Fatty Liver

Why it works: Reduces ER-stress & improves insulin signaling. Chronic endoplasmic reticulum (ER) stress contributes to NAFLD progression. TUDCA is a hydrophilic bile acid and “chemical chaperone...

Instructions: Form & dose used in human metabolic research: Oral TUDCA 1,750 mg/day (typically divided doses) for 4 weeks improved insulin sensitivity in a small RCT; this is the best-described...

Warnings: Because TUDCA isn’t licensed for NAFLD, we lean on UDCA (closely related) patient information and ph...

Studies: Human RCT on metabolic endpoints (not NAFLD biopsy):Kars et...

Why it works: Targets the drivers of fatty liver. Curcumin down-regulates inflammatory pathways (e.g., NF-κB), reduces oxidative stress, and improves insulin resistance—mechanisms that contribut...

Instructions: These are examples from clinical trials in NAFLD; discuss with your clinician which (if any) fits you.. • Phytosomal curcumin 1000 mg/day (often labeled as “curcumin phytosome” or...

Warnings: Rare but real risk of liver injury (DILI). Australia’s medicines regulator (TGA) warns of a rare ris...

Studies: Randomized controlled trialsPhytosomal curcumin 1000 mg/day,...

Why it works: Antioxidant & anti-inflammatory effects. Lignans in Schisandra (e.g., schisandrin A/B/C, gomisin A, schisantherin A) up-regulate endogenous antioxidants (glutathione, SOD, catalase...

Instructions: Dried fruit/powder (traditional use): 1.5–6 g/day (often split doses). Drugs.com. • Standardized extract (capsules): ~500–2,000 mg/day, typically standardized to ≥1–2% total lignan...

Warnings: Major drug interactions (high-importance): Schisandra (especially S. sphenanthera extracts) can inhi...

Studies: Human trials in NAFLD: Published data specific to NAFLD are...

Why it works: Lipid-lowering & bile-flow effects. Artichoke leaf polyphenols (notably luteolin and chlorogenic acids/cynarin) can inhibit hepatic cholesterol synthesis and promote bile flow (cho...

Instructions: Forms: Standardised artichoke leaf extract capsules/tablets (not the edible head/food). Look for products referencing Cynara cardunculus/scolymus leaf and pharmacopeial standards....

Warnings: Do NOT use if you have bile duct obstruction; use only with medical supervision if you have gallston...

Studies: NAFLD RCT (2018, n=100, 8 weeks): ALE 600 mg/day vs placebo...

Why it works: Antioxidant & Nrf2 activation: Silymarin’s flavonolignans (e.g., silybin) scavenge reactive oxygen species and up-regulate the Nrf2 antioxidant pathway, which is relevant because o...

Instructions: Form & standardization. • Use an oral standardized extract (typically 70–80% silymarin). Health Canada. Dose ranges seen in authoritative monographs & trials. • Authoritative monog...

Warnings: Common side effects: GI upset (nausea, bloating, diarrhea), headache, pruritus. Mayo Clinic. Allergy...

Studies: Randomized trials2017 CGH RCT (NASH): Silymarin did not sign...

Why it works: Improves hepatic fat handling via AMPK activation. Berberine activates the cellular energy sensor AMPK, which down-regulates lipogenesis (e.g., ACC, ChREBP) and promotes fat oxidat...

Instructions: Form & dose used in clinical studies:. • The most cited randomized trial in NAFLD used berberine 0.5 g three times daily (total 1.5 g/day) for 16 weeks, added to lifestyle advice—i...

Warnings: Who should not use berberine:. • Pregnancy & breastfeeding: Avoid. Reason: risk of neonatal jaundice...

Studies: Randomized clinical trial (open-label, 3-arm):Zhang et al.,...

Why it works: Metabolic re-programming (SIRT1 → AMPK): Resveratrol activates SIRT1 and downstream AMPK signaling, pathways that reduce hepatic lipogenesis and improve fatty-acid oxidation—mechan...

Instructions: Form & dose used in trials: Most NAFLD RCTs used trans-resveratrol 500–600 mg/day for 8–12 weeks; a notable negative trial used 3 g/day for 8 weeks. If used, many clinicians mirror...

Warnings: Bleeding risk (theoretical/experimental): Resveratrol has antiplatelet activity in human platelets a...

Studies: Individual RCTs500 mg/day for 12 weeks: Some RCTs reported i...

Why it works: Insulin resistance & lipids: NAFLD is tightly linked to insulin resistance and dyslipidaemia. A double-blind RCT in NAFLD patients found that cinnamon improved insulin resistance (...

Instructions: Form: Capsules of ground cinnamon. Most trials didn’t rigorously verify the species; if you self-supplement, choose Ceylon cinnamon to minimise coumarin exposure. Species mis-label...

Warnings: Coumarin hepatotoxicity risk (mostly Cassia): EFSA/BfR set a TDI of 0.1 mg/kg/day for coumarin. Cass...

Studies: Individual trialsAskari et al., 2013 (Nutrition Research) –...

Why it works: Bile-acid & FXR signaling: YCHD appears to rebalance bile-acid metabolism and activate the FXR–FGF15 axis (gut–liver signaling that regulates lipid and bile-acid homeostasis). This...

Instructions: Classical composition (decoction):. • Artemisia capillaris (Yin Chen) ~18 g (principal herb). • Gardenia jasminoides (Zhi Zi) ~6–9 g. • Rheum palmatum (Da Huang) ~6 g. • These prop...

Warnings: Because YCHD contains Artemisia capillaris, Gardenia jasminoides, and Rheum palmatum, consider the f...

Studies: Animal NAFLD/NASH • High-fat-diet NASH rats: YCHD reduced he...

Why it works: Improves liver fat and enzymes in humans. A multicenter, randomized, double-blind clinical trial in NAFLD found QSHY reduced liver fat, and led to greater improvements than an acti...

Instructions: Formulation & ingredients: The classic formula contains five herbs (see above). SpringerLink. Clinical dosing schedule used in trials: In a 24-week randomized protocol using QSHY g...

Warnings: Because QSHYD is a combination of five herbs, safety considerations come from both trial data and kn...

Studies: Human clinical evidenceMulticenter RCT (2024, Phytomedicine)...

Why it works: Targets “phlegm-damp” & dyslipidemia (TCM → metabolic overlap). Erchen Decoction dries dampness, transforms phlegm, regulates qi, and harmonizes digestion—the traditional pattern t...

Instructions: Classical formula & amounts (crude herbs per day):. Ban Xia (processed Zhi Ban Xia) 9–15 g, Chen Pi/Ju Hong 9–15 g, Fu Ling 6–9 g, Zhi Gan Cao 3–4.5 g; commonly add Sheng Jiang 3 g...

Warnings: Use processed Pinellia only. Raw Pinellia (Sheng Ban Xia) is toxic to mucosa and should not be taken...

Studies: Systematic review & meta-analysis of RCTs (n=7 trials; 1...

Why it works: Modulates lipid synthesis & accumulation (animal data): In high-fat–diet mice, Danning Tablets reduced hepatic triglycerides/cholesterol, curbed weight gain, and lessened liver fat...

Instructions: Typical labeled dosing (example, Shanghai Hutchison product):. Oral; 5 tablets per dose, 3 times daily, after meals. The insert also notes it’s intended for patterns such as “liver...

Warnings: From a representative Chinese package insert (ShangYao/Shanghai Hutchison):. • Common effect: Increa...

Studies: Randomized & comparative clinical evidenceMulticenter ra...

Why it works: Multitarget metabolic & anti-inflammatory actions. Preclinical and systems-pharmacology work shows CHSGS down-regulates lipogenesis and inflammation (e.g., AMPK–mTOR, TLR4/NF-κB/NL...

Instructions: Important: CHSGS is a pattern-based TCM prescription (classically for “Liver-Qi stagnation” with chest/upper-abdominal fullness, rib-side discomfort, wiry pulse, etc.). Dosing and...

Warnings: Because CHSGS mixes seven herbs, screen for contraindications and drug–herb interactions:. Licorice...

Studies: 2025 meta-analysis (English-language abstract available): A...