Liver Health – How herbs and nutrients can protect and support liver function

The liver is a vital and complex organ that performs more than 500 functions in the body [1]. Located on the upper right side of the abdomen and underneath the diaphragm, the liver is the largest internal organ that weighs around 1.5kg in the average adult [1].

A primary function of the liver is to act as a ‘filter’ by detoxifying blood. As blood passes through the liver, substances such as alcohol, medication and caffeine are broken down during the cleansing process. Other important functions of this organ includes processing food, distributing and storing nutrients, producing bile for digestion, and regulating metabolism.

The liver is a resilient organ because of its ability to repair and regenerate itself. Even though it has this ability, we still need to actively safeguard our liver health to maintain its function for our overall health and well-being.

Our liver health is impacted by our lifestyle choices. By making healthy choices we look after our liver and optimise its function. To provide further support to our liver health, there are commercially available herbs and nutrients that function as hepatoprotectants (i.e. prevent liver damage), liver tonics, detoxifiers, lipotropic factors (i.e. remove and prevent fatty deposits in the liver) and antioxidants. This article will explore these different ‘liver helpers’ and explain how Liver Detox Max can help you.

Healthy lifestyle choices for a healthy liver

Our lifestyle choices greatly influences our liver health and function. Healthy choices lead to optimal liver function, and also reduces the risk of liver disease (i.e. non-alcoholic fatty liver disease and alcoholic fatty liver disease). These lifestyle choices include eating healthy foods, maintaining your ideal body weight, exercising, and moderating your alcohol intake.

Factors that cause the liver to be under constant stress, or hamper its function can lead to liver injury and disease. These factors include excessive alcohol intake, and a diet high in fats. Alcohol abuse leads to destruction of liver cells, alcoholic fatty liver disease, liver inflammation, oxidative stress, or worse cirrhosis (scarring of the liver tissue). Whereas a diet high in fats can lead to fat accumulation in the liver, causing liver injury, inflammation, scarring and non-alcoholic fatty liver disease.

Liver helpers – Herbs and nutrients that protect and support the liver

There are a number of herbs and nutrients that act as ‘liver helpers’ to protect and support liver function. For example:

  • Hepatoprotectants: milk thistle, globe artichoke, schisandra chinensis, taurine
  • Detoxifiers: dandelion root, glutathione, milk thistle
  • Aids digestion: dandelion root, milk thistle
  • Lipotropic factors: choline and inositol
  • Antioxidants: globe artichoke, broccoli (BroccoPhane®), glutathione, milk thistle

The combined health benefits of these herbs and nutrients can be found in the formulation Liver Detox Max.

Liver Detox Max – Liver Tonic. Formula to support the liver.

Liver Detox Max is a comprehensive liver tonic and detox formulation featuring 10 active ingredients. It has been formulated based on traditional medicine and clinical research.

Each ingredient has been carefully selected and sourced for quality and efficacy from reputable suppliers around the world. Our suppliers are leaders in the health and pharmaceutical industry, e.g. Naturex in France, Nutegrity in USA, and Kyowa Hakko Bio Co. in Japan.

Proudly made in Australia, this formulation is regulated by Therapeutic Goods Administration (TGA) – a division in the Australian Department of Health, and manufactured in Australia in compliance with the Good Manufacturing Practice (GMP) to ensure quality, safety and efficacy.

Understanding how Liver Detox Max works

Milk Thistle (Silybum marianum)

Milk thistle is a herb found natively in Europe. In traditional medicine it was used as a herbal remedy for a variety of liver ailments. Milk thistle functions as a hepatoprotectant, liver detoxifier, antioxidant and aids digestion.

Its medicinal properties is due to the presence of silymarin, a mixture of flavonolignan compounds that are extracted from the seeds. Silybin has been identified as the main active compound, and most abundant flavonolignan; representing 50-70% of silymarin content [7, 8]. Silybin is largely responsible for the liver health benefits of silymarin.

Mechanism of action

Silymarin protects liver cells through its antioxidant properties [9]. As a hepatoprotectant it helps prevent tissue scarring on the liver, and may block the inhibition of toxins to hepatocyte (liver) cells [8]. In addition, it has anti-inflammation properties and can assist liver repair by supporting new cell growth [10, 11].

Clinical studies

Numerous clinical studies have demonstrated the beneficial effects of milk thistle in participants with liver disease. Results include significant improvements in liver function and morphology [12]. The commonly used dosage in clinical trials was 420mg/day of standardized silymarin extract [12]. Based on this clinical evidence, Liver Detox Max was formulated to provide a daily dosage of 428.6mg standardized silymarin extract (each tablet contains 214.3mg of standardized silymarin extract, the dosage recommends taking 2 tablets per day).

In a different study consisting of participants with non-alcoholic fatty liver disease, they were supplemented with a silymarin containing treatment for 6 months [13]. Results found that silymarin was effective in reducing the biochemical and inflammatory indices of hepatic steatosis (infiltration of fat in to liver cells). Improvements in hepatocyte integrity and liver function was observed [13].

Milk thistle featured in Liver Detox Max is sourced from Network Nutrition, a leader in therapeutic grade herbal extracts.

Globe artichoke (Cynara scolymus)

Globe artichoke is a perennial plant that has been used in traditional European medicine [14]. The leaves contain various bioactive constituents with medicinal properties that include antioxidant, hepatoprotective, anti-inflammatory, cholerectic (bile flow stimulation) diuretic, and lipid lowering effects [14]. These bioactive constituents include, cynarin, luteolin, cynardoside, scolymoside and chlorogenic acid. Cynarin is the most studied constituent for globe artichoke.

Mechanism of action

Bile produced in the liver is the principle mechanism for eliminating lipids from the body [15]. Globe artichoke can stimulate bile production and flow, thereby reducing the net reductions of lipids in the liver and serum [15].  Through its antioxidant activity it can reduce low density lipoprotein oxidation and lower blood lipid concentration [16].

Clinical studies

In a randomised, double-blind placebo-controlled clinical trial consisting of participants with mild hypercholesterolaemia, artichoke leaf extract was administered for 12 weeks [17]. Artichoke leaf extract reduced total plasma cholesterol levels by an average of 4.2-6.68%, and improved general well-being by 11% [17].

In a different randomised, double-blind, placebo-controlled clinical trial consisting of overweight participants with mild hypercholesterolaemia, supplementation with artichoke leaf extract for 8 weeks resulted in an increase in good fats (high-density lipoprotein), and a decrease in total cholesterol and low-density lipoprotein [18].

Brassica oleracea var. italica (BroccoPhane®) – Broccoli sprout & broccoli

Broccoli is an important vegetable that provides numerous health benefits including antioxidant properties [19]. The presence of glucosinolates (sulfur containing compounds) in broccoli are responsible for its health benefits.

During food preparation, chewing, and digestion – gluconsinolates are converted to bioactive compounds such as indoles (e.g. indole-3-carbinol), isothiocyanates (e.g. sulforaphane), nitriles and thiocyanates. Sulforaphane produced from the metabolism of glucoraphanin (a gluconsinolate) by the enzyme myrosinase, is one of the most frequently studied plant-derived isothiocyanates [20, 21]. Its health benefits include, antioxidant, anti-inflammatory and anti-microbial [22-24].

Mechanism of action

The hepatoprotective effects of sulforaphane has been associated with its primary action of Nrf2 activation [25]. The Nrf2 pathway has a vital role in enhancing antioxidant activity to protect cells and tissues from oxidative damage [25]. In in vivo and pre-clinical studies, sulforaphane was found to benefit liver health and fatty liver disease. Results found that sulforaphane stimulated a number of antioxidant and detoxifying enzymes, protected hepatocyte cells, reduced liver lipid accumulation, improved liver function, and reduced liver inflammation [26-29].

Clinical studies

The effects of supplementary sulforaphane-rich broccoli sprout extract was studied in male participants with fatty liver disease for 2 months in a randomised, placebo-controlled, double blind trial [30]. Results displayed improvements in liver function and hepatocyte integrity in the treatment group, and no improvements were observed in the control group. It was concluded that sulforaphane supplementation improved liver function by reducing oxidative stress [30].

BroccoPhane®

BroccoPhane® is a Broccoli Sprout Powder extract, standardized for sulforaphane. Sourced from Nutregrity in the USA, a supplier that specializes in quality nutritional ingredients for the health industry.

Taraxacum officinale – Dandelion root

Dandelion is a common flowering perennial plant with a long history of use in traditional medicine [31]. Traditionally, the leaves were used as a diuretic, and the root as a liver tonic. Hence, different parts of the plant is beneficial for different purposes. The root has numerous health benefits for liver health, including detoxifying the liver, supporting liver function, aid digestive problems and exert antioxidant activity [32]. Various active constituents are found in the root, including triterpenes, steroids, cinnamic acids, and monocaffeyltartaric acids [33-35].

Mechanism of action

Dandelion root extract displays antioxidant, anti-inflammatory and hepatoprotective effects. In an in vitro study, several isolated triterpenoid compounds were suggested to potentially have anti-inflammatory activity [36].

High levels of aminotransferase levels is a biomarker for liver disease and damage. It was found that cinnamic acid, caffeic acid and its substituents contribute to hepatoprotective activity by reducing both aminotransferase levels and lipid peroxidation [37]. In pre-clinical studies, cinnamic acids was found to also improve liver function, liver steatosis and bile production in animal models of non-alcoholic fatty liver disease [38-39].

Clinical studies

To date, only pre-clinical studies exist for dandelion root and its benefits in liver health. A study investigated the possible hypolipidemic and antioxidative effects of dandelion root and leaf in 28 rabbits fed with a high cholesterol diet [40]. Results found in the treatment group displayed marker improvements in hepatocyte integrity, liver function and lipid peroxidation [40]. In an in vitro and in vivo study consisting of alcoholic liver damaged mice models, dandelion root treatment groups had protective activity against alcohol-induced toxicity in the liver by elevating antioxidative activity and decreasing lipid peroxidation [41].

In traditional medicine, the recommended minimum therapeutic dosage is 1.5g/day of dried dandelion root. Liver Detox Max was formulated based on this recommendation, and provides a daily dosage of 1.5g extract equivalent to dry dandelion root (each tablet contains 750mg of extract equivalent to dry dandelion root, the dosage recommends taking 2 tablets per day).

Schisandra chinensis

Schisandra chinensis is a herb used in traditional medicine primarily for various liver conditions. Its fruits contains medicinal properties that include hepatoprotective, antioxidant and anti-inflammatory activity. Bioactive constituents found in the fruit are deoxychisandrin (schisandrin A), gamma-schisandrin (schisandrin B), schizandrin, and gomisin A [42]. Schisandrin B is the most abundant lignin in the fruit.

Mechanism of action

Schisandra chinensis exerts its hepatoprotective activity in a number of mechanisms. In an in vivo study, schisandra chinensis extract was found to upregulate both drug metabolizing enzymes and drug transporters (involved in xenobiotic detoxification), and is involved in the activation of the Nrf2 pathway [43]. Drug metabolising enzymes in the liver have the vital role of detoxifying drugs and environmental toxins, as well as maintaining liver function [44]. Drug transporters provide cellular protection by removing xenobiotics that can accumulate in cells and lead to toxicity [43]. The Nrf2 pathway has a vital role in enhancing antioxidant activity to protect cells and tissues from oxidative damage [43]

Schisandra chinensis also increased intracellular levels of GSH, insufficient GSH levels is closely associated with toxicant-induced hepatotoxicity [43].

Clinical studies

In a randomised, parallel, placebo-controlled study, the antioxidative effects and hepatoprotective activity of schisandra chinensis was studied in participants over 5 months [45]. The participants had high levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) [45]. ALT and AST are biomarkers for liver disease, and high levels of these enzymes are linked to liver damage. The treatment group was administrated a mixture of schisandra chinensis extract and sesamin.  Results demonstrated a reduction in ALT and AST levels, improvements in fatty liver status and liver function.

Taurine

Taurine is an amino acid found abundantly in the human body, including the liver [46]. Taurine is a hepatoprotectant, functioning to protect the liver from xenobiotics and preventing liver disease [47, 48].  It also has antioxidant activity and can lower lipid levels in the liver [49]. Low hepatic taurine levels is linked to liver disease and or xenobiotics-induced liver injury [47, 48].

Mechanism of action

Taurine lowers lipid and cholesterol balance through the following actions: (1) reduce cholesterol levels in the blood by increasing liver uptake, (2) converting cholesterol to bile acid in the liver, and (3) excreting cholesterol and bile acid from the intestine [50].

Clinical studies

The effects of taurine supplementation on liver function in chronic hepatitis patients were studied in a placebo-controlled clinical trial over a 3 month period [51]. Results found a reduction in ALT, AST, cholesterol, and triglyceride levels in the treatment group, thereby taurine can reduce liver injury in chronic hepatitis patients. These results were not observed in the placebo group.

Glutathione

Glutathione is a tripeptide, consisting of cysteine, glycine and glutamic acid [52]. It is found in high levels in most cells. Its functions include antioxidant, detoxifying the liver, and regulating cellular proliferation and apoptosis [53].

Mechanism of action

As an antioxidant, glutathione has a vital role in protecting cells from reactive species [52]. It neutralizes free radicals produced from Phase I liver metabolism of chemical toxins [52]. It helps protect cells by recycling antioxidants vitamin C and E. Glutathione is also involved in the detoxification and excretion of toxins through different pathways, one of which includes the glutathione conjugation [52]. Low levels of glutathione is associated with long term exposure to toxins, hence, maintaining glutathione levels is important for liver health and function.

Clinical studies and Setria® glutathione

Some clinical studies have shown that oral administration of glutathione in participants with different liver conditions (e.g. alcoholics with liver injury, cirrhosis), was not effective in raising glutathione levels [53]. Setria® Glutathione consists of reduced glutathione (i.e. L-Glutathione), a more bioavailable form of glutathione. It is manufactured by a patented fermentation process by Kyowa Hakko Bio Co., Ltd, a pharmaceutical and biotechnology company in Japan. Setria® has been clinically studied in a 6 month, randomized, double-blind, placebo-controlled trial [54]. Participants of this study consisted of non-smoking adults. An increase of bodily glutathione levels was observed in the treatment group, and glutathione levels increased in a dose and time dependent manner. Setria® glutathione was effective in raising glutathione levels to support liver health.

 Choline

Choline is an essential nutrient with lipotropic functions. It is important for the normal metabolism and transport of lipids [55]. Choline deficiency is associated with abnormal fat deposits in the liver, which can lead to non-alcoholic fatty liver disease [55].

Mechanism of action

Choline is used for the synthesis of phosphatidylcholine, a phospholipid required for the assembly and secretion of very-low-density lipoproteins from the liver. Without adequate phosphatidylcholine, fat and cholesterol ends up accumulating in the liver. This results in liver steatosis, and can lead to liver damage. In addition, lipid build up in the liver causes impaired mitochondrial function, which increases the production of reactive oxygen species that triggers lipid peroxidation. Elevated biomarkers of liver disease (e.g. ALT and AST) are decreased upon choline repletion [55].

Clinical studies

In an interventional study, healthy adults were subjected to choline-deficient diets. The majority of participants (77% of men, 80% of postmenopausal women, 44% or premenopausal women) developed fatty liver, liver damage, and muscle damage [56]. However, reintroduction of choline in their diets reversed the early signs of liver damage and restored liver function.

Inositol

Inositol, also known as myo-inositol is a nutrient that functions as a lipotropic factor, meaning it has the ability to remove and prevent fatty deposits in the body [57, 58]. Inositol is synthesized in the body to produce Phosphatidylinositol, an essential phospholipid in the liver. Phosphatidylinositol is important for maintaining hepatocyte integrity [59].

Mechanism of action and clinical studies

Phosphatidylinositol was found to regulate some liver genes involved in lipid synthesis and metabolism. In pre-clinical studies, a diet deficient in inositol resulted in low levels of inositol in all tissues (including liver, lung and heart), low phosphatidylinositol levels in the liver, and consequently an increased accumulation of hepatic lipid [59].

Summary

Liver Detox Max is a comprehensive formulation for liver health and function. Consisting of 10 active ingredients, Liver Detox Max provides multiple actions that include hepatoprotectant, antioxidant and aids digestion. Formulated based on traditional medicine and scientific evidence, Liver Detox Max will help you look after your liver.

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