Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease, and the numbers are on the rise—including in kids. NAFLD is now one of the most common causes of liver transplant. In NAFLD, fats, including cholesterol and triglycerides, collect in liver tissue. It affects as many as 30 percent of people, but most people who have it probably don’t even know it. Being overweight and being insulin resistant play key roles in the progression of NAFLD.
Lipotropics & Liver Herbs
Lipotropics increase the flow of fat and bile to and from the liver, decongesting the liver and improving fat metabolism and liver function. Look for lipotropic formulae with betaine, choline and either methionine or cysteine. The best lipotropic may be 200-400 mg a day of SAMe.
The active component of the great liver herb milk thistle, silymarin, is effective for NAFLD and lowers liver enzymes better than drugs.1 Meta-analysis of eight controlled studies confirms silymarin’s ability to significantly reduce levels of the liver enzymes AST and ALT.2
Licorice is a great herb for the liver. When people with NAFLD were given 2 g of licorice extract or placebo for two months in a double-blind study, liver enzymes went down significantly only on the licorice. ALT dropped from 65.09 IU/ml to 51.27 on licorice, but only from 66.9 to only 62.77 on placebo. AST went from 58.18 to 49.45 on licorice, but only from 57.86 to 54.81 on placebo.3
Another great liver herb is artichoke. It was found that 600 mg artichoke leaf extract a day for two months significantly improves of NAFLD in 81.6 percent of people versus 5 percent for placebo. Artichoke significantly lowers ALT and AST.4
Nonalcoholic steatohepatitis (NASH) is an advanced type of NAFLD that occurs in about 10 percent of cases. It can lead to cirrhosis and liver failure. When people with NASH were given either placebo or 2.7 g artichoke leaf extract a day, artichoke led to significantly greater improvement in liver enzymes: ALT dropped from 81.77 mg/dL to 38.40 mg/dL, and AST dropped from 45.53 mg/dL to 24.60 mg/ dL. Artichoke also led to significantly greater improvements in cholesterol and triglycerides.5
Antioxidants
Curcumin could go under liver herbs or antioxidants because it’s both: maybe that’s why it works so well. Eight weeks of curcumin reduces fat in the liver by 78.9 percent compared to 27.5 percent on placebo in people with NAFLD. Curcumin also significantly reduces BMI, total cholesterol, LDL cholesterol, triglycerides, glucose and liver enzymes.6
And when people with NAFLD are given placebo or curcumin for eight weeks, curcumin significantly reduces BMI (body mass index) and waist circumference. While liver enzymes continued to go up on placebo, they drop significantly on curcumin. Ultrasound showed improvement in the livers of only 4.7 percent of the placebo group but in a remarkable 75 percent of the curcumin group.7 Imaging in a second study also found that curcumin improves disease activity. In addition, 500 mg of curcumin daily for 12 weeks significantly improved ALT, AST, ALP and cholesterol.8 And when overweight people with NAFLD were given curcumin or placebo for three months, curcumin led to significant improvements in total, HDL and LDL cholesterol, triglycerides, insulin sensitivity and resistance, HbA1C (the best marker of long-term diabetes and blood sugar control), inflammation and waist circumference. Fatty liver degree and markers of liver disease were significantly improved.9
A systematic review and meta-analysis has now looked at nine studies of curcumin and NAFLD. It found that curcumin significantly improves ALT, AST, total and LDL cholesterol, insulin resistance and waist circumference—all crucial things to improve in NAFLD.10
A new antioxidant-rich herb for NAFLD is cranberry. The first double-blind study of cranberry extract for NAFLD, which used 288 mg a day, found that it significantly reduces ALT, insulin and insulin resistance.11
A meta-analysis of five controlled studies shows that vitamin E significantly improves liver function in people with NAFLD and NASH. It reduces AST, ALT, ALP, retention of fats in the liver and inflammation. In people with the more advanced NASH, it reduces AST and ALT, retention of fats, inflammation and even fibrosis.12
Other antioxidants help, including resveratrol.13 When overweight people with cholesterol problems and NAFLD were given green tea extract, they had significant improvement in weight, BMI, total LDL and HDL cholesterol, triglycerides, liver enzymes, inflammation and insulin resistance. Green tea also caused a 67.5 percent regression of fatty liver versus 25 percent on placebo.14
In a double-blind study, 100 mg of CoQ10 a day has been shown to significantly improve liver enzymes, inflammation and severity of NAFLD.15
More Herbal Help
When people with NAFLD were given placebo or 2 g of black seed for 12 weeks, 57.14 percent of the black seed group had normal ultrasounds, and there was a “remarkable” reversal of liver enzymes. Black seed also improved weight and BMI.16 Another study gave 2.5 mL of standardized black seed oil every 12 hours for three months to people with NAFLD. The grade of fatty liver was significantly reduced on black seed versus placebo. Liver enzymes, cholesterol and triglycerides all improved significantly.17
When a double-blind study gave 2 g of ginger a day or placebo to people with NAFLD, ALT decreased significantly more, and a marker of liver function improved significantly more on ginger. Accumulation of fat in the liver cells decreased significantly more on ginger: down 52.04 points versus 11.09 points on placebo. Markers of inflammation and of insulin resistance improved significantly more on ginger.18
The first study to look at garlic added either placebo or 400 mg of garlic powder, containing 1.5 mg allicin, four times a day to standard treatment. At the end of the 12-week study, waist circumference went down significantly with garlic compared to placebo. Importantly, according to abdominal ultrasounds, steatosis or fat accumulation in the liver, was significantly reduced in the garlic group compared to placebo. Liver enzymes, including ALT, AST and GGT decreased significantly in the garlic group versus placebo. Cholesterol and triglycerides improved significantly with garlic.19
The newest entry on the NAFLD herb list is hibiscus. A double-blind study found that a 450 mg capsule of hibiscus tea for eight weeks significantly improves ALT and AST as well as triglycerides and antioxidant capacity.20
Omega-3 EFA’s & Probiotics
A meta-analysis of four studies found that giving kids omega-3 EFAs significantly improves fat in the liver and liver function as well as levels of AST and ALT.21 When the omega-3 DHA is given to kids with NAFLD, it significantly improves liver fat, insulin resistance, triglycerides and ALT.22 Giving 1 g a day of omega-3 EFAs to obese kids with NAFLD for a year significantly improves their BMI, insulin levels, insulin resistance and liver enzymes. 67.8 percent have improvement in fatty liver.23 A systematic review found omega-3s effective in the early stages of NAFLD.24
Omega-3s from flax help insulin resistance, fatty liver, fibrosis and lower liver enzymes.25 When omega-3s from flax and wheat germ oil were combined with probiotics for type 2 diabetics with NAFLD in a double-blind study, fatty liver improved significantly on the supplement but not on placebo. The supplement also significantly reduced triglycerides, total cholesterol and markers of inflammation.26
Speaking of probiotics, they also may help.27 When obese kids with NAFLD took placebo or probiotics for 12 weeks, probiotics significantly improved ALT, AST, cholesterol and triglycerides. At the end of the study, livers had returned to normal in 53.1 percent of the kids versus only 16.5 percent of the placebo group.28VR
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Linda Woolven is a master herbalist, acupuncturist and solution-focused counsellor with a virtual practice in Toronto, ON, Canada. Woolven and Ted Snider are the authors of several books on natural health. You can see their books at www.thenaturalpathnewsletter.com. They are also the authors of the natural health newsletter The Natural Path. The Natural Path is a natural health newsletter specifically designed to help health food stores increase their sales by educating their customers. The Natural Path contains no advertising and never mentions a brand name. Retailers can provide The Natural Path Newsletter to their customers. For more information, contact Snider at tedsnider@bell.net or (416) 782-8211.
