Liver health may not get as much attention as, say, heart health, but it certainly deserves to. After all, the liver is a powerhouse in the human body. It’s responsible for filtering out the toxins we’re exposed to every day in our food, water, air, beauty products, cleaning supplies and more.

Sadly, even as we’re demanding more from our livers with an increasingly toxic environment, we’re making it harder for them to do their job well.

Did you know?
Rising obesity rates and excessive alcohol use are both contributing to widespread liver dysfunction—and in some cases lasting liver damage.

But armed with some expert information about how to improve liver health—including the best foods and supplements for liver health—you can turn this trend around and get your liver functioning at its best.

The liver’s role in health

Before exploring how to promote liver health, let’s first consider why liver health is important, to begin with. According to Dr. Sara Celik, ND, (1) a Toronto-based naturopathic doctor, the liver is one of the more fascinating organs in the body.

“The liver is a spectacular organ that works like a factory,” Celik says. “Not only does it support the other organs in the body, but it also processes virtually everything we breathe, take in, or put on our skin.”

doctor examining a patient's liver

The liver’s primary role is to cleanse the blood of impurities that we’re exposed to daily.

The liver has many roles, Celik explains, but its primary purpose is to cleanse the blood of impurities. It converts these toxins into nontoxic waste, which then is eliminated through the urine, stool, and sweat.

“Since we live in a sea of toxins,” Celik says, “liver health is more important today than ever before.”

Are you at risk of liver problems?

Everyone should be concerned with liver health—after all, we’re all exposed to toxins every day, and we need our livers to filter them for us. But certain people are at higher risk of developing liver problems than others, according to Celik:

  • If you’re obese, have high cholesterol, are diabetic, or have a family history of liver problems, you need to pay special attention.
  • If you drink alcohol, use drugs, or take medications (especially for prolonged periods of time), you may be putting undue strain on your liver.
  • If you eat a lot of processed or sugary foods, your liver is working overtime to handle them.

Two main liver health concerns

From an integrative health perspective, an underperforming liver is tied to any number of health concerns. Dr. Mona Morstein, ND, DHANP, author of the book Master Your Diabetes (2), looks to liver performance with various conditions.

Practitioner insight

“If you have hemorrhoids, hormonal problems, estrogen dominance, blood sugar irregularities, low blood sugar, you have to think the liver’s involved,” Morstein says. “Digestive problems, gut function, allergies, skin problems, bad breath … If we feel the body isn’t detoxifying well and is creating conditions in other areas of detoxification, we’re always going to, naturopathically, be looking at the liver and trying to maximize its health. That helps alleviate strain in the rest of the body, with toxins being properly excreted.”

But while the conditions with an underlying liver component are many, Morstein sees two primary reasons for a sluggish liver.

Nonalcoholic fatty liver disease (NAFLD) is on the rise

One of the most prevalent liver conditions is nonalcoholic fatty liver disease (NAFLD). In fact, it’s so common that some experts predict it’ll be the leading reason for liver transplant in the coming decades. (3)

In NAFLD, the liver cells have excessive amounts of fat. As the name suggests, NAFLD is not related to alcohol use. There are two degrees of NAFLD: nonalcoholic fatty liver is the first, less serious condition. The second, nonalcoholic steatohepatitis (NASH), involves both fatty liver and significant inflammation. And it’s a real cause for concern.

Did you know?
Left uncorrected, NASH can lead to cirrhosis and even liver cancer. (4) Risk factors for NAFLD include obesity (especially in the abdominal area), type 2 diabetes, dyslipidemia, and metabolic syndrome. (5)

NAFLD doesn’t typically cause any symptoms, so it has to be diagnosed by an informed clinician. Morstein sees a lot of overweight patients in her Tempe, Arizona naturopathic clinic (6), and many have NAFLD. Her first step when she suspects the condition is to order lab work. “The number one lab you’ll see is elevated ferritin,” she says. “If the liver enzymes are elevated, then that tends to be more a reflection of switching over to NASH.”

If Morstein sees elevated ferritin, she’ll first rule out hemochromatosis with an iron panel. Then she’ll do an abdominal ultrasound and see if there’s evidence of fatty liver.

Alcohol dependence is a lifestyle

The second cause of poor liver performance that Morstein sees commonly is chronic alcohol use. Even a drink a day can lead to an “unhappy liver,” she says.

The main problem with regular alcohol consumption is that it puts extra strain on the liver. But alcoholic drinks also contain about 100 calories per serving—and those extra calories aren’t doing any favors to people with NAFLD, who typically struggle with weight.

So if you turn to a glass of wine to unwind at the end of the day, Morstein suggests finding a healthier outlet for your stress. “I’m not a fan of regular use of alcohol,” she says. “We need to get people out of the habit that coming home from a day of work requires alcohol.”

How to improve liver health naturally

For NAFLD, the only real therapy that’s been shown to be safe and effective is weight loss. (7) And for anyone with liver health concerns, it’s important to abstain from alcohol. In addition to those two overarching guidelines, there are several others that may be effective in promoting liver health. But before getting into those, let’s explore how the digestive system and the liver are interconnected.

The liver-gut connection

Liver health is inextricably linked to digestive health. Diet and the health of the microbiome have a direct effect on liver health. That’s in part because the liver receives blood from the gut via the portal vein. (8)

It’s no surprise, then, that people with NAFLD have been found to have altered gut microbiota and increased intestinal permeability. (9)(10) So one of the keys to improving liver health is to improve gut health—and many of the liver-supporting diet and supplement tips that follow will do just that.

Foods that are good for liver health

Several studies have shown that people with NAFLD typically consume diets that are heavy on calories, saturated fat, and refined sugar and light on polyunsaturated fats and antioxidants.

An antidote for this eating pattern is the Mediterranean diet. This diet favors fresh fruits and vegetables, lean meats and fish, healthy oils, and some whole grains. Take note of what’s not on the list: refined carbohydrates and processed foods. One study found that the Mediterranean diet improves several health markers in people with NAFLD. (11)

One of the big benefits of the Mediterranean diet when it comes to liver health is that it’s high in fiber. Fiber, which is essential for eliminating the toxins that the liver filters out of our food, water, and environmental exposures, is crucial for liver health. Dietary fiber may improve liver health by changing the gut microbiome, reducing intestinal permeability, and curbing inflammation. (12)

cut up lemons & lemons in a glass of water

Diets that are heavy on calories, saturated fat, and refined sugar can lead to bad liver health. A glass of lemon-water, on the other hand, is a great way to start your day.

Another bonus of the Mediterranean diet is that it’s rich in antioxidants. And that’s important because according to Morstein “fatty liver with low antioxidants tends to have more of a chance to become NASH. They find low vitamin A, low vitamin E in livers that have fatty liver, so the foods that are richest in antioxidants can help support the liver.”

Celik’s list of the best foods for liver health is a trove of both fiber and antioxidants:

  • Cruciferous vegetables (broccoli, brussels sprouts, bok choy, kale, collard greens, cabbage, cauliflower)
  • Garlic and onions
  • Artichoke
  • Beets
  • Lemons and limes
  • Spirulina
  • Ginger and turmeric
  • Avocados

The best supplements for liver health

In an article published in Natural Medicine Journal, Dr. Todd A. Born, ND, outlined a list of “nutrients have shown the greatest clinical efficacy in addressing and even reversing the spectrum of NAFLD”: (13)

  • Tocotrienols (200 mg, twice daily with food)
  • N-acetyl-cysteine (NAC) (600 mg, twice daily on an empty stomach)
  • Omega-3 essential fatty acids (2 g to 4 g daily)
  • Milk thistle (Silybum marianum) (280 mg to 360 mg daily)
  • L-carnitine (1 g twice daily)
  • Choline (250 mg to 1,000 mg daily)
  • Betaine (20 g daily, though he notes that 1-6 g/day may adequate if used in conjunction with other therapies)
  • Vitamin E (as RRR-α-tocopherol) (400 IU, twice daily with food)

Disclaimer: The U.S. Food and Drug Administration (FDA) recently adopted a position prohibiting supplement manufacturers from marketing N-acetyl-L-cysteine (NAC) products as dietary supplements. At this time, all NAC products will remain available through the Fullscript catalog. Fullscript will be closely following the Council for Responsible Nutrition (CRN) and the FDA for guidance and will not be removing NAC from the catalog until it is mandated. Fullscript’s quality team is continuing to monitor this situation, and should any changes occur, Fullscript will promptly notify practitioners.

On the topic of supplements, Celik cautions that certain herbs are a no-no for anyone with liver problems:

  • Black cohosh
  • Ephedra
  • Kava
  • Senna

“I recommend consulting a naturopathic doctor before starting any new supplements or herbs if you have liver problems,” she says.

Should you detox for liver health?

Opinions are split on detoxes, but for Celik, it’s an enthusiastic yes—as long as there are no contraindications.

“Detoxing is the first step in almost all of my treatment protocols,” she says. “It’s like building the foundation. We can’t build a house without preparing the foundation. In my practice, this is how we begin any path to better health.”

The components of a successful liver detox? It should be gentle, doable, and supportive. “I don’t believe in aggressive detox programs where people are so tired they have to stay home from work,” Celik argues.

man and woman meditating

You should consider consulting a naturopathic doctor before starting any new supplements or herbs if you have liver problems.

Practitioner insight

And daily liver support is important, advices Dr. Sara Celik, ND. “I encourage my patients to do something that’s liver-loving every day, such as having lemon water in the morning, eating cruciferous vegetables, drinking liver-cleansing tea, or practicing yoga.”

Here are some of Celik’s other liver-loving detox pearls:

  • Eat natural, whole foods
  • Engage in physical activity
  • Avoid stress
  • Cut alcohol, caffeine, and any foods to which you’re sensitive
  • Make sure you’re eliminating well—take a flax-based fiber supplement and drink plenty of water

Morstein isn’t a fan of the term detox, because she feels it connotes a temporary break from bad habits. Instead, she’d like to see people support their livers with healthy diets every day of the year. She does, however, advocate for an annual juice fast.

Her reasoning is twofold: First, a break from food gives the liver a chance to rest and reset. Second, it can change your relationship to food. After people do a fast, Morstein says, “They have more control over food instead of food having control over them. There’s a lot of things that happen psychologically — as well as physically — when you do fast.”

The bottom line

“The liver has to work harder today than any other time in history,” says Celik. That’s why she and other integrative health experts are working to raise awareness about liver health. You can promote liver health by eating right, maintaining a healthy weight, avoiding toxins, and taking liver-boosting supplements. And whether you call it a fast or detox, you might want to dedicate a week or so a year to a liver-loving cleanse.

Remember to speak to your healthcare practitioner about liver health and your wellness!

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