Liver Long and Prosper: Best Supplements for Liver
If there’s one truth underlying the “detox diet” craze — and, indeed, there may only be one — it’s that liver health is vitally important to your overall wellbeing. So let’s cut through all the hype and talk about the best supplements for liver health.
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But first, it would help to better understand this essential organ and some other parts of the body it affects, including the gallbladder and biliary system.
The real importance of your liver
Imagine your liver as a waste treatment plant, factory, warehouse and distribution center all under one roof. In terms of a building, this would surely cover many acres of real estate, though in your body it fits neatly into an oblong organ about the size of an American football. More than 500 functions of the liver have been identified, some of the most critical including:
- Digestion of food
- Processing and distribution of nutrients
- Storage of energy
- Storage of vitamins and minerals, such as vitamin D and iron
- Removal of toxins/poisons
- Blood clotting
- Production of key hormones
It’s safe to say that without just one or two of these primary functions, you’d be in deep trouble. So if you didn’t before, hopefully you now understand what’s on the line — and why preventing liver disease should be one of your highest priorities if you want to live a long, healthy life.
What can damage the liver?
Unfortunately there are several common conditions that can damage the liver including:
- Viral infections such as hepatitis A, B and C
- Autoimmune hepatitis
- Poisoning by drugs, alcohol or toxic chemicals
- Overload of fat, i.e. non-alcoholic fatty liver disease (NAFLD)
- Cirrhosis secondary to alcohol or non-alcoholic steatohepatitis (NASH)
What are the main risk factors?
Several lifestyle risk factors can greatly affect your chances of getting liver disease. These include:
- Alcohol use/abuse
- Drug use/abuse (including prescription and over-the-counter drugs)
- Shared needles, unsafe tattoo or body piercing practices
- Unprotected exposure to blood and bodily fluids
- Chemical exposure
- Pollution exposure
- Poor diet
Often those with developing liver disease will be symptom-free for years. When symptoms do manifest, they often include swelling of the legs (edema) and also swelling of the abdomen that can become severe (ascites). Abdominal pain, bruising, gastrointestinal problems (diarrhea or constipation, color changes in stool or urine), fatigue, nausea, vomiting, loss of appetite, muscle wasting and yellowing of the skin and eyes (jaundice) may also occur.(1, 2)
Most liver disease can be detected early, if certain markers called liver function tests (LFTs) are checked on a blood panel. Thereafter another diagnostic procedure such as MRI or CT may be used to more specifically diagnose the type of liver disease present.
The weak link: gallbladder and biliary system
Perhaps because it’s the largest internal organ in the body, the liver can often take many years of abuse prior to showing acute signs of disease. In many cases, however, problems in the gallbladder and biliary system will emerge much earlier.
The gallbladder is a small, pear-shaped organ that serves as a holding tank for bile produced by the liver, while the biliary system includes a series of tubes connecting the liver, gallbladder and small intestine. The bile itself has a dual purpose, as it contains both digestive juices (bile salts), mainly for breaking down dietary fat, as well as cholesterol and waste products. These latter ingredients tend to cause the most trouble.
Cholesterol is a waxy substance, and liver waste products often include fine, sand-like sediment. When you put them together the result is a thick sludge, which may clog the biliary system. This thick bile hinders gallbladder function, and also creates perfect conditions for the formation of gallstones, or cholelithiasis.(3,4)
Spotting gallbladder health issues
The presence of gallbladder sludge also tends to increase the chances of infection. When the gallbladder itself becomes infected and inflamed, this gallbladder illness is known as cholecystitis. The most common cause is a gallstone that becomes lodged in the a bile duct leaving the gallbladder, thus blocking the flow of bile and disrupting proper gallbladder function. Less commonly a bile duct defect or tumor will cause similar problems.
Acute gallstone symptoms include:
- Abdominal pain and tenderness, usually
on the right side, sometimes to the back or shoulder
Flare-ups often occur during or immediately after a meal, particularly one containing fatty or greasy foods.(5)
When to see your doctor
If you suddenly experience abdominal pain too severe to be typical indigestion, or if you have any persistent symptoms causing you concern, it’s probably a good idea to seek medical attention right away. Ignoring gallbladder problems — or administering ineffective home remedies — may, in turn, trigger other problems such as acute pancreatitis, which can be a medical emergency.
An ounce of prevention
As Benjamin Franklin famously said, it’s worth a pound of cure. But considering how life-altering and even life-threatening gallbladder illness and especially liver disease can be — a ton of cure may be more like it! The good news is, there are many steps you can begin taking right now to help prevent both gallbladder and liver disease. Arguably the most important lifestyle factor is your diet, so let’s start there.
Some of you may be disappointed to learn there are no magical foods you simply need to add to your existing diet to preserve these key organs. No, as usual a measured approach is needed, and some of your favorite comfort foods may be relegated to the “special occasion only” category.
Limit these three things and you’ll be off to a great start:
especially saturated fat from meat and baked goods
especially from beverages like sodas, sweet tea and fruit juice
especially from processed meats, fast food and crunchy snacks
Incidentally, there’s an interesting book called Salt Sugar Fat: How the Food Giants Hooked Us, in which author Michael Moss tells the story of how these three insidious ingredients became so highly featured in modern culture. But whether or not there’s a conspiracy afoot, it doesn’t make much difference. Instead, what matters is that we have the will to take charge of our own health, and the knowledge of good choices we should be making.
Good fat, bad fat
Let’s drill deeper. With regard to fat, the landscape can indeed be very confusing, with a multitude of so-called health and fitness experts giving mixed messages.
The truth is that fat can be very good for you — if it’s part of a balanced diet, and if most of it comes from plants. Olive oil for example, a staple of the Mediterranean diet. Avocados. Nuts. Flax. Chia seeds. Wheat germ. All excellent sources of fat. The exception in the animal kingdom of course is fish. Rest assured nothing has changed there, the fat contained in salmon and seafood in general is very much still on the table.(6)
With regard to meats like chicken, pork and beef — by all means continue to eat them, but consider doing so less often. Also, when you do choose meat, choose the leanest cuts and prepare them without a lot of added fat. That is, not fried, and not drowned in creamy sauces or gravies.
The controversy of dairy fats
Dairy fat is even more controversial a subject. Going against years of conventional wisdom, multiple studies have shown even high-fat dairy to be inversely proportional to obesity — that is, those who consume products such as whole milk and cheese appear less likely to be obese. There is also ample evidence that yogurt consumption is associated with maintaining a healthy weight.(8,9,10,11)
While less comprehensive, there’s additional research showing that dairy fat may actually improve insulin sensitivity (anti-diabetes) in the liver and reduce the build-up of liver fat. Nevertheless many nutritionists remain hesitant to recommend adding foods such as cream and whole milk yogurt to their patients’ diets — especially those who already struggle with obesity and metabolic syndrome.
Just keep in mind that virtually all the fat you put in your mouth will end up in your liver. From there, a certain amount will be shipped off to be used for energy or various metabolic functions — but any above what is needed will begin to deposit in the liver itself. More saturated fat also translates to more cholesterol, a lot of which will flow through your gallbladder and biliary system, increasing the probability of gallstones or gallbladder disease.
The sticky truth about sugar
The case against sugar is a little different, yet just as clear cut — and by no coincidence this is the title of another expository book about the food system, The Case Against Sugar by Gary Taubes. It’s no secret by now that high sugar intake is a risk factor for obesity, high blood pressure, diabetes and heart disease. Well, you can now add two more to the list — gallbladder and liver disease.
Perhaps the biggest problem with sugar has to do with the fact that it’s sticky. Think about pancake syrup. Now imagine that same gooey substance sloshing around in your bloodstream and pervading every major organ of your body. Blood cells effectively become candy-coated (Hemoglobin A1C is a measure of this), blood vessels become narrower and stiffer. The liver is no exception. In fact, it’s among the hardest hit.
Limiting sugar in your diet is fairly straightforward. As mentioned before, start with what you’re drinking — if it contains sugar, give it a hard look. Next move on to desserts. Then to other baked goods, breads and processed foods high in carbohydrates, such as breakfast cereals and granola bars.
Unless you have pre-diabetes or diabetes however, restricting all carbs across the board is not essential. Fruit, starchy vegetables and whole grains like oats most certainly have their place in a healthy diet as well — because they are rich in vitamins, minerals and dietary fiber. French fries, not so much!
Salt is NOT a healthy food
The scientific evidence is extremely convincing on the association between salt (or sodium) intake and high blood pressure (hypertension) — even though some recent studies lay substantial blame on diets lacking potassium as well. There’s also little doubt that uncontrolled hypertension raises your risk of all-cause mortality, which in science language means dying for any reason whatsoever.(12, 13, 14)
However, many wannabe health experts repeat the false claim that you can eat all the salt you want without negative consequences — as long as it comes from pristine environments like the Dead Sea or Himalayan Mountains. This is pure nonsense — no pun intended — but as usual there is a “grain” of truth. Yes, topping wholesome foods like green leafy vegetables with a pinch of sea salt is better than eating hot dogs and French fries, any day of the week!
For those who already have issues with hypertension, the stakes are much higher. Because water tends to follow salt wherever it goes, increased salt in the bloodstream means higher blood volumes, which invariably raises blood pressure. The increased pressure, in turn, damages blood vessels and organs, especially those with a high blood perfusion like the kidneys and liver.(15)
Best liver and gallbladder supplements
Once you’ve 1) avoided all possible toxins and risky behaviors, and 2) fine-tuned your diet to include more plant-based fiber, while limiting the trifecta of badness — saturated fat, sugar and salt — you can finally start to think about choosing the best supplements for liver and gallbladder. Just understand that no supplement will completely erase the damage done by a wayward lifestyle, and certainly none will cure a cirrhotic liver. Once that kind of damage is done, it’s done. Period.
In order to choose the best supplements for liver and gallbladder:
- Ask your doctor (MD) or a registered dietitian (RD)
- Follow expert advice (i.e., this article and others like it), not marketing jargon or anecdotal stories
- Do research — search PubMed using terms like “[supplement name] and [gallbladder, liver, etc.]” or “natural remedies for [gallstones, liver disease, etc.]”
- Look for products certified by an independent third-party, such as USP
- Add one supplement at a time, trying to keep your diet and lifestyle factors as constant as possible — to best assess any positive or negative effects
- Be wary of very cheap products, such as those sold at dollar stores
Top liver supplements
For centuries the Chinese have been enjoying dandelion greens as a culinary staple, while also utilizing the plant for a variety of pharmacological remedies.
In animal models, dandelion has successfully protected the liver from acetaminophen (Tylenol) toxicity and lead poisoning. Furthermore it has shown promise in reducing oxidative stress from alcohol and slowing the progression of fatty liver disease.(16, 17)
Milk thistle has been used as an herbal remedy for more than 2000 years, mainly for liver and gallbladder health problems. The extract from milk thistle plant and seeds is called silymarin, a compound high in bioactive flavonolignans.(18)
Silymarin has been shown to reduce fasting glucose and triglycerides. Most notably however, patients with alcoholic cirrhosis who took silymarin supplements lived significantly longer, on average, than those taking a placebo.(19)
This nutrient-dense green algae is commonly added to various “superfood” products, and for good reason. Chlorella is rich in vitamins and minerals, as well as omega-3 fatty acids and potent antioxidants such as carotenoids lutein and zeaxanthin.
Studies suggest chlorella can help reduce total cholesterol and triglyceride levels if taken as a daily supplement, which has long-term implications for cardiovascular and liver health. Also, when tested on specific populations with fatty liver disease (NAFLD), chlorella was credited with improving blood sugar, cholesterol, triglycerides and liver function tests, while promoting weight loss.(20, 21)
Several users of this product found it a nice addition to their “detox” program for heavy metals or other toxins.
Compared to milk thistle and dandelion, alpha lipoic acid (ALA) is a relatively modern phenomenon, identified in the 1950s as an extremely potent antioxidant capable of protecting cells from free radical damage. The human body is able to produce its own ALA, however production decreases with age — making it a potentially beneficial anti-aging supplement.(22)
ALA has exhibited several different liver-protective attributes. In multiple studies it has shown to reduce oxidative stress, insulin resistance and inflammation, prevent fibrosis and protect against chemical toxicity.(23, 24)
Numerous customers report that ALA helped with their neuropathy, or nerve pain, usually in the feet. Others took it to help with metabolism, blood sugar and triglyceride levels. Overall, it is considered one of the best supplements for liver.
Top gallbladder supplements
This spice is traditionally featured in many Indian dishes alongside ginger, garlic and turmeric, all of which are known to have health benefits. Although its study as a dietary supplement are very limited, Fenugreek does show potential as a natural anti-gallstone agent.(25, 26)
This grease-cutting compound known as a terpene can be found in citrus oils such as orange, lemon, lime and grapefruit. It is widely used as a natural surface-cleaning agent, but can also be taken in capsule form as a dietary supplement.
Although the evidence is somewhat limited, d-Limonene has shown promise in its ability to dissolve cholesterol gallstones, at least in a laboratory setting (in vitro).(27)
With many years of excellent track record as a digestive health and even weight loss supplement, the fact that it may also lower cholesterol and thus prevent the formation of gallstones comes as little surprise.(28)
Users of psyllium claim it can help with both constipation and diarrhea, as well as create a sense of satiety thus decreasing hunger and caloric intake.
Arguably the supplement of the decade, if not the century, curcumin’s list of virtues just keeps getting longer. Not only is it a potent weapon against inflammation, curcumin may also be the most effective tool we have in preventing gallstones and gallbladder disease.(29)
Customers praise curcumin for relieving joint and muscle pain, helping bowel inflammation, increasing energy and mental sharpness, and many other health benefits.
Diet and lifestyle first, supplements second
Given how important liver and gallbladder health are to quality of life, it makes sense that you’d want to give your body every possible advantage. However, when it comes to dietary supplements, just remember that more is not always better. Not to mention the fact that, if the diet you’re supplementing is extremely poor, or other risk factors are present, you may not see any noticeable benefit from natural remedies.
As with any health condition, if you suspect liver or gallbladder health issues, it’s probably smart to visit your doctor — sooner rather than later.