April 22, 2026
Liver health
In this episode, hosts Carmenn Miles and Dr. Rajay Seudath welcome Dr. Amber Stephens for an insightful conversation on liver health and why it plays a vital role in overall wellness. They break down the essential functions of the liver, common conditions that affect liver health, and warning signs that are often overlooked. They also explore lifestyle factors, prevention strategies, and when patients should seek medical care.
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Show transcript
Podcast transcript
INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-host Dr. Rajay Seudath and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Dr. Rajay Seudath.
CARMENN MILES
Welcome, everybody. We're delighted to have you with us on the award winning Docs in a Pod presented by WellMed. I'm Carmenn Miles alongside our co-host for today, Dr. Rajay Seudath. As a reminder, you can find Docs in a Pod on any music podcast listening platform and you can also find us on the radio and several Texas and Florida markets. Each week we huddle together to discuss health and wellness topics, especially those that impact our senior community. Our goal each week is to share practical information on how we can all live healthier, happier lives, and hopefully to help us better manage some of those chronic conditions. We're thrilled you're spending part of your day with us today. If you're a regular listener, you're already familiar with our great co-host for today, Dr. Rajay Seudath, our resident celebrity on the show. Dr. Seudath is a board certified family medicine physician. He's a proud Tampa native and the lead physician at the University location for Optum. He brings so much passion to primary care. He makes health literacy sound so interesting and fun that you just want to keep learning more. Dr. Seudath, how the heck are you?
DR. RAJAY SEUDATH
Doing pretty good. Happy to be back.
CARMENN MILES
We're happy to have you back. We're happy to have Dr. Stephens back as well, our guest on today's show. She's no stranger to the show. Dr. Stephens is a board certified family medicine physician. She received her medical degree from Drexel University College of Medicine in Philadelphia, Pennsylvania, and completed her residency at Bayfront Family Medicine in Saint Petersburg, Florida. Dr. Stephens is affiliated with the Optum - main clinic. She's married, has two boys, two dogs, two cats, a bearded dragon, and the family's snake breeding business, of which is now up to 140 snakes. Last we spoke, you were at 40 something snakes. So, we've grown significantly. Dr. Stephens loves being a baseball mom, working out and does a lot of media educational presentations on behalf of Optum/WellMed. Welcome back to the show, Dr. Stephens. We've missed you.
DR. AMBER STEPHENS
Thanks for having me back.
CARMENN MILES
This is the first one for this year, right?
DR. AMBER STEPHENS
I think so. First for 2026. It's been busy. IÕm losing track of time.
CARMENN MILES
I know. This year is off and running. We're already in the second quarter. It's unbelievable. Today we're talking about an organ that quietly works for us around the clock. It rarely complains, and yet it's absolutely essential to our survival. We're talking about, I call it the metabolic control center, the liver, which is our largest internal organ. Am I right about that?
DR. AMBER STEPHENS
Yeah.
CARMENN MILES
Dr. Stephens, yesterday, I ask my liver how it was doing. Do you want to know what it said?
DR. AMBER STEPHENS
What did it say?
CARMENN MILES
It said I'm good, but as usual, I'm busy filtering your bad decisions. That's my attempt at a corny joke. But all jokes aside, the liver is proof that forgiveness exist, right? It rarely runs out of second chances for us when we make some not so great decisions. We'll get into that. Dr. Stephens, the liver is the ultimate multitasker. Let's just start from scratch, from the ground floor up. Let's talk about the liver and its key function within our body.
DR. AMBER STEPHENS
That's a very big umbrella.
CARMENN MILES
We can narrow it down.
DR. AMBER STEPHENS
I think most people are aware of the liver in regard to, if you drink too much alcohol, it's in charge of filtering those kinds of decisions. I think people are somewhat aware because of that, that it tends to filter out toxins and does a lot of metabolic work on that end. I think people are maybe less aware of how it affects your actual metabolism, your insulin, your sugar, your digestion. It makes bile so you can break down your food. It breaks down all your medications. I mean, obviously the kidneys play a role there, too, but it's a huge player across the board. It just kind of, like you said, never really stops doing what it's doing. So, it's very important, but it is a very big multitasker.
CARMENN MILES
Very much so. Dr. Seudath, do you want to add to that a little bit?
DR. RAJAY SEUDATH
I think you guys hit it on the head. Exactly right. It's one of the major detoxifying organs of the body. I think that's how most people think about that. You know, something's going on in my body, my liver is going to get rid of it for me. Like Dr. Stephens said, it's the liver and the kidneys play a role in excretion, getting rid of drugs, those kind of things.
CARMENN MILES
Very good. Let's take a moment to welcome those who may have just joined us. You're listening to the award winning Docs in a Pod presented by Well WellMed. I'm Carmenn Miles alongside co-host Dr. Rajay Seudath and our guest for today's show, Dr. Amber Stephens. Our podcasts are available wherever you listen to podcasts. You can also find us on the radio and several Texas and Florida markets. Today, we're discussing the largest organ in the human body. Your liver, your life. What everyone should know about liver health. I want to jump into the biggest threats to liver health today. We often hear about the effects of alcohol consumption over time and the effects that it may have on the liver. But there are other things that affect our liver as well. You mentioned, it's a huge umbrella in terms of talking about how the liver functions and all the functionality it has within the body, but what are some are some other threats outside of alcohol? Obviously, you can touch on alcoholism, but what are some other threats to our liver function?
DR. AMBER STEPHENS
Yeah, drugs and alcohol are major impactors. I hate to say this, but a lot of people can drink and their liver keeps up just fine. We donÕt often tell people that because then they're like, oh, we're good. That can be obviously a major player there. As far as what I'm seeing, and I would assume Dr. Seudath is the same thing since our patient population is obviously quite similar, we're seeing patients that are metabolic patients. They are morbidly obese, they're diabetics, and people in that situation, a lot of times, I don't think they realize how much of a role their liver plays in that game. Their ability to balance insulin and sugars, their ability to manage body fats, etc. It all kind of comes back to how well the liver is functioning, and the liver itself does take a hit when we are obese, when we eat too many carbohydrates, too many sugars. In fact, unless you're in the situation, you may not even be aware of how much fatty liver plays a role. I would argue fatty liver is a much bigger insult, and is directly related to body mass and dietary, especially if someone has high cholesterol, high triglycerides. There's a good chance have high fatty liver, metabolic syndrome. If someone were going for bariatric surgery, the diet two weeks before the bariatric surgery actually isn't to get the patient to lose weight, it's to shrink the liver so that when they go in to do the surgery, they can actually lift the liver out of the way and have a safe surgery. The longer you have a fatty liver, the more inflamed it gets. It creates a hepatitis all on its own. It's not infectious. It's not like getting hepatitis C or anything like that, but it's an inflammation. So, you can get a fatty liver that's inflamed, and over time that can cause scarring, that can cause dysfunction and damage. And it affects how you then proceed to manage things like sugars and insulin and then you canÕt even metabolize drugs as well as you used to and it can still put you at risk for cirrhosis just because you are obese.
CARMENN MILES
You mentioned hepatitis A, B and C. Is it all that that we should be concerned about?
DR. AMBER STEPHENS
Those are your major viral players. I mean, there's like that Delta agent thing. Especially with B and C, you're getting back into more of that drug environment. It's more of a I.V. drug thing or sexually transmitted. C we think maybe drugs but it's still kind of not 100% sure how people end up with that. You can sometimes connect dots, sometimes you can't. A is food borne. It's fecal oral. So, you hear about these outbreaks of hepatitis A, it's usually related to produce issues where it came in from unclean produce. The hepatitis of itself is that it's inflamed. So, just like we would use the term pharyngitis to represent a sore throat or a sinusitis or represent a sinus infection, it's inflammation. It's something is hot and angry and it's not it's not happy, so we need to figure out a way to make it happy as we can. So, in the case of a viral hepatitis, if we have the opportunity to treat, we can treat. Some of it's just supportive and let the body try and take care of it. When you start talking about fatty liver, and you're starting to talk about what we call as a nonalcoholic steatohepatitis, which are very big words for fatty liver that's angry, the answer is weight loss. The answer is reducing the carbohydrates in your diet so that you have less simple sugars running in and out. ItÕll store sugar as triglycerides or fats in your liver because it's running out of room to put it in other places. It's trying to get it out of the bloodstream and it's just storing it. So, if you aren't consuming as much, then your body has an opportunity to use what it's stored. Now it's reducing that inflammation. It's making it a little happier. So, in this case it's really a lifestyle change that helps manage it.
CARMENN MILES
I read just preparing for this podcast how there's some prescribe medications out there that can be damaging to our liver if taken over a period of time. What I was surprised to learn, and you can tell me if this is accurate information or not, that there are some herbal and natural supplements out there that we take to supplement our diet that can also be damaging to the liver. Is that accurate?
DR. AMBER STEPHENS
Well, I think most things that we take, food or otherwise, a lot of supplements, medications, a lot of it is risk versus benefit ratio. How many of our patients are taking statins? We can run down the rabbit hole with that if we wanted to, but the reality is that they can be liver toxic as well. The challenge with some of the supplements and vitamins and stuff thatÕs out there is that they're not. You need to verify where you're getting them from. Some of them can have additives that can cause issues as well. In terms of specific supplements, I have really more seen people taking things like milk thistle to help as opposed to hurt, but anything can be at risk.
CARMENN MILES
Very good. We need to take just a quick break, but please stay with us as we continue this great discussion on liver health. You're listening to Docs in a Pod presented by WellMed. We'll be right back.
AD
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CARMENN MILES
We're back on Docs in a Pod presented by WellMed. I'm your host, Carmenn Miles, along with co-hosts Dr. Rajay Seudath and our guest today, Dr. Amber Stephens. Today we're chatting about the largest internal organ, our body's metabolic center, the always on duty, the great multitasker, our body's livers. We're talking about our livers. Before the break, we touched on medicines and even some of these supplements that are out there that could, over time, become harmful to the liver. Dr. Seudath, I know you had a few that you wanted to mention that could be problematic over time. You want to share with us?
DR. RAJAY SEUDATH
Yes. In the past several years, ashwagandha has become more popular because there are more companies that are making it more available to people. Tumeric in pill form or even fresh has become something that helps with chronic inflammation, joint pains and things like that. In a moderate to and a moderate amount, that is helpful. They do have good evidence to show that they can help people with some certain issues. But if the bottle says take one capsule, well, if one is good, 10 is better. That's the kind of things that we frown upon. We want to make sure patients are not harming themselves, especially if they already have liver disease. So, if a person has diabetes, they have fatty liver, they have heart failure, they have COPD, they have these kinds of things, and then they're going to start taking supplements on top of their other medicines. We want to make sure that one, there's not going to be interactions, and two, making sure that taking it in a dose moderated form. So, that was one of the things that I've seen happen, and it's one of the things that can be an issue.
DR. AMBER STEPHENS
Yeah. Baseline environment and making sure that everybody's on the same page goes a long way.
CARMENN MILES
That's why you guys pound into us. Let us know what you're taking. Are you taking any supplements? What have you added to your regimen? ThatÕs something IÕve learned over the years. It's very important.
DR. RAJAY SEUDATH
I tell them I want you to tell me everything you put in your body for a healthful benefit. That's kind of the umbrella for anything and everything.
CARMENN MILES
I like that. It makes them think broader and they don't forget about those little supplements that they're taking regularly. That's good. Dr. Stephens, I want to get into some of the warning signs. If there is an issue with our liver function, are the symptoms pretty apparent most times, or is that just something that comes out through blood work or some other test? What are some of those symptoms that we should be aware of that are obvious?
DR. AMBER STEPHENS
If you have a quick onset or what we call an acute onset of liver inflammation, where it's being caused by a virus like one of our hepatitis A B Cs. There are other types out there, and we talked about fatty liver, but in terms of like autoimmune, a lot of those things tend to kind of hit hard and heavy really quickly. So, you're going to see the fever, the nausea, the vomiting, belly pain, appetite. You're going to see a lot of the stuff that people think of when they think of hepatitis like yellow eyes. I think people are always looking for. People who glow in the dark, that kind of thing. I would say if you see those things happening, by all means talk to your doctor because it's not normal to have yellow eyes. It's also not normal to have kind of like a yellow tent to your skin. If you're having problems with nausea or vomiting, obviously. Even if you're just not as hungry as you used to be or youÕre having some weight loss, dark urine, those are things that can indicate there's a problem that we need to be exploring, quickly. So, when we start talking about some of those slower inflammations, more related, like the fatty liver, you may not see some of those things right off the bat simply because it's just such a slower process. It's this kind of low level irritation as opposed to this big explosion inflammation that occurs with the other processes. So, you may not see a lot of those things. What we see as physicians is we're going to do your blood work. So, we're going to potentially see things like, hey, your liver enzymes are elevated, so obviously something's not happy. That'll give us the design that we need to then move forward and do follow up testing and figure out what's going on. There are other things that can also cause the liver to be angry that we would be testing for besides the viral hepatitis, besides looking at fatty liver, we'd be looking at things like copper levels, iron levels. There are some other viruses like Epstein-Barr, cytomegalovirus, those kinds of things can all make the liver go up and enzymes as well. We need the mean to figure out what's causing the problem, as well as do a really good look at medications and supplements because then, maybe there's a medicine that's causing a problem that we need to hold. Maybe there's a supplement we need to nix for a month and then see if things calm down. The good news here is that if you catch things early, the liver is very forgiving and very regenerative, and we can get back to where we need to be pretty quickly if we need to.
CARMENN MILES
I know. I found that interesting too. So, it does regenerate over time if we can catch some of these things early on?
DR. AMBER STEPHENS
Absolutely. I would say regenerate, yes, but also, it's forgiving. It heals. When you start getting into conversations about liver transplants and stuff like that, if someone has to undergo something like that, then they don't have to get a whole liver to be completely functional, which is amazing. Not only that, the liver will grow to what the patient needs. So, it's amazing. In the world of organs, it's amazing, but it has signs when it's bad really quickly, but sometimes it's just better to be on top of things and make sure you're having conversations with your physician and making sure things look good.
CARMENN MILES
The body is truly remarkable. I see you shaking your head, Dr. Seudath. Do you want to add to that or are you just agreeing with Dr. Stephens?
DR. RAJAY SEUDATH
Definitely agreeing. Trying to catch these things early. Even for hepatitis C, we actually have a cure for hepatitis C, which was Harvoni. I remember a long time ago, it was just interferon and you had these treatments that that didn't really work. Now we actually have a cure for that disease. Sometimes we get some flack that, oh, they don't cure any diseases anywhere. No, they got they got that one under control. But again, hepatitis B, hepatitis A, if a person has a chronic infection that can cause inflammation of the liver that progresses. So, I wanted to touch a little bit on that progression. Let's say we didn't catch it early. Let's say it is progressing. What are some of the things that we can do? What are the things that we can look into? What we see is that progression of hepatitis that's kind of moving into cirrhosis. What cirrhosis is, is the blood doesn't really flow through the liver. So, your heart pumps the blood to your lungs, comes back to your heart, goes to the rest of your body, then it goes to your liver, then it goes back to your heart. So, when itÕs going from your body to the liver, if it has cirrhosis, it can't really flow through that organ. So, it backs up everywhere and we get a lot of fluid retention, sometimes in the abdomen, sometimes in your legs. So, that's when you could have changed things with your lifestyle, now you have to change things because there's no turning back on that point.
CARMENN MILES
Yeah. Let's talk about some of those things that we can do as patients to protect our livers, even though we've learned maybe our liver is not in great health. Before then, for those of us who want to be on top of things and make sure that our liver is in good health, what are some of the things that we can do to protect our liver? You mentioned some earlier.
DR. AMBER STEPHENS
Things that we can do, obviously avoid the things that are toxic. So, if we know there's an issue, let's not be drinking alcohol. Let's start there. Let's make sure that we're running all of our supplements, all of our medications past our physicians, making sure that we're not doing anything that could be causing problems. There are some good ones for detoxification. Milk thistle is really good for liver detoxification and can be started safely. But once again, let's have a conversation about it and make sure everybody's on the same page. Then making sure that you're doing the things that your body needs to support healing. Make sure you're eating well. Make sure that you're drinking your fluids. Make sure you're getting enough protein. Particularly patients who have liver issues tend to have problems metabolizing all the proteins your body needs because the liver kind of makes all those things. So, you start looking at, hey, look, I'm getting I'm having trouble with bleeding. I'm having trouble with my blood pressure. But it's the proteins the liver makes that helps control a lot of those things. So, making sure that we're giving the liver whatever it needs that whatever still functioning can do what it can. Then obviously, if you're getting to the point where it's not functioning as well as it should be and potentially your candidate, you can talk to a physician. At this point, you're probably seeing a gastroenterologist or a hepatologist, and they can talk to you about whether or not you'd be a candidate for something like a liver transplant, but that's very far down the road and thankfully, a very small population of people that would even need to have that conversation.
CARMENN MILES
Dr. Seudath, last words?
DR. RAJAY SEUDATH
CARMENN MILES
The moral of the story is exercise. Keep the fatty liver under control, prevent it. If there's not so many triglycerides and cholesterol, some fats in your bloodstream, because you're living a healthy life, it won't accumulate in your liver. So, that's kind of the thing that we're looking for.
DR. AMBER STEPHENS
Absolutely.
CARMENN MILES
Very good. Well, listen, we are out of time. The bonus is by incorporating some of these healthy habits, we're not just protecting our livers. We improve our heart health, our metabolic health, and our overall longevity of life. So, thank you so much for being here, talking about our livers and how resilient and essential they are, but not invincible. So, we must pay attention to the warning signs. The good news is that many liver diseases are preventable and early action really makes a difference. Thank you both for being on the show today. We just want to thank all of our listeners. Please, if you have family and friends that could benefit from this information sharing is caring. Share this podcast with them. Remember, you can listen to Docs in a Pod wherever you get your podcasts, and you can also catch us on the radio and several Texas and Florida markets. Thanks again for joining us. Until next time, stay well.
OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.
DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.
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