Supplements for Liver Health: Do They Work?
Medically reviewed by Elizabeth Barnes, RDN
Your liver is one of the most important organs in your body and is responsible for a number of key processes that are vital to your overall health.
Probably the most important job of the liver is to act as a filter, removing toxins and waste from your blood. The liver is also involved in metabolism, protein synthesis, and iron storage, among other things.
However, a damaged or diseased liver cannot perform all its essential tasks. It's probably no wonder, then, that supplements for liver health are a multibillion-dollar industry.
Despite their popularity, liver health supplements are not supported by strong scientific evidence. Various supplements for liver health claim to "detoxify," "cleanse," and "nourish" your liver, yet these claims are largely unfounded.
This article will explore certain vitamin and herbal supplements for liver health plus the health claims surrounding them. It will also cover the roles of the liver and whether you need to take a liver health supplement.
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Liver Health & Supplement Claims
Supplement brands sometimes add health and medical claims to their packaging or labels. And while many labels give accurate information, other brands may make false or misleading health claims to sell their products.
The Food and Drug Administration (FDA) does not approve health claims on new supplement labels. Therefore, it's important to do your due diligence when choosing a supplement product.
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.
It's only natural to want a quick and easy solution to a problem, even when it comes to health. The reality is, though, that dietary supplements are not magic pills that can instantly improve your health or heal your liver.
While some supplements for liver health may offer health benefits, 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.
What Does the Liver Do?
Your liver has many jobs, all of which are important.
The liver is a fairly large organ that is found within the right side of your abdominal cavity. It is constantly receiving blood from both the hepatic artery (oxygenated blood) and the hepatic portal vein (nutrient-rich blood). All blood from your intestines goes through your liver to be filtered.
The liver is known to have hundreds of functions, including:
Bile production
Synthesis of certain proteins
Cholesterol production
Glycogen synthesis and storage
Amino acid regulation
Hemoglobin processing
Conversion of ammonia to urea
Drug metabolism
Blood-clotting regulation
Removal of bacteria, wastes, and toxins from the blood
Bilirubin clearance
Nutrition plays a key role in the health of your liver. Therefore, certain herbs and nutrients have been studied for their potential roles in liver health.
Herbal Supplements for Liver Health
Herbs typically possess a scent, flavor, or therapeutic property that may benefit your health. Herbal supplements are used for their purported medicinal qualities.
Various herbs found in some supplements are thought to improve the health of your liver. However, there isn't much evidence that supports the claims of many herbal supplements for liver health on the market today.
Milk Thistle
One herb that commonly shows up in supplements for liver health is milk thistle (Silybum marianum). Milk thistle is a flowering herb found in many parts of the world. It contains a bioactive compound called silymarin that may support liver health.
Silymarin has been used in a number of clinical trials focused on liver disease. According to one review, clinical research shows that silymarin 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) levels in people with MASLD.
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 led to decreases in the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The researchers gave jujube to the treatment group of rats for 10 days. On day nine, they gave them acetaminophen.
The rats who were 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 important to note this study was performed in 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.
Beetroot
Some studies suggest that supplementing with beetroot may treat MASLD.
Beetroot is a source of bioactive substances, including betaine and antioxidants, that are thought to 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, levels of 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. Those who took beetroot juice also experienced significant reductions in the size of their livers.
Artichoke
Artichoke (Cynara scolymus) is an edible plant that is 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 levels of both liver enzymes and lipids in people with MASLD. Some research suggests that artichoke leaf extract may even improve the flow of blood through the hepatic (liver) veins.
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 the antioxidant activity of dandelion.
Dandelion is a common herb in supplements for liver health. However, clinical trials are required to confirm its benefits in humans.
Chanca Piedra
Chanca piedra (Phyllanthus niruri) is an herb commonly used in Ayurveda and other types of traditional medicine to treat liver disease. It is known to contain antioxidant and anti-inflammatory substances that may benefit liver health.
Researchers from one study looked at the effects of chanca piedra on people with alcoholic hepatitis.
In the small study, participants were randomized to take either a placebo or chanca piedra for four weeks. Chanca piedra was found to have only slight beneficial effects on AST and ALT levels. However, study participants who took chanca piedra did have significant increases in total antioxidant levels compared to those who took the placebo.
Vitamins for Liver Health
Vitamins and minerals are considered micronutrients because you need them in small amounts every day. You can get micronutrients from food or dietary supplements, although a food-first approach is recommended.
Taking certain vitamins may improve your liver health, especially if deficiencies are present. Some minerals may also be able to help.
Choline
A deficiency in choline may lead to MASLD. This is because choline is needed to carry fat away from the liver. High fat accumulation in the liver can cause MASLD.
According to the 2017-2018 National Health and Nutrition Examination Survey (NHANES), people who get enough choline from their diet have a lower risk of developing MASLD.
There's not a clear understanding of how choline supplementation may be used to treat or prevent MASLD. More research is needed.
Vitamin C
There is evidence that using vitamin C supplements can improve liver health, especially in people with liver disease.
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 had significant improvements in liver enzymes compared to those who took the placebo. These effects were thought to be caused by the ability of vitamin C 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.
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 maintained liver function over three years.
Selenium
Research shows that a deficiency in selenium is likely in people with chronic liver diseases like hepatitis, cirrhosis, and liver cancer. Correcting a selenium deficiency may help improve symptoms and outcomes of these and other types of liver disease, according to studies.
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.
Vitamin E
Vitamin E is a fat-soluble vitamin and antioxidant that may play a role in the treatment and management of MASLD and metabolic dysfunction-associated steatohepatitis (MASH), which was formerly known as nonalcoholic steatohepatitis (NASH).
A systematic review and meta-analysis that included 15 human trials found that vitamin E supplementation improved liver enzymes (ALT and AST) and fibrosis in both adults and children with MASLD. However, some studies included 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, as well as inflammation and fat accumulation in the livers of people with MASLD. Researchers also concluded that vitamin E may be a useful complementary treatment for MASLD.
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 beneficial 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 that is rich in 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 important to talk with a healthcare provider before taking any supplements for liver health.
Summary
The liver is a large organ that plays a part in hundreds of bodily processes. Certain types of liver disease may hinder some of these processes and negatively impact your overall health.
Scientific evidence shows that some supplements for liver health may be useful, especially when liver disease is present. However, there is little research that supports the use of supplements in people with healthy livers.
If you think you may need a liver health supplement, talk with a healthcare provider.
Read the original article on Verywell Health.
