Prevalence: ~4.5 million US adults diagnosed with liver disease (NCHS); NAFLD affects up to 25% globally
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Milk thistle (silymarin 140-420mg/day) is the most studied hepatoprotective supplement, improving liver enzymes and histology in NAFLD. NAC (600-1200mg/day) supports glutathione production and is the medical standard for acetaminophen toxicity. TUDCA (250-500mg/day) is an emerging bile acid supplement that supports bile flow and reduces ER stress.
The liver performs over 500 vital functions including detoxification, protein synthesis, and bile production. Approximately 4.5 million US adults have been diagnosed with liver disease, and non-alcoholic fatty liver disease (NAFLD) affects up to 25% of the global population. Several supplements have shown hepatoprotective effects in clinical trials.
| # | Supplement | Typical Dose | Evidence |
|---|---|---|---|
| 1 | Milk Thistle (Silymarin) | 140-420mg silymarin daily | Strong |
| 2 | N-Acetyl Cysteine (NAC) | 600-1200mg daily | Strong |
| 3 | TUDCA (Tauroursodeoxycholic Acid) | 250-500mg daily | Emerging |
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Jarrow Formulas Milk Thistle 150mg
Jarrow Formulas
NOW Foods NAC 600mg
NOW Foods
Nutricost TUDCA 250mg
Nutricost
Milk thistle (silymarin) is the most extensively studied liver supplement, with meta-analyses showing significant reductions in liver enzymes (ALT and AST) in NAFLD patients. It works through antioxidant, anti-inflammatory, and anti-fibrotic mechanisms. NAC is also highly effective as a glutathione precursor and is medically used for liver toxicity treatment.
Yes. Silymarin, the active compound in milk thistle, has been studied in over 50 clinical trials. A meta-analysis of 8 RCTs found it significantly reduced ALT and AST liver enzymes in NAFLD patients. It works by stabilizing hepatocyte cell membranes, scavenging free radicals, and inhibiting inflammatory pathways. Typical effective doses are 140-420mg of standardized silymarin extract daily.
NAC is one of the most evidence-backed supplements for liver support. It is the medical standard of care for acetaminophen (Tylenol) overdose and works by replenishing glutathione, the liver's primary antioxidant. Studies in NAFLD patients show NAC supplementation (600-1200mg/day) can improve liver enzyme levels and markers of oxidative stress. It is well-tolerated at recommended doses.
TUDCA (tauroursodeoxycholic acid) is a water-soluble bile acid naturally produced in small amounts by the body. It supports liver health by improving bile flow, reducing endoplasmic reticulum (ER) stress, and protecting hepatocytes from bile acid-induced damage. Clinical trials have shown benefit in cholestatic liver conditions, and emerging research suggests potential in NAFLD. Typical doses are 250-500mg daily.