Fatty Liver Support

Protocols Fullscript Protocols
Fatty Liver Support

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

As a result, the Fullscript Integrative Medical Advisory team advises using an evidence-informed approach to protocol development. To simplify this process for practitioners, we have assembled a sampling of evidence-based standardized protocols that practitioners can use as a foundation when developing individualized protocols.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through D-quality evidence. These are categorized as follows:

Class Qualifying studies Minimum requirements
A Systematic review or meta-analysis of human trials
B Human RDBPC ≥ 2 studies and/or 1 study with ≥ 50
subjects
C Human RDBPC or RCT 1 study < 50 subjects
D Human trials or In-vivo animal trials

RDBPC = Randomized Double-Blind Placebo Controlled
RCT = Randomized Controlled Trials

Please refer to the complete Rating Scale for further information.

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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Fatty Liver Support

Milk Thistle (Silybum marianum)

70-140mg, two to three times per day, minimum 12 weeks1

  • Compared to a controlled regimens, significant reduction of AST and ALT levels were observed1,2,3
  • Demonstrated decrease in transaminases of NASH patients, which led to a revival of liver function in NASH patients, hence improving prognosis and progression of liver cirrhosis1,2,3
Milk Thistle (Silybum marianum) in the Fullscript catalog.

Vitamin E

800 IU, once per day, minimum 2 years4

  • Compared to control, vitamin E was shown to be effective in reducing fibrosis, AST, ALT, ALP, steatosis and inflammation5
  • It has been shown that vitamin E is the therapeutic choice for NASH as it has properties as an anti-inflammatory, anti-apoptotic and antioxidant6
Vitamin E in the Fullscript catalog.

Artichoke (Cynara scolymus)

600mg, once per day, minimum 2 months7

  • Artichoke leaf extract has been shown to have beneficial effects on liver enzymes ALT and AST7
  • Symptoms associated with NASH have been shown to be alleviated by artichoke leaf extract in addition to improving lipid levels and liver enzymes8
Artichoke (Cynara scolymus) in the Fullscript catalog.

Turmeric (Curcuma longa)

500-1000mg, total per day, minimum 8 weeks10,11,12

  • As a result of its anti-inflammatory, anti-apoptotic, and antioxidant properties, turmeric (Curcuma longa) has been shown to improve enzyme levels and histology of the liver. For example, turmeric (Curcuma longa) increases lipid peroxyl radical scavenging, decreases COX2, and decreases caspases 9, 8, and 39,12
  • Reduction in ALT, AST and GGT levels was observed10,11,12
Turmeric (Curcuma longa) in the Fullscript catalog.

New and upcoming research:

Reishi (Ganoderma lucidum)

225mg, total per day, minimum 6 months13

  • Ganoderma lucidum was shown to reverse mild fatty liver to a normal condition13
  • Reduction in GOT and GPT levels was observed13
Reishi (Ganoderma lucidum) in the Fullscript catalog.

References

1
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728929/
5
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/26059365
6
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313719/
9
Systematic review or meta-analysis of human trials
a
https://www.ncbi.nlm.nih.gov/pubmed/29966389