In a country where self-medication is a common practice, the silent threat to liver health is a growing concern. India's unique relationship with medication, characterized by self-prescription and sharing of remedies, has led to a health crisis that often goes unnoticed.
Dr. Kavya Harika Dendukuri, a leading hepatologist, sheds light on this issue, highlighting how well-intentioned individuals often unknowingly harm their livers. The liver, an organ that quietly suffers, can withstand significant damage before any symptoms arise, making it a prime target for unnoticed harm.
The Resilience and Vulnerability of the Liver
The liver's extraordinary resilience is both a blessing and a curse. Its ability to function with up to 75% capacity loss without any noticeable symptoms has bred a false sense of security. People assume that the absence of sickness means they are invulnerable, but this couldn't be further from the truth.
When the liver finally shows signs of distress, it's often too late. Jaundice, abdominal swelling, confusion, and bleeding gums are all late-stage indicators of liver damage. By then, the damage might be irreversible.
Drug-Induced Liver Injury: A Rising Concern
Drug-induced liver injury is now a leading cause of acute liver failure in India, second only to viral hepatitis. The problem lies in the misconception that over-the-counter medications are inherently safe.
Paracetamol, for instance, is a common culprit. Sold under various brand names and widely available, it's often taken without reading the label, leading to accidental overdoses. Combined with alcohol, paracetamol can cause catastrophic liver failure within just 72 hours.
Anti-tuberculosis drugs like isoniazid and rifampicin, while life-saving, require mandatory liver monitoring. Unsupervised use of these drugs can lead to dangerous consequences, as patients might stop their follow-up visits, unaware of the damage being done to their livers.
NSAIDs, ibuprofen, and diclofenac are also prevalent, especially among those with fatty liver disease or early cirrhosis. A study found that non-alcoholic fatty liver disease affects nearly 30% of the Indian population, making these common painkillers a potential threat.
The Insidious Nature of Supplements
The natural supplement industry presents a unique danger. The marketing of these products as "natural" and "safe" leads to a false sense of security. Detox supplements, weight-loss blends, and Ayurvedic formulations promise liver health, but they can cause severe hepatotoxicity when taken in unsupervised doses.
Dr. Dendukuri has seen young, healthy individuals develop fulminant liver failure from online-purchased supplements. The unregulated nature of the natural medicine industry means there's no oversight, no standardisation, and no monitoring, leaving individuals vulnerable to unknowingly taking unsafe doses.
Who's at Risk?
Anyone can develop drug-induced liver injury, but certain groups are at higher risk. Those with fatty liver disease, diabetes, older individuals, those on multiple medications, and regular alcohol drinkers have a depleted liver reserve, making them more susceptible to liver damage from seemingly harmless drugs.
Self-medication is especially dangerous for those with chronic conditions, as they're often the most vulnerable to liver damage. A combination of medications that might be safe for a healthy individual could be catastrophic for someone with compromised liver function.
The Need for Respect and Awareness
Dr. Dendukuri emphasizes the need for respect towards the liver, an organ that works tirelessly to filter blood and detoxify our bodies. She urges individuals not to live in fear of medication but to approach it with caution and awareness.
Never assume a drug is safe just because it's over-the-counter. All medications, including vitamins, supplements, and herbal preparations, are processed by the liver and carry risks. Regular liver function tests and open communication with healthcare professionals are crucial steps towards liver health.
The next time you reach for a tablet without a prescription, pause and consider the potential impact on your liver. It might just be the most important health decision you make.
