Toxic Hepatitis (Liver Toxicity)

What is toxic hepatitis (liver toxicity)?

Toxic hepatitis, or liver toxicity, is liver swelling (inflammation) that results from contact with a harmful substance (toxin), whether you:

• Touched something toxic.
• Breathed toxic air.
• Swallowed something toxic.

Liver inflammation can also occur if you take too much of certain medications or drink too much alcohol. Over time, inflammation causes permanent liver damage.

What does your liver do?

Your liver is one of your largest organs. It helps clean (filter) your blood and remove toxins from your body.

Are there different types of toxic hepatitis?

Types of toxic hepatitis include:

• Acute toxic hepatitis: This type develops suddenly. Symptoms occur immediately or shortly after exposure to a toxic substance.
• Chronic toxic hepatitis: This type may take longer to develop. You may not have any hepatitis symptoms for weeks or months.

Healthcare providers also categorize types of hepatitis according to the cause:

• Chemical-induced hepatitis: You develop this because of exposure to chemicals through ingesting, breathing or touching the chemical.
• Drug-induced hepatitis: You develop this type because of taking too much of certain medications, such as acetaminophen, nonsteroidal anti-inflammatory drugs and other drugs.
• Alcohol-induced hepatitis: This type is due to alcohol use disorder, especially if you also use recreational drugs.

What are the signs of a toxic liver?

Yellow skin or eyes (jaundice) is a common sign of liver disease. Other liver toxicity symptoms may include:

• Abdominal pain.
• Ascites.
• Fatigue.
• Fever.
• Loss of appetite.
• Nausea and vomiting.
• Urine changes, especially dark-colored urine.

You may also experience toxic hepatitis rash. If you have this skin rash, small purple dots or splotchy areas appear. You may also have pruritus (itchy skin).

What causes toxic hepatitis?

Exposure to certain chemicals or medications can cause toxic hepatitis symptoms to develop. Symptoms may develop soon after exposure, or they may develop over weeks or months.

But exposure to these substances doesn’t mean you’ll always develop toxic hepatitis. Every person reacts differently.

Some causes of toxic hepatitis include:

Drug-induced hepatotoxicity

This type of toxic hepatitis results from medications or supplements. Certain medications or dietary supplements may cause this drug-induced liver injury, including:

• Herbal supplements.
• Nonsteroidal anti-inflammatory drugs (NSAIDs).
• Prescription medications.

Alcohol-induced toxic hepatitis

Drinking too much alcohol can cause alcohol-induced hepatitis. If you experience alcohol use disorder, it’s important to talk to a healthcare provider.

Acetaminophen liver toxicity

You may develop liver toxicity if you take too much acetaminophen (Tylenol®), an over-the-counter pain reliever. Many people use acetaminophen to treat fever and pain. Most adults shouldn’t take:

• More than 4,000 milligrams of acetaminophen in one day (24 hours).
• Acetaminophen for more than 10 days in a row.

Too much acetaminophen can be dangerous if you already have liver disease. Call your healthcare provider right away if you take more than the recommended dose. Your provider may order an acetaminophen level test.

Vitamin A liver toxicity

Taking too much vitamin A (more than 40,000 IU daily) can cause vitamin A liver toxicity. Talk to your healthcare provider about any supplements or over-the-counter medications you take.

Can toxic hepatitis be transmitted?

Toxic hepatitis can’t be passed (transmitted) from one person to another. The condition isn’t contagious.

What are the risk factors for toxic hepatitis?

Anyone can develop toxic hepatitis.

You have an increased risk if you:

• Are assigned female at birth (AFAB).
• Have alcohol use disorder.
• Have liver disease, including hepatitis B or hepatitis C.
• Take certain prescription medications or over-the-counter drugs.
• Work or are around certain chemicals, like solvents.

You are also at higher risk if you have a genetic disorder, like:

• Alpha-1 antitrypsin deficiency.
• Hemochromatosis (iron overload).

What are the complications of toxic hepatitis?

Toxic hepatitis can lead to acute liver damage (cirrhosis) and chronic liver failure. If you develop liver failure, you may need liver transplantation.

How do healthcare providers diagnose toxic hepatitis?

Your healthcare provider talks with you about your symptoms and lifestyle. They also do a physical examination. Your provider may order tests to confirm a toxic hepatitis diagnosis.

What toxic hepatitis blood tests will I have?

You may have certain blood tests such as:

• Comprehensive metabolic panel (CMP).
• Liver function tests.

Your provider may order a blood alcohol content (BAC) or drug test. Blood and urine tests help your provider figure out the level of alcohol or drugs in your blood.

Are there other tests for toxic hepatitis?

If your provider wants more information about your liver health, you may have:

• Imaging tests, such as CT scan or MRI.
• Liver biopsy.

What’s the treatment for toxic hepatitis?

Toxic hepatitis treatment depends on the extent of damage to your liver. After checking your liver, your healthcare provider may recommend that you:

• Avoid taking certain medications or supplements that may cause liver toxicity.
• Stop drinking alcohol.
• Talk to your supervisor about changing duties if you’re exposed to chemicals in your workplace.
• Wear protective equipment if you work with certain chemicals.

Is toxic hepatitis curable?

In many instances, toxic hepatitis is curable. Your liver can replace damaged cells over time, reversing the damage that occurred. But if you have advanced liver disease like cirrhosis, you may be at risk for liver failure. Your care team may talk to you about liver transplantation.

How long does it take to recover from toxic hepatitis?

Toxic hepatitis recovery time depends on:

• How long you’ve had the condition.
• The damage to your liver.

If damage is mild to moderate, your liver may take a few weeks or months to replace the damaged cells and heal.

Can I prevent toxic hepatitis?

To help prevent toxic hepatitis:

• Avoid exposure to industrial chemicals that may affect your liver.
• Don’t use recreational drugs like cocaine or marijuana.
• Limit how much alcohol you drink.
• Carefully follow dosage instructions for over-the-counter medications.
• Talk to a healthcare provider before taking any supplements.

How can I lower my risk of liver toxicity?

You can help keep your liver healthy by making healthy lifestyle changes. While there’s no specific toxic hepatitis diet, what you eat and drink can help your liver work well. Try to:

• Drink fluids, especially water, to avoid dehydration.
• Eat plenty of fiber, including foods like beans and whole grains.
• Limit high-fat, high-sugar foods.
• Reduce your salt intake.

What can I expect if I have toxic hepatitis?

Talk to your healthcare provider about your liver health. Follow your provider’s instructions for how to take care of yourself as you recover from toxic hepatitis.

When should I call my healthcare provider if I have toxic hepatitis?

Call your healthcare provider right away if you have worsening symptoms of liver failure or symptoms of acute liver failure. These include:

• Dark or tar-like stool.
• Delirium.
• Jaundice.
• Loss of appetite.
• Sudden bruising (ecchymosis).
• Trouble moving.
• Vomiting blood.