Nearly every American carries some level of “forever chemicals” in their system.1 These compounds, formally known as per- and polyfluoroalkyl substances (PFAS), are a large group of synthetic chemicals so resistant to breakdown that once they enter your body, some can linger for years. They’re used to make products slick, stain-proof, grease-resistant, or waterproof — from nonstick pans and fast-food wrappers to carpeting and rain jackets.
The liver receives the highest burden of forever chemicals as it filters these toxins from the blood. PFAS can interfere with the liver’s ability to package and export fat, promoting fat buildup inside liver cells.2 Now, research shows that during adolescence, this interference carries a greater risk because the liver is still adapting to hormonal shifts, growth signals, and increased metabolic demands.3
Adolescent PFAS Exposure Is Linked to Higher Fatty Liver Disease Risk
Fatty liver disease is now estimated to affect 7% to 9% of all children, and up to 41% of children with obesity. A recent study published in Environmental Research analyzed how exposure to various PFAS compounds may be contributing to this trend, particularly in adolescents and young adults from families with increased risk for metabolic conditions.4
• Two PFAS compounds showed the strongest links to fatty liver disease — Higher blood levels of the forever chemical perfluorooctanoic acid (PFOA) were linked to nearly three times higher risk of fatty liver disease, while a newer replacement PFAS, perfluoroheptanoic acid (PFHpA), raised the risk by 1.7-fold.
The effect was stronger in older teens and those with genetic susceptibility. For families already dealing with metabolic concerns, including overweight or Type 2 diabetes, PFAS exposure represents an added stressor on the liver that isn’t picked up in routine checkups and often goes unnoticed.
• This study builds on earlier research confirming the same pattern — An earlier work published in Communications Medicine in late 20255 found that adolescents with double the PFHpA concentration in their blood had an 80% greater risk of fatty liver disease compared to peers with lower levels. Elevated PFHpA was also linked to more advanced liver injury, including inflammation and fibrosis (scarring).
Together, these results highlight adolescence as an important window for identifying environmental contributors like PFAS, when intervention may still prevent long-term metabolic damage. For a deeper look at how PFAS affects your health beyond liver disease, read “Toxic and Tenacious — How ‘Forever Chemicals’ Are Damaging Your Health.”
Microplastics as PFAS Carriers — A Double Threat to Liver Health
PFAS don’t always travel alone. Growing evidence shows that microplastics serve as both a reservoir and a transport system for forever chemicals,6 delivering them deep into your tissues and bypassing many of your body’s normal protective barriers against chemical exposure.7
• Microplastics form from the breakdown of larger plastics — Common items such as packaging, textiles, and household goods degrade into microscopic fragments. Some of these fragments are manufactured with PFAS for durability or chemical resistance, while others absorb PFAS from the surrounding environment. Either way, the particles act as a direct and sustained source of internal exposure.
• Inhalation is a primary route of exposure — Microplastics circulate in indoor and outdoor air, and are small enough to evade upper airway defenses. Once inhaled, they reach the alveoli (the deepest region of the lungs), where oxygen exchange occurs. From there, they either embed in lung tissue or pass directly into circulation, carrying their chemical load to the liver, as well as the kidneys, brain, and other organs.
• Microplastics contain a wide range of synthetic chemicals — In addition to PFAS, these particles contain endocrine-disrupting chemicals (EDCs) like phthalates, bisphenol A (BPA), flame retardants, and stabilizers. These interfere with hormone signaling by mimicking or blocking natural hormones and altering how they are produced, transported, or cleared.
The effects span multiple systems, including metabolism, fertility, neurodevelopment, and immune regulation. Experimental models show that combined exposure to PFAS and microplastics produces additive and synergistic toxicity, causing greater harm than either chemical alone.
The body has no internal mechanism that can break down plastic polymers or reliably remove embedded microplastic particles once they enter tissue. The good news is that researchers are actively investigating strategies to help reduce the body’s burden of persistent plastics and chemicals, including PFAS.
Some of this emerging research was discussed in my recent CBS interview, which is featured above. These findings and the ways these pollutants behave in human tissue are examined in detail in my upcoming book, “Microplastics Cure: Total Body Cleanse,” which comes out soon.
How to Reduce PFAS Exposure and Manage Its Effects
Because PFAS are widespread and long-lasting, protecting your health as well as your family’s means taking steps on two fronts — limiting new exposures and helping your body eliminate what’s already built up. Here are some practical strategies to help you get started:
1. Filter your drinking water with a system designed to remove PFAS — If PFAS are in your household tap water, you’re being exposed every time you drink, cook, or shower. Check your local water quality report or test your water using a PFAS-specific kit.
If contamination is confirmed, install a water filtration system certified to NSF/ANSI Standard 53 (for activated carbon) or Standard 58 (for reverse osmosis) — these certifications verify actual PFAS removal, which marketing claims alone do not guarantee.8
2. Limit PFAS-containing products in your home — Avoid nonstick cookware, stain-resistant carpets and upholstery, and water-repellent clothing. If you have children, pay special attention to school uniforms, outdoor gear, and athletic wear that may be treated with water- or stain-repellent chemicals. Choose materials like cotton, wool, leather, or cast iron instead of synthetic, chemically treated options.
Food packaging is another major source of exposure. Microwave popcorn bags, fast-food wrappers, pizza boxes, and takeout containers are among the worst offenders, as they’re often coated with PFAS to prevent grease and moisture from soaking through. Plastic packaging can also break down into microplastics. Whenever possible, cook at home, and transfer takeout food to glass or stainless steel containers rather than eating directly from the packaging.
Personal care products can also be hidden sources, so check labels for ingredients like polytetrafluoroethylene (PTFE) or anything containing “fluoro.” Look for fluorine-free certifications or use databases like the Environmental Working Group’s (EWG) Skin Deep to help guide safer choices for your household.9
3. Consider blood or plasma donation if you are eligible — If you meet donation criteria, this is one of the most effective ways to lower PFAS levels in the body. Research shows that regular donations accelerate the removal of long-lasting compounds like forever chemicals, which otherwise persist for years.
4. Support liver and kidney function through daily habits — Eat sulfur-rich foods such as garlic, onions, broccoli, and Brussels sprouts to support the production of glutathione, the body’s master detoxification compound, which binds to toxins so they can be eliminated. Pair this with adequate hydration using filtered water, which supports normal kidney function.
Because PFAS clearance depends partly on healthy mitochondrial function, reducing factors that impair mitochondria, including excess linoleic acid from seed oils like soybean, corn, and sunflower oil, may support your body’s ability to process these chemicals. Limiting or avoiding alcohol further reduces strain on the liver and supports more efficient detoxification.
5. Support broader efforts to reduce environmental exposure — The widespread presence of PFAS in people’s blood and environments is the result of decades of unregulated chemical use. While personal steps matter, broader policy change is needed to protect communities.
Support efforts to ban PFAS in consumer products, push for full ingredient transparency, and demand government-led testing and cleanup in contaminated areas. Each reduction in exposure — whether personal or collective — lowers the toxic burden on future generations.
5 Strategies to Support Liver Health
Reducing exposure to PFAS is only part of protecting your liver. You also need to supply it with the nutrients and inputs it needs to function well, repair cellular damage, and export stored fat. These five strategies focus on practical, foundational ways to support liver recovery and resilience over time:
1. Prioritize choline-rich foods — Choline is one of the most important nutrients for liver health because it helps move fat out of the liver and supports cell membrane repair. A single hard-boiled egg can contain anywhere from 113 milligrams (mg) to 147 mg of choline,10,11 or about 25% of your daily requirement,12 making it one of the best choline sources in the American diet.13
Muscle meats and fish also provide moderate amounts and fit easily into most diets.14 Some plant foods, including soybeans and cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts, contain smaller amounts but can still contribute to your overall intake.15
2. Consider choline supplements if your diet falls short — If you struggle to get enough choline from food, supplementation may help, but the form matters. I recommend citicoline (also known as CDP-choline) because it is well absorbed and supports the production of key phospholipids that keep liver cells and mitochondria functioning properly.
At daily doses of 500 to 2,500 mg, citicoline has the added benefit of raising acetylcholine levels, which supports cognitive function. Moreover, it does not significantly increase trimethylamine N-oxide (TMAO), a metabolite linked to cardiovascular risk, compared to some other choline forms.
3. Increase your intake of other liver-supportive nutrients — Your liver needs certain nutrients called methyl donors — folate (B9), vitamin B12, and methionine — to run a vital repair process called methylation. This process helps regulate gene activity, manage inflammation, and carry out essential detox and fat metabolism tasks.
Without enough methyl donors, fat starts to accumulate and liver function slows down. Getting these nutrients through food helps keep your liver resilient and metabolically active. Key dietary sources include:
• Folate (B9) — Beef liver and dark leafy greens such as spinach and kale, and asparagus16
• Vitamin B12 — Animal sources like wild-caught Alaskan salmon, pastured eggs, and grass fed dairy and beef; for vegetarians or vegans, consider taking a B12 supplement17
• Methionine — High-protein foods like eggs, chicken, turkey, beef, and lamb18
4. Support liver health with regular movement — Physical activity helps regulate blood sugar, increase insulin sensitivity, and stimulate fat transport out of the liver. You don’t need a demanding workout routine. A brisk 10- to 20-minute walk after meals, daily stretching, and two to three sessions of resistance training totaling 40 to 60 minutes each week go a long way.
Waist circumference matters, too. More than 40 inches for men or 35 inches for women signals excess visceral fat,19 which is strongly tied to liver scarring. Shifting your focus toward losing inches around the waist, rather than just the number on the scale, gives you a more accurate measure of progress.
5. Get restorative sleep nightly — Your liver depends on quality sleep for repair and detoxification. Chronic sleep loss or disrupted sleep patterns interfere with glucose regulation, raise inflammation, and impair mitochondrial function in liver cells.
Aim for consistent sleep in a dark room, ideally at a temperature between 60 and 68 degrees Fahrenheit (15 to 20 degrees Celsius). Teenagers need eight to 10 hours of sleep per night, while adults need at least seven.20 Additionally, avoid late-night meals, as they can spike blood sugar and keep your liver metabolically active when it should be resting.
Frequently Asked Questions (FAQs) About Forever Chemicals and Liver Disease
Q: How do I know if I’ve been exposed to PFAS?
A: You have almost certainly been exposed. PFAS are found in drinking water, food packaging, cookware, clothing, and household products, and studies consistently show detectable levels in the blood of nearly all Americans. Exposure often happens gradually over years, so you usually won’t notice symptoms tied to a single source.
Q: What does PFAS do to liver health?
A: PFAS can disrupt how your liver handles fat, responds to insulin, and clears toxins. These disruptions raise your risk of developing fatty liver disease. Over time, this can lead to more serious issues like inflammation, fibrosis, or insulin resistance.
Q: Why does PFAS exposure matter more during adolescence?
A: The adolescent liver is still adapting to growth hormones and metabolic changes, making it more susceptible to chemical interferences like PFAS. Genetic differences and age further influence the risk, meaning two teens with identical PFAS exposure can have very different outcomes depending on inherited susceptibility and their stage of adolescence.
Q: How are microplastics linked to PFAS exposure?
A: Microplastics can carry PFAS on their surface and transport them into the body through inhalation or ingestion. Once inside, these particles can bypass normal detox barriers and deliver the chemicals to organs such as the liver, increasing overall internal exposure to PFAS.
Q: What can I do to reduce exposure to PFAS in our home?
A: You can lower PFAS exposure in your home by focusing on the most common sources. Use a water filtration system that removes PFAS, especially for drinking and cooking. Avoid nonstick cookware and products treated to resist stains, water, or grease, including some carpets, furniture, and clothing.
Store and prepare food using glass, stainless steel, or cast iron, and check personal care products for ingredients that include “PTFE” or anything containing “fluoro.” These steps reduce the amount of PFAS entering your home on a daily basis.
Test Your Knowledge with Today’s Quiz!
Take today’s quiz to see how much you’ve learned from yesterday’s Mercola.com article.
What percentage of adults experience some level of smell loss?
