Alarming fact—about 30 million Americans have some form of liver disease. That’s one-tenth of the population. Yet it’s normal for people to go undiagnosed for years or even decades.

Unless liver disease is detected and treated early, it can cause severe inflammation that can lead to scarring (cirrhosis), organ failure and/or cancer—and it even may require a transplant. It is a leading cause of death in the US.

Important: I advise patients who have risk factors for liver disease to get their livers checked—the inexpensive group of blood tests can be done during routine checkups. Risk factors include obesity, metabolic syndrome, hepatitis and a history of alcohol or drug abuse.

If you have liver disease, medications may be required, but herbs and supplements can help reduce inflammation, improve liver function and slow ongoing damage. Always speak with your doctor before taking any natural supplements.

I usually advise patients to start with just one remedy at a time. After six to eight weeks, we reassess to see if there’s improvement and if an additional supplement is required. Any of the herbs
below can be started first, but milk thistle and turmeric are among the more common options.

Milk Thistle

Milk thistle has been used for thousands of years for liver health. It’s among the most studied herbs for treating hepatitis and other liver diseases.

Milk thistle (a member of the plant family that includes daisies and sunflowers) contains a flavonoid called ­silymarin. It’s an antioxidant that ­reduces inflammation, blocks the movement of toxins into liver cells and increases the output of enzymes that prevent toxin-related damage.

Research suggests that milk thistle can improve liver function and improve survival in patients with chronic hepatitis and/or cirrhosis. One study found that it reduced the viral load (the amount of viral particles in the blood) in hepatitis C patients who hadn’t responded to drug treatments.

Typical dosage: If you have risk factors for liver disease or if you’ve been diagnosed with liver disease, talk to your doctor about taking 100 mg twice a day, to start—your doctor might recommend a higher dose (between 200 mg and 600 mg) if lab tests aren’t improving. Milk thistle is unlikely to cause side effects, although it should be avoided if you’re allergic to ragweed or one of its relatives, such as sunflower seeds or chamomile.

Turmeric

The active ingredient in this spice, curcumin, is an exceptionally potent ­antioxidant that has been shown to reduce jaundice (the dark urine and/or yellowing of the skin or eyes that often occurs in liver patients).

There’s also some evidence that it reduces liver scarring. A study published in Gut found that turmeric helped prevent a hepatitis-causing virus from moving from one cell to another.

Typical dosage: Between 500 mg and 1,500 mg of a turmeric supplement daily, divided into two or three doses. (Exact dose will depend on your weight, symptoms and other ­factors.)

Caution: Turmeric has blood-­thinning properties, so it may not be best if you are on a blood thinner such as warfarin or if your liver disease is advanced and clotting of the blood is a problem.

N-acetylcysteine (NAC)

Doctors who specialize in natural health recommend this supplement for liver patients. It reduces inflammation and increases intracellular levels of glutathione, the “master antioxidant” that is mainly produced and stored in the liver and that is depleted by liver disease.

Doctors give it to improve the viability of transplanted livers. It also is used in patients with liver damage caused by acetaminophen overdose (acetaminophen rapidly depletes glutathione).

Typical dosage: 600 mg, twice daily.

Glutathione

You don’t have to take this supplement if you already are using NAC (which is converted to glutathione in the body), but I often advise my patients to take glutathione because it helps rebuild body tissues, including liver cells.

Glutathione is particularly helpful if you regularly use acetaminophen for treating arthritis or another painful condition because acetaminophen, as mentioned before, can deplete glutathione levels. Oral glutathione usually needs to be taken with cysteine, which helps glutathione get into the cells.

Follow dosing directions on the label.

Coffee

Coffee isn’t a cure for liver disease, but there’s good evidence that it reduces liver inflammation and may reduce liver-­related health risks, including cirrhosis and cancer.

One study found that hepatitis B ­patients who drank more than four cups of coffee a week were only about half as likely to develop hepatocellular carcinoma (a form of liver cancer) as those who did not drink coffee.

Another study—one that looked at 430,000 people—found that people who drank an extra two cups of coffee a day could potentially reduce their risk for cirrhosis by 44%.

Weight Loss Is Crucial for Your Liver

Non-alcoholic fatty liver disease (NAFLD) is the leading type of liver disease in the US. It affects up to 25% of all adults and is linked to obesity and metabolic syndrome (a constellation of problems that includes high blood pressure, high blood sugar and elevated triglycerides, along with obesity).

A liver is considered “fat” if more than 5% to 10% of its weight comes from fatty tissue. This serious disease can lead to severe inflammation, ­cirrhosis or liver failure.

You have to lose weight if you’ve been diagnosed with NAFLD. Studies have shown that it may be possible to eliminate the condition altogether by losing as little as 10% of your total weight.

Also helpful: Alpha lipoic acid. It’s a well-researched supplement that can decrease insulin resistance and improve metabolic syndrome. I advise patients with NAFLD to take 200 mg daily, increasing the dose by 100 mg weekly until they reach a maximum dose of 400 mg to 600 mg.

If you have diabetes or are at risk for diabetes, you may need to check your blood glucose levels because alpha lipoic acid has the potential to decrease glucose levels in some ­individuals.