Liver supplements are marketed for their ability cleanse the liver of impurities and support the healthy function of the liver.
Although some common ingredients found in liver supplements — milk thistle, artichoke leaf, dandelion root, licorice root extract, turmeric and sea buckthorn — may be beneficial to the liver, studies find that they are most helpful in those with liver disease.
It is not yet known if these supplements can improve liver function in otherwise healthy people.
Doctors also point out that the liver is the body’s built-in detoxifier (1).
A healthy liver converts toxins into harmless substances or ensures that they are excreted from the body. For individuals who are in good health and not overloading their systems with toxic substances (such as alcohol), their liver will cleanse itself well.
There is no evidence backing the notion that the liver itself needs to be cleansed of impurities.
Liver supplements are not endorsed in the medical community since they are not regulated by the FDA. This lack of oversight means that unlike a pharmaceutical drug, individuals may not know exactly what they are getting or even if others have experienced adverse effects.
Until well-designed human studies are carried out, medical professionals recommend adopting certain lifestyle choices to improve liver health rather than relying on over-the-counter liver supplements.
These include: limiting alcohol intake, avoiding weight gain, not using harmful or illicit drugs, not mixing alcohol and certain medications and getting vaccinated to protect against liver viruses — hepatitis A and B.
1 Liver supplements may protect against liver damage. Turmeric extract is one of the ingredients found in some liver supplements. Studies show that turmeric’s major active compound — curcumin — can alleviate liver damage.
Data from a 2016 study suggest that turmeric extract and curcumin protect against liver-induced injury in rats by suppressing liver oxidative stress.
Oxidative stress occurs when there is an imbalance between the production of harmful free radicals in the body, and the body’s ability to counteract their negative effects through neutralization by antioxidants.
Oxidative stress is recognized as a key factor in the progression of chronic liver disease and liver cancer (2).
2 Liver supplements may be useful against alcoholic liver disease. Milk thistle is another main ingredient found in liver supplements. The main flavonoid extracted from the plant’s seeds —silymarin — may protect the liver against damage from toxins and disease by acting as an antioxidant, immune-stimulant and anti-inflammatory agent.
The effects of silymarin therapy in 36 patients with chronic alcoholic liver disease was studied in a six-month double-blind clinical trial.
The results of the trial indicated that silymarin exerts liver-protecting activity and is able to improve liver functions in alcoholic patients (3).
3 Liver supplements may offer antioxidant benefits. In a study evaluating the in vitro free radical scavenging activity and antioxidant properties of silymarin, researchers found silymarin to be a powerful antioxidant herbal drug which can protect biological systems against oxidative stress.
While researchers suggested that silymarin may be used in preventing free radical-related diseases as a dietary natural antioxidant supplement, they also stressed the importance of performing more studies (4).
4 Liver supplements may improve liver fibrosis. Liver fibrosis occurs when long-lasting injury or inflammation of the liver causes the buildup of excessive amounts of scar tissue. This scar tissue can block or limit the flow of blood within the liver, which can eventually kill healthy liver cells.
In a randomized trial of 99 patients, researchers found that silymarin (700 mg, given 3 times daily for 48 weeks) reduced liver fibrosis (5).
Although promising, these are the results of just one study, and the role of silymarin for the treatment of liver diseases remains uncertain.
Part of this uncertainty is due to silymarin having poor absorption and rapid metabolism. The oral absorption of silymarin is only about 23-47 percent, leading to low bioavailability of the compound. It therefore, requires an enhanced formulation to make it available in the body.
More studies are needed to learn how to improve its bioavailability.
5 Liver supplements may treat liver cirrhosis. Cirrhosis is a late stage of scarring of the liver. Cirrhosis is caused by many forms of liver diseases and conditions such as chronic alcoholism and hepatitis.
According to a study published in the World Journal of Hepatology, silymarin treatment caused a slight increase in the survival of patients with cirrhosis due to alcoholism compared with untreated controls (6).
In another study, sea buckthorn (an ingredient some manufacturers include in their liver supplements) successfully increased the blood markers of liver function in patients with cirrhosis.
Although these effects seem promising, more studies are necessary to make firm conclusions.
6 Liver supplements may help treat hepatitis. Hepatitis is inflammation of the liver that can progress to scarring, cirrhosis or liver cancer if not successfully treated. Interferon-based therapies were once the go-to standard of treatment for several chronic forms of viral hepatitis.
In one study, 20 individuals with hepatitis C who failed to respond to traditional interferon treatment, successfully responded to 1400mg a day of silymarin. Complete viral suppression was induced in 13 of 20 subjects within the first week after the short-term silymarin infusion (7).
There is also some evidence that liver extract may be effective in treating the fatigue and loss of appetite that affects patients with chronic hepatitis B.
A 2014 study found that liver oil taken from cow embryos can help to reduce bilirubin levels (a complication in hepatitis patients that causes weakness and fatigue) and treat loss of appetite (8).
While some studies suggest that liver extracts may be a promising treatment for hepatitis, other studies show the opposite to be true.
According to the results of a 2012 study, published in the Journal of the American Medical Association, (JAMA), silymarin did not provide greater benefit than placebo for patients with treatment-resistant chronic hepatitis C infection (9).
7 Liver supplements may help regenerate liver cells. Artichoke leaf extract is another ingredient several manufacturers include in their liver supplements. Ongoing animal research indicates that artichoke has several medicinal qualities. Most significant appears to be its beneficial effect on the liver.
In animal studies, liquid extracts of the roots and leaves of artichoke have demonstrated an ability to protect the liver, with the possibility of even helping liver cells regenerate (10).
Studies in humans, however, are lacking.
8 Liver supplements may treat nonalcoholic fatty liver disease. Nonalcoholic fatty liver disease (NAFLD) is the buildup of extra fat in liver cells that is not caused by alcohol. Nonalcoholic steatohepatitis (NASH), a potentially serious form of the disease, is marked by liver inflammation, which may progress to scarring and irreversible damage (11).
In a randomized double-blind clinical trial, 60 patients suffering NASH were randomly assigned to receive artichoke leaf extract (6 tablets per day consisting of 2700 mg extract of the herb) or placebo for two months.
At the end of the study, the group receiving artichoke leaf extract showed improvement in liver enzymes.
This study shed light on the potential liver-protective activity of artichoke leaf extract in the management of NASH (12).
9 Liver supplements may treat chemotherapy‐associated liver damage. The main function of the liver is to filter toxic substances from the blood. Chemotherapy drugs may cause liver damage because they are toxins and can place added stress on the liver’s filtering function. If toxins accumulate in the body faster than the liver can process them, liver damage can result (13).
In a double‐blind study, children with acute lymphoblastic leukemia and liver toxicity were randomized to receive milk thistle or placebo orally for 28 days. Liver function tests were evaluated during the study period.
At the end of the study, milk thistle was associated with a trend toward significant reductions in liver toxicity (14).
Different adverse reactions may occur depending on the formulation of the liver supplement and the ingredients used.
1 Liver supplements may cause gastrointestinal issues. Milk thistle supplements have been linked to nausea, vomiting, diarrhea, flatulence and abdominal pain.
Milk thistle may also cause headaches.
2 Liver supplements can raise blood pressure. In supplements that add licorice root, unless the licorice is specially processed to remove a particular compound (glycyrrhizin), it can raise blood pressure (15).
3 High doses of milk thistle’s silymarin can actually cause liver problems by elevating bilirubin and liver enzymes. Elevated bilirubin levels may indicate liver damage, while elevated liver enzymes indicate inflamed or injured liver cells. (16)
Due to conflicting evidence on the efficacy of liver supplements, and the need for further studies on the effects of the individual ingredients found in these supplements, a recommended dosage has not been established.
What are the best liver support supplements? Over-the-counter liver supplements are not regulated by the FDA, and many have not been clinically tested for their effectiveness.
While some common ingredients in liver supplements have been shown to have positive results — milk thistle has been shown to decrease liver inflammation, and turmeric extract has been shown to protect against liver injury — there have not been adequate clinical trials performed in humans to recommend the best liver support supplements.
What ingredients are in liver supplements? Liver supplements contain a blend of ingredients. Manufacturers commonly include milk thistle, artichoke leaf and dandelion root.
Other ingredients may include licorice root extract, turmeric, sea buckthorn and bupleurum.
What is a liver cleanse? Liver cleanses are touted for their ability to detox and cleanse the liver, especially after a weekend of overindulging on food or alcohol. Manufacturers of cleanses also claim their products help maintain daily liver function and repair an already damaged liver.
Medical experts stress that cleanses have not been proven to be effective in ridding the body of damage from excess food and alcohol consumption.
In addition, contrary to popular belief, cleanses have not been proven to treat existing liver damage, such as hepatitis. There are many other scientifically proven forms of treatment for these conditions that are recommended by doctors (17).
Furthermore, for those who are in good health and not overloading their systems with toxic substances (such as alcohol), a liver cleanse is not needed. Their liver does a good job of converting toxins into waste products and cleansing their blood.
Are liver detoxes safe? Many medical practitioners argue that the liver does not need detoxing supplements and that doing so might even be dangerous.
A 2017 article in the Journal Hepatology even reports that liver injury caused by herbal and dietary supplements are on the rise in the U.S., contributing to 20 percent of liver toxicity cases (18).
Since they are not regulated by the FDA, the safety and efficacy of over-the-counter liver detox supplements is not fully known.
That is why the claims that companies make on their product labels all include the disclaimer: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”
What are the side effects of a liver cleanse? If you heed the advice of medical professionals and focus on switching to a healthy, liver-friendly lifestyle instead of taking store-bought liver cleanse supplements, the side effects of a natural cleanse should be minimal.
These include headaches and irritability, fatigue and nausea and stomach upset.
One of the reasons you may feel these side effects is because your body goes through withdrawal from all your unhealthy lifestyle habits (such consuming processed foods, refined sugar and alcohol).
To avoid these symptoms, it is best to slowly cut back on sugar, coffee and processed foods to avoid a dramatic change for your body.
Another reason, is attributed to your body releasing stored toxins which have to make their way through the body before being released.
These side effects typically last a few days.
What foods help cleanse the liver? Eating more cruciferous vegetables (like broccoli, cabbage and Brussels sprouts), help eliminate chemicals and other toxins from the body.
Other foods that may help flush out toxins include lemons, watercress (a natural diuretic making it easier for your body to flush out toxins), apples (carry pectin and malic acid that help remove toxins) and turmeric (this spice contains the compound curcumin which helps flush out carcinogens).
What foods are bad for the liver? The following foods should be avoided, especially in those with fatty liver disease: alcohol, foods with added sugar (sodas, candy, baked goods, etc.), fried foods, beef, deli meat, white bread, rice and pasta.
Also avoid raw or undercooked shellfish such as oysters and clams, as they put you at increased risk for hepatitis A.
Can liver supplements help treat a fatty liver? Artichoke leaf extract — an ingredient found in many liver supplements — holds promise in treating nonalcoholic steatohepatitis, a potentially serious form of fatty liver disease.
In one study, 60 patients diagnosed with this condition showed improvement in liver enzymes after receiving artichoke leaf extract.
Many more studies are needed, however, to confirm these findings.
It is also important to note that the dosage used in the study was 2700 mg extract of the herb — much higher than what is typically found in supplements.
What foods improve liver health? If you are looking for liver-friendly foods to keep your liver healthy, you have quite a few options.
Drinking more green tea has been shown to improve blood markers of liver health and may also reduce oxidative stress and fat deposits in the liver. Fruits are also beneficial, especially grapefruit, blueberries, cranberries, grapes and prickly pear.
Also consider adding the following to your diet: artichokes (help protect liver cells and help them regenerate), flaxseed (contains lignan, a type of plant compound that helps prevent inflammation in the liver), beetroot juice (contains betaine, which promotes liver cell regeneration), omega-3-rich fatty fish (help prevent fat from building up and keep enzyme levels normal) and nuts (improve levels of liver enzymes).
Coffee has been shown in multiple studies to provide a major boost to liver health. Some studies show that patients with NAFLD who drank coffee (about two cups every day) had a decreased risk of fibrosis.
Be sure to also drink plenty of water. In addition to preventing dehydration, it also helps your liver function better.
What are natural ways to boost liver health? There are several steps you can take to ensure a healthy liver.
These include: maintaining a healthy weight (being overweight or obese puts you in danger of having a fatty liver), eating a balanced diet (less fatty foods and more fiber), limiting alcohol intake (heavy drinking can damage or destroy liver cells and scar your liver), avoiding the use of illicit drugs, getting vaccinated against hepatitis A and hepatitis B and exercising regularly.
Also limit direct contact with toxins from cleaning and aerosol products, insecticides and chemicals, as these toxins can injure liver cells.
Making healthy lifestyle changes can do wonders not only for your liver, but your entire body.
How does milk thistle help the liver? Of all the ingredients found in liver supplements, milk thistle shows the most promise in being beneficial to the liver. Studies have shown it can help reduce liver inflammation and reduce damage to the liver caused by free radicals.
However, the results from studies have been mixed, and not all have found milk thistle extract to have a beneficial effect on liver disease.
How does dandelion root help the liver? Liver root has long been held in high regard as a liver tonic in folk medicine.
In 2017, researchers found that the polysaccharides in dandelion root may be beneficial to liver function due to their ability to protect mice against acetaminophen-induced liver injury.
What does turmeric do for the liver? Turmeric (the spice that gives curry its yellow color) has been shown to have a protective role against the onset of liver diseases.
Research points to turmeric’s potential in treating non-alcoholic steatohepatitis, alcoholic liver disease, liver fibrosis and cirrhosis as well as liver injury.
How does licorice root benefit the liver? Studies show the protective effect of licorice against alcohol-induced liver injury due to its anti-inflammatory activity and enhancement of antioxidant defense.
Does sea buckthorn benefit the liver? Much like milk thistle, sea buckthorn is backed by a growing number of studies showing its potential liver-protecting qualities.
Most parts of this plant are considered to be a good source of a large number of bioactive substances — including vitamin E and carotenoids — all of which may safeguard liver cells from damage.
In one animal study, sea buckthorn oil significantly improved markers of liver function in rats with liver damage. Other studies show its potential to significantly improve liver enzyme levels in people with nonalcoholic liver disease.
What supplements are bad for the liver? According to a 2017 issue of Gastroenterology & Hepatology, doctors have been noting an increase in patients presenting with liver disease or injury from supplements.
Currently, the supplements that are most likely to cause liver injury are believed to be bodybuilding supplements and over-the-counter weight-loss supplements.
Researchers are trying to clue in on what it is exactly about these types of supplements that make them harmful. Some suspect it could be the types of ingredients. Green tea extract, for example, (which refers to an extract of the plant, not the green tea that people drink) may cause liver injury when taken in high doses.
Green tea extract can be found in many weight-loss supplements (19).
Researchers are working to develop a better understanding of the actual causes of liver injury from supplement use.
Liver supplements are marketed for their ability to cleanse the liver of toxins and keep the liver in optimal shape. So far, these claims have not been backed by scientific data.
Although some of the individual ingredients found in liver supplements may improve liver health, studies find that they are most helpful in those with liver disease.
It is not yet known if these supplements can improve liver function in otherwise healthy people.
Medical professionals also stress that the liver is already the body’s natural detoxifier, and there is no evidence that the liver itself needs to be rid of impurities.
Doctors recommend adopting certain lifestyle choices to improve the health of the liver, rather than turning to liver supplements.
This includes eating a balanced diet, exercising regularly, steering clear of pesticides and toxins (read warning labels on the chemicals you use), limiting alcohol consumption, getting vaccinated against hepatitis A and B and not engaging in behaviors such as illicit drug use.