Metabolic Health Protocol

Fatty Liver Support

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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.

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 C-quality evidence.

Systematic review or meta-analysis of human trials
RDBPC human trials
2+ studies and/or 1 study with 50 + subjects
RDBPC human trials
1 study

Milk thistle (Silybum marianum)

70-140 mg, 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)

600 mg, 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)

500-1000 mg, 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)

225 mg, 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


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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Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials
Systematic review or meta-analysis of human trials

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