Alcohol-associated liver disease
Supplements studied for alcohol-associated liver disease.
Overview
Only Alpha-Lipoic Acid is indexed for alcohol-associated liver disease, with one low-rated study (WA 32) for effect size and evidence and medium trust.
Oral alpha-lipoic acid at 300 mg daily for up to six months does not appear to improve liver function or reduce liver damage in people with liver disease caused by alcohol. The available trial found no benefit on these outcomes over the study period.
Evidence remains very limited to this single study. The evidence review below summarizes the trial in more detail.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Milk Thistle | ★★★★★ | Low |
| Vitamin A | ★★★★★ | Very Low / None |
| Alpha-Lipoic Acid | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
3 supplements for and rated at least stars. All purchase bands. No minimum star filter.
Milk ThistleView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear if taking milk thistle helps people with liver damage related to alcohol use.
- Some studies suggest that taking a milk thistle product with silymarin (420 mg daily) for periods ranging from one month to several years may improve liver tests, liver tissue health, and survival.
- Other studies found no benefit compared to a placebo.
- A review of the research showed that milk thistle does not lower the risk of death or liver-related problems in people with alcohol-related liver disease.
- Differences in study quality may explain why the results are mixed.
Browse 11 studies·2 meta-analyses
MetaAn updated systematic review with meta-analysis for the clinical evidence of silymarin2008
An updated systematic review found silymarin may reduce liver-related mortality in alcoholic Child A cirrhosis, but evidence for viral hepatitis and toxic liver disease remains limited.
- Effect
- Benefit
MetaMilk thistle for alcoholic and/or hepatitis B or C virus liver diseases2007n=1,088
A Cochrane meta-analysis of 18 RCTs (1,088 patients) found milk thistle did not significantly reduce overall mortality in alcoholic or viral liver disease, despite a signal for lower liver-related mortality in lower-quality trials.
- Effect
- No Benefit
- Population
- ALL patients
- Participants
- 1,088
RCTEffects of silymarin MZ-80 on oxidative stress in patients with alcoholic cirrhosis. Results of a randomized, double-blind, placebo-controlled clinical study2002n=49
An RCT of 49 alcoholic cirrhosis patients found silymarin 150 mg three times daily for 6 months increased erythrocyte glutathione and reduced lipid peroxidation without changing routine liver tests.
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 150 mg 3×/day
- Population
- Adults with alcoholic cirrhosis
- Participants
- 49
RCTEffects of silymarin in alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind, randomized and multicenter trial1998n=29
An RCT of 200 alcoholic cirrhosis patients found silymarin 450 mg/day for 2 years did not improve survival or alter the clinical course vs placebo.
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 450 mg/day
- Population
- Adults with alcoholic cirrhosis
- Participants
- 29
RCT[Controlled study of the effect of silymarin on alcoholic liver disease]1992n=10
An RCT of 72 alcoholic liver disease patients followed about 15 months found 280 mg/day silymarin did not change disease evolution, final laboratory values, or mortality vs placebo.
- Effect
- No Benefit
- Duration
- 15 months
- Dose
- 280 mg/day
- Population
- Adults with alcoholic liver disease
- Participants
- 10
Controlled trial[Liver-protective action of silymarin therapy in chronic alcoholic liver diseases]1989n=36
A 6-month double-blind trial of 36 chronic alcoholic liver disease patients found silymarin normalized liver enzymes and improved histology vs placebo.
- Effect
- Benefit
- Population
- Adults with chronic alcoholic liver disease
- Participants
- 36
RCT[Treatment of alcoholic hepatitis with silymarin. A double-blind comparative study in 116 patients]1989n=57
An RCT of 116 alcoholic hepatitis patients found silymarin 420 mg/day for 3 months did not improve histology or liver enzymes more than placebo.
- Effect
- No Benefit
- Duration
- 3 months
- Dose
- 420 mg/day
- Population
- Adults with alcoholic hepatitis
- Participants
- 57
RCTRandomized controlled trial of silymarin treatment in patients with cirrhosis of the liver1989n=170
An RCT of 170 cirrhosis patients found silymarin 140 mg three times daily for about 4 years increased 4-year survival to 58% vs 39% with placebo, especially in alcoholic Child A patients.
- Effect
- Benefit
- Duration
- 2 years
- Dose
- 140 mg 3×/day
- Population
- ALL patients
- Participants
- 170
- Avg age
- ~57
Controlled trialHepatoprotective and immunomodulatory effects of antioxidant therapy1988n=40
A 1-month double-blind trial of 40 alcoholic cirrhosis patients found silymarin normalized liver enzymes and improved immunologic markers vs placebo.
- Effect
- Benefit
- Population
- Adults with alcoholic cirrhosis
- Participants
- 40
RCTEffect of silymarin on chemical, functional, and morphological alterations of the liver. A double-blind controlled study1982
An RCT of 97 liver disease patients found silymarin for 4 weeks produced a significantly greater decrease in ALT and AST and more frequent BSP normalization vs placebo.
- Effect
- Benefit
- Duration
- 4 weeks
- Population
- Adults with liver disease
RCT[The influence of therapy with silymarin on the survival rate of patients with liver cirrhosis (author's transl)]1980
A randomized double-blind cirrhosis trial reported significantly higher survival with silymarin in alcoholic cirrhosis, though full clinical and laboratory results were pending at publication.
- Effect
- Benefit
Alpha-Lipoic AcidView supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking alpha-lipoic acid by mouth does not seem to help liver function or reduce liver damage in people with liver disease caused by alcohol.
- Studies found no benefit with 300 mg daily for up to 6 months.
Browse 1 study
RCTTreatment of alcohol-related liver disease with thioctic acid: a six month randomised double-blind trial1982n=20
6-month double-blind RCT in 40 alcohol-related liver disease patients given 300 mg/day thioctic acid found no liver outcome difference versus placebo, regardless of abstinence.
- Effect
- No Benefit
- Dose
- 300 mg/day
- Population
- Alcoholic liver disease patients
- Participants
- 20
Vitamin AView supplement →
Do not purchase·★★★★★
How we scored this▸
- Vitamin A alone has not been studied for alcohol-related liver disease.
- One small study tested vitamin A combined with other vitamins and supplements for people with alcohol-related liver inflammation and found it did not help people live longer.
Browse 1 study
RCTA randomized trial of antioxidant therapy alone or with corticosteroids in acute alcoholic hepatitis2007n=70
A 6-month RCT of 70 patients with severe alcoholic hepatitis found antioxidant therapy including vitamin A, with or without corticosteroids, did not improve 180-day survival (52.8% vs 55.8%, P=0.699).
- Effect
- No Benefit
- Duration
- 6 months
- Population
- Patients With Acute Alcoholic Hepatitis
- Participants
- 70
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Milk Thistle | ★★★★★56% | 11 | 2 | 85% |
| Alpha-Lipoic Acid | ★★★★★32% | 1 | 0 | 8% |
| Vitamin A | ★★★★★32% | 1 | 0 | 8% |