Your liver is the consummate multi-tasker. It helps digest food, regulates cholesterol and fat metabolism, and plays a key role in the processing and removal of metabolic waste products and most ingested drugs, to name only several of its 500 or so essential functions.
It’s no wonder then that there are dozens of dietary supplements—pills, powders, and tonics—touted to protect this vital organ. LiverCare, Liverite, Liver Plus, and Liver-Rx are but a few that claim to “neutralize toxins” and repair and regenerate the liver. Some products even claim to alleviate chronic fatigue, food allergies, PMS, and immune problems, as well as increase energy, lower cholesterol, and help you lose weight.
Let’s filter out these claims.
A thorn in the thistle?
Of all ingredients commonly found in these products, the herb milk thistle (Silybum marianum) is one of the more researched. Reports of its use date back to the ancient Greek physician Dioscorides, who used this white-veined plant to treat serpent bites. In Europe, milk thistle has been a popular folk remedy for liver disease and is sometimes given as an intravenous drug to treat liver damage from mushroom poisoning.
Lab studies suggest that silymarin, a group of compounds extracted from the plant’s seeds, may protect the liver against damage from toxins and disease by acting as an antioxidant, immune-stimulant, and anti-inflammatory agent. It may also help stabilize membranes so toxins can’t bind and help regenerate liver cells, among other mechanisms.
While this all sounds promising, studies in people have been flawed, and results have been inconsistent or inconclusive. In a 2007 review of 13 clinical trials, the independent Cochrane Collaboration questioned the use of milk thistle for alcoholic liver disease and hepatitis B and C because of the poor quality of the research.
Perhaps the best clinical trial on milk thistle extract was published in the Journal of the American Medical Association in 2012 and involved 154 people who had chronic hepatitis C and were not responding well to interferon antiviral therapy. It found that a standardized silymarin extract (Legalon 140, approved as a prescription drug to treat liver diseases in several European and Asian countries) taken for six months did no better than a placebo in reducing blood levels of ALT, an enzyme that’s a marker for liver injury.
Moreover, nearly all studies have looked at milk thistle or silymarin in chronic liver disease.There’s little if any evidence the herb can “detoxify” or protect a healthy liver, though this is what these supplements are typically marketed for. And no matter how convenient it would be, milk thistle is not an antidote for a night of heavy drinking or for smoking, as some supplement makers suggest.
Do these ingredients deliver?
Other common “liver herbs” include licorice root extract, Phyllanthus.Various mixtures (often proprietary) of herbs used in Ayurvedic (Indian) or traditional Chinese medicine are widely available as well. As with milk thistle, lab studies suggest these herbs may have some liver-protective properties. But there are no good human studies.
The same goes for the other herbs (such as dandelion, artichoke, and sea buckthorn), amino acids, vitamins (such as B12 and E), and other substances (such as choline, inositol, and chlorophyll) that may be found in liver supplements. Some ingredients may have dangerous side effects. For example, unless licorice is specially processed to remove a particular compound(glycyrrhizin), it can raise blood pressure.
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Bottom line: Avoid “liver support” supplements. Just because a healthy liver helps detoxify your body, that doesn’t mean it needs to be detoxified itself. It is not like a clogged filter. And a healthy liver has a remarkable ability to restore itself when damaged. If you have liver disease,consult your doctor before taking any supplement or medication.
Published September 13, 2018