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Comment by sandworm101 | Hacker News Reader

Surprisingly little. Most of the liver stand by at idle ready to filter intermittent massive doses of things, such the stuff arriving in your bloodstream after a big meal. This is what makes many liver diseases so evil. A person can live basically free of symptoms for many years as their liver struggles and is progressively damaged by some substance (alcohol). Until one day the amount of remaining functional liver dips slightly below the minimum needed to sustain daily functions. After decades of drinking, over the course of a month a functional alcoholic can go from being a happy drunk to a patient dying in hospital in need of a new liver.

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So alcoholics should do a periodic stress test of binge eating to get an early warning.

Just do blood tests for liver diseases markers every year. Even if you're not an alcoholic - there's many other diseases that result in similar damage.

For example if you have asthma and especially if you have colitis ulcerosa or crohn's disease - you're at much higher risk of PSC - an autoimmune liver disease which does basically the same thing as decades of drinking.

Tangentially, I just found out in a routine test that I have a condition called "gilbert's syndrome" [0]. It's harmless tho. It came from my parents, it seems. My dad died of liver cancer, but I don't know if he was diagnosed with that syndrome and if they were related.

[0]. https://www.mayoclinic.org/diseases-conditions/gilberts-synd...

I've got Gilbert's as well - found out about ten years ago during some routine blood work.

The only thing I've noticed is that dehydration hits me a little harder than most people. If I don't drink enough water throughout the day I get fatigued, and if I don't drink enough water after a night out I get pretty gnarly hangovers.

This is just comparing me to my peers though, and might not be due to my Gilbert's at all, but the fact that these things have been linked to Gilbert's in studies means it's possible they're related.

Anyway, staying hydrated never hurts, so thought I'd pass that along in case it helps you too.

Thanks for your comment!

What you said makes a lot of sense, I started taking more care of my health in the last 45 days, I took several tests, etc. and then I discovered this condition.

The nutritionist, not yet knowing about Gilbert's syndrome, asked me to drink 2 to 3 liters of water a day and what I noticed was a huge reduction in the sleep I felt during the day. I also realized that caffeine consumption also bothers me and I'm trying to reduce it.

Don't even get me started on the hangover, every time I go out I already know I'm going to have a hellish next day! It's great to know that I'm not the only one and that someone else continues to drink even though they have a "problem" with their liver, so I feel less guilty!

PSC is a rough disease with the bile ducts. I'm surprised we haven't any treatment for it yet.

Not to mention non-alcoholic fatty liver disease and its evolution, non-alcoholic steatohepatitis.

Readers beware that, like most random testing/imaging, this can lead you down an expensive road with no resolution in sight. Liver markers are frequently elevated, non-symptomatic and with no obvious cause in healthy individuals. It starts with blood tests and progresses to imaging and invasive biopsy.

I suggest finding a good doctor instead and letting them manage the frequency and depth of testing like this. Many chronic liver diseases aren’t curable or even satisfactorily treatable. Losing weight, watching carb intake, and avoiding alcohol are the big preventative measures.

I'm rather unclear about the speed of regrowth. From one source (the web?) It was a matter of years, yet talking to a herpetologist (edit: hepatologist. Blame voice recognition) in a pub, she said it can regrow 80% of itself in a matter of weeks. Assuming a healthy liver, how fast is regrowth?

Assuming a cirrhosed liver , how would that affect regrowth time? TIA.

When a liver has cirrhosis, its scarred beyond functional repair which means no growth.

One of our dogs had days to live by the time we found out he had a congenital defect that caused a fibrous liver. In retrospect some parts of his personality may have been symptoms, but we were wrecked.

What aspects of his personality would you suspect?

Very easily satisfied by activity. Afterward I was less convinced he was a chill dude and more concerned he was easily exhausted.

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