider

Acute liver failure, liver failure that happens suddenly, can occur in as soon as 48 hours.

It's crucial to contact a healthcare provider if you are experiencing any signs of liver damage. Any jaundice, pain on the right side of your abdomen, fatigue, nausea, and diarrhea shouldn't be ignored.

Maintaining a Healthy Liver

A healthy liver is essential in maintaining overall health. Some of the best ways to keep the liver healthy are to minimize alcohol consumption, avoid toxins, get vaccinated for hepatitis A and B, always practice safe sex, use medications as prescribed, eat a healthy diet, and exercise.


Liver failure is a medical emergency that either can come on quickly or slowly over time. There are many signs of liver failure, but not everyone will experience all or even any symptoms. The most common symptoms are jaundice, nausea, fatigue, and pain on the right side of the abdomen.

A Word From Verywell

The signs of liver failure can be subtle or overt. You may experience all of the symptoms or perhaps none at all.

This makes liver failure a difficult condition to diagnose. If you do develop any of the signs of liver failure it is important to bring them to your healthcare provider's attention. A provider will be able to order blood tests and imaging to help determine the cause of your symptoms and develop a treatment plan for you.

Frequently Asked Questions

  • How do you know if your liver is getting worse?

    You know that your liver function is worsening if the signs of liver failure have started or are increasing. Look out for jaundice (yellowing of the eyes and skin), nausea, fatigue, and pain on the right side of the abdomen.

  • What part of the body itches with liver problems?

    Liver problems can cause itching anywhere. But it is more common on the palms of the hands, the soles feet, or on one of the limbs.

  • What happens when your liver shuts down?

    If the liver shuts down and treatment isn't sought immediately, the other organs in the body will begin to shut down and it will ultimately lead to death.

17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Patty Weasler, RN, BSN
Patty is a registered nurse with over a decade of experience in pediatric critical care. Her passion is writing health and wellness content that anyone can understand and use.