Why Is Toxic Liver Disease Rising Across Every Age Group?

Added: 2026-05-11

[00:00:00]Uh good evening again. Thank you for joining me. I'm Dr. Philip McMillan and I continue to analyze the data post pandemic. I have the privilege of being able to understand in detail what happens in hospitals and I've taken nine years of hospital data to analyze and to look for trends post pandemic. It seems I'm one of the few people who is doing this and very few people have been looking at these kind of statistics and I think that this is probably why there is an underestimation about what is going on at at this time. I have been saying for years that clinical presentation is changing and quite rapidly and without this kind of data it's very difficult to make a case. So what we're doing is sequentially going through specific areas that I think are important with unusual patterns and trying to make sense of them. So without further ado, I'll get straight into the presentation. If you're on YouTube, you'll see the first part of this presentation. Those people who had registered will continue with me and to listen to the full presentation. Look out for links if you want to see the full thing as well as the dashboard which looks at the liver trajectory across the UK population. So let's get uh straight into it.

[00:01:35]Toxic liver disease is rising across every single age group and this is based on the UK hospital episode statistics between 2016 to 2025.

[00:01:50]And before we start, just an important disclaimer that this is information that is being shared based on my research, but it cannot uh it cannot replicate you going to see your doctor or your emergency department if you are unwell.

[00:02:07]And so this is for your information only.

[00:02:11]One liver code has changed its shape since 2020.

[00:02:17]And this one does not fit a single toxin explanation. This is an important point and what I'll be hoping to get through in this presentation by the time you are finished is I'm covering an a few important points. Overview of what I consider to be the three primary drivers for this increase in toxic liver disease.

[00:02:42]looking at the three drivers gut immune, metabolic and hippattotoxic exposure.

[00:02:48]Then looking at how this liver injury could translate into the symptoms that people are feeling and broad practical strategies that could be used to help people mitigate or um get around some of these risks. And so this is essentially what we will be going for. And this is the reality that has been happening is when we look at toxic liver disease and I'll explain this in a little more detail as to what exactly this is making reference to. This has had a 189% increase in terms of hospital admissions from a baseline between 2016 to 2019 compared to where it is in 202425.

[00:03:40]We have not seen that in any other liver coal.

[00:03:44]And the drivers as I mentioned I'll go through in more detail. The problem is is that most people will sit in overlap zones. they are not necessarily in any specific one and this is part of what makes it very difficult to understand and I'll be looking at the five pillar resolution framework mapped to these general drivers and what they mean.

[00:04:10]You have to understand that your liver is critical critical for health and it will help you throughout life to be able to um remain well. When we look specifically at what has been happening by age cohort and so this is the first thing is because I've mentioned age when you look across the age groups you can see that this is pretty significant.

[00:04:37]Each line represents an age cohort. 18 to 29 in blue, 30 to 44 in orange, 45 to 59 in green, 60 to 74 in red, and over 75 in purple. Every single one is rising. It's interesting that 18 to 29 remained stable up till 22 23 and then started to rise in an unusual way. Prior to that it seemed as though it was decreasing and now suddenly starts to increase. So across every single age group we are seeing this kind of pattern. But what really is going on?

[00:05:19]What is it and why would it be happening? That's really the question that we're trying to understand. When you think about the liver, it is absolutely essential for life.

[00:05:32]It does multiple um um critical actions in in your body. Breaks down glucose and carbohydrates, vitamin storage, immune function, metabolizes proteins, bile production, and drug and toxin detoxification as well. All of those things are absolutely critical in terms of what your body will do. And the liver is a central part of that specific mechanism that we are seeing when we look at the liver patterns that are occurring. You can see here that across multiple conditions and so this when I did the analysis then looked not just at toxic liver disease which went up 189% compared to just liver disease went up by 49%.

[00:06:28]Heart attacks, knee operations, hernia operations, they are all up but not 189% increase in the past 9 years. That's three times faster than the overall liver disease. And this is looking at 1,200 ICD codes. Huge volume, 186 million uh cases. And this K71 ranks in the top 1% for post-pandemic growth. We'll be going through exactly what K71 is in just a minute. But what are these ICD codes and why are they relevant in terms of what we're looking at? ICD means international classification of diseases and it's it's a standardized diagnostic label. So all across the world we use these ICD codes.

[00:07:22]It doesn't matter what country you're in. And it then helps us to be able to understand patterns of disease across countries. And every hospital admission will receive at least one of these ICD codes. So we can then look at disease trends across the population, how it has changed over time like exactly what I've shown and how it connects with other conditions looking at emerging public health uh signals. And the one we're looking at in detail is K71 or toxic liver disease. So this is a critical piece of the question. What really is it and how does it fit in terms of why we could be seeing this kind of presentation?

[00:08:09]When we look carefully at toxic liver disease, it is one of the ICD codes looking at liver injury linked to substances like drugs, alcohol, supplements, environmental exposures.

[00:08:23]And there are nine subcodes which I will show you.

[00:08:29]of K71 which covers cell damage uh choleistasis and fibrosis. The two of the subcodes that are standing out are K71.6 for hepatitis and K71.9 toxic liver disease unspecified.

[00:08:48]Those two codes are where most of the growth is concentrated. And when we look carefully at the family and this is what the family of um ICD codes for K71. So K71 is toxic liver disease.

[00:09:07]These are all of the codes. They give a 0.1 to break it down further. So they specifically look at say conditions with impaired bile flow that's K71.0.

[00:09:19]Hippatic necrosis death of cells K71.1 acute hepatitis. Sudden onset point 2 hepatitis where not elsewhere classified. So that's liver damage where we can't quite see if it's infection or otherwise gets classed as K71.6.

[00:09:38]Fibrosis is 7 and unspecified liver disease which is not necessarily a hepatitis coded as.9.

[00:09:48]These two 6 and 0.9 seem to be the ones that are rising in a way that doesn't make sense. And so when you look carefully at it, and I'm going to show you what the subcodes look like.

[00:10:04]So now that you understand what it means, you can then get a better grasp as to how this fits. So here we have the K71 sub codes.

[00:10:16]Red represents K71.6 with hepatitis, not elsewhere classified and brown is K71.9 unspecified.

[00:10:26]You can see that they were all hanging about down here and there is a minor rise for some of the other ones like acute hepatitis, but this has shot off the scale. hepatitis not elsewhere classified and unspecified damage to the liver, toxic liver disease. These two codes represent the ones that are standing out. And so when people are talking about it, what you have to remember is that you have to look beyond the surface because they will tell you straight away, okay, this is just something like um alcohol liver disease or something like that. No, that's not what the codes are telling us. And actually, we know that people are drinking less than they used to. But here is a little bit of hisytologology so that you understand what the liver represents. When we look at the liver, it's broken down into these lobules. So these are multiple lobules here within the inside of the liver. And when you break down the lobule, you then realize what's happening with the liver. It's like a massive civ. Blood comes in in the artery here.

[00:11:43]This blue here represents the portal vein. So it is collecting blood from the intestine. So the blood coming from the heart, blood coming from the intestine mixes together and then they come out of this vein into the portal vein.

[00:12:02]Bile is green and this is where you produce your bile. So this civ literally filters most of the blood coming from your intestine as well as a proportion of the blood coming from the heart. So this is the purpose of this liver. It really is a filter to clear rubbish that is coming especially from the intestine.

[00:12:28]This is why when I look at the three primary drivers, this is why I think these three represent the top ones. The first is postcoid gut immune activation.

[00:12:42]A lot of people don't realize that COVID even affects the gut. But this is likely to be one of the most serious long-term impacts of COVID because the gut is sending signals to the liver that it was not expecting. Then there is a pre-existing metabolic and hippatic vulnerability. Now these people have no spare capacity and they are struggling with regards to their uh liver anyway.

[00:13:11]And then he h hepattoxic medication where some simple medication and supplements can push the liver over the edge. And it's this combination that I'm looking at as being the primary mechanism that is causing this rise in toxic liver disease. And when you look in more detail as I showed you at the liver, as I said, this is the central vein. This is the portal vein bringing blood into the liver where it's filtered through. Everything is then checked and absorbed and fixed and so it's filtering. This is why even medication that you take gets filtered through the liver before it gets to the rest of the body. And so this first pass metabolism of the liver for everything that goes through your intestine, now most everything, not necessarily absolutely everything, is one of the critical things. And it seems that this liver is becoming overwhelming and this is the overlap that I've been talking about.

[00:14:20]Most patients will sit in this overlap.

[00:14:24]some immune COVID activation. They already have some metabolic hypatic vulnerability.

[00:14:31]They may already have some exposure. And when you combine them, you overlap them.

[00:14:37]And if all three are overlapped, this is where we get very unusual presentation.

[00:14:43]This is something I'll be coming back to, especially when I look at the different mechanisms and the way that the disease presents. So as I said before this code is absolutely rising.

[00:14:57]Toxic liver disease has risen since 2020. But of this K71 K71.6 and.96 is hepatitis not classified.9 is unspecified damage to the liver.

[00:15:16]These two stand out as the most significant risers for which there at the moment is no clear explanation. It's not simply explained by one narrow toxin. So don't say alcohol. It won't do this kind of pattern. It's unlikely. And so we have to start thinking differently about what is going on. And this is where I come back to the basics of what has changed since 2020 is that one increased exposure to the liver from the gut immune inflam inflammation.

[00:15:56]We have to include the possibility that autoimmune inflammatory processes even from vaccines could have an impact and it lowers the threshold for liver injury. And this vulnerability then magnifies the risk in people who already have some damage. And on top of it, if you have medications and supplements or even alcohol, these become the trigger for what may cause these patients to be admitted to hospital. One thing you have to be clear about is that if this is about people being admitted to hospital, it is very likely that this signal is much more significant broadly across the population because only the really sick get admitted into hospital. So this is still an explanatory model. Okay, we can't absolutely say what the cause is.

[00:16:55]I am giving you an extrapolation of it where K71 is related to toxic drug or related family. My proposal is that COVID or even COVID vaccination is an upstream susceptibility shift. So it's not the direct cause. It just increases the vulnerability. And what I'll be trying to explain is how all of this ties together so that we have two main triggers. K781.6 hepatitis not elsewhere classified and K71.9 unspecified damage to the liver. Why are these two rising so much at this point?

[00:17:41]That's the challenge that we have to explain and to emphasize the point as we come to the end of this section.

[00:17:49]This is real. These are real numbers.

[00:17:54]When we look at every adult age group above the age of 18, 90% increase, 140% increase for 30 to 44s, 209% increase 45 to 59. 240% increase 60 to 74 and 219% increase in 75 year olds. So the 189% increase is actually peaking at 240% in the 60 to 74s. This group seems to be the most vulnerable to what exactly is happening here. But across every age group including children there is a 90% increase for them as well. This is significant. What exactly would we expect? We would not expect to see this coming from just niche exposure. This all suggests something else far more significant is occurring. And as I said before, one liver code essentially changed the shape since 2020 and it does not fit a single toxin explanation.

[00:19:13]Thank you all very much. If you are on YouTube, I appreciate you being with us for the first section. This is a very important topic and please if you are interested, look out for the links. uh they'll be shared later for when this is put together as a course with the full dashboard as well. And so for those who are with me in the presentation, just hang while we close out with our YouTube um group.