As the name implies, the liver is important to maintaining life. One of the largest internal organs, it’s integral to digestion by producing bile, which helps break food down into the vital nutrients needed by cells.
The liver also plays a critical role in keeping the body healthy by removing waste products. Specifically, the liver generates urea when breaking down the waste product ammonia. The urea is then filtered out of the blood by the kidneys and excreted in urine. The liver also excretes bilirubin, a waste product that results from the breakdown of hemoglobin, a protein in red blood cells.
The liver is an incredible organ — it can actually regenerate after an injury. But it’s also vulnerable to various infections and diseases, such as viral infections, such as hepatitis A, B and C, that can lead to long term liver damage.
The Centers for Disease Control and Prevention reports that 4.5 million American adults, nearly 2% of the population, have been diagnosed with chronic liver disease or cirrhosis. Cirrhosis occurs when the liver builds up excess scar tissue. It can result from an infection, injury or chronic abuse of alcohol.
Should You Take a Liver Supplement?
If you’re concerned about the health of your liver, you may be wondering whether taking a liver supplement is a good idea. Emily Rice, staff dietitian with the Ohio State University Wexner Medical Center in Columbus, says these products can contain a wide range of herbal ingredients that are marketed as being supportive of liver health, but it’s not clear whether they work.
“Liver supplements are supposedly supporting the liver by detoxing it, undoing damage to cells and improving blood flow to the liver,” Rice explains. “However, the liver is one of the most important organs in our body as it metabolizes sugar, fat, alcohol and medications. It naturally detoxifies itself by filtering food byproducts out of the body through urine and stool. No supplements are needed to aid this process in a healthy individual.”
[SEE: 7 Foods That Are Good for Your Liver.]
What’s in Liver Supplements?
Dr. Benjamin Hyatt, a gastroenterologist with the Middlesex Digestive Health & Endoscopy Center in Acton, Massachusetts, says several ingredients commonly found in liver supplements include:
— Milk thistle.
— Artichoke leaf.
— Dandelion.
— Zinc.
— Turmeric or curcumin.
Milk Thistle
Milk thistle, or Silybum marianum, is a prickly, flowering herb that’s sometimes used in herbal remedies. It’s “the most common ingredient in liver supplements,” because of its “antioxidant as well as anti-inflammatory properties,” Hyatt explains. “Functioning as an antioxidant, milk thistle is thought to protect liver cells from free radicals — reactive molecules that can damage tissues — which are produced when toxins are metabolized in the liver.”
While milk thistle might be a popular supplement, it’s not clear that it actually works. Hyatt notes that “a few studies have demonstrated that milk thistle can reduce liver enzymes, but a larger systematic review in 2017 showed that these improvements were not clinically significant.”
Similarly, a 2007 review of “literature studying milk thistle use in liver disease due to viral hepatitis or alcohol questioned the beneficial effects due to lack of high-quality evidence,” Hyatt says.
Milk thistle is generally considered safe when taken in usual doses, but “it can rarely cause allergic reaction, diarrhea, nausea, vomiting, rash or headaches,” Hyatt says. It can also interact with some medications “so, it’s important to discuss the use of this medication with your physician.”
Artichoke Leaf
When used as a food item, artichokes are high in fiber, vitamin C and other antioxidants. While they’re typically prepared like a vegetable, artichokes are actually a type of thistle. An extract from the plant is sometimes used in supplements, which have been “shown to have antioxidant effects and is used to support liver health,” Hyatt notes.
Some studies have suggested that artichoke leaf extract could help support healthy blood pressure and lower levels of LDL or the “bad” type of cholesterol.
Similarly, “a randomized double-blind study published in 2016 showed improvement in liver enzymes,” in patients who had one type of non-alcoholic fatty liver disease, Hyatt says. Non-alcoholic fatty liver disease, also sometimes called metabolic dysfunction associated fatty liver disease, can develop when too much fat accumulates in the liver and hinders optimal function. Obesity and Type 2 diabetes are risk factors for NAFLD.
But this evidence is slim, Rice says. “Current literature states that there is minimal to no benefit of milk thistle and artichoke leaf on the liver.”
[READ: What Is Nonalcoholic Fatty Liver Disease?]
Dandelion
Known for its cheerful yellow flowers and recognizable sawtooth leaves, dandelions are more than just a garden variety weed. Long used as a food source and in homeopathic remedies, it seems there could be something about this common plant that can help support health.
The entirety of the dandelion plant is edible, and when used as a food, it can provide lots of vitamins, including A, C and K. Dandelions also are a rich source of beta-carotene, the same antioxidant that gives carrots their orange color and can be converted by the liver into vitamin A.
The dandelion plant has anti-inflammatory and antioxidant effects that are thought to protect the liver. However, Rice notes that “there isn’t enough research to state whether dandelion root is safe and/or effective for the liver.”
Zinc
“Zinc is a trace mineral that is essential for cell growth,” Hyatt explains. But levels of this essential mineral are “often low in patients with liver disease.” Therefore, zinc supplementation is thought to be protective in maintaining liver function.
Zinc supplementation is sometimes used as part of the treatment protocol for patients with alcohol-related cirrhosis, and a 2018 review of studies noted that patients who received a combination of zinc supplementation with medication over three to six months had better outcomes than those treated with the medication alone.
Turmeric or Curcumin
The compound curcumin is the active component of turmeric, a bright orange spice that’s used widely in Indian and South Asian cuisine. Like dandelion, turmeric also has antioxidant and anti-inflammatory properties that are believed to be protective for the liver.
“Two randomized placebo controlled trials from 2016 and 2017 studying the use of turmeric (curcumin) in non-alcoholic fatty liver disease showed some benefit with reduction in liver fat and improvement in liver tests,” Hyatt says.
Curcumin supplements often also contain another compound called piperine, which is an extract of black pepper that significantly improves curcumin absorption.
Talk to Your Doctor Before Supplementing
Hyatt cautions that while some studies have suggested that certain supplements might offer liver protection, “high-quality robust evidence is lacking and more studies are needed.”
Rice agrees. “Most research on liver supplements is more evident in animal studies than human studies, so we have yet to find a significant benefit, if any, from them.”
Although many of the supplements listed above have been used for years and “are generally considered safe in recommended quantities, the safety of any herbal supplement cannot be guaranteed given lack of significant oversight by the FDA,” Hyatt adds. “Furthermore, federal law does not require dietary supplements to be proven safe prior to marketing.”
Plus, because the Food and Drug Administration doesn’t regulate supplements like it does medications, “supplements are considered food and it’s hard to know exactly what’s in the supplement and at what quantities without third-party testing,” Rice says.
What’s worse, the supplement you’re taking to support liver health could actually have the opposite effect. “Herbal supplements can be harmful to the liver, and cases of severe liver injury due to supplements are increasing,” Hyatt says.
The issue is that the liver is the organ responsible for removing toxins from the body, and depending on the components of the supplement, when it’s broken down the supplement can in some cases actually generate toxic metabolites that the liver must now process and excrete. Your liver may end up having to work harder to cope with the supplement that was meant to support its function. Therefore, before you start taking any supplement, “it’s important to review possible side effects” Hyatt says.
In addition, some ingredients in herbal supplements could make other medications you’re taking less effective or heighten their side effects. In all cases, it’s really important to talk with your health care provider before starting any supplement.
And naturally, if you’ve recently been diagnosed with liver disease, it’s best to confer with your doctor about all medications and supplements you’re taking or considering taking and to review your diet and other lifestyle factors that can exacerbate liver disease.
[Read: What Is Liver Cancer?]
Lifestyle Modifications for Liver Health
While it may be appealing to reach for a pill to support liver health rather than change your diet or make other lifestyle changes, Rice notes getting the nutrients you need through food is best. There’s a complex interplay between the various components of the many foods we eat, and just because a specific compound has been shown in cells or animals to potentially be supportive of liver health, when that compound enters the context of the human body and all the other lifestyle and dietary factors that are in play, the results may not be the same.
Instead of spending money on products that may not help and could actually cause harm, Rice recommends focusing on supporting liver health through lifestyle instead. This entails:
— Eating a balanced, healthy diet. Incorporating more fruits and vegetables, whole grains, lean protein and low-fat dairy are the basis of a healthy diet, and that can support liver health. An overall healthy diet provides all the vitamins and nutrients the body needs to repair itself and stay in functional balance. For the liver, that means it’s supported in doing its work.
— Exercising regularly. Being physically active can “keep body weight in a normal range, which reduces the risk of fatty liver,” Hyatt says. Preventing NAFLD reduces your risk of developing scarring of the liver or cirrhosis.
— Avoiding significant alcohol consumption. Alcohol is metabolized by the liver and can place undue stress on this vital organ. “Current guidelines advise consuming less than one drink per day for women and less than two drinks per day for men,” Hyatt notes. Each additional drink places more strain on the liver and can lead to dependence, which over time can increase your risk of developing alcohol-related cirrhosis.
— Limiting higher fat and sugary foods. Rice says limiting fried foods, desserts and fast food can also help support good liver health. To break down foods that are high in saturated fats, the liver must work harder than when it processes healthy fats and lower-fat foods. Chronic consumption of high fat foods can also limit the liver’s ability to store glucose, which may elevate risk for Type 2 diabetes.
More from U.S. News
Food Cravings That Wreck Your Diet
7 Habits for a Long, Healthy Life
22 Ways Alcohol Affects the Aging Process
Everything You Need to Know About Liver Supplements originally appeared on usnews.com
Update 01/17/22: This article has been updated with new information.
