Fatty liver alert: Supplements that aren’t a magic fix, but you are taking them anyway

About 100 million people have non-alcoholic fatty liver disease in the United States, according to the American Liver Foundation. This liver condition is also increasingly becoming common among young adults, and major lifestyle interventions, along with medication, are often advised to manage it effectively.

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Yet, many people turn to supplements hoping for a quick fix. The supplement market is booming, with countless products claiming to improve liver health or even reverse liver damage. In reality, most of these supplements aren’t a magic fix. In fact, some supplements may strain your liver and cause more harm than good. Take a look.

Milk thistle tops the list of one of the most popular supplements when it comes to improving liver function. But does it really work? Milk thistle, a plant with a long, thin stem, spiny leaves, and a purplish-pink thistle at the top, contains silymarin, a flavonoid, which is believed to have antioxidant properties and thereby protect the liver. The compound is linked to lowering elevated enzymes like ALT and AST in NAFLD patients. A 2012 study by the University of Pennsylvania researchers found that silymarin does not offer significant improvements for liver disease patients. A 2024 meta-analysis deemed benefits modest at best, not reversing disease progression.

Most people are obsessed with detoxifying their bodies, including the liver. They often seek the help of herbal supplements for this. However, many don’t realize that the liver itself is in charge of this process. You hardly need detoxification drinks or supplements. In fact, many such herbal supplements can damage the liver. A recent by the University of Michigan researchers was published in the journal JAMA. found that herbal supplements may contain potentially harmful natural ingredients. They identified six herbal supplements that are potentially hepatotoxic.

The potentially hepatotoxic supplements include:

• turmeric or curcumin
• green tea extract
• ashwagandha
• black cohosh
• garcinia cambogia
• red yeast rice

“Our interest started when we saw cases of liver toxicity from herbal and dietary supplement use in people enrolled in the ongoing NIH-funded DILIN study,” the lead author, Alisa Likhitsup, M.D., M.P.H., the clinical assistant professor of Medicine at U-M, said.

The study also revealed the shocking number of people consuming these supplements. “The major finding here is the large number of Americans taking these products, with an estimated 15 million adult Americans taking them on a regular basis,” Likhitsup added.

The supplement sales have surpassed $150 billion in the United States in 2023. There are over 80,000 unique supplement products available for purchase worldwide. However, mislabeling of the products is common.

“We performed analytical chemistry and found about a 50% mismatch between stated ingredients on the label and what they actually contained, which is quite alarming. If you buy a supplement and it says it has a certain ingredient, it's basically a coin flip if that’s true or not,” Robert Fontana, M.D., Michigan Medicine hepatologist, professor of medicine, and the study’s senior author, said.

“We're not trying to create an alarm. We're just trying to increase awareness that the over-the-counter supplements people are taking and buying have not been tested nor necessarily proven to be safe,” Fontana added.