Popular liver health supplements such as milk thistle, artichoke, vitamin C, and others are marketed with unfounded claims that they "detoxify," "cleanse," and "nourish" the liver.
Research suggests that although they might benefit those with existing liver disease, they don't help those with healthy livers.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. When choosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
1. Milk Thistle
One herb commonly found in supplements for liver health is milk thistle (Silybum marianum).Thisflowering herb is found in many parts of the world and contains a bioactive compound called silymarin that may support liver health.
Silymarin has been used in several clinical trials focused on liver disease. According to one review, clinical research shows that it may improve symptoms of liver cirrhosis, reduce oxidative stress, and help normalize liver function in diseased livers. Silymarin may even decrease liver-related deaths.
Milk thistle has also shown promise as a complementary treatment for metabolic dysfunction-associated steatotic liver disease (MASLD), which was previously known as nonalcoholic fatty liver disease (NAFLD). In one study, milk thistle use was associated with decreased levels of triglycerides (a type of fat in the blood) in people with MASLD.
2. Jujube
Jujube (Ziziphus jujuba) is a sweet fruit that contains phenols and flavonoids, two types of antioxidants that may have liver-protective qualities.
In rats with liver damage caused by high doses of acetaminophen, jujube supplementation decreased theliver enzymesalanine aminotransferase (ALT) and aspartate aminotransferase (AST). The researchers gave jujube to the treatment group of rats for 10 days, and on day nine, they gave them acetaminophen.
The rats given jujube had less liver damage when given toxic doses of acetaminophen, signaling that jujube might help protect the liver. These changes were thought to be caused by the antioxidant content of the jujube fruit given to the rats. However, it is essential to note that this study was performed on rats, not humans.
A small pilot study was conducted on people with tuberculosis with drug-induced liver damage. In the study, participants were given either a placebo (an ineffective substance given to a control group) or jujube syrup every day for four weeks.
Compared to the placebo, jujube syrup was associated with fewer cases of liver toxicity as well as less significant increases in ALT and AST.
3. Beetroot
Beetroot is a source of bioactive substances, including betaine and antioxidants, that help prevent fat from accumulating in the liver.
In a study on adults with MASLD, beetroot juice was compared to the Mediterranean diet, which is also high in antioxidants and other bioactive substances. Participants were randomized to either a control group, a Mediterranean diet-only group, a beetroot juice-only group, or a Mediterranean diet plus beetroot juice group.
After 12 weeks, liver enzymes, total cholesterol, triglycerides, and low-density lipoprotein (LDL) cholesterol (considered "bad cholesterol") were decreased, and high-density lipoprotein (HDL) cholesterol ("good cholesterol") was increased in all groups except for the control.
In a different study, adults with MASLD were randomized to receive either a beetroot supplement or a placebo for 12 weeks. Participants who used beetroot juice had significant decreases in liver enzymes and lipid profiles. They also experienced substantial reductions in the size of their livers.
4. Artichoke
Artichoke (Cynara scolymus) is an edible plant sometimes used as a dietary supplement for various health conditions, including liver disease.
A systematic review and meta-analysis of clinical trials found that artichoke has a beneficial effect on decreasing liver enzymes ALT and AST. These enzymes are commonly elevated in diseased livers. According to researchers, this effect suggests a liver-protective role of artichoke supplements.
Artichoke has also been shown to improve liver enzymes and lipid levels in people with MASLD. Some research suggests that artichoke leaf extract may even improve blood flow through the hepatic (liver) veins.
5. Dandelion
Dandelion (Taraxacum officinale) has exhibited liver protective effects in experimental studies. Researchers believe that dandelion may reduce oxidative stress and reduce various liver injury biomarkers (like AST, ALT, and bilirubin).
In animal research, dandelion has also been found to reduce liver fibrosis (scarring). This is thought to be due to its antioxidant activity.
Dandelion is a common herb in supplements for liver health. However, clinical trials are required to confirm its benefits in humans.
6. Chanca Piedra
Chanca piedra (Phyllanthus niruri) is an herb commonly used in Ayurveda and other traditional medicine to treat liver disease. It contains antioxidant and anti-inflammatory substances that may benefit liver health.
Researchers examined the effects of chance piedra on people with alcoholichepatitis. Participants were randomized to take either a placebo or chance piedra for four weeks. Chanca piedra was found to have only slight beneficial effects on AST and ALT levels. However, study participants who took chance piedra did have significant increases in total antioxidant levels compared to those who took the placebo.
7. Choline
A choline deficiency may lead to MASLD. Choline is needed to carry fat away from the liver, and high-fat accumulation in the liver can cause MASLD. People who get enough choline from their diet have a lower risk of developing MASLD.
There's no clear understanding of how choline supplementation may treat or prevent MASLD. More research is needed.
8. Vitamin C
One study compared vitamin C supplementation to a placebo in people with hepatitis C. At the end of the one-month study, participants who used vitamin C significantly improved liver enzymes compared to those who took the placebo. These effects were thought to be caused by vitamin C's ability to reduce oxidative stress.
Another study compared varying doses of vitamin C in patients with MASLD. In the study, participants took 250 milligrams (mg), 1,000 mg, or 2,000 mg per day of vitamin C for 12 weeks. Researchers noted positive effects of all three doses of vitamin C for glucose metabolism and overall liver health, but the 1,000 mg per day dose appeared to be the most beneficial.
9. Zinc
Deficiencies in the mineral zinc are often present in people with various types of liver disease. Although more research is needed, zinc supplementation has shown promise as a treatment for liver cirrhosis and hepatic encephalopathy, which causes brain function loss.
Researchers have looked at the long-term use of zinc supplements as a possible way to prevent hepatocellular carcinoma (HCC), a common liver cancer.
In one study, zinc supplementation for at least six months was correlated with lower incidences of liver cirrhosis and HCC in people with chronic liver diseases. Compared to people with chronic liver disease who didn't use zinc supplements, those who did maintain liver function over three years.
10. Selenium
Research shows that a selenium deficiency is likely in people with chronic liver diseases like hepatitis, cirrhosis, and liver cancer. According to studies, correcting a selenium deficiency may help improve symptoms and outcomes of these and other types of liver disease.
Selenium supplements may also help people with MASLD. However, the relationship between selenium and MASLD is not well understood.
Experimental studies show that selenium may reduce fat accumulation in the liver by modulating certain enzymes. Selenium also acts as an antioxidant, reducing inflammation and oxidative stress in the liver.
More research is needed to determine if and how selenium supplements may improve MASLD and other liver diseases.
11. Vitamin E
Vitamin E is a fat-soluble vitamin and antioxidant that may help treat and manage MASLD andmetabolic dysfunction-associated steatohepatitis (MASH),formerly known as nonalcoholic steatohepatitis (NASH).
A systematic review and meta-analysis of 15 human trials found that vitamin E supplementation improved liver enzymes (ALT and AST) and fibrosis in adults and children with MASLD. However, some studies in the review concluded that vitamin E was not superior to other measures in improving MASLD or MASH.
A different review found similar results, concluding that vitamin E supplementation may improve ALT and AST levels and inflammation and fat accumulation in the livers of people with MASLD. Researchers also concluded that vitamin E may be a beneficial complementary treatment for MASLD.
Liver Health & Supplement Claims
Supplement brands sometimes include health and medical claims in their packaging or labels. And while many labels give accurate information, other brands may make false or misleading health claims to sell their products.
There are common trends for liver health supplement labels. By clicking on just a few supplements marketed for liver health online, you'll see that many make promises to do the following:
- Detoxify your liver
- Repair liver damage
- Cleanse your liver and body
- Nourish your body
- Support digestion
- Support liver function and enzymes
- Boost energy
- Aid immune health
Yet, there still isn't solid scientific evidence that liver health supplements work in these ways or at all. With a healthy diet and lifestyle, supplements are often unnecessary.
Some supplements for liver health may offer health benefits, while others may not. Therefore, it's important to be aware of common health claims made by such supplements so you can make knowledgeable decisions for your health.
Do I Need to Take a Liver Health Supplement?
Most healthy people do not need to take a liver health supplement.
For the most part, studies on supplements for liver health have concluded that certain herbs, vitamins, minerals, and other nutrients may be beneficial if you have liver disease. However, there isn't strong evidence that supplements are helpful or necessary if your liver is healthy.
Fortunately, there is evidence that lifestyle habits can improve the health of your liver. Some ways to protect the health of your liver include:
- Eat a well-balanced diet of fiber, healthy fats, and lean protein.
- Engage in regular physical activity.
- Limit alcohol.
- Avoid using recreational drugs.
- Avoid dirty needles.
- Practice good hygiene.
- Use medications and supplements only as directed.
Certain herbs and supplements (especially vitamins) have been found to harm or damage the liver. For this reason, it's essential to talk with a healthcare provider before taking any supplements for liver health.
Summary
The liver is a large organ that is involved in hundreds of bodily processes. Certain types of liver disease may hinder some of these processes and negatively impact overall health.
Scientific evidence shows that some supplements for liver health may be helpful, especially when liver disease is present. However, little research supports the use of supplements in people with healthy livers.
If you need a liver health supplement, talk with a healthcare provider.
