What are the best supplements for fatty liver disease?

This is the question I’ll attempt to answer in today’s post, but before I do I’m obligated to state my belief that you can reverse fatty liver disease without supplements.

The five steps I’ve outlined in my beginners guide to reversing fatty liver disease will show you how.

That does not mean, however, that the right supplement for the right person won’t help.

Many people with a fatty liver also deal with insulin resistance, high triglycerides, blood sugar irregularities and microbiome dysbiosis too.

There are supplements that can help with these concerns and, in turn, contribute to the process of healing one’s liver in conjunction with dietary changes.

Let’s explore what those are.

In no particular order:

Omega-3 Fatty Acids [EPA/DHA]

Multiple controlled trials and meta-analyses have demonstrated that exposure to 2 grams or more per day of the omega-3 fatty acids EPA/DHA may make it easier for your liver to get rid of stored fat and make it less likely that it will store more in future as demonstrated by a reduction in blood triglyceride levels.

This is a scientific oversimplification, but keeping in mind that to get 2 grams of EPA/DHA requires consuming ~600g of salmon per week – it is not something that everyone is willing or able to do via diet.

EPA/DHA supplementation is also vegan friendly and available via algae-based supplements.

I’d recommend omega-3 supplementation for anyone with fatty liver who does not consume ~600g of fatty fish like salmon on a weekly basis.

Probiotics/Synbiotics

After blood flows through the digestive system it goes straight to the liver next and whether that blood helps or harms the liver depends a great deal on the state of your gut bacteria.

Many people with a fatty liver tend to have imbalances between good and bad gut bacteria which is at least part of the reason why we’ve seen that synbiotic supplements do help improve some relevant biomarkers in people living with fatty liver disease.

For those who may not know, synbiotic is a fancy term for a product that contains both a probiotic [healthy gut bacteria] and a prebiotic [a type of fibre known to feed those bacteria].

A supplement of this nature may be more useful for someone who has a history of antibiotic use (more likely disruption to gut bacteria) or who is currently struggling to eat a higher polyphenol + fibre diet which would otherwise feed and foster the growth of their own gut bacteria.

Insulin Resistance Trio – Magnesium, Berberine & Psyllium Fibre

Insulin resistance is a big driver of fatty liver disease and, as such, any supplement with the demonstrated potential to help fight back against insulin resistance could play a supportive role in reversing fatty liver disease.

Each of magnesium, berberine and psyllium fibre work on different bodily systems to reduce insulin resistance, but their value or necessity goes down in someone who is able to make big changes to their diet and be physically active.

Whether or not I’d recommend these supplements depends a great deal on the individual in front of me.

Bonus – Milk Thistle & More?

Milk thistle, scientifically referred to as Silymarin, is a potent antioxidant compound which has demonstrated evidence for reducing liver enzyme levels and may have some unique protective effects for liver health.

CoQ10 and Curcumin have also generated some scientific interest and I suppose could be justified in those who have other concerns for which these supplements might contribute to, although I’ve never explicitly recommended them to a fatty liver client.

The Honest Reality

Is that you can reverse fatty liver disease and improve all aspects of your metabolic health + bloodwork without ever using the supplements above.

However, doing so requires a meaningful commitment to changing your nutrition and lifestyle – which I can help with.

In the average individual with fatty liver disease who was unwilling or unable to make such changes at this time, you could make a case for the supplements discussed in today’s post being valuable tools for improving insulin resistance, triglyceride and liver enzyme levels.

The extent to which they’d lower liver fat is MUCH less certain, and ultimately the true path forward to your best liver health requires liver fat reduction and will involve much more than a few science-based supplements.

That’s where I come in – I’d love to chat about working with you privately to reverse fatty liver disease so don’t hesitate to reach out.

Until then,

Andy De Santis RD MPH