Fatty Liver Support | Elite Nutrition Serv

Fatty Liver Support Protocol

Elevated liver enzymes may indicate hepatic pathology. The most common cause for liver enzyme elevations is non-alcoholic fatty liver disease (NAFLD). (1) NAFLD has a global prevalence of roughly 25% and is associated with comorbidities such as obesity, type 2 diabetes, hyperlipidemia, hypertension, and metabolic syndrome. (2) Having one of the comorbidities associated with NAFLD also increases risk of NAFLD. (1) A specific type of NAFLD is nonalcoholic steatohepatitis (NASH), which describes when there is also inflammation and/or liver damage with NAFLD.

Treatment for NAFLD typically consists of lifestyle changes such as diet, exercise and weight loss. (3) When NAFLD is progressive, such as in the case of NASH, pharmacological intervention may be recommended. (3) Supplements offer a promising alternative for managing the elevations in liver enzymes and other aspects of NAFLD.

The ingredients presented in the protocol below reflect research findings that demonstrate efficacy to support hepatic function.

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About the Protocol

Milk Thistle (Silybum marianum)

Recommended Dose: 70-140 mg, two to three times per day, minimum 12 weeks (4)

Milk Thistle is an effective herb for detoxifying the liver by promoting the flow of bile and protecting hepatocytes. Designs for Health’s Milk Thistle is standardized to 80% silymarin.

Benefits of Milk Thistle

Improved hepatic function as demonstrated by a decrease in ALT, AST, hepatic steatosis, and GGT

Vitamin E

Recommended Dose: 800 IU, once per day, minimum 2 years (5)

Natural Vitamin E 400 IU (with mixed tocopherols, natural source) contains naturally occurring d-alpha, beta, gamma and delta tocopherols, the most biologically active forms of Vitamin E. Vitamin E is a powerful antioxidant and free radical scavenger.

Benefits of Vitamin E

Promote healthy cardiovascular and blood vessel function and supports many physiological functions.
Provide antioxidant protection against free radicals
Maintain cell membrane integrity, promote a healthy nervous system, and support healthy cognitive function.

Turmeric (Curcuma longa)- Curcumin Phytosome (formerly Meriva)

Recommended Dose: 500-1000 mg, total per day, minimum 8 weeks (6-8)

Thorne's Curcumin Phytosome is the most clinically studied curcumin on the market. More than 30 clinical trials using the curcumin phytosome, Meriva. The formula is designed to help maintain a healthy inflammatory response in the joints, muscles, GI tract, liver, brain, and nerves.

Benefits of Curcumin:

Joint Stiffness and Muscle Soreness

Reduces joint stiffness
Promotes flexibility
Provide relief from minor aches and muscle soreness
Protects muscles against exercise stress and helps reduce delayed onset muscle soreness (DOMS)
May reduce muscle injury from training or exertion
Helps protect muscle tissue from the effects of chronological age
Helps maintain a balanced inflammatory response throughout the body, including in the joints, muscles, GI tract, liver, brain, eyes, and nerves

Liver Support

Promotes healthy cholesterol metabolism and up-regulation of liver enzymes
Supports maintenance of normal blood sugar

Artichoke (Cynara scolymus)- Liver Support II

Recommended Dose: 600 mg, once per day, minimum 2 months (9)

Liver Support II (with Picrorhiza) is a combination of herbs traditionally used in liver support supplements, with the unique added benefit of the Ayurvedic herb picrorhiza.

Picrorhiza has been shown to help increase bile production in the liver and inhibit prostaglandin formation. It is hepatoprotective and has liver cell promoting effects similar to silymarin. Liver Support II contains Silybin, one of the primary constituents of Milk Thistle, supports the liver's efforts to remove exogenous toxins. Curcumin is included in Liver Support II as an inhibitor of arachidonic acid metabolism, which also has potent antioxidant properties.

Benefits of Liver Support II:

Supports detoxification process of liver
Promotes bile production
Liver Support II contains Picrorhiza which helps inhibit prostaglandin formation

Vitamin D- Vitamin D3 2000 Complex

Recommended Dose: 50,000 IU once per week, 12 weeks (10) or 2100 IU per day, up to 48 weeks (11)

High-potency formula for bone and immune health * Vitamin D3 2000 Complex 50 mcg (2,000 IU) of vitamin D3 in each tablet. Added isoflavones help the body utilize vitamin D3 effectively.

References

1. Vernon, G., Baranova, A., & Younossi, Z. M. (2011). Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Alimentary Pharmacology & Therapeutics, 34(3), 274–285. https://pubmed.ncbi.nlm.nih.gov/21623852/ 2. Younossi, Z. M., Koenig, A. B., Abdelatif, D., Fazel, Y., Henry, L., & Wymer, M. (2016). Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology , 64(1), 73–84. https://pubmed.ncbi.nlm.nih.gov/26707365/ 3. Leoni, S., Tovoli, F., Napoli, L., Serio, I., Ferri, S., & Bolondi, L. (2018). Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis. World Journal of Gastroenterology: WJG, 24(30), 3361–3373. https://pubmed.ncbi.nlm.nih.gov/30122876/ 4. Zhong, S., Fan, Y., Yan, Q., Fan, X., Wu, B., Han, Y., Zhang, Y., Chen, Y., Zhang, H., & Niu, J. (2017). The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials. Medicine, 96(49), e9061. https://pubmed.ncbi.nlm.nih.gov/29245314/ 5. Sanyal, A. J., Chalasani, N., Kowdley, K. V., McCullough, A., Diehl, A. M., Bass, N. M., Neuschwander-Tetri, B. A., Lavine, J. E., Tonascia, J., Unalp, A., Van Natta, M., Clark, J., Brunt, E. M., Kleiner, D. E., Hoofnagle, J. H., Robuck, P. R., & NASH CRN. (2010). Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. The New England Journal of Medicine, 362(18), 1675–1685. https://pubmed.ncbi.nlm.nih.gov/20427778/ 6. Kim, S.-W., Ha, K.-C., Choi, E.-K., Jung, S.-Y., Kim, M.-G., Kwon, D.-Y., Yang, H.-J., Kim, M.-J., Kang, H.-J., Back, H.-I., Kim, S.-Y., Park, S.-H., Baek, H.-Y., Kim, Y.-J., Lee, J.-Y., & Chae, S.-W. (2013). The effectiveness of fermented turmeric powder in subjects with elevated alanine transaminase levels: a randomised controlled study. BMC Complementary and Alternative Medicine, 13, 58. https://pubmed.ncbi.nlm.nih.gov/23497020/ 7. Panahi, Y., Kianpour, P., Mohtashami, R., Jafari, R., Simental-Mendía, L. E., & Sahebkar, A. (2017). Efficacy and Safety of Phytosomal Curcumin in Non-Alcoholic Fatty Liver Disease: A Randomized Controlled Trial. Drug Research, 67(4), 244–251. https://pubmed.ncbi.nlm.nih.gov/28158893/ 8. Rahmani, S., Asgary, S., Askari, G., Keshvari, M., Hatamipour, M., Feizi, A., & Sahebkar, A. (2016). Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled Trial. Phytotherapy Research: PTR, 30(9), 1540–1548. https://pubmed.ncbi.nlm.nih.gov/27270872/ 9. Panahi, Y., Kianpour, P., Mohtashami, R., Atkin, S. L., Butler, A. E., Jafari, R., Badeli, R., & Sahebkar, A. (2018). Efficacy of artichoke leaf extract in non-alcoholic fatty liver disease: A pilot double-blind randomized controlled trial. Phytotherapy Research: PTR, 32(7), 1382–1387. https://pubmed.ncbi.nlm.nih.gov/29520889/ 10. Hussain, M., Iqbal, J., Malik, S. A., Waheed, A., Shabnum, S., Akhtar, L., & Saeed, H. (2019). Effect of vitamin D supplementation on various parameters in non-alcoholic fatty liver disease patients. Pakistan Journal of Pharmaceutical Sciences, 32(3 Special), 1343–1348. https://pubmed.ncbi.nlm.nih.gov/31551213/ 11. Geier, A., Eichinger, M., Stirnimann, G., Semela, D., Tay, F., Seifert, B., Tschopp, O., Bantel, H., Jahn, D., Marques Maggio, E., Saleh, L., Bischoff-Ferrari, H. A., Müllhaupt, B., & Dufour, J.-F. (2018). Treatment of non-alcoholic steatohepatitis patients with vitamin D: a double-blinded, randomized, placebo-controlled pilot study. Scandinavian Journal of Gastroenterology, 53(9), 1114–1120. https://pubmed.ncbi.nlm.nih.gov/30270688/