Half a death cap mushroom can be enough to kill an adult. The death cap is behind most of the world's mushroom deaths, possibly including the Roman emperor Claudius in AD 54, and its poison, alpha-amanitin, destroys the liver and the kidneys.
One of the treatments used against it in Europe comes from a thistle. Silibinin, extracted from milk thistle, is given straight into a vein, and it stops liver cells taking up the poison. In one report on 60 people treated with it, everyone who started within four days of eating the mushroom, with kidneys still working, survived.
That injection, in a hospital, is milk thistle at its most convincing. The capsules on the shelf, sold for "liver support", rest on much less. Same plant, very different paperwork.
Milk thistle, dandelion, turmeric, ginger and black radish appear on every list of herbs that support liver function, each with a mechanism and a promise. The question here is plainer: what has each one shown in people, and what can go wrong?
The liver does its own work
Your liver does not need detoxing. It is the detox. It was doing the job long before the word became a product.
It works in two phases. In the first, enzymes change fat-soluble compounds, from medicines to alcohol to the by-products of your own metabolism. In the second, it attaches other molecules to them so they dissolve in water. Then they leave, through bile into the gut or through the kidneys into urine.
It is also built to recover. The liver is the only internal organ that grows back lost tissue: as little as a quarter of it can grow back to a whole liver's worth. Writing on that ability often cites Prometheus, the Titan whose liver an eagle ate every day and which grew back every night. The same reserve has a downside. A liver can lose a great deal before it complains, and it often shows symptoms only after extensive damage.
Every herb sold for "liver support" is a claim to help that system along. Most of the support comes from lab dishes and animals. People are the harder test, and that is where this article looks.
Milk thistle
Milk thistle is a purple-flowered thistle of the daisy family, also called Mary thistle or Saint Mary's thistle. Its seeds hold silymarin, a mix of compounds that has been tested on the liver for decades.
Its name was made in 1989, when 170 people with cirrhosis were given silymarin or a dummy pill and followed for years. After four years, 58% of the silymarin group were alive, against 39% on the dummy. The benefit showed in alcohol-related cirrhosis and in the earliest stage of the disease.
Then came the reviews. In 2007, a Cochrane review pooled 18 tests in 1,088 people with alcohol-related or viral liver disease. Most were of low quality. Milk thistle made no significant difference to deaths, complications or the state of the liver itself. Across all the tests, deaths from liver disease seemed to halve, but in the well-run tests alone that effect was no longer clear.
A large modern test went back to the oldest use. At four US centres, 154 people with long-standing hepatitis C took silymarin at one of two strengths, or a dummy, for 24 weeks. Two people in each group reached the target for liver enzymes. Enzymes, virus levels and quality of life came out the same. A draw, at two strengths.
Then fatty liver. In Malaysia, 99 people with fatty liver inflammation confirmed by biopsy took silymarin or a dummy for 48 weeks. The main score improved no more than with the dummy: 32.7% against 26.0%. Scarring did fall in more of the silymarin group, 22.4% against 6.0%, which the team said still needed confirming in a larger group.
The one place milk thistle may do something is not the liver. A small number of tests suggest its extracts may help control blood sugar in type 2 diabetes. Most were run in Middle Eastern countries, and whether the result holds elsewhere is unclear.
So the honest summary for the liver is a maybe. And the product is a second question. Some milk thistle supplements have been found to contain far more or less silymarin than the label says, or to be contaminated with pesticides, microbes or mycotoxins, the poisons made by moulds. If you react to ragweed, chrysanthemums, marigolds, daisies or chamomile, all from the same plant family, milk thistle may set you off too.
Dandelion
Dandelion is the most familiar of the five. The US National Center for Complementary and Integrative Health puts it bluntly: no "compelling" evidence supports using dandelion for any health condition. What exists is lab work on extracts. The weed on your lawn has a better reputation than record.
If you try it anyway, know that root and leaf are sold as different products, and the liver claims are made for the root. Dandelion in food amounts is considered likely safe. In larger amounts, it may interact with diabetes medicines, blood thinners and water pills, and it belongs to the same daisy family as milk thistle.
Turmeric
Turmeric's active compound, curcumin, barely gets into the blood on its own. Food Pairings That Improve Nutrient Absorption has the fix supplement makers use: taken with piperine, from black pepper, its absorption rose by around 2,000%.
That fix has a catch, and it sits inside a bigger picture. A US network collects cases of liver injury caused by medicines and supplements. Of its 839 cases from 2004 to 2013, 130 were caused by herbs and supplements, and their share rose from 7% to 20% over those years. The injuries from supplements other than bodybuilding products were the most severe, with more deaths and liver transplants.
Turmeric has its own entries. The same network found 10 cases linked to it, every one since 2011 and six since 2017. Five people were admitted to hospital and one died of liver failure. Three of the products also contained piperine. Seven of the ten carried the same immune gene variant, at about seven times its usual frequency. The network calls turmeric liver injury "a growing problem".
The US health agency adds that liver damage has been reported with the products made to be absorbed better. A spice sold for the liver, made stronger, has been hurting livers. Better absorbed is not the same as better.
Green tea extract shows the same pattern. Liver injury, though uncommon, has been reported in people taking green tea products, mostly extracts in tablets and capsules. People with a particular immune gene variant, carried by 5 to 15% of Americans, appear especially susceptible. And the tea itself carries caffeine.
Kava shows why the form matters. Many countries banned or restricted it in 2002 over safety concerns. When the World Health Organization looked again, it judged the traditional drink, roots steeped in water, an "acceptably low level of health risk", while extracts made with organic solvents, or too much low-quality kava, may raise the risk of liver injury. The same plant can be a drink or a hazard, depending on how it is extracted.
There is a second cost. When 11 healthy adults took turmeric supplements for four weeks, the oxalate in their urine rose more than with cinnamon or with water. High oxalate in the urine is a major risk for kidney stones, and turmeric is one more source of it.
Ginger
Ginger is the one most kitchens already have, and its liver evidence is thin.
When 76 people with type 2 diabetes and fatty liver took ginger capsules or dummy capsules for three months, liver enzymes fell in both groups. The fat in the liver, measured on a scan, did not change in either. Ginger did improve blood pressure. As a liver remedy, the dummy did as well. And the dummy cost less.
Where ginger does have evidence is nausea, especially in pregnancy. If you take any medicine, check for interactions before you add a ginger supplement, and enjoy the root in your cooking.
Black radish
Black radish is the strangest entry. It is a root, a cousin of mustard and horseradish, and it has long been sold as a liver tonic.
The evidence is one kind: mice. Fermented black radish reduced fatty liver in mice fed a diet designed to give them one. No test in people was found. That puts black radish where dandelion is: an old reputation, no human record. The mice are doing well.
They are worth a second look, though. The diet used to give them fatty liver was short of one nutrient in particular: choline.
What the liver runs on
In 1932, Charles Best, one of the team that discovered insulin a decade earlier, was working on fatty liver in rats. He showed it could be prevented by feeding them lecithin, and that the choline in it did the work.
It took until 1998 for the US to set its first recommendation for choline in the human diet. In 2007, 57 adults were fed a diet with the choline taken out. Of the men, 77% developed fatty liver or muscle damage. So did 80% of women past menopause. Only 44% of younger women did, because oestrogen helps the body make its own. Six of the men showed signs while still eating the recommended amount.
The richest sources are liver and egg yolks. 8 Smart Ways to Fight Cognitive Decline with Food has what the form of choline in eggs does for the brain as well.
The rest of the liver's machinery runs on the same food. Both phases need protein for the enzymes and for glutathione, the molecule the second phase uses most. They need B vitamins and magnesium. No herb supplies any of that.
The clearest proof sits in a hospital. Paracetamol is the most common cause of acute liver failure in the US and the UK, and the damage comes from one of its breakdown products, which strips the liver of glutathione. The antidote is acetylcysteine, a form of the amino acid cysteine, and it works by raising glutathione again. The one liver rescue with solid evidence behind it is a building block for the liver's own defence, and in food that building block comes from protein.
Eat the liver
There is an irony in the liver-support business. It sells extracts to protect your liver, while the most useful thing for it is liver. The organ beats the extract.
Beef liver carries vitamin A, B12, iron, folate, choline, copper and zinc in one serving. Copper and Your Health: Too Little, Too Much, and Why has the copper alone: about two weeks' worth in one serving. 7 Surprising Sources of Vitamin D3 You Need to Know for Better Health adds vitamin D, and a rule worth keeping: if you eat liver every week, leave the cod liver oil on the shelf.
That rule matters because vitamin A builds up. In 1597, Gerrit de Veer wrote that he and his crew, stranded over winter on Novaya Zemlya, fell badly ill after eating polar bear liver. About 500 grams of it is estimated to be a poisonous dose for a person. In 1913, the Antarctic explorers Douglas Mawson and Xavier Mertz ate their sled dogs' livers, and Mertz died; vitamin A was blamed, though exhaustion and hunger may explain it better. Beef liver is far milder than polar bear. But if you are pregnant, or take a multivitamin or cod liver oil, count them together.
If you cannot face it on a plate, a of freeze-dried liver carries much the same nutrients without the taste.
What loads the liver
The herbs work on the consequences. The causes sit on your plate and in your glass.
The Hidden Cost of Your Daily Sugary Drink, linked below, has how fast the liver answers: 40 teenage boys with fatty liver cut added sugar and juice to almost nothing for eight weeks, and their liver fat fell from 25% to 17%. The boys who ate as usual went from 21% to 20%.
Carbohydrate in general does the same. When people with fatty liver ate a low-carbohydrate, higher-protein diet with the same number of calories, the result was "rapid and dramatic reductions of liver fat".
Weight is the bigger lever still. In Havana, 293 people with fatty liver inflammation confirmed by biopsy were helped to change how they ate and moved for a year. The inflammation cleared in 25% of them, and the scarring went back in 19%. The best results, for both, came in those who lost 10% or more of their weight. No herb in this article comes near that.
And alcohol is the liver's most direct load. No herb has been shown to undo it, and taking milk thistle before a drink only gives the drink an excuse.
If you still want a herb
One at a time. Adding five at once tells you nothing about which, if any, did something. A single-herb product keeps it to one: a certified organic standardised for silymarin also answers the pesticide question.
Know your starting point. A finger-prick measures your liver enzymes at home, before and after. Remember that in the ginger test the enzymes fell with the dummy too.
Check your medicines. Milk thistle and dandelion may interact with blood thinners and diabetes medicines, and dandelion with water pills.
Check your allergies. Milk thistle and dandelion belong to the daisy family, with ragweed and chamomile.
Mind your gallbladder. If you have gallstones, ask before taking anything sold to make bile flow.
Skip the flush. The "liver flush", a fast followed by Epsom salt, olive oil and grapefruit juice, is sold to pass gallstones. When the "stones" were analysed, they were mostly fatty acids: soap stones, made in the gut by the mixture itself. Pain and diarrhoea are common, and one person was reported to develop pancreatitis.
Be careful with strong turmeric. Liver damage has been reported with the products made to be absorbed better.
Stop at the signs. Tiredness, nausea, loss of appetite, dark urine, or yellow skin or eyes are signs of liver trouble. Stop the herb and get checked.
In pregnancy, skip the liver herbs. Little is known about the safety of milk thistle or dandelion in pregnancy, and turmeric supplements may be unsafe. Ginger for nausea is the one with evidence behind it.
The thistle and the mushroom
Milk thistle earned its place in medicine against one poison, given into a vein, in a hospital. On the shelf, it and the other four are a maybe at best, and turmeric is a risk.
The things that change a liver are the plain ones: choline and protein in, sugar and alcohol out. Herbs can fill a gap in a liver that is otherwise looked after. When they become the whole plan, the causes carry on undisturbed.
This week, put beef liver on your plate once, before you put a liver herb in your basket.
Drinking your sugar? The Hidden Cost of Your Daily Sugary Drink — what a litre of cola a day did to the liver in six months, the "healthy" glass that carries nearly as much sugar as cola, and the cola "flavouring" that 23 out of 25 drinkers failed to taste.
Buying herbs for another reason? Fertility Herbs: Which Work, and What Matters More — which fertility herbs have real evidence for specific problems, which rest on tradition, and the two-and-a-half-month clock that matters more than any capsule.
Know someone with a cupboard full of liver detox capsules? Send them this, and a pound of beef liver.
Disclaimer: This article is general information. For advice about your own health, talk to a qualified health professional, especially if you have a liver condition or gallstones, take any prescribed medicine, are pregnant or breastfeeding, or notice tiredness, nausea, dark urine or yellowing of the skin or eyes. Do not stop a prescribed medicine without advice.
Affiliate Disclosure: This article contains affiliate links. As an Amazon Associate, All For Life earns from qualifying purchases, at no extra cost to you. We only link to products we would recommend without the commission.
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