I think the liver is the overlooked workhorse of the body. Most people know that the liver is the major organ of detoxification. Without the liver, that shot of tequila would be around for a very long time indeed, circulating and causing trouble. We would not be able to live much more than a day or two if our liver stopped working.

However, you may be surprised at some of the other things your liver does:

• Makes immune factors

• Removes bacteria from the bloodstream

• Creates bile for toxin removal plus bile breaks up dietary fats

• Makes cholesterol, the building block of sex hormones and vitamin D

• Stores vitamins and iron

• Helps regulate blood sugar by turning excess sugar into glycogen

• Regulates blood clotting

• Filters out bilirubin, a compound released when red blood cells break down

• Removes drugs and other poisonous substances

• Regulates body temperature

• Only organ that can regenerate itself, even if 90 percent is removed.

And this list is not even all-inclusive! Your liver health affects every single system in your body, but two areas you may notice quickly if your liver is not up to par is that your energy will decrease, and your brain health and even mental health will suffer. If your liver is sluggish, toxins will remain in circulation, and you will not feel your best.

One liver problem we are seeing at epidemic levels is non-alcoholic fatty liver disease (NAFLD) which often goes hand-in-hand with type 2 diabetes and obesity. It is estimated that 25 percent of adults in the U.S. have this disease, and many (many) more have fatty liver changes that left unchecked will lead to this disease.

One of the most important keys to a long and healthy life is a vigorous and powerful liver.

There are supplements that can have a profound benefit for nearly any kind of liver sluggishness or disease, and some of the best are milk thistle, curcumin, andrographis and grape seed extract.

Milk Thistle

The liver undergoes stress just like any other organ in the body, and that increases both inflammation and free radical activity. Milk thistle contains components, especially one called silybin, that addresses both. There is also research indicating that milk thistle standardized to silybin can help protect liver cells from toxins and boost self-repair. Animal studies have shown that this amazing herb can reduce damage caused by acetaminophen, carbon tetrachloride, radiation, iron overload, certain prescription drugs, alcohol, and even the liver poisonous mushroom, Amanita phalloides. Standardized milk thistle has been used to treat alcoholic liver disease as well as toxin-induced liver diseases. The ability of a quality milk thistle to protect against fibrosis (liver scarring which can lead to irreversible cirrhosis of the liver) has been repeatedly demonstrated. It is a very highly regarded herbal medicine for all aspects of liver care.

Curcumin

After working in mainstream medicine for years, then integrative medicine for more than 26 years, I have been exposed to a lot of research on thousands of natural compounds. However, I have not seen any herb as good for as many things as is curcumin. I think we could play a game to try to come up with a health concern for which curcumin would not be an effective treatment. Curcumin has very powerful and specific activity in reducing inflammation, oxidative stress, boosting liver function and detoxification, and regulating a multitude of cancer progression pathways. It is a powerful component in any liver health protocol.

In a double-blind, placebo-controlled study of 58 people with cirrhosis of the liver, curcumin was found to be superior at reducing the symptoms of this disease, including upper abdominal pain, depression, decreased appetite, fatigue, daytime sleepiness, itching and jaundice.

For liver cancer, curcumin has been shown to downregulate specific tumor promoting pathways while upregulating tumor suppressor pathways. It reduces the likelihood of cancer cells to create cancer stem cells that hide from treatment only to reawaken months or years later and cause a recurrence of the diseases. Curcumin supports healthy bile production, which is extremely important to liver detoxification activity, as bile carries the toxins out of the liver and into the intestines for excretion.

Curcumin has also been shown to increase the capacity of the liver to make glutathione, which is a super potent endogenous antioxidant that also is crucial to liver detoxification (both phase one and phase two glucuronidation). If there is a fountain of youth in the body, it may be glutathione, so increasing and protecting its production is important for long-term health.

For curcumin to be effective, it must be absorbed, so enhanced absorption is a better consideration. Some methods to boost absorption can be hard on the liver, so I prefer the use of a clinically studied curcumin boosted with turmeric essential oil, a form that has shown approximately 700 percent increase in absorption over plain curcumin. It is the most clinically studied enhanced absorption curcumin in the world and has been specifically studied for NAFLD. Researchers found that supplementation with turmeric essential oil enhanced curcumin was associated with significant decrease in hepatic fibrosis.

Andrographis

Andrographis is called the king of bitters, but that is not an insult. Many botanical practitioners and herbalists equate the bitterness of a plant with its medicinal benefits, so calling andrographis the king of bitters is a bit like calling it the best of the best.

In a recent study, researchers fed animals a diet with high levels of unhealthy fats and cholesterol to cause them to develop fatty liver disease. Some animals also received andrographis. Those in the herbal group were much healthier, with lowered oxidation of liver fat, and reduction in inflammation and oxidative damage.

One marker of liver health is measurement of liver enzymes. Elevated enzymes are indicative or liver concerns. A scientific study showed that andrographis can lower the abnormal liver enzymes caused by liver dysfunction, which is an indicator of improved liver health.

The key compounds in andrographis are called andrographolides, so standardization to at least 20 percent yielding 80 mg of andrographolides is key to replicating dosage in human studies showing benefits.

Grape Seed Extract

Some may consider standardized French grape seed extract ([GSE] high levels of OPCs standardized to be small enough for absorption) as a great product for heart health, and they would be correct. GSE is indeed very useful for blood vessel resilience and integrity and has been proven to lower high blood pressure. However, you may be surprised to learn that is also has excellent liver benefits. Animal studies have shown that it protects against the formation of fatty tissue in the liver in the first place, as well as protecting liver cells from damage by toxins such as lead or chemical exposure. Since uncontrolled blood sugar levels are damaging to the liver and are a big contributing factor to fatty liver disease, GSE has been shown to modulate blood sugar metabolism and reduce insulin resistance. There are also studies on the impressive anticancer benefits of GSE, alone, or in combination with curcumin and andrographis. Preventing liver cancer or liver cancer recurrence requires a healthy nutrient regimen.

Summary

This is a short list of powerful natural medicines to protect liver health and treat liver disease. There are many others, including berberine, glutathione, coenzyme Q10, ashwagandha and even melatonin also have published studies on liver health benefits. No matter your age or health condition, there are supplements that can make a real difference.VR

References:

Liver: Anatomy and Functions. Available at: www.hopkinsmedicine.org/health/conditions-and-diseases/liver-anatomy-and-functions. Accessed on 1/23/25.

Chua LS. Review on liver inflammation and anti-inflammatory activity of Andrographis paniculata for hepatoprotection. Phytother Res. 2014 Nov;28(11):1589-98.

Chen HW, Huang YJ, Yao HT, Lii CK. Induction of Nrf2-dependent Antioxidation and Protection Against Carbon Tetrachloride-induced Liver Damage by Andrographis Herba (chuān xīn lián) Ethanolic Extract. J Tradit Complement Med. 2012 Jul;2(3):211-9.

Choudhury BR, Poddar MK. Andrographolide and kalmegh (Andrographis paniculata) extract: in vivo and in vitro effect on hepatic lipid peroxidation. Methods Find Exp Clin Pharmacol. 1984 Sep;6(9):481-5.

Ladas et al. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL). Cancer. 2010;116(2):506-13.

Miyazaki K, Morine Y, Xu C, Nakasu C, Wada Y, Teraoku H, Yamada S, Saito Y, Ikemoto T, Shimada M, Goel A. Curcumin-Mediated Resistance to Lenvatinib via EGFR Signaling Pathway in Hepatocellular Carcinoma. Cells. 2023 Feb 14;12(4):612.

Farzaei MH, Zobeiri M, Parvizi F, El-Senduny FF, Marmouzi I, Coy-Barrera E, Naseri R, Nabavi SM, Rahimi R, Abdollahi M. Curcumin in Liver Diseases: A Systematic Review of the Cellular Mechanisms of Oxidative Stress and Clinical Perspective. Nutrients. 2018 Jul 1;10(7):855.

Chashmniam S., Mirhafez S.R., Dehabeh M., Hariri M., Azimi Nezhad M., Nobakht M.G.B.F. A pilot study of the effect of phospholipid curcumin on serum metabolomic profile in patients with non-alcoholic fatty liver disease: A randomized, double-blind, placebo-controlled trial. Eur. J. Clin. Nutr. 2019;15:15.

Chirapongsathorn S., Jearjesdakul J., Sanpajit T., Juthaputthi A. Curcumin trend to improve alanine transaminase (ALT) in non-alcoholic fatty liver disease (NAFLD) with abnormal ALT. J. Gastroenterol. Hepatol. 2012;27:231–232.

Hariri M., Gholami A., Mirhafez S.R., Bidkhori M., Sahebkar A. A pilot study of the effect of curcumin on epigenetic changes and DNA damage among patients with non-alcoholic fatty liver disease: A randomized, double-blind, placebo-controlled, clinical trial. Complement Ther Med 2020;51:102447.

Saadati S, Sadeghi A, Mansour A, et al. Curcumin and inflammation in non-alcoholic fatty liver disease: a randomized, placebo controlled clinical trial. BMC Gastroenterol. 2019 Jul 25;19(1):133.

Federico A, Dallio M, Loguercio C. Silymarin/Silybin and Chronic Liver Disease: A Marriage of Many Years. Molecules. 2017 Jan 24;22(2):191.

Loguercio C, Festi D. Silybin and the liver: from basic research to clinical practice. World J Gastroenterol. 2011;17(18):2288-2301.

Wellington K, Jarvis B. Silymarin: a review of its clinical properties in the management of hepatic disorders. BioDrugs. 2001;15(7):465-89.

Desplaces A, Choppin J, Vogel G, Trost W. The effects of silymarin on experimental phalloidine poisoning. Arzneimittelforschung 1975;25:89-96.

Carducci R, Armellino NIF, Volpe C, et al. Silibinin and acute poisoning with Amanita phalloides. Minerva Anestesiol 1996;62:187-193.

Kalantari H, et al. Effects of silybum marianum on patients with chronic hepatitis C. J Res Med Sci. 2011;16(3):287-90.

Liu B, Jiang H, Lu J, Baiyun R, Li S, Lv Y, Li D, Wu H, Zhang Z. Grape seed procyanidin extract ameliorates lead-induced liver injury via miRNA153 and AKT/GSK-3β/Fyn-mediated Nrf2 activation. J Nutr Biochem. 2018 Feb;52:115-123.

Long M, Yang SH, Han JX, Li P, Zhang Y, Dong S, Chen X, Guo J, Wang J, He JB. The Protective Effect of Grape-Seed Proanthocyanidin Extract on Oxidative Damage Induced by Zearalenone in Kunming Mice Liver. Int J Mol Sci. 2016 May 25;17(6):808. doi: 10.3390/ijms17060808. PMID: 27231898; PMCID: PMC4926342.

Khoshbaten M, Aliasgarzadeh A, Masnadi K, et al. Grape seed extract to improve liver function in patients with nonalcoholic fatty liver change. Saudi J Gastroenterol. 2010 Jul-Sep;16(3):194-7.

Gonciarz M, Bielański W, Partyka R, Brzozowski T, Konturek PC, Eszyk J, Celiński K, Reiter RJ, Konturek SJ. Plasma insulin, leptin, adiponectin, resistin, ghrelin, and melatonin in nonalcoholic steatohepatitis patients treated with melatonin. J Pineal Res. 2013 Mar;54(2):154-61.

Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of scientific affairs and education for EuroPharma, Inc.