When the liver begins to struggle, the body often sends warning signals—but many people overlook them in the early stages.

The liver is one of the most vital organs in the human body. It performs more than 500 essential functions, including filtering toxins from the bloodstream, producing bile to aid digestion, regulating blood sugar, storing vitamins and minerals, balancing hormones, and supporting immune defense. Because it plays such a central role in metabolism and detoxification, liver dysfunction rarely affects just one area. When the liver becomes damaged, symptoms can appear throughout the body.

One of the earliest and most noticeable areas of discomfort is the upper right abdomen.

The liver sits beneath the rib cage on the right side of the body. When it becomes inflamed—due to conditions such as fatty liver disease, viral hepatitis, medication toxicity, or alcohol-related injury—it may enlarge. This swelling stretches the protective capsule surrounding the liver, leading to a dull ache, pressure, fullness, or sometimes sharper discomfort in that region. Many people ignore this sensation at first, especially if the pain is mild or intermittent.

Pain can also radiate to the right shoulder or upper back.

This occurs because liver inflammation may irritate the diaphragm, which shares nerve pathways with the shoulder area. The brain can interpret this nerve irritation as shoulder pain—a phenomenon known as referred pain. If unexplained right shoulder discomfort appears alongside fatigue, nausea, or digestive changes, liver involvement may be worth evaluating.

The skin often reflects liver health as well.

When the liver cannot properly process bile, bile salts may accumulate in the bloodstream and deposit in the skin. This can cause persistent itching, known as pruritus. Unlike typical skin irritation, this itching may occur without a visible rash and often worsens at night.

Another visible sign is jaundice, a yellowing of the skin and the whites of the eyes. Jaundice develops when bilirubin—a yellow pigment normally processed and excreted by the liver—builds up in the blood. This is a clear signal that liver function is impaired and requires medical attention.

The digestive system is frequently affected.

Because the liver produces bile to break down dietary fats, reduced bile flow can lead to bloating, nausea, indigestion, and discomfort after eating fatty meals. Appetite may decrease, and some people experience unexplained weight changes.

In more advanced stages, fluid may accumulate in the abdomen, a condition called ascites. This causes visible swelling, tightness, and sometimes abdominal pain or difficulty breathing due to pressure on surrounding organs.

Swelling may also appear in the legs and ankles.

When liver function declines significantly, the body produces less albumin—a protein that helps keep fluid within blood vessels. As albumin levels drop, fluid can leak into surrounding tissues, leading to edema (swelling), particularly in the lower extremities. The legs may feel heavy, tight, or uncomfortable.

Fatigue is one of the most common but least specific symptoms of liver dysfunction.

When toxins are not efficiently filtered from the bloodstream, they can accumulate and affect energy levels. Many individuals report persistent tiredness, weakness, brain fog, and difficulty concentrating. In severe cases, toxin buildup can affect the brain, leading to confusion, mood changes, or memory problems—a condition known as hepatic encephalopathy.

The muscles and joints may also ache.

Chronic liver disease can contribute to systemic inflammation. Certain liver disorders have autoimmune components that may cause joint stiffness or discomfort. Muscle cramps—especially at night—are also commonly reported in individuals with chronic liver conditions.

Changes in urine and stool color provide additional clues.

Dark urine may signal elevated bilirubin levels, while pale or clay-colored stools can indicate reduced bile flow. Although these symptoms do not directly cause pain, they often accompany abdominal discomfort and suggest impaired liver function.

It is important to understand why liver damage creates such widespread symptoms. The liver acts as the body’s central processing and detoxification hub. When it becomes inflamed, scarred (as in cirrhosis), or overloaded with fat deposits (as in non-alcoholic fatty liver disease), its ability to regulate metabolism, filter toxins, and support other organs declines. Because nearly every system depends on liver function, the effects can be systemic rather than localized.

Common causes of liver damage include:

• Excessive alcohol consumption

• Viral hepatitis (such as hepatitis B or C)

• Obesity-related fatty liver disease

• Certain medications or supplements

• Exposure to toxins

• Autoimmune disorders

Early-stage liver disease often produces few symptoms, which is why it is sometimes called a “silent” condition. By the time noticeable pain or visible signs appear, significant damage may already have occurred.

The encouraging news is that the liver has a remarkable ability to regenerate if damage is detected early. Lifestyle changes can significantly improve liver health. These include reducing or eliminating alcohol intake, maintaining a healthy weight, exercising regularly, eating a balanced diet rich in vegetables and lean proteins, limiting processed and high-sugar foods, staying well hydrated, and avoiding unnecessary medications or supplements that strain the liver.

Anyone experiencing persistent upper right abdominal pain, unexplained fatigue, yellowing of the skin or eyes, severe itching, swelling, or digestive changes should consult a healthcare professional. Blood tests measuring liver enzymes, imaging studies such as ultrasound, and other diagnostic tools can help determine the cause and severity of liver involvement.

In summary, when the liver is damaged, multiple parts of the body may begin to hurt or show distress. The upper right abdomen, right shoulder, skin, digestive system, legs, muscles, and even cognitive function can be affected. Recognizing these warning signs early and seeking medical evaluation can make a critical difference in preventing long-term complications and protecting overall health.