Your Definitive Guide To The Best Supplements For Fatty Liver Disease (+ How To Start Healing Naturally!)
Fatty liver disease is a condition that has grown by leaps and bounds, affecting millions of Americans on a daily basis. Often asymptomatic in its early stages, many people are left wondering how to support their liver health before it progresses into a more severe condition.
As a functional medicine expert, it’s my job to help you identify the root cause behind every health problem you are dealing with and offer natural solutions to find healing. And one way to support your liver health is through supplements. From vitamins to natural herbs, read on to learn more about this condition and my favorite supplements for fatty liver.
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What is fatty liver?
Fatty liver disease is a condition that happens when there is an accumulation of fat in the liver cells. It is a surprisingly common condition affecting up to 25% of the total population (1) and up to 85% of obese individuals (2) that can be categorized into two main types:
Non-alcoholic Fatty Liver Disease (NAFLD)
This is the most common type of fatty liver and is not related to excessive alcohol consumption. NAFLD often occurs in people who have risk factors such as obesity, type 2 diabetes, high cholesterol, or metabolic syndrome. It can range from simple fatty liver (steatosis) to a more severe condition known as non-alcoholic steatohepatitis (NASH), which involves liver inflammation and damage. If left untreated, NASH can progress to cirrhosis, liver failure, or liver cancer.
Alcoholic Fatty Liver Disease (AFLD)
This type of fatty liver is directly caused by excessive alcohol consumption and can also range from simple fatty liver to more severe conditions, including alcoholic hepatitis and alcoholic cirrhosis, depending on the amount and duration of alcohol abuse.
The main risk factors for fatty liver include:
- Insulin resistance and type 2 diabetes
- High levels of triglycerides and cholesterol in the blood
- Rapid weight loss
- Certain medications
- Viral hepatitis
- Rapid weight loss
Common symptoms of fatty liver
Fatty liver disease, particularly in its early stages, often doesn't cause noticeable symptoms. Many people with fatty liver don’t experience any symptoms and they only discover they have this condition through a routine medical check-up or tests for other health concerns. However, as the disease progresses into more severe forms, some individuals may experience symptoms such as:
- Abdominal Discomfort
- Mild Abdominal Pain
- Unexplained Weight Loss
- Jaundice (Yellowing of the Skin and Eyes)
- Enlarged Liver
- Dark Urine
- Spider Angiomas: (small, spider-like blood vessels)
It's important to note that these symptoms are not exclusive to fatty liver disease, and they can also indicate the presence of other liver conditions. Fatty liver disease is diagnosed through imaging tests such as ultrasound, CT scan, or MRI or liver function tests including blood tests.
The connection between gut health and liver health
Like most things with your health, it all comes back to your gut. Working in constant communication with your stomach, pancreas, gallbladder, and the rest of your digestive system, your liver is responsible for storing and converting nutrients from the foods you eat for your body to utilize. Through its role in the metabolism of fat, protein, and carbohydrates, your liver works to ensure (3) that blood glucose levels stay stable, preventing blood sugar imbalances and other metabolic problems.
But one of its other primary functions is to filter out toxins from the foods you eat and the things you are exposed to in your environment. It’s also a blood purifier, clearing your blood of these impurities so that you only use what you need and don’t get too affected by those things that could compromise your health.
As you can see, your liver is one busy organ and works hand in hand with your gut to process everything you consume - whether that is beneficial nutrients or toxins. And now that we understand this vital relationship, we can see just how important a healthy gut is to avoiding NAFLD.
In fact, researchers have found such a strong connection between your gut and your liver they have coined the impact of this relationship the “gut-liver axis”. For example, studies have found that underlying conditions like leaky gut syndrome, (4) SIBO, (5) and bacterial dysbiosis (6) in your gut and oral microbiome have all been directly linked to the development of NAFLD.
Best supplements for fatty liver
As a functional medicine expert, I understand that supplements shouldn’t be your foundation for wellness. However, there are many supplements for fatty liver that have been clinically studied for their ability to help support liver function and Non-Alcoholic Fatty Liver Disease.
1. Milk thistle
As one of my top favorite detox supplements, milk thistle is a plant that aids in eliminating toxins that have built up in the liver while also helping to restore liver cells that have been damaged from increased toxin exposure. It’s one of the most well-researched natural remedies for treating liver problems and has been used for years to treat (7) a variety of liver ailments, from hepatitis to alcoholic liver disease.
My supplement, The Detoxer, is formulated with high-quality milk thistle to support your body’s natural ability to detox by facilitating optimal function of both phase I and phase II of the detoxification process.
Omega-3 fish oil supplements, specifically those containing EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), have been shown to significantly reduce (2) the accumulation of fat in the liver. Plus, omega-3s are known for their ability to help lower inflammation and blood sugar levels - two hallmarks of NAFLD.
Unfortunately, not all fish oil supplements are created equally. Unlike most other fish oils that can be hit or miss in terms of bioavailability, my supplement The Omega+ is formulated with MaxSimil® monoglyceride fish oil that has a three times greater EPA+DHA absorption rate than an equivalent dose of other leading fish oils.
N-acetyl-cysteine - or NAC for short - is a potent antioxidant that has long been studied for its ability to protect the liver from oxidative damage from toxins. Researchers have even found NAC to be so beneficial for liver health that doctors often administer it (8) in the cases of drug overdose and liver cancer.
Formulated with N-acetyl-L-cysteine (NAC), my supplement The Detoxer, is designed to support critical steps in your liver's detoxification process to rid your body of toxins like heavy metals and xenoestrogens.
Considering the role of the gut in NAFLD, daily probiotics are one way to ensure your gut is getting exactly what it needs to thrive. One study (9) of over 21 clinical trials showed that regular probiotic supplementation regulated both liver function and insulin levels in people diagnosed with NAFLD, in addition to their ability to help with everything from gut microbiome balance, gut barrier function, and inflammation levels.
With 100 billion CFUs per capsule, my supplement The Probiotic, contains four strains of beneficial bacteria, including the extensively studied HN019 strain of Bifidobacterium lactis for enhanced microbiome support.
5. Vitamin E
Vitamin E is an antioxidant that may have a protective effect on the liver and has been studied for its potential benefits in NAFLD. But with that said, talk with your doctor before taking vitamin E as high doses can have side effects.
Non-alcoholic fatty liver disease is associated with lower levels of Coenzyme Q10, with multiple studies showing that supplementing with Coenzyme Q10 can notably decrease (10) the high oxidative stress and inflammation levels commonly seen in NAFLD patients.
Multiple studies have found that turmeric supplementation is quickly able to reduce (11) liver enzymes like ALT in those with NAFLD in as little as 8 weeks!
For a targeted dose of curcumin - the therapeutic compound found in turmeric - look no further than my supplement The Curcumin, that is packed with pure turmeric extract from BCM-95® which has been extensively studied for its proven efficacy and enhanced bioavailability.
Other ways to support healing
Remember, you can’t supplement your way into good health. That’s why healing from fatty liver, whether it's non-alcoholic fatty liver disease (NAFLD) or alcoholic fatty liver disease (AFLD), involves making significant lifestyle changes in order to address the root cause of this condition.
1. Limit alcohol consumption
Even if you aren’t diagnosed with alcoholic fatty liver disease, it’s important to greatly limit your alcohol consumption since alcohol itself can contribute to fat accumulation in the liver. By cutting back on or eliminating alcohol consumption, you reduce the burden on your liver and give it a chance to process and eliminate accumulated fat.
2. Drink more coffee
If you’re a coffee lover, you’re in luck! Studies have found that drinking anywhere between 2 to 3 cups of coffee per day can have a positive effect (12) on liver function by encouraging the production of anti-inflammatory liver enzymes and reducing overall liver damage.
3. Avoid added sugar + manage blood sugar levels
Fatty liver disease often coexists with insulin resistance, a condition where your body's cells don't respond effectively to insulin. Insulin helps regulate blood sugar levels. When you have insulin resistance, your body produces more insulin to compensate. When this happens, your body compensates with higher blood sugar levels that encourage your liver to convert excess glucose into fat for storage - specifically in your liver.
To manage your blood sugar, reduce your intake of sugar and processed foods and instead focus on clean, whole food sources of protein, carbohydrates, and healthy fats.
4. Manage your weight
In functional medicine we understand that you have to get healthy to lose weight, not lose weight to get healthy. However, for some people with NAFLD, taking steps to manage your weight can significantly improve NAFLD. Since this condition is associated with a sedentary lifestyle and obesity, making an effort to move your body regularly and limiting your intake of sugar and processed foods like I mentioned above, can make a huge difference in improving underlying mechanisms that play a role in weight gain.
5. Go non-toxic
Excessive toxin exposure can put additional, unnecessary stress on your liver. Take small steps to reduce toxin exposure by swapping out conventional cleaning, beauty, and self-care products for ones that are labeled non-toxic.
Choosing the right supplement plan for you
When it comes to NAFLD, it’s important to remember that this condition is not due to a lack of supplementation. While there are many supplements that have been clinically shown to help support liver function, supplements are just one part of your healing journey. If you are struggling with NAFLD, I recommend working with a qualified practitioner who can help you identify and address the underlying causes of your condition through dietary and lifestyle changes in addition to supplements.
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- American Liver Foundation "What is fatty liver disease" Accessed September 2023. https://liverfoundation.org/liver-diseases/fatty-liver-disease/nonalcoholic-steatohepatitis-nash/nash-definition-prevalence/
- Parker, Helen M et al. “Omega-3 supplementation and non-alcoholic fatty liver disease: a systematic review and meta-analysis.” Journal of hepatology vol. 56,4 (2012): 944-51. doi:10.1016/j.jhep.2011.08.018
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the liver work? 2009 Sep 17 [Updated 2016 Aug 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279393/
- Kessoku, Takaomi et al. “The Role of Leaky Gut in Nonalcoholic Fatty Liver Disease: A Novel Therapeutic Target.” International journal of molecular sciences vol. 22,15 8161. 29 Jul. 2021, doi:10.3390/ijms22158161
- Augustyn, Monika et al. “Small intestinal bacterial overgrowth and nonalcoholic fatty liver disease.” Clinical and experimental hepatology vol. 5,1 (2019): 1-10. doi:10.5114/ceh.2019.83151
- Wang, Ting et al. “Oral and Gut Microbial Dysbiosis and Non-alcoholic Fatty Liver Disease: The Central Role of Porphyromonas gingivalis.” Frontiers in medicine vol. 9 822190. 2 Mar. 2022, doi:10.3389/fmed.2022.822190
- Abenavoli, Ludovico et al. “Milk thistle in liver diseases: past, present, future.” Phytotherapy research : PTR vol. 24,10 (2010): 1423-32. doi:10.1002/ptr.3207
- Mokhtari, Vida et al. “A Review on Various Uses of N-Acetyl Cysteine.” Cell journal vol. 19,1 (2017): 11-17. doi:10.22074/cellj.2016.4872
- Zhou, Xiangyu et al. “Efficacy of probiotics on nonalcoholic fatty liver disease: A meta-analysis.” Medicine vol. 102,4 (2023): e32734. doi:10.1097/MD.0000000000032734
- David Mantle, Iain P Hargreaves."Coenzyme Q10 supplementation in non-alcoholic fatty liver disease: an overview" Journal of Prescribing Practice April 2020.
- Mansour-Ghanaei, Fariborz et al. “Efficacy of curcumin/turmeric on liver enzymes in patients with non-alcoholic fatty liver disease: A systematic review of randomized controlled trials.” Integrative medicine research vol. 8,1 (2019): 57-61. doi:10.1016/j.imr.2018.07.004
- Wadhawan, Manav, and Anil C Anand. “Coffee and Liver Disease.” Journal of clinical and experimental hepatology vol. 6,1 (2016): 40-6. doi:10.1016/j.jceh.2016.02.003
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BY DR. WILL COLE
Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular The Art Of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum and the brand new book Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel.
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