a cartoon pair of anthropomorphic lungs, has fists and is punching down at the liver

COPD and Liver Disease - Could One Be Causing the Other?

Last updated: June 2023

Alpha-1 Antitrypsin Deficiency is a condition that may result in serious lung disease in adults and/or liver disease in infants, children, or adults. This condition is passed on from parents to their children through genes.1

Not just my lungs

When I was diagnosed with Alpha-1 in 2010, I thought it was only my lungs that were affected. I have emphysema, asthma, and chronic bronchitis in my lungs and later found out that I have liver fibrosis (beginning stages of cirrhosis) and had fatty liver. The reason that having Alpha-1 affects the lungs and liver is that my body doesn’t produce enough Alpha-1 protein to protect my lungs, and the little bit that it does produce misfolds and gets stuck in the liver causing liver damage.1

Learning about liver damage


I would have never known about my liver damage if it wasn’t for the liver study that I was enrolled in for 5 years. I was enrolled at St. Louis University Hospital. The reason for the study was to monitor the liver and see how or if it would decline in those 5 years.

Many tests

They did many tests. The first year and fifth year I had to do a liver biopsy, PFT (breathing test), liver FibroScan, blood work, and a liver ultrasound. Years two through four I had to do everything but the liver biopsy and FibroScan. All of the bloodwork showed that it was normal, but in the other testing, it showed that I had fatty liver and liver fibrosis.

Liver doctor

I think this shows that it is important to have at least one good checkup with a liver doctor with all of those tests and continue every year after that like is suggested by the Alpha-1 Foundation.1

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Signs of liver disease

Some signs of liver disease are:1

  • In infants, jaundice that lasts more than a few days, diarrhea, and lack of normal weight gain.
  • In children, doctors may find an enlarged liver or spleen on an exam or parents may find a swollen belly. Liver scarring can also lead to ascites (swelling of the abdomen caused by fluid buildup), and intestinal bleeding.
  • Adults can have any of the above and also feel weak and tired.

Other things and more information

Another thing that I had learned while being enrolled in the five-year liver study was that with my lung damage from emphysema, my lungs are enlarged. They pushed down my diaphragm which also moved my liver down. This is something I will be sure to mention to all my doctors when they are examining me for other reasons. I also have to get blood work monthly because I take medicine for my rheumatoid arthritis that can also affect my liver.

I hope that this has helped you understand how the liver can be connected to COPD. If you would like more information about liver disease, you can find it at the Alpha-1 Foundation, American Liver Foundation, and Children’s Liver Disease Foundation.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The COPD.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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