Evidence Level
Glutathione's role in liver health is among the most well-established in biochemistry. Hayes et al. (2005) published the definitive review on glutathione S-transferases and their role in detoxification. Prescott et al. (1979) established IV NAC as the standard treatment for acetaminophen toxicity by restoring hepatic glutathione. Honda et al. (2017) provided clinical evidence for direct glutathione supplementation in NAFLD. Lu (2013) published a comprehensive review in Biochimica et Biophysica Acta linking glutathione depletion to the pathogenesis of virtually all forms of liver disease. The key challenge with oral glutathione supplementation has been bioavailability — liposomal technology and S-acetyl forms have largely addressed this limitation, while NAC remains the most cost-effective strategy for raising hepatic GSH levels.