What is toxic hepatitis?
Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements.
In some cases, toxic hepatitis develops within hours or days of exposure to a toxin. In other cases, it may take months of regular use before signs and symptoms appear.
The symptoms of toxic hepatitis often go away when exposure to the toxin stops. But toxic hepatitis can permanently damage your liver, leading to irreversible scarring of liver tissue (cirrhosis) and in some cases to liver failure, which can be life-threatening.
How common is toxic hepatitis?
Please discuss with your doctor for further information.
What are the symptoms of toxic hepatitis?
The common symptoms of toxic hepatitis are:
- Jaundice , a condition that causes a yellow tint in the skin and eyes
- Loss of appetite
- Nausea and vomiting
- Abdominal pain
- Dark urine
- White or clay-colored stools
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
See your doctor right away if you have any signs or symptoms that worry you.
Overdoses of some medications, such as acetaminophen (Tylenol, others), can lead to liver failure. Get immediate medical care if you think an adult or a child has taken an overdose of acetaminophen. Signs and symptoms of a possible acetaminophen overdose include:
- Loss of appetite
- Nausea and vomiting
- Upper abdominal pain
What causes toxic hepatitis?
Many chemicals that are intentionally or unintentionally inhaled or consumed can have toxic effects on the liver. Among these chemicals are drugs, industrial solvents and pollutants. Virtually every drug imaginable has at one time or another been indicated as a cause of toxic hepatitis. Toxins can occasionally cause chronic liver disease and even cirrhosis if exposure to the toxin is not stopped.
Toxins that can damage the liver have been divided into two groups:
- Predictable, those that are known to cause toxic hepatitis and liver damage with sufficient exposure to one or more of these chemicals. Examples of chemicals found in this group are cleaning solvents, carbon tetrachloride and the pain reliever acetaminophen.
- Unpredictable, those toxins that damage the liver in a very small proportion of individuals exposed to the chemical. Unpredictable injury produced by most drugs is very poorly understood but recent data suggest that a toxic response to a drug probably depends on the kind of enzyme a person inherits to metabolize the drug.
The liver is susceptible to injury by chemicals because it plays a fundamental role in chemical metabolism. The liver has the unique job of processing almost all chemicals and drugs that enter the blood stream and removing the chemicals that are difficult for the kidneys to excrete. The liver turns these chemicals into products that can be eliminated from the body through bile or urine. However, during this chemical process in the liver, unstable highly toxic bi-products are sometimes produced; these highly toxic bi-products can attack and injure the liver.
Regular alcohol consumption will likely enhance the chance of drug toxicity especially in the case of acetaminophen. Therefore, alcohol should not be consumed when using medications.
What increases my risk for toxic hepatitis?
There are many risk factors for toxic hepatitis, such as:
- Taking over-the-counter pain relievers or certain prescription drugs. Taking a medication or over-the-counter pain reliever that carries a risk of liver damage increases your risk of toxic hepatitis. This is especially true if you take multiple medications or take more than the recommended dose of medication.
- Having a liver disease. Having a serious liver disorder such as cirrhosis or nonalcoholic fatty liver disease makes you much more susceptible to the effects of toxins.
- Having hepatitis. Chronic infection with a hepatitis virus (hepatitis B, hepatitis C, or one of the other — extremely rare — hepatitis viruses that may persist in the body) makes your liver more vulnerable.
- As you age, your liver breaks down harmful substances more slowly. This means that toxins and their byproducts stay in your body longer.
- Drinking alcohol. Drinking alcohol while taking medications or certain herbal supplements increases the risk of toxicity.
- Being female. Because women seem to metabolize certain toxins more slowly than men do, their livers are exposed to higher blood concentrations of harmful substances for a longer time. This increases the risk of toxic hepatitis.
- Having certain genetic mutations. Inheriting certain genetic mutations that affect the production and action of the liver enzymes that break down toxins may make you more susceptible to toxic hepatitis.
- Working with industrial toxins. Working with certain industrial chemicals puts you at risk of toxic hepatitis.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is toxic hepatitis diagnosed?
In making a diagnosis of toxic hepatitis, your doctor will ask about your medical history, including detailed information regarding your medications, use of herbs or other over-the-counter nutritional supplements and alcohol consumption. Your doctor also will carry out a thorough physical exam, which can be helpful in determining the presence or absence of significant chronic liver disease.
The following tests may be performed to assess the presence and severity of liver damage:
- Liver Function Tests — These include a series of special blood tests than can help determine if the liver is functioning properly. These tests also can assist in determining the extent and type of liver damage.
- Ultrasound — An ultrasound uses high-frequency sound waves to create images of organs and systems within your body. An ultrasound may be performed to generate detailed pictures of your liver.
- Computed Tomography (CT) — Your doctor also may suggest a computed tomography scan, also known as a CT scan, to obtain two-dimensional images of your liver. CT is an X-Ray technique that produces more detailed images of your internal organs than conventional X-Ray exams. This technology uses an X-Ray sensing unit, which rotates around your body, and a large computer to create cross-sectional images of the inside of your body.
- Liver Biopsy — A biopsy may be performed following blood tests and X-Rays if questions still exist about the nature and severity of your liver problem. During a biopsy, a small sample of tissue is removed from your liver using a thin needle. The tissue is prepared and stained in a laboratory for examination under a microscope.
How is toxic hepatitis treated?
The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. In the case of alcohol-related liver damage, joining a treatment program such as Alcoholics Anonymous is highly recommended. Alcoholism is a serious addiction and without the proper treatment and support networks, many people experience a relapse and return to alcohol.
Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement.
Patients with end-stage cirrhosis from alcohol may be considered for transplantation. However, they are considered candidates for transplantation only if they have been completely abstinent from alcohol and in a treatment program for a minimum of six months.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage toxic hepatitis?
The following lifestyles and home remedies might help you avoid toxic hepatitis:
- Limit medications. Take prescription and nonprescription drugs only when absolutely necessary. Investigate nondrug options for common problems such as high blood pressure, high cholesterol and arthritis pain.
- Take medications only as directed. Follow the directions exactly for any drug you take. Don’t exceed the recommended amount, even if your symptoms don’t seem to improve. Because the effects of over-the-counter pain relievers sometimes wear off quickly, it’s easy to take too much.
- Be cautious with herbs and supplements. Don’t assume that a natural product won’t cause harm. Discuss the benefits and risks with your doctor before taking herbs and supplements. The National Institutes of Health maintains the LiverTox website where you can look up medications and supplements to see if they are linked to liver damage.
- Don’t mix alcohol and drugs. Alcohol and medications are a bad combination. If you’re taking acetaminophen, don’t drink alcohol. Ask your doctor or pharmacist about the interaction between alcohol and other prescription and nonprescription drugs you use.
- Take precautions with chemicals. If you work with or use hazardous chemicals, take all necessary precautions to protect yourself from exposure. If you do come in contact with a harmful substance, follow the guidelines in your workplace, or call your local emergency services or your local poison control center for help.
- Keep medications and chemicals away from children. Keep all medications and vitamin supplements away from children and in childproof containers so that children can’t accidentally swallow them.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Toxic hepatitis. https://www.mayoclinic.org/diseases-conditions/toxic-hepatitis/symptoms-causes/syc-20352202. Accessed December 14, 2017.
Toxic Hepatitis. https://www.ucsfhealth.org/conditions/toxic_hepatitis/. Accessed December 14, 2017.
Toxic Hepatitis. https://www.liver.ca/patients-caregivers/liver-diseases/toxic-hepatitis/. Accessed December 14, 2017.
Review Date: December 15, 2017 | Last Modified: December 15, 2017