January 10th 2024
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Liver Health: Why and How to Support a Healthy Liver

When did you last check in about your liver health? 

The liver is your largest internal organ and performs critical actions to support your well-being. However, the health status of the liver is often overlooked in conversations about overall wellness. Learn how the liver works and how to protect it so that you can live your longest, healthiest life.  When did you last check in about your liver health? 

Why You Need to Care About Liver Health  

If the health of your liver hasn’t been a focus for you, now is the time to change that. The liver participates in over 500 different chemical processes in the body and is responsible for numerous functions, including supporting your metabolism and digestion, mounting immune responses, and filtering your blood.1,2 

A liver that is not functioning properly interferes with all these activities and more. In some cases, the liver is affected by inherited genetic diseases, like hemochromatosis, but most liver diseases arise within one’s lifetime. Unfortunately, liver disease is increasing dramatically—especially in young people—due to factors like increased alcohol consumption.3,4 

The most common liver diseases include viruses like hepatitis A, B, and C, fatty liver disease, cirrhosis, and liver cancer. A person's risk for developing one of these conditions is influenced by their lifestyle and environment. Factors that increase risk for liver disease include:5 

  • High alcohol intake 
  • Obesity 
  • Type 2 diabetes
  • Needle sharing
  • Being exposed to certain toxins 
  • Unprotected sex  

Some people develop liver disease without any of these risk factors, but for most people, proactive, healthy lifestyle habits can help prevent liver conditions from developing. 

5 Liver Facts You Need to Know 

Liver health is a crucial component of your overall health. Below are some fundamental facts you need to know about this efficient, hardworking organ.6 

  1. Your liver creates bile. Bile is a fluid that helps with digestion by carrying away waste and turning fats into energy. Certain liver diseases like cirrhosis and hepatitis can block the flow of bile, causing jaundice, which leads to yellowing of the skin and eyes.  
  2. Your liver filters harmful substances from your blood. The liver catches, purges, and detoxifies the body of bacteria, viruses, and chemicals. When the liver is overloaded with alcohol, drugs, or other harmful substances, it is not able to process them efficiently, and toxins can build up, contributing to liver disease.  
  3. Your liver stores vitamins. The liver acts as a reservoir or storage unit for essential antioxidant and inflammation-modulating nutrients like vitamin A, vitamin D3, vitamin E, and vitamin K.2 These important vitamin reserves are released when the body needs them. 
  4. Your liver regulates your blood sugar levels. The liver also manufactures and stores excess glucose and controls its release based on your body’s needs. Liver damage can increase your blood sugar levels and lead to the development of type 2 diabetes.  
  5. Your liver can regenerate itself. The liver is the only organ that has the ability to regrow after injury. After part of the liver has been removed, the remaining liver cells have a special ability to signal regrowth in order to keep the size of the organ in balance with the rest of the body. However, once liver cells are damaged by liver disease, such as cirrhosis, they are unable to regenerate.7

The liver is a cornerstone of your physical health, performing wide-ranging functions that can be disrupted when the liver is overburdened or diseased.  

The Truth About Liver Detoxes

For decades, health and wellness industry influencers have promoted liver detoxes or cleanses as methods for improving liver health, managing weight, or recovering from heavy alcohol consumption. However, there is no universal definition for “liver cleanse” or “liver detox,” and it’s important to understand the potential risks and benefits of products that make these claims.  
Certain liver health supplements can have cleansing effects, but no single substance has been shown to prevent liver disease or to undo the harmful effects of activities like drinking alcohol.

  • Milk thistle seed (Silybum marianum). The milk thistle plant is related to sunflowers and has become well-known for its medicinal seeds which contain an antioxidant compound called silymarin. Clinical evidence indicates that silymarin-containing supplements may promote liver health by helping liver cells regenerate, protecting the liver from foreign substances, and neutralizing free radicals.8 Research indicates that it may help improve outcomes in patients with fatty liver disease, cirrhosis, and hepatitis.9 
  • Artichoke leaf (Cynara cardunculus). Artichoke leaf has been investigated as a liver support supplement because it is not only rich in antioxidant compounds, but increases the production of bile, which assists the breakdown of dietary fats. Current evidence suggests that artichoke leaf may be effective not only in lowering cholesterol levels, but more importantly, lowering elevated liver enzyme levels associated with liver disease.10 
  • Turmeric. Turmeric is an aromatic underground stem used as both a spice and as a medicinal product. Turmeric supplements have a long history of use in Ayurvedic medicine to aid circulation and digestion. Curcumin is a pungent, dark yellow compound that has been investigated extensively for its antioxidant and anti-inflammatory properties. Several human studies indicate that curcumin counteracts the cellular damage caused by free radicals that contributes to many chronic inflammatory liver conditions.11 However, individuals with pre-existing liver damage should be cautious as there have also been some reports associating curcumin supplementation, especially highly bioavailable formulations, with liver injury, which resolves after stopping the supplements.12,13 
  • N-acetylcysteine (NAC). NAC is also an antioxidant and is prescribed as a liver protector after an overdose of acetaminophen (Tylenol).14 NAC directly neutralizes free radicals and acts as a precursor to glutathione, one of the body’s most potent antioxidant compounds. Preliminary studies suggest that taking NAC supplements may help improve liver function in people with fatty liver disease.15 
  • Glutathione. Glutathione is another potent antioxidant and helps the body metabolize toxic substances.16 Early research indicates that glutathione supplementation may counter the cellular stress underlying many liver diseases.16,17

As you explore supplements for liver health, discuss the available options with your health care provider for assistance selecting the best combination for you.  

How to Keep Your Liver Healthy

Even though the idea of a universal “liver cleanse” is not backed by science, maintaining and restoring your liver health is within your control. Take charge by following these safety precautions to keep your liver healthy and disease free.  

  • Eat a balanced diet. Your liver has to interact with and process every substance you bring into your body, so think carefully about what you’re eating. Following a “green” Mediterranean diet by choosing whole foods like fresh fruits and vegetables, eggs, nuts, beans, whole grains as well as products that contain antioxidant-packed polyphenols (like green tea) is a delicious way to promote liver health.18 
  • Stay active. To combat the buildup of liver fat deposits that can lead to fatty liver disease, it’s important to get plenty of exercise. Aim for 2.5 hours of moderate-intensity exercise and two days of muscle strengthening every week.19 Exercise has even been shown to be an effective treatment for people who have already developed fatty liver disease.20 
  • Avoid alcohol or consume in moderation. From the perspective of liver health, there is no safe level of alcohol consumption. But many people prefer not to quit alcohol completely. According to the CDC, if you choose not to abstain from drinking, you should limit your intake to 2 drinks per day for men or 1 drink per day for women.21 
  • Take medication carefully. Some drugs or supplements interact with each other in ways that can harm the liver. If you take more than one medication or supplement, be sure to speak with a health professional about whether the combination could cause problems. Additionally, taking too much of certain medications, such as Tylenol or acetaminophen, can tax the liver.22 
  • Get hepatitis vaccinations. Vaccines are available that prevent hepatitis A and hepatitis B. Many people receive these vaccines during childhood, but if you did not, or if you aren’t sure whether you’ve been vaccinated, connect with your health care provider.23,24 
  • Don't share needles. You can contract hepatitis by using a tattoo or body piercing needle or a needle for injecting drugs if someone else with hepatitis has already used it.25 
  • Practice safe sex. Hepatitis can also be spread through sexual intercourse. Use condoms to prevent transmission.1 

FAQs About Liver Health

When Should I Get My Liver Checked?  

Your health care provider may recommend liver function testing as part of a routine checkup or if you have symptoms that could be caused by liver disease. Several blood tests are typically performed at the same time to assess liver function. These include albumin, liver enzymes, and bilirubin.26 If one or more liver test results come back high or low, your provider may recommend additional testing.  

What Foods Are Good for Liver Health?  

Research shows that a Mediterranean diet is associated with many positive health outcomes, including cardiovascular, metabolic, and liver health.18 The Mediterranean diet includes a heavy emphasis on vegetables, fruits, legumes, nuts, whole grains, and extra virgin olive oil with moderate consumption of fish, cheese, and yogurt. Under the Mediterranean diet, eat little or no meat, opt for poultry over red meat, and avoid sweets and butter.  

Amplify these health effects by following a green-Mediterranean diet, which includes all the components of the Mediterranean diet plus products that contain potent polyphenols, such as green tea and walnuts.18 

Can Liver Damage Be Reversed? 

The liver can repair minor damage by itself. For example, when fatty liver disease is caused by high alcohol consumption, avoiding alcohol causes the liver to heal. However, when the disease progresses further and causes cirrhosis, more severe liver damage occurs, and healthy liver tissue is replaced with scar tissue. This type of damage is difficult or impossible to reverse.  

Where Can I Find Help Quitting Alcohol or Injectable Drugs? 

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the leading public health agency dedicated to helping people recover from substance use disorders. SAMHSA’s National Helpline is available 24 hours a day, 7 days a week at 1-800-662-HELP (4357) and provides referrals to local treatment clinics, support groups, and community resources. They also offer an online treatment locator and text message assistance.  

Understanding the importance of liver health can empower you to protect it. By making mindful choices like eating well, exercising, and limiting alcohol consumption, you can nurture your liver as it works to perform vital functions. These acts of self-care reverberate throughout your entire body and pay off in long-term health.  

References 

  1. Global Liver Institute. “Liver health basics.” 2022, https://globalliver.org/wp-content/uploads/2022/08/Liver-Health-Basics-Booklet.pdf. Accessed 26 December 2023. 
  2. Kalra, Arjun, et al. “Physiology, Liver.” StatPearls, 2023, https://www.ncbi.nlm.nih.gov/books/NBK535438/. 
  3. Tapper, Elliot B., and Neehar D. Parikh. “Mortality due to cirrhosis and liver cancer in the United States, 1999-2016: observational study.” BMJ, vol. 362, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050518/  
  4. Mikolasevic, Ivana et al. “Liver disease in the era of COVID-19: Is the worst yet to come?” World Journal of Gastroenterology, vol. 27, no. 36, 2021, pp. 6039-52, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476340/. 
  5. Mayo Clinic. “Liver disease.” 2023, https://www.mayoclinic.org/diseases-conditions/liver-problems/symptoms-causes/syc-20374502. Accessed 26 December 2023.   
  6. American Liver Foundation. “The healthy liver.” 2023, https://liverfoundation.org/about-your-liver/how-liver-diseases-progress/the-healthy-liver/. Accessed 26 December 2023. 
  7. Michalopoulos, George K., and Bharat Bhushan. “Liver regeneration: Biological and pathological mechanisms and implications.” Nature Reviews Gastroenterology & Hepatology, vol. 18, no. 1, 2021, pp. 40-55. https://www.nature.com/articles/s41575-020-0342-4. 
  8. Karimi, Gholamreza et al. “’Silymarin,’ a promising pharmacological agent for treatment of diseases.” Iranian Journal of Basic Medical Sciences, vol. 14, no. 4, 2011, pp. 308-17, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586829/. 
  9. Gillessen, Anton, and Hartmut H-J Schmidt. “Silymarin as supportive treatment in liver diseases: A narrative review.” Advances in Therapy, vol. 37, no. 4, 2020, pp. 1279-301. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140758/. 
  10. Amini, Mohammad Reza et al. “Effects of artichoke supplementation on liver enzymes: A systematic review and meta-analysis of randomized controlled trials.” Clinical Nutrition Research, vol. 11, no. 3, pp. 228-39, 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9348909/  
  11. Farzaei, Mohammad Hosein et al. “Curcumin in liver diseases: A systematic review of the cellular mechanisms of oxidative stress and clinical perspective.” Nutrients, vol. 10, no. 7, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073929/. 
  12. About Herbs, Botanicals & Other Products. “Turmeric: Purported benefits, side effects & more.” Memorial Sloan Kettering Cancer Center, 2023, https://www.mskcc.org/cancer-care/integrative-medicine/herbs/turmeric. Accessed 26 December 2023. 
  13. National Institute of Diabetes and Digestive and Kidney Diseases. “Turmeric.” LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, 2021, https://www.ncbi.nlm.nih.gov/books/NBK548561/. Accessed 26 December 2023. 
  14. National Institute of Diabetes and Digestive and Kidney Diseases. “Acetylcysteine.” LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, 2016, https://www.ncbi.nlm.nih.gov/books/NBK548401/. Accessed 26 December 2023. 
  15. Khoshbaten, Manouchehr et al. “N-acetylcysteine improves liver function in patients with non-alcoholic fatty liver disease.” Hepatitis Monthly, vol. 10, no. 1, 2010, pp. 12-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270338/. 
  16. Vairetti, Mariapia et al. “Changes in glutathione content in liver diseases: An update.” Antioxidants, vol. 10, no. 3, 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997318/. 
  17. Honda, Yasushi et al. “Efficacy of glutathione for the treatment of nonalcoholic fatty liver disease: an open-label, single-arm, multicenter, pilot study.” BMC Gastroenterology, vol. 17, no. 1, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549431/. 
  18. Yaskolka Meir, Anat et al. “Effect of green-Mediterranean diet on intrahepatic fat: The DIRECT PLUS randomised controlled trial.” Gut, vol. 70, no. 11, 2021, pp. 2085-95. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8515100/. 
  19. Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. “How much physical activity do adults need?” Centers for Disease Control and Prevention, 2022, https://www.cdc.gov/physicalactivity/basics/adults/index.htm. Accessed 26 December 2023. 
  20. van der Windt, Dirk J et al. “The effects of physical exercise on fatty liver disease.” Gene Expression, vol. 18, no. 2, 2018, pp. 89-101. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954622/. 
  21. Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion. “Dietary guidelines for alcohol.” Centers for Disease Control and Prevention, 2022, https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm. Accessed 26 December 2023. 
  22. NIH News in Health. “Your liver delivers.” National Institutes of Health, 2014, https://newsinhealth.nih.gov/2014/03/your-liver-delivers. Accessed 26 December 2023 
  23. National Center for Immunization and Respiratory Diseases, “Hepatitis B vaccine information statement.” Centers for Disease Control and Prevention, 2023, https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hep-b.html. Accessed 26 December 2023. 
  24. National Center for Immunization and Respiratory Diseases, “Hepatitis A vaccine information statement.” Centers for Disease Control and Prevention, 2021, https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hep-a.html. Accessed 26 December 2023. 
  25. Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, “People who use or inject drugs and viral hepatitis.” Centers for Disease Control and Prevention, 2020, https://www.cdc.gov/hepatitis/populations/idu.htm. Accessed 26 December 2023. 
  26. MedlinePlus. “Liver function tests.” National Library of Medicine, 2023, https://medlineplus.gov/lab-tests/liver-function-tests/. Accessed 26 December 2023. 

Alexa Fry is a health educator with a certificate in technical writing and 10 years of experience in the medical field. She has held roles as a science writer and clinical trial specialist at the National Cancer Institute's Cancer Information Service. She also wrote, edited, and coordinated content for Testing.com, SleepFoundation.org, and SleepDoctor.com. Alexa is passionate about making meaningful, actionable medical information available to everyone.