Root Causes of Chronic Fatigue, Part 11: Your Sluggish Liver

Health Tips / Root Causes of Chronic Fatigue, Part 11: Your Sluggish Liver
Sluggish Liver

Spread your left hand across your upper abdomen. Beneath it lies your liver, the largest organ in your body. Liver metabolism is so complex that the late medical essayist Lewis Thomas, MD, wrote “Nothing would save me and my liver if I were in charge…for I am considerably less intelligent than my liver.”

And yet until this very moment you might not have given your liver much consideration. That’s because it’s so good at its job that it rarely tells you that something might be wrong.

But there is one warning symptom that something might be amiss with your liver and that is fatigue. 

Although the common liver tests (among them ALT and AST) are included in the metabolic profile done during routine blood tests, they often return completely normal results while deep inside your liver is behaving sluggishly.

Your liver has three major functions: detoxification, metabolism, and storage. Each is essential.

Detoxification is exactly what it sounds like. All the toxic chemicals you come in contact with–from inhaled diesel fumes and the chemicals that lace processed foods to prescription and recreational drugs, including your vodka martini, and even the Omicron variant you just inhaled–are carried into the liver’s blood supply (this remarkable organ processes 1.5 quarts a minute or 25% of our cardiac output) and then deactivated, rendered harmless, and excreted. This is what happens when your liver is working correctly.

Metabolism: At the same time that it’s busy detoxifying, your liver is at work metabolizing, which is to say “making things.” It converts fat to energy, glucose to fat, and fat to phospholipids. It manufactures albumin, globulin, bile for digestion, cholesterol for sex hormones, and a whole lot more.

Storage: Inside your liver are stored reserves of energy (saved as glycogen), vitamins (A, D, and B-12), and iron.

Sluggish liver

The term sluggish liver is taken from Functional Medicine. I learned nothing about it in medical school. As fledgling doctors, we learned about liver diseases like hepatitis, fatty liver, cirrhosis, and liver cancers. But sluggish liver was not part of the curriculum.

You get sluggish liver by not paying attention to your health and well-being. It’s caused by chronic, low-level neglect catching up to you.

The symptoms of sluggish liver are vague and patients often see a variety of specialists who treat the symptoms but never get to the root cause. Here are the top symptoms:

  • Fatigue, sluggishness, listless, restlessness, and apathy.
  • Depression  Mood swings, PMS, anxiety, irritability, and poor focus and concentration.
  • Food and chemical sensitivities  Nausea, weight problems, breath issues, bloating, high-fat food intolerances, bitter taste, constipation, excessive gas, and GERD (heartburn).
  • Skin problems  Dry skin, acne, itching, excessive sweating,  peeling, and hair loss.
  • Muscle and joint aches.

What you can see immediately from this list is that people with sluggish liver feel generally unwell day to day, often for months. In between appointments with specialists, or waiting to be scheduled for various diagnostic tests (all negative), the period of not feeling well stretches on. Finally, you might hear the inevitable: “Maybe you’re just depressed.”

If, while reading this Health Tip, you were wondering if you have a sluggish liver, consider this. If you feel great, if you’re energetic, active, and take good care of yourself, eating a healthy whole-food diet, keeping your alcohol intake moderate and your sugar/refined grains to a bare minimum, and taking a few carefully selected nutritional supplements, my answer is “You’re just fine.”

Patients with a sluggish liver simply don’t feel well.

Diagnosing sluggish liver

As I mentioned, most of the time liver function tests are normal. Your liver has a remarkable capacity to keep going even under dire conditions.

Over the years, various tests measuring your liver’s detox capacity have come and gone, but none has ever been so reliable as simply undergoing your own personal detoxification and seeing how you feel afterwards. Here’s a sentence that clinches the diagnosis of sluggish liver: “I did a detox. It was really tough at first, but when it was over I felt as good as I’ve ever felt in my life.”

For those interested in the history of medicine, the concept of detoxification actually goes back hundreds of years, following then the same basic principles as it does today. You free your body of “disturbing elements” (toxins) while feeding it good balancing habits, healthful foods, nutritional supplements, and low stress.

One of the most famous detox centers was up in Battle Creek, MI, founded by John Kellogg, brother of the cereal magnate. Today, there are dozens around the world. We call them spas.


The best detoxification products are the Ultra Clear family formulated by the Father of Functional Medicine Jeffrey Bland, PhD.

I’ve been recommending UltraClear products for more than 25 years, though I admit I was a bit put off by their original advertising logo—the UltraClear banner drawn flying above what appeared to be downtown Gary, Indiana, complete with towering smokestacks. The banner read, “You need UltraClear!”

You can start with a ten-day detoxification, called Clear Change. However, if you have a lot of symptoms and you think your liver is especially sluggish, you could go for the full Clear Change 28-day Day Program, though a 28-day detox is challenging.

By the time you’ve completed your detox, however long, you will have learned a great deal about healthful eating. Both the ten- and 28-day Clear Change programs contain menu plans and shopping guides. You’ll learn to make good choices from these, but it’s also helpful to schedule an appointment with Becca Zachwieja, our nutritionist.

Afterwards, for maintenance, I recommend starting two supplements: Detoxication Factors and Lipotropic Complex, both by Integrative Therapeutics. Take one of each twice daily. These two products contain herbs, vitamins, and amino acids formulated to support all aspects of healthy liver function.

Your liver will be deeply appreciative and your sluggish liver will be history.

Be well,

David Edelberg, MD

4 thoughts on “Root Causes of Chronic Fatigue, Part 11: Your Sluggish Liver

    Hello there, I have been diagnosed with a fatty liver. I have never drank alcohol or smoked in my entire like. I am more of a carbohydrate girl as most things do not agree with my stomach. I also have fibromyalgia and chronic fatigue which is getting worse not better. Would the detox be a good idea for me, my liver and my other issues?
    Thank you,

    Judy Elsey
    Posted May 26, 2022 at 5:19 am

      Hi Judy,
      Sounds like you have a few conditions we can help you with. Please feel free to give us a call at 773-296-6700 to schedule an appointment.

      WholeHealth Chicago
      Posted May 27, 2022 at 9:55 am

    I don’t have many of the symtpoms for liver issues. However since covid I have increased my alcohol consumption greatly. With that I want to decrease and wonder if the supplements mentioned will help without doing the detox?

    Connie Bailey
    Posted February 16, 2022 at 10:19 am

      Hi Connie,

      You’re certainly not alone here! Depending on your health history and any other symptoms, some of these supplements may be helpful. If you feel like you need some assistance in creating a plan to reduce alcohol consumption and get healthier, any of our functional medicine clinicians can help! Please give our patient services staff a call to set up an in-person or virtual visit. 773-296-6700.

      My best to you!
      Dr M

      Posted March 18, 2022 at 9:48 am

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