Nearly 4 million people in the United States have been diagnosed with some form of liver disease, whether it be hepatitis, cirrhosis, an autoimmune disorder, or an inherited metabolic disorder.

The scary thing about liver disease is that many patients don’t feel pain or discomfort in its earliest, most treatable stages. All too often, folks are forced to face pain and suffering, loss of work, the prospect of a transplant surgery, or even death when something could have been done with an earlier diagnosis.

Just the same, there are some symptoms associated with liver disease that are completely perceptible. Here are 7 subtle — and not-so-subtle — ways your body may be trying to tell you that it’s time to get your liver checked!

1. Your skin or eyes appear yellow

   Although this condition is relatively common in newborns, adult jaundice is a completely different animal. The yellowing of the eyes and skin can be caused by allergic reactions to medications, but doctors usually check for liver-damaging viruses, like hepatitis B and C, first.

2. Your urine is dark in color

   Unless you’re in a constant state of dehydration (which isn’t something to aspire to!) or you are on medications that turn your fluids psychedelic hues, your urine should not regularly be an orange or brown color.

   Darker-than-normal urine could be an indication that the liver is having trouble breaking down bilirubin, an issue that is commonly seen in those who are experiencing liver failure. If this symptom is coupled with pale, bloody, or tar-colored stools,  it’s definitely time to see a professional.

3. Your skin is itchy

   One of the hallmark symptoms of liver damage is intensely itchy or very dry skin. This happens because when the organ is in a state of decline, it’s unable to break down bile deposits. With nowhere to go, these deposits can end up being expelled from the epidermis.

   Itching is definitely one of liver disease’s sneakier symptoms but for many, it’s also one of the most obvious—and uncomfortable— ones.

4. You bruise easily

   Sure, we all suffer bruises from time to time, but if yours seem to pop up out of nowhere at a high frequency, then it could mean that your liver function is not where it should be.

   Bruising and, in more severe cases, uncontrollable bleeding occurs in liver disease patients because the damaged organ is unable to produce the compounds necessary for clotting. Proof that mysterious bruising should never be overlooked!

5. You are tired all the time

   We know, we know— fatigue is one of those symptoms that seems to be found in virtually every condition or disease profile, but when it comes to the topic of the liver, it’s a big one!

   Doctors think this happens because so many liver disease patients suffer from malnutrition and even hormonal abnormalities, two things that can contribute to body weakness and lead to chronic fatigue.

6. Your weight is fluctuating

   If weight is either piling on or falling off without you having made any major changes in lifestyle or diet, then your liver may be to blame.

   Weight loss can occur because bodies with failing livers have a hard time metabolizing nutritional components like carbohydrates, lipids, and proteins. In terms of mysterious weight gain, dense, high-in-fat bile that gets recirculated through a sluggish or underperforming liver could be the culprit.

7. You are running hot

   Though the causes of liver disease can vary, one common thing that doctors see in many of their patients is a high fever. Because the organ is not functioning properly, some sufferers see an increase in endotoxins in the blood, bad stuff that, when not sufficiently cleared by the liver, can force the body to reach unhealthy temperatures.

   In addition, patients who suffer from cirrhosis due to alcoholism have compromised immune systems that are not equipped to stave off infections. This detail can, of course, cause these patients to fall sick more frequently.

Definitely signs that you should NEVER ignore! We’d like to hear your thoughts on this subject. Have you been diagnosed with liver disease or liver failure? If so, what caused you to develop this condition? What does your personal medical plan entail?