Deaths from liver cirrhosis jumped 65% in the U.S. between 1999 and 2016.^3,4

Key factors contributing to liver disease are obesity, diet, and alcohol consumption.^1,2

Milk thistle extract has demonstrated protective effects against an array of liver disorders.^5-8

Nonalcoholic Fatty Liver Disease

In the past, viral hepatitis and excess alcohol ingestion were considered the greatest threats to the liver.²

Today, the surge in diabetes and obesity has resulted in an epidemic of nonalcoholic fatty liver disease (NAFLD),⁹ which is characterized by the accumulation of fatty compounds in the liver in the absence of chronic alcohol use.

It can progress over time to cause liver fibrosis (tissue scarring) that can lead to liver cancer, cirrhosis, and/or liver failure.^10-13

Extracts of the herb milk thistle, containing the compound silymarin, have long been used to protect liver function in patients with liver disease.

Several clinical trials found that milk thistle, alone or in combination with vitamin E, and phosphatidylcholine reduces liver fat, fibrosis, andenzyme levels in patients with NAFLD.^14-17

A meta-analysis of eight randomized, controlled trials found that milk thistle may help improve NAFLD.¹⁷

Milk thistle has been shown to improve blood markers of liver damage and may also help reduce fasting glucose and LDL cholesterol elevations that often accompany NAFLD.^17,18

Measuring liver enzyme blood levels is an important tool for identifying liver injury and helping track response to treatment.

Liver function tests are included in many Life Extension^® blood panels.

Probiotics Target Liver Health

One in four adults in the U.S. has nonalcoholic fatty liver disease (NAFLD).^21-24
Despite over four decades of research, there are still no medications approved by the U.S. Food and Drug Administration (FDA) to treat fatty liver disease.

However, research has found a link between the gut microbiota and liver health. This led researchers to create a blend of probiotics and a prebiotic to target liver health.

In two clinical trials of people with NAFLD, a carefully designed blend of seven probiotics and a prebiotic decreased a marker of liver damage and reduced levels of fibrosis (scarring) from moderate or almost severe to normal.^25,26

These findings suggest that the probiotic-prebiotic blend stopped the progression of liver disease and reversed liver damage that was already present.

Liver Toxins

The liver is susceptible to toxins known as hepatotoxins, which include the commonly used pain medication acetaminophen, alcohol, and others.

In rats, milk thistle extract helped prevent liver damage when given before or during the exposure to a liver toxin.¹⁹

In one study, a group of patients with alcohol-induced liver disease who were treated with milk thistle extract showed improvements in liver enzymes and liver pathology.⁸

Cirrhosis

Cirrhosis is the end stage of chronic liver injury in both alcoholic and nonalcoholic liver disease. It is generally considered irreversible, but scientists have observed promising improvements with milk thistle extract in clinical trials.

In one study, giving 420 mg of milk thistle extract to patients with cirrhosis was associated with an overall higher four-year survival rate.⁵

For optimal absorption, a standardized extract of milk thistle is used by readers of this publication that has been made more bioavailable via a phospholipid delivery system.²⁰

Other Nutrients That Promote Liver Health

Some nutrients have also shown promise as a way to help control liver disease.

In human trials, vitamin E tocotrienols improved markers of liver health seen on an ultrasound, while reducing liver enzymes, C-reactive protein, and signs of oxidative stress.^27-29

Phosphatidylcholine is an essential phospholipid which is a vital part of cellular membranes. Phospholipids have been used safely for years to protect liver function in patients with various liver diseases.³⁰ In a number of human trials, phosphatidylcholine intake alone or with other nutrients improved NAFLD, reducing liver enzyme levels and improving ultrasound findings.^30-32 A more bioavailable form of phosphatidylcholine known as polyenylphosphatidylcholine or PCC is the preferred choice for liver support as it specifically targets hepatocytes.

N-acetyl-L-cysteine (NAC), a versatile sulfur-rich compound prevents liver damage following acetaminophen poisoning.³³ NAC rapidly restores depleted glutathione levels, sparing liver cells from the effects of oxidative damage.^34-36

If you have any questions on the scientific content of this article, please call a Life Extension Wellness Specialist at 1-866-864-3027.

References

1. Available at: https://www.nytimes.com/2018/07/18/health/cirrhosis-liver-cancer.html. Accessed March 28, 2022.
2. Tapper EB, Parikh ND. Mortality due to cirrhosis and liver cancer in the United States, 1999-2016: observational study. BMJ. 2018;362:k2817.
3. Marchesini G, Petta S, Dalle Grave R. Diet, weight loss, and liver health in nonalcoholic fatty liver disease: Pathophysiology, evidence, and practice. Hepatology. 2016 Jun;63(6):2032-43.
4. Cheemerla S, Balakrishnan M. Global Epidemiology of Chronic Liver Disease. Clin Liver Dis (Hoboken). 2021 May;17(5):365-70.
5. Ferenci P, Dragosics B, Dittrich H, et al. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol. 1989 Jul;9(1):105-13.
6. Federico A, Dallio M, Loguercio C. Silymarin/Silybin and Chronic Liver Disease: A Marriage of Many Years. Molecules. 2017 Jan 24;22(2).
7. Vailati A, Aristia L, Sozze E, et al. Randomized open study of the dose-effect relationship of a short course of IdB 1016 in patients with viral or alcoholic hepatitis. Fitoterapia. 1993;64(3):219-28.
8. Salmi HA, Sarna S. Effect of silymarin on chemical, functional, and morphological alterations of the liver. A double-blind controlled study. Scand J Gastroenterol. 1982 Jun;17(4):517-21.
9. Le MH, Devaki P, Ha NB, et al. Prevalence of non-alcoholic fatty liver disease and risk factors for advanced fibrosis and mortality in the United States. PLoS One. 2017;12(3):e0173499.
10. Available at: https://www.uptodate.com/contents/cirrhosis-beyond-the-basics. Accessed May 10, 2022.
11. Calzadilla Bertot L, Adams LA. The Natural Course of Non-Alcoholic Fatty Liver Disease. Int J Mol Sci. 2016 May 20;17(5):774.
12. Musso G, Gambino R, Cassader M, et al. Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity. Ann Med. 2011 Dec;43(8):617-49.
13. Noureddin M, Vipani A, Bresee C, et al. NASH Leading Cause of Liver Transplant in Women: Updated Analysis of Indications For Liver Transplant and Ethnic and Gender Variances. Am J Gastroenterol. 2018 Nov;113(11):1649-59.
14. Cacciapuoti F, Scognamiglio A, Palumbo R, et al. Silymarin in non alcoholic fatty liver disease. World J Hepatol. 2013 Mar 27;5(3):109-13.
15. Federico A, Trappoliere M, Tuccillo C, et al. A new silybin-vitamin E-phospholipid complex improves insulin resistance and liver damage in patients with non-alcoholic fatty liver disease: preliminary observations. Gut. 2006 Jun;55(6):901-2.
16. Loguercio C, Andreone P, Brisc C, et al. Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: a randomized controlled trial. Free Radic Biol Med. 2012 May 1;52(9):1658-65.
17. Zhong S, Fan Y, Yan Q, et al. The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials. Medicine (Baltimore). 2017 Dec;96(49):e9061.
18. Huseini HF, Larijani B, Heshmat R, et al. The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res. 2006 Dec;20(12):1036-9.
19. Clichici S, Olteanu D, Nagy AL, et al. Silymarin inhibits the progression of fibrosis in the early stages of liver injury in CCl(4)-treated rats. J Med Food. 2015 Mar;18(3):290-8.
20. Kidd P, Head K. A review of the bioavailability and clinical efficacy of milk thistle phytosome: a silybin-phosphatidylcholine complex (Siliphos). Altern Med Rev. 2005 Sep;10(3):193-203.
21. Younossi Z, Anstee QM, Marietti M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018 Jan;15(1):11-20.
22. Available at: https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/definition-facts. Accessed June 8, 2022.
23. Estes C, Razavi H, Loomba R, et al. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018 Jan;67(1):123-33.
24. Alkhouri N, Scott A. An Update on the Pharmacological Treatment of Nonalcoholic Fatty Liver Disease: Beyond Lifestyle Modifications. Clin Liver Dis (Hoboken). 2018 Apr;11(4):82-6.
25. Mofidi F, Poustchi H, Yari Z, et al. Synbiotic supplementation in lean patients with non-alcoholic fatty liver disease: a pilot, randomised, double-blind, placebo-controlled, clinical trial. Br J Nutr. 2017 Mar;117(5):662-8.
26. Eslamparast T, Poustchi H, Zamani F, et al. Synbiotic supplementation in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled pilot study. Am J Clin Nutr. 2014 Mar;99(3):535-42.
27. Magosso E, Ansari MA, Gopalan Y, et al. Tocotrienols for normalisation of hepatic echogenic response in nonalcoholic fatty liver: a randomised placebo-controlled clinical trial. Nutr J. 2013 Dec 27;12(1):166.
28. Pervez MA, Khan DA, Ijaz A, et al. Effects of Delta-tocotrienol Supplementation on Liver Enzymes, Inflammation, Oxidative stress and Hepatic Steatosis in Patients with Nonalcoholic Fatty Liver Disease. Turk J Gastroenterol. 2018 Mar;29(2):170-6.
29. Pervez MA, Khan DA, Slehria AUR, et al. Delta-tocotrienol supplementation improves biochemical markers of hepatocellular injury and steatosis in patients with nonalcoholic fatty liver disease: A randomized, placebo-controlled trial. Complement Ther Med. 2020 Aug;52:102494.
30. Dajani AI, Abuhammour A. Agents for the treatment of fatty liver disease: focus on essential phospholipids. Drugs & Therapy Perspectives. 2021;37(6):249-64.
31. Maev IV, Samsonov AA, Palgova LK, et al. Effectiveness of phosphatidylcholine as adjunctive therapy in improving liver function tests in patients with non-alcoholic fatty liver disease and metabolic comorbidities: real-life observational study from Russia. BMJ Open Gastroenterol. 2020;7(1):e000368.
32. Maev IV, Samsonov AA, Palgova LK, et al. Effectiveness of phosphatidylcholine in alleviating steatosis in patients with non-alcoholic fatty liver disease and cardiometabolic comorbidities (MANPOWER study). BMJ Open Gastroenterol. 2020;7(1):e000341.
33. Millea PJ. N-acetylcysteine: multiple clinical applications. Am Fam Physician. 2009 Aug 1;80(3):265-9.
34. Bajt ML, Knight TR, Lemasters JJ, et al. Acetaminophen-induced oxidant stress and cell injury in cultured mouse hepatocytes: protection by N-acetyl cysteine. Toxicol Sci. 2004 Aug;80(2):343-9.
35. de Oliveira CP, Simplicio FI, de Lima VM, et al. Oral administration of S-nitroso-N-acetylcysteine prevents the onset of non alcoholic fatty liver disease in rats. World J Gastroenterol. 2006 Mar 28;12(12):1905-11.
36. Mehta K, Van Thiel DH, Shah N, et al. Nonalcoholic fatty liver disease: pathogenesis and the role of antioxidants. Nutr Rev. 2002 Sep;60(9):289-93.