Liver is one of the most vital organs in your body. You may think of the liver as a manufacturing factory that -- also happens to ‘sort out’ wastes for you, if you will. More than 500 biological functions have been identified with the liver. Some of the more well-known functions include the following:
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Production of bile, which helps carry away waste and break down fats in the small intestine during digestion
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Production of certain proteins for blood plasma
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Production of cholesterol and special proteins to help carry fats through the body
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Conversion of excess glucose into glycogen for storage (glycogen can later be converted back to glucose for energy) and to balance and make glucose as needed
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Regulation of blood levels of amino acids, which form the building blocks of proteins
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Processing of hemoglobin for use of its iron content (the liver stores iron)
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Conversion of poisonous ammonia to urea (urea is an end product of protein metabolism and is excreted in the urine)
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Clearing the blood of drugs and other poisonous substances
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Regulating blood clotting
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Resisting infections by making immune factors and removing bacteria from the bloodstream
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Clearance of bilirubin, also from red blood cells. If there is an accumulation of bilirubin, the skin and eyes turn yellow.
When the liver has broken down harmful substances, its by-products are excreted into the bile or blood. Bile by-products enter the intestine and leave the body in the form of feces. Blood by-products are filtered out by the kidneys, and leave the body in the form of urine. It is not exaggerating when people call the liver a ‘detoxifying organ’.
What harms your liver?
It goes without saying that liver is an amazing organ that we can’t live without. Unfortunately, our modern and industrious lifestyle has taken liver for granted. If you have a history of long-term alcohol abuse, you are already at risk of a myriad of liver diseases. Even if you are not an alcoholic, if your daily diet is filled with fried food, processed food and high in sugar, you are at risk of having high blood cholesterol, being overweight or obese and have diabetes. These are independent factors that increase your risk of getting non-alcoholic fatty liver disease -- a condition which fat builds up in the liver and can disrupt your liver function.
Other factors that may cause liver diseases include history of illicit drug use, certain harmful chemicals in insecticides or cleaning products, and mixing alcohol and medications.
Examples of common liver diseases are:
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Infection origin: hepatitis A, B and C
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Abnormality in the immune system: Autoimmune hepatitis, primary cholangitis
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Genetics: Wilson’s disease
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Liver cancer
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Alcoholic fatty liver disease
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Non-alcoholic fatty liver disease
These conditions may worsen over time and results in liver cirrhosis, which is an end-stage liver failure and there’s no cure for it.
Common liver tonic supplements
There are many products out there that claim they can ‘strengthen’ your liver and ‘detox’ your body. Do liver supplements work? And does the organ that detoxifies your body really need its own detox? In reality, many of the claims on liver supplement bottles don’t stand up to the research.
Nevertheless, some studies have shown promising results from certain herbal and dietary supplements, here we list the common liver tonic supplements you can find in Malaysia.
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Milk thistle
Milk thistle (Silybum marianum) bears an eye-catching color to its flowers. It contains silymarin, which is the active ingredient that gives rise to the liver-protecting benefits. Milk thistle is well-known for its antioxidant and anti-inflammatory properties.
A 2017 analysis of studies found that silymarin slightly improves the markers of liver damage in people with liver diseases. We do not know how well milk thistle is going to improve the liver in healthy people.
A Cochrane review evaluated 18 milk thistle studies including people with liver conditions. The supplement didn’t have much effect on liver disease complications or deaths compared to placebo treatment. However, many of the studies included in the review were of poor quality to begin with. More well-designed experiments are needed to know how well milk thistle might work.
Milk thistle may produce allergies in people who are allergic to plants in the same family such as daisy, chrysanthemum, and marigold. It is also known that milk thistle may lower blood sugar level in people with Type 2 diabetes, therefore it should be used with caution. (NCCIH - Milk Thistle)
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Dandelion root
The leaves, flowers, and root of the dandelion (Taraxacum officinale) have traditionally been used in Mexican and other North American medicine. In modern times, it has been utilized for the treatment of various ailments such as indigestion, spleen and liver complaints, hepatitis and lack of appetite. However, its use has not been supported by compelling scientific evidence so far. The use of dandelion in the amounts commonly found in food is generally considered safe, but its safety beyond that amount is unknown.
It is common to see that liver tonic supplements often combine both dandelion and milk thistle together for a more superior antioxidant and anti-inflammatory effects for the liver. However, bear in mind that not much scientific studies have been conducted on both dandelion and its combination with milk thistle.
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Phosphatidylcholine (PC)
Have you ever played Lego® before? The logic works the same for the membrane of our cells. A PC is like each individual Lego® and many PCs are stacked together to form the membrane of our cells. This is essential for repairing and regenerating damaged liver cells. Our liver also requires choline, a component inside the PC, to carry fat to the rest of the body, which prevents fat from accumulating in the liver. According to a study conducted in 2010, PC helped reduce fat that can lead to a fatty liver in mice fed a high-fat diet. An observational study conducted in Russia this year found that giving 1.8g/day of PC to patients with non-alcoholic fatty liver disease improved their markers for liver damage. Nonetheless, there is a lack of scientific evidence regarding PC in improving liver functions.
Image credit: https://www.alpropharmacy.com/oneclick/product/powerlife-hepapho-3x10s/
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Essential phospholipids
Image credit: https://www.lypoextract.com/phospholipids/
Similar to PC, phospholipids are also part of our cell membranes. They contain extract of PC molecules from soybean and a high content of polyunsaturated fatty acids, i.e. the ‘good fats’. Essential phospholipids have been administered to people with fatty liver since 1988 due to their antioxidant, anti‐inflammatory, and cell death‐modulating effects. A review published in 2016 did alleviate discomforts in non-alcoholic fatty liver disease and alcoholic liver disease patients. The benefits of essential phospholipids need to be further confirmed with more rigorous randomised controlled trials.
Using liver tonic supplements wisely
The supplements we mention here show some promising results, although better scientific studies need to be conducted to claim they really hold up to how they are advertised to the public. These liver tonic supplements are generally safe to be consumed, but if you are pregnant or breastfeeding, it is better that you avoid using them or consult your doctor first, as no studies have been conducted on their safety in pregnant and breastfeeding women.
Some of these supplements may interact with the other medications or herbs and supplements you are taking. In addition, they may not be suitable to consume under certain medical conditions. Always consult a doctor or pharmacist before you start taking any supplement.
Many unscrupulous manufacturers sell their own version of ‘liver tonic’ or ‘detox products’ that are not registered with the National Pharmacy Regulatory Agency (NPRA). Do not buy any products that are not registered with the NPRA as their products may have been adulterated or not on par with the safety standards set by the agency.
Check if the product is registered on NPRA website.
If a product has been reported to be adulterated, it will be recorded in this portal.
Use liver tonic supplement wisely so that it positively contributes to better health and not the other way around.
It goes hand-in-hand with these
To prevent liver disease, taking a liver tonic supplement alone is not enough. Practise the following for a healthy liver:
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Drink alcohol in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
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Maintain a healthy weight by adopting a healthy lifestyle. It includes a healthy diet low in fat, salt and sugar; as well as regular physical activities.
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Avoid risky behaviors, such as using illicit drugs and unprotected sex. This prevents you from getting infected by hepatitis viruses that harm your liver.
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Get vaccinated against hepatitis A and B viruses.
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Do not mix your medications or any herbs and supplements with alcohol. There may be drug-drug interactions that can damage your liver.
