How healthy is your liver? Now there’s a lunchtime liver scan that’ll tell you

If you think about everything our liver does – hormone regulation, metabolism, detox, to name just a few of its jobs – it’s crazy that it doesn’t receive the same love as, say, our gut health does.

While you might be taking care to eat 30 plants per week, start your day with electrolytes or creatine and mainline medicinal mushrooms, you probably haven’t given your liver – the body’s main metabolic processing factory – a second thought. Big mistake – non-alcoholic fatty liver disease (NAFLD, ie where alcohol is not the cause) is on the rise, even among people who consider themselves to have healthy lifestyles.

The contributing factors such as stress, menopause, and sleep might surprise you. Which is why I – a healthy eater and imbiber of almost no alcohol, but a stressed-out menopausal insomniac – booked in for a new ‘lunchtime’ liver test, more of which below.

What does the liver do exactly?

Your liver is your protector: like a nightclub bouncer for your body, nothing gets past it and into your bloodstream without good reason. None of the nutrition from your food will get absorbed and distributed efficiently unless your liver has processed it first. Your liver filters out toxins such as metabolic waste, alcohol and harmful environmental chemicals, and it regulates your hormones as well as your metabolism. If these processes don’t function well, you can experience everything from bloating to brain fog to even liver disease.

Why is it important to look after your liver?

With such a roll-call of essential functions, you can see why a liver in great shape is key to a body and mind that work and feel at their best. And yet instances of liver cancer and non-alcoholic fatty liver disease (liver disease not caused by heavy drinking) are steeply rising. Liver cancer (which is linked to a fatty liver) is now the fastest-growing cancer in the UK. One in five of us have NAFLD, says British Liver Trust with rates increasing in step with rising obesity and type two diabetes. “Among people in middle-age and above, the estimate is that as many as 50 per cent have some fatty deposits on the liver,” says nutritionist Dr Federica Amati, who is chief medical officer at The Liver Clinic, a global chain of liver health clinics offering private liver scans and a liver health tonic called Deliverance.“The increase is really rapid.” According to one study, 38 per cent of people globally have a fatty liver, an early stage in many types of fatty liver disease.

What are your liver’s worst enemies?

We don’t need to tell you that alcohol and recreational drugs are silent assassins for your liver. But there are other culprits to be aware of, according to Amati and Siggi Clavian, founder and CEO of The Liver Clinic.

• UPFs – ultra processed foods. Eating too many ultra-processed foods with ingredients such as sweeteners, emulsifiers, preservatives, fructose syrup and gelling agents can lead to inflammation in the liver and subsequent fibrosis, or scar tissue.

• Paracetamol. The painkiller is not as innocuous as most people think it is. When metabolised, it releases compounds that are toxic to the liver, so you should be cautious about taking high doses.

• Being overweight. Obesity causes fat to build up in the liver and over-taxes its fat-processing ability. People who have trouble processing fat (such as those with hypertriglyceridemia, high blood cholesterol or metabolic syndrome) are at high risk of fatty liver disease.

• Stress and sleep deprivation. Stress and lack of sleep reduce blood flow to the liver, accelerate cell death and produce liver-inflaming cortisol, impairing its ability to maintain homeostasis (the body’s state of balance) and making you feel permanently worn out.
• Menopause. If you’re in perimenopause or menopause, check your liver because you are potentially more susceptible to post-meal fluctuating blood sugar; as oestrogen levels fall, the body can become less responsive to insulin. Insulin resistance means there’s a higher chance of conditions that put you at risk of a fatty liver, such as obesity and metabolic syndrome.

Avoiding fatty liver is key but it’s hard to detect. “Most people don’t find out until they’re in advanced stages of liver failure, which is a tragedy because NAFLD is entirely reversible with relatively simple lifestyle and diet changes,” says Dr Amati. But that could all change thanks to a new lunchtime liver test called Fibroscan, wich is being rolled out in clinics around the country. I tried the service at The Liver Clinic at central London pharmacy and health centre John Bell & Croyden.

What is the lunchtime liver scan?

Fibroscan is a five-minute, painless and non-invasive liver test that’s long been used by the NHS, but only on patients with advanced liver disease. The irony is that Fibroscan is actually best-placed as a preventative test to catch liver issues at a very early stage, that way giving you a real chance to fix your liver or avoid issues altogether.

Five minutes and you’re done: the Fibroscan test is quick and painless.

The specialised ultrasound test, executed by a trained technician (in my case a nutrition consultant) gives a readout of your liver health in minutes, without the need for a blood test. Hilariously, the machine was developed for cheese makers who needed a way to determine how hard their wheels of cheese were in the centre; a clever clogs then realised the technology could be used in medicine.

“I have referred patients for the Fibroscan when their liver function test has come back abnormal but also after diagnosing high cholesterol,” says hormone and integrative doctor Sohere Roked.  “If you think you have risk factors, Fibroscan can definitely be useful in terms of monitoring what is going on with your liver.”

What happens in a Fibroscan liver test?

This test certainly is quick and, on the face of it, simple. I answered some lifestyle questions, after which my technician applied gel to my abdomen then passed a buzzing probe emitting painless high-frequency sound waves over the liver area for a minute or three.

The sound waves give a reading of the liver’s ‘bounce’: a healthy liver, like your skin, is springy, but a fibrous (or stiff) liver means there is scar tissue. That’s a sign of a liver that is overloaded and inflamed. The test also determines what percentage of your liver is made up of fatty deposits: too much fat wears the liver down and impairs its function.

Your results place you in one of five risk-level zones; the worse your score, the more risk of unpleasant metabolic diseases such as type two diabetes and stroke. Not pleasant to hear, but the point of an elective Fibroscan is to help prevent early signs of liver damage turning into full-blown liver and other diseases.

My technician took just minutes to produce a number of readings that put my liver in the NAFLD-free ‘green’ zone; super-spongy and fat-free. Pat on the back for me. I was sent away with basic lifestyle and nutrition advice, but those with more cause for concern can get nutrition advice and referrals. A copy of your scores can be sent to your GP. It costs £299 at The Liver Clinic.

What are signs you should get a liver test?

Fibroscan should be used primarily as a screening and preventative tool, says Amati, but it can also be helpful to determine if persistent vague symptoms are potentially due to a struggling liver. “You could have trouble maintaining your weight, high cortisol levels, bad fatigue, brain fog, itchy skin, a swollen tummy, shortness of breath – all these things mean it’s worth making sure that your liver is in a good place,” says Amati.

Clavian notes that many women book in their middle-aged husbands with expanding tummies for a Fibroscan. But you don’t have to be overweight: “As you approach your 50s and 60s and have a life that’s chronically stressful, that’s where your liver will really start to show signs of struggling,” says Amati. It’s why she advises most of her clients over 45 to have the test.

In fact, stress can be a red flag even if you’re young: “I sent a client in his early thirties in a really high-stress job, but fit and on a very balanced diet, for the scan. He turned out to have significant fatty deposits on his liver,” says Amati. “They were purely caused by stress.”

If your signs are more than vague (jaundice, chronic excessive water retention, upper abdominal pain) and you suspect you may already have liver disease, you should see you GP as soon as possible for bloods and further tests.

Why not just get a liver blood test from your GP?

“A liver blood test will provide a comprehensive overview of the underlying cause of any liver disease, such as infections or cancer cells,” says Clavian. “But it does not identify a fatty liver or liver stiffness, which are the big warning signs that even more serious liver disease could be developing,”

Fatty liver disease is not detected in a whopping 90 per cent of people who have a liver blood test, he adds.

What can you do if you get a bad score Fibroscan score?

Clavian says that depending on the severity of it, you may be referred for an MRI, but this is rare. The advice after a concerning score is to speak to a nutritionist to look into your diet, as adjusting it can reverse your liver fat and stiffness.

These are some of the liver-friendly habit changes our experts recommend.

• Eat fresh. Ultra-processed foods are probably your liver’s greatest silent assassin, so aim to cut as many from your diet as possible. Focus on fresh, raw ingredients and avoid any mass-produced fast food, pre-prepared and convenience foods and meals, and diet foods and drinks. Think plain yogurt with fruit and honey rather than a Müller Corner!
• Ramp up your plant foods. Continue with your 30 weekly plant points: the polyphenols in plants protect from liver damage. “The theory is that they refuel an exhausted liver’s mitochondria [your cells’ ‘batteries’] so it can get back to work protecting the body and itself,” says Amati.
• Work out. “Regular exercise is hugely beneficial for the liver,” says Clavian. It’s been shown to reduce fatty deposits in the liver and have an anti-inflammatory effect on the organ. Exercise also reduces liver-threatening stress in the body.
• Don’t pop too many pills. Cutting back on alcohol is a given, but so is limiting any recreational drugs and prescription painkillers and other drugs, if you can, as all put the liver under strain.
• Choose supplements wisely. Some (not much) research suggests that supplement ingredients like milk thistle and artichoke extract can help support the liver. But when choosing health supplements, be aware that these too can contain ‘junk’ ultra-processed ingredients such as fillers and binders. Choose a good liver support complex from a clean supplements brand such as Cytoplan.
• Do breathing exercises. Any stress-reducing strategies will benefit your liver. The quickest breathwork practice, says GTG editorial director Victoria Woodhall in this Insta post, is simply two sharp inhales through the nose and one long, slow exhale through the mouth.
• Try a liver shot. De-liver-ance, £200 for 30 shot drink doses, is a science-backed supplement that reversed fatty liver deposits in 83 per cent of study participants in three months of daily shots. It tastes like alcohol-free Jågermeister and packs 17 herbs, roots and plant extracts providing, says Dr Amati “a ridiculous amount of polyphenols” thought to support liver function. It can also be taken preventatively: Amati, who has been involved with the brand, pops a vial before a night out as it “reduces blood alcohol concentration by 50 per cent.”

Fibroscan is available nationwide at private clinics such as The Liver Clinic, Randox Health and Welbeck, with prices ranging from about £200 to £600