Liver Functions: Detoxification, Metabolism, Storage, Bile Production, and Clotting Regulation

The liver performs over 500 vital functions. Key roles include:

• Detoxification: Metabolizes drugs, alcohol, toxins (Phase I/II reactions); converts ammonia → urea.
• Metabolic Regulation: Gluconeogenesis, glycogenolysis, glycogenesis; lipid synthesis/oxidation; amino acid deamination.
• Storage: Glycogen (glucose reserve), vitamins (A, D, E, K, B12), iron (ferritin), copper.
• Bile Production: 600–1000 mL/day; emulsifies fats, excretes bilirubin, cholesterol, drugs.
• Protein Synthesis: Albumin, clotting factors (II, VII, IX, X, fibrinogen), complement, carrier proteins.
• Immune Function: Kupffer cells clear gut-derived bacteria/endotoxin; acute-phase proteins.
• Hormone Regulation: Degrades insulin, estrogen, cortisol; produces IGF-1, thrombopoietin, hepcidin.
• Blood Filtration: Portal blood from gut → liver before systemic circulation (first-pass).

Liver dysfunction manifests as coagulopathy, encephalopathy, ascites, jaundice, hypoglycemia, and immune compromise.