Are Liver Supplements Effective, or Do They Cause More Harm?
The liver is one of the most vital organs in the human body and responsible for more than 500 processes, of which some of the most important include blood cleansing, protein synthesis, digestion assistance, and hormone production! Many liver supplement producers claim that their products can heal, detoxify and rejuvenate your liver, but is that true?
The liver represents our body's primary detoxification and filtration system and can detoxify independently, so can supplements help us speed up that process without causing harm?
In this blog post, I will examine some of the research behind liver supplementation to help you determine whether these products are safe and effective!
Some claims supplement manufacturers make about their products:
Detoxify the liver and kidneys
Promote overall liver health
Optimize liver function
Protect liver cells from inflammation
Promote bile production
Increase metabolism and aid in weight loss
Support respiratory and immune system function
The above are just some of the claims producers of dietary supplements make in their advertising campaigns; however, taking herbal and nutritional supplements can have positive and negative effects on our bodies! Some data I found suggests that herbal dietary supplements are responsible for 20% of liver injuries in the United States of America!
According to one DILIN (Drug-Induced Liver Injury Network) study, herbal dietary supplements can cause severe injuries in more cases than conventional medications.
Liver injuries from these supplements can contribute to the following:
Reduced blood clotting
Abdominal swelling
Jaundice (yellowing of the skin and eyes)
Encephalopathy (brain damage)
People with drug-induced liver injury may require a liver transplant.
People conducting the DILIN study also found that liver transplants and death occurred more frequently in people taking supplements than those taking pharmaceutical medication.
Important Note:
The Food and Drug Administration (FDA) does not require the same rigorous safety testing for supplements as for medications.
Unlike medicines, supplement manufacturers can also begin selling or marketing supplements without FDA approval.
Common ingredients in liver supplements
Many liver supplements contain herbal ingredients, vitamins, and minerals. Let's take a deeper look at some of the most common ingredients in liver supplements:
Milk thistle extract
Another name for milk thistle is silymarin, the most commonly used herbal supplement consumed for liver problems in the United States. Milk thistle contains approximately 50% silibinin, an active ingredient in silymarin.
Silibinin acts as an antioxidant to remove free radicals that contribute to inflammation.
One 2013 study found that 7 grams per day of Epaclin, a food supplement containing silymarin, vitamin E, and amino acids, significantly lowered the levels of liver enzymes associated with liver damage.
Link to STUDY.
In a 2015 clinical trial, researchers discovered that taking 420 milligrams of silymarin daily for four weeks reduced the risk of drug-induced liver injury by 28% in people taking antituberculosis medications.
Link to STUDY.
However, other findings from a Cochrane Review and a 2017 systematic review suggest that while silymarin supplementation may lead to minimal reductions in liver enzymes, these benefits are not clinically significant.
Cochrane Review - link
The authors of the Cochrane Review note that most of the studies reviewed had weak methodologies.
Zinc supplementation
Zinc is an essential mineral found in foods and different supplements, and it promotes:
cell division
DNA synthesis
immune function
If you have liver damage, it can often lead to zinc deficiency.
Very few studies support the claim that Zinc supplementation can help protect the liver from oxidative stress.
Licorice root
Licorice root contains an active compound called glycyrrhizic acid, which may help reduce inflammation in the liver and regenerate damaged liver cells.
Again due to a lack of studies, we can not be sure about the positive effects of licorice root on the liver.
One study conducted on rats in 2016 found that raw licorice root extract reversed the effects of alcohol-induced inflammation and fat accumulation in the livers of rats.
2012 a phase III clinical trial was conducted with 379 people with chronic hepatitis C. They received glycyrrhizin injections three or five times a week or five placebo injections weekly.
Individuals that received glycyrrhizin had a significant reduction in symports compared to the placebo group.
Link to STUDY.
However, the current evidence is too limited to support the use of licorice root for treating or preventing liver disease.
Important Note:
A Phase III clinical trial represents the most crucial step in the testing and developing of new treatments. It is conducted on a larger scale after Phase I and II with a larger group. In phase III, the effectiveness of the treatments is compared to existing standard treatments or a placebo.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), consuming high doses of licorice root over an extended period can lead to heart and muscle complications.
Signs of liver problems
We have already established that our liver is a complex organ that performs various essential functions.
A liver that works optimally eliminates blood waste, synthesizes hormones, and metabolizes fat. When our liver is damaged, diseased, or malfunctioning, it can have dangerous, even life-threatening consequences.
Hepatitis refers to self-limiting or chronic inflammation of the liver.
Hepatitis most often occurs as a result of a viral infection. However, excessive alcohol consumption, exposure to various toxins, some medications, and fat deposits in the liver can also cause hepatitis, aka liver inflammation.
Important Note:
According to the NIDDK, some people may develop symptoms of hepatitis C within 1–3 months and symptoms of hepatitis B within 2–5 months. People with chronic hepatitis may show no signs for several years.
Signs of a malfunctioning liver include:
Fatigue
Weakness
Loss of appetite
Unintentional weight loss
Nausea and vomiting
Dark yellow urine
Gray stools
Discomfort in the upper right part of the abdomen
People with advanced liver damage may experience the following:
Bleeding and bruising easily
Edema (swelling in the lower legs, ankles, and feet)
Fluid retention in the abdomen
Itchy skin
Jaundice (yellowing of the skin and eyes)
Confusion or difficulty thinking
Memory loss
Personality or mood changes
How to maintain a healthy liver
As we established, supplements could help; however, there is not enough scientific evidence to fully support using herbal supplements to treat or prevent liver disease. That is why lifestyle changes are the most critical step you can take toward improving your liver health and overall well-being.
Lifestyle changes you can make to improve your liver health:
Limit saturated fat intake.
High levels of triglycerides and cholesterol in the blood can lead to fat deposits around the liver, which may result in nonalcoholic fatty liver disease (NAFLD) and long-term liver damage.
Limit alcohol consumption
The liver produces toxic chemicals, such as acetaldehyde, when metabolizing alcohol.
Important Note:
Healthcare experts define heavy alcohol use as eight or more drinks per week for females and 15 or more for males. Heavy alcohol use can increase a person's risk for liver disease and other chronic conditions.
Consuming four to five drinks in 2 hours or less can lead to steatosis, in which fat droplets accumulate inside liver cells.
Stopping alcohol consumption can reverse the effects of steatosis. However, continuous binge drinking can lead to chronic steatosis and liver disease.
The Dietary Guidelines for Americans 2015–2020 recommend limiting alcohol consumption to one drink per day for females and no more than two drinks per day for males.
Minimize exposure to toxins.
The liver breaks down toxic substances in the blood.
Exposure to environmental toxins, such as cleaning products, pesticides, and tobacco smoke, can damage the liver as it filters these substances from the blood.
Avoid chronic drug use.
The liver metabolizes medications and drugs in the blood.
Chronic use of illicit drugs, such as heroin and cocaine, can lead to liver inflammation and damage.
Prescription and over-the-counter (OTC) medications can also contribute to drug-induced liver injury.
According to the FDA, medications that can contribute to liver damage include antibiotics (such as amoxicillin and erythromycin), acetaminophen (an OTC pain and fever reducer), cancer drugs (such as mercaptopurine, lapatinib, and pazopanib), and antianxiety and antidepressant medications (including duloxetine and nortriptyline).
When to see a doctor?
You should visit a doctor as soon as you experience one of the symptoms of liver disease or if you believe you may have been exposed to a hepatitis virus.
Most people remain asymptomatic (no symptoms) in the early stages of liver disease. However, doctors can often detect early signs of liver damage during annual checkups and routine screening appointments.
Suppose you have a family history of liver disease or one or more risk factors for liver disease. In that case, you should perform regular checkups and make necessary lifestyle changes.
Common questions and answers
What is nonalcoholic fatty liver disease?
Nonalcoholic fatty liver disease (NAFLD) is a condition that happens when you accumulate excess fat in your liver, even though your alcohol consumption is minimal to none. NAFLD is commonly associated with obesity, insulin resistance, and metabolic syndrome. NAFLD can have minor symptoms but can also cause severe cases of liver damage and can even progress to cirrhosis and liver failure.
Can lifestyle changes cure chronic liver disease?
Lifestyle choices play the most significant role in treating chronic liver disease. If you adopt a healthy diet, maintain a healthy weight, and engage in regular physical activity while avoiding alcohol and tobacco. If you manage underlying conditions like diabetes and high blood pressure, you can see dramatic changes in your health and improvement in your liver function. However, I always advise that you consult with your healthcare provider as, in some cases, medication will have to support the lifestyle changes to see optimal results.
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