There are many signs of alcoholic liver damage, especially towards the end-stage of the disease. However, most people don't recognize the early signs. That's because they are vague and confusing and overlap with many other illnesses.
In fact, one of the first signs is excessive fatigue. Of course, this sign likely wouldn't alarm anyone because honestly, who isn't experiencing fatigue right now? However, the fatigue of liver damage feels a bit different than regular tiredness.
How do I know this? I am a former nurse and recovering alcoholic and I lost my father to alcoholic liver disease 6 years ago. Since I was quite close to my father, I had the sad experience of watching his symptoms from the very beginning until the very end. I remember clearly that fatigue was the first noticeable symptom that something wasn't right, and it showed up about 15 years before his death.
Looking back, I am amazed that his liver damage began so long ago yet only became glaringly obvious towards the end of his life. However, this is fairly common in liver disease as it's a hearty organ that can withstand a lot of damage before it finally gives up.
With liver disease, especially alcohol-related liver disease, it's very difficult to piece together all the confusing symptoms that crop up slowly over the years. Often, it's only when we look back at the patterns that we can see how it all plays out. This was definitely the case for my father. And when I look at the trajectory of my own drinking, I can see that I was following a similar pattern as well.
Since the liver is so involved in metabolic, immunologic, hemodynamic, and digestive processes, the symptoms of damage may seem varied and nonsensical. Liver symptoms are different than say cardiovascular symptoms. The heart has only one job, to pump blood through the body. With an action as straight forward as that, any damage is quite obvious. This is not the case for the liver.
So when the liver begins to get damaged, it's as if all of its functions slow down a little. Hence, why we feel fatigued and slowed down. It takes a very long time for the liver to actually reach a point of failure because it's one of the only organs in the body that can repair itself. The liver will keep fighting and fighting until it has no more healthy cells left.
In a sense, the fatigue of liver disease is a sign that the organ is just fighting to stay afloat and perform all of its functions while also trying to keep up with repairing itself. This process can go on a very long time, as it did with my father.
However, as the years pass, if there is no decrease in drinking, the alcohol will eventually damage all the liver cells one by one until it comes tumbling down like a house of cards. This is literally the best description I can think of to describe what I witnessed in my fathers death from alcoholic liver disease.
However, it's become clear to me that once we begin to understand the earlier signs of potential liver damage, we can prevent liver failure before it takes us by surprise. If I can help even one person to figure out their symptoms, then I will consider it a job well done.
If you are a heavy drinker and experiencing crushing fatigue that seems unusual or out of character for you, it might be time to visit your doctor and let him or her know how much you drink. If you want to live a full life, it's also time to consider seriously cutting back your alcohol intake or quitting altogether. Of course, you have to want to quit and that can be a serious challenge for people who drink heavily.
My father told me on his deathbed that if he had known he was in trouble all those years ago, he may have taken steps to curb his drinking or get sober. He just never thought anything bad would happen. He used alcohol to cope with his depression and traumatic childhood and thus, he had a very hard time giving it up. I understand this because I also used alcohol to cope with depression. And I can't tell you how hard to was to watch my father slowly destroy himself over the course of my life.
In any case, I managed to get sober; it was extremely difficult but I did it and so I know it's possible. For anyone struggling with fatigue and other vague health signs, the first step is to talk honestly with your doctor. The next step is reducing or quitting alcohol use.
The more we understand how alcoholic liver disease manifests, the better decisions we can make.