Liver Supplements Info.
Supplements for the Liver
Herbs
Milk Thistle (Silymarin)
The milk thistle plant contains silymarin and related flavonoids which are some of the most potent liver-protecting substances known. These flavonoids are powerful antioxidants so protect the liver from damaging toxins and free radicals. They also stimulate healing and the production of new liver cells and cause the liver to increase production of glutathione, the bodies most important antioxidant and detoxifying substance. Silymarin has been proven to both protect liver cells and repair existing damage in animals intoxicated with mushroom toxins, medicines, heavy metals or toxic organic solvents3. Human studies have also shown decreased mortality in patients with alcoholic liver damage who are treated with silymarin3. Milk thistle is commonly available in capsule or tincture form and a common dose would be 200mg 2/3 times per day. For hepatitis and cirrhosis doses of 400mg or more 3 times per day are common.
Burdock
Burdock contains a number of nutrients important to liver function. These include vitamins B1, B6 and B12 which are essential for the function of phase 1 liver detoxification's pathways, vitamin E, a powerful antioxidant and sulphur which is essential for a number of important phase 2 liver detoxification pathways in which potent toxins created by phase 1 detoxification are neutralized. Phase 2 pathways requiring sulphur include those utilizing glutathione. Burdock also contains other substances such as arctiin which act to improve liver and gallbladder function.
Dandelion
Clinical studies have shown dandelion extract to have protective effects against lipid peroxidation and free radicals, both damaging products of a poorly functioning liver4. Like burdock, dandelion contains a wealth of nutrients important to liver function, especially the B vitamins. It cleanses the liver and increases the production of bile. Dandelion is often used as a herbal treatment for all liver diseases of the liver including hepatitis, cirrhosis and jaundice.
Nutrients
N-Acetyl-Cysteine (NAC)
Cysteine is a sulphur containing amino acid and is a major component of glutathione (the others being glutamine and glycine). Supplementing cysteine boosts levels of this important 'master antioxidant'. Cysteine is one of the best free radical destroyers and helps to detoxify harmful toxins in the body and also binds to potentially harmful heavy metals, removing them from the body. Clinical studies have shown that pretreatment with NAC before parecetomol overdose protects liver cells and maintains glutathione levels. Treatment after overdose raises glutathione levels to normal and prevents further liver cell damage5. Excessive levels of toxins from the environment and from gut dysbiosis and leaky gut syndrome can lead to depletion of cysteine. This in turn leads to depletion of glutathione and allows free radicals and other toxins to get into the bloodstream un-neutralized, causing damage to tissues. In these instances cysteine levels can be raised by supplementation, indeed any treatment aimed at restoring liver function should include cysteine. The best form to supplement is n-acetyl-cysteine as this has been shown to increase glutathione levels in the body more than cysteine and even glutathione itself. Typical doses are 500-1500mg per day in divided doses.
Taurine
Taurine is a unique amino acid in that it is not incorporated into proteins and enzymes. Instead it is essential for the formation of bile in the liver and acts as a potent detoxifier and antioxidant throughout the body. Alcohol and aldehydes are known to decrease levels of taurine in the liver and it is thought that this is because taurine is used up in protecting liver cells from damage due to these and other toxins. This makes it important for people with gut dysbiosis as bacterial and yeast overgrowths lead to the excessive production of these substances. In one study taurine has been shown to protect against the toxic effects of a chemical called carbon tetrachloride-induced toxicity. In rats exposed to carbon tetrachloride (CCl4), hepatic taurine content decreased significantly 12 and 24 hours after CCl4 administration. When taurine was given to CCl4-exposed rats it was able to protect them from hepatic taurine depletion, suggesting that taurine in the liver may play a critical role in the protection of liver cells against toxins such as CCl46. Similar results have also been found in studies involving human patients with acute hepatitis7. The amount of taurine used in these studies was very high, 4g three times per day, but levels much lower than this are generally believed to be beneficial for less severe liver dysfunction such as that experienced by many environmental illness sufferers. Many doctors and nutritionists recommend 500mg twice a day. Taurine typically comes in 500mg capsules.
Methionine/S-adenosylmethionine (SAMe)
Like cysteine, methionine is a sulphur containing amino acid that is important for detoxification. Both cysteine and taurine can be synthesized in the body from methionine so long as enough vitamin B5 is available. Through this mechanism, methionine can be said to be the starting point for glutathione production, which as already described is the 'master detoxifier' of the body and protects liver cells from the effects of harmful toxins and free radicals. Like cysteine this amino acid is a chelater, binding to heavy metals and removing them from the body before they can build up and cause damage to tissues. Methionine is also important in the metabolism of fats and prevents them building up in the liver which impairs liver function. Typical doses of methionine recommended for liver support are 500-1000mg per day. Doses higher than 2g per day should be viewed with caution, especially when B vitamin deficiencies are present (as they commonly are in environmental illnesses8 as the excess methionine may be converted into homocysteine, a toxic substance implicated in hardening of the arteries and heart disease9. Methionine is typically available in 500mg capsules. When significant liver impairment is present due to the effects of alcohol and related substances studies have shown that a different form of methionine called S-adenosylmethionine (SAMe) needs to be supplemented instead as the livers ability to convert methionine to SAMe is impaired10,11. In fact SAMe is currently one of the most promising treatments being studied for the full spectrum of liver diseases. An effective dosage for severe liver disorders like cirrhosis and chronic hepatitis appears to be in the range of 800-1600mg12, obviously for less severe impairment of liver function as may be seen in environmental illnesses, a significantly lower dose could be helpful. A major drawback of SAMe is its high price. To avoid build of homecysteine when supplementing methionine/SAMe it is advisable to take supplements of Vitamins B12 and B6, folate and possibly trimethyl glycine (TMG)
Arginine
When the liver is functioning poorly ammonia begins to build up. This is especially true when gut dysbiosis is present as an overgrowth of micro-organisms in the gut leads to increased ammonia production as they produce ammonia as a by-product of protein metabolism. Arginine aids liver function by neutralizing ammonia. A typical dose is 500mg per day.
Polyenylphosphatidylcholine (PPC)
PPC supplements supply the body with phosphatidylcholine. This substance is extremely important for the integrity of cell membranes and for supporting detoxification processes. These roles are due to the fact that phosphatidylcholine influences lipid metabolism and cell membranes are composed predominantly of lipids. Currently, along with SAMe, PPC appears to show the most promise of all nutrients tested for the treatment of the whole spectrum of liver disorders. This is borne out by the number of studies investigating its effects and the positive results that are being obtained. In a recent study investigating novel new treatments the investigators studied PPC in detail and found it to be highly effective at treating both cirrhosis and alcoholic hepatitis. They found the beneficial effects to be due to PPC's ability to oppose lipid peroxidation (damage to fats (including cell membranes) due to free radicals) and restore phospholipid levels thus regenerating damaged liver cells13. In diseases of the liver there is an increased production of toxic acetaldehyde and free radicals due to the increased activity of a specific enzyme and multiple studies have shown that this can be effectively opposed by administration of PPC11,14. Finally PPC has been shown to restore depleted SAMe due to alcoholic liver injury. SAMe is required for the synthesis of phosphatidylcholine so supplementing PPC and thus supplying phosphatidylcholine reduces the bodies requirements for SAMe and may allow stores to regenerate. As a result of the increased levels of SAMe, glutathione levels increase in turn and oxidative stress is reduced15. As with SAMe, PPC is unfortunately an expensive supplement.
Alpha Lipoic Acid
Alpha Lipoic Acid is a sulphurous fatty acid that was originally classified as a vitamin until it was discovered that it could be synthesized in the human body. Sometimes referred to as 'thioctic acid' it is often described as the universal antioxidant due to the fact that it is active in both the water and fat based regions of cells unlike other antioxidants like vitamin C which is only water soluble and vitamin E which is only fat soluble. As well as being a particularly powerful antioxidant in its own right, directly neutralizing free radicals, alpha lipoic acid also plays a role in recycling other important antioxidants such as vitamins C and E, glutathione and Coenzyme Q1016. Alpha lipoic acid is said to quench the powerful peroxynitrite radical, an especially dangerous type consisting of both oxygen and nitrogen, according to a recent paper in FEBS Letters (Whiteman M, et al., FEBS Letters, 1996; 379:74-6). Peroxynitrite radicals have been implicated in the development of atherosclerosis, lung disease, chronic inflammation, and various neurological conditions. This 'universal antioxidant' has been shown to be effective in the treatment of a number of serious diseases, most notably diabetes, liver disorders and neuropathies17,18. Alpha lipoic acid comes in 50-600mg capsules or tablets. 600mg per day or more is recommended for liver disorders so well below this level will likely be beneficial to environmental illness sufferers.
B Vitamins
The B vitamins are all essential for healthy liver function. They are required for the formation of a huge number of enzymes including the P450 Cytochrome enzymes which are the basis of the phase 1 liver detoxification pathways. These B vitamin containing enzymes initiate the first part of the detoxification process before glutathione and the other phase 2 enzymes deal with the products of this. When the toxic load on the liver is increased the P450 enzymes tend to become more active which means the requirement for B vitamins increases. It is therefore easy to see how with a constantly increased toxic load from gut derived toxins (gut dysbiosis and leaky gut) and/or environmental exposures can lead to B vitamin deficiencies8. The B vitamins should be taken together as they are synergistic. A capsule form is often sufficient but injections of B12 and folic acid may be necessary as they are not well absorbed, especially in the presence of unhealthy gut flora.
Anti-oxidant Vitamins (A, C, E)
Vitamins A, C and E are all powerful anti-oxidants and are utilized by phase 1 liver detoxification pathways. Recent research shows that vitamins C and E act synergistically to neutralize free radicals with vitamin C scavenging for free radicals in bodily fluids and vitamin E protecting the cell membranes. All of these vitamins help protect the body from environmental toxins and the fat soluble vitamins, A and E , also help protect and repair the intestinal tract thus also protecting the liver indirectly by reducing the severity of leaky gut syndrome. Vitamin E also protects vitamin A from damage by free radicals. Common dosages of these vitamins are 400IU of vitamin E, 10,000IU of vitamin A (more can be toxic to a damaged liver) and any amount up to bowel tolerance of vitamin C is often recommended for people with health problems involving toxicity and oxidative stress as there are no known adverse effects.
