Cirrhosis
Supplements studied for cirrhosis.
Overview
Several supplements have small or mixed cirrhosis trials. L-Carnitine taken for months may reduce muscle cramps and improve quality of life, with some signals for survival benefit in more severe disease. Taurine may lessen cramps and portal high-blood-pressure in short studies.
Milk Thistle long-term use showed possible liver test and survival improvements in some hepatitis B cirrhosis research but remains inconclusive across etiologies. Cocoa with a meal reduced postprandial portal pressure in one trial. Astragalus injections combined with danshen may reduce scarring in low-quality Chinese studies. See the heatmap and evidence reviews below.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Milk Thistle | ★★★★★ | Low |
| L-Carnitine | ★★★★★ | Low |
| Taurine | ★★★★★ | Low |
| SAMe | ★★★★★ | Low |
| N-Acetyl Cysteine (NAC) | ★★★★★ | Low |
| Cocoa | ★★★★★ | Low |
| Astragalus | ★★★★★ | Low |
| Selenium | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
8 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 milk thistle is helpful for cirrhosis caused by different conditions.
- Some early research shows that taking milk thistle for a long time (up to 4 years) might improve liver test results and help people live longer.
- One study of people with cirrhosis from hepatitis B found that taking milk thistle along with antiviral medicine lowered death rates and the need for liver transplants compared to antiviral medicine alone.
- But overall, the evidence is mixed and more research is needed to know how well milk thistle works for cirrhosis.
Browse 3 studies·1 meta-analysis
ObservationalSilymarin Synergizes with Antiviral Therapy in Hepatitis B Virus-Related Liver Cirrhosis: A Propensity Score Matching Multi-Institutional Study2024n=319
A propensity-matched cohort of 319 hepatitis B cirrhosis patients on antiviral therapy found adding silymarin for at least 30 days was associated with lower 1- and 2-year mortality.
- Effect
- Benefit
- Population
- ALL patients
- Participants
- 319
MetaMilk thistle for the treatment of liver disease: a systematic review and meta-analysis2002n=433
A systematic review and meta-analysis of 14 trials (433 participants) found milk thistle did not reduce mortality or improve liver histology, with only a negligible ALT reduction.
- Effect
- No Benefit
- Dose
- 9 IU/day
- Population
- ALL patients
- Participants
- 433
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
L-CarnitineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In people with cirrhosis, taking L‑carnitine daily for several months may reduce muscle cramps and improve quality of life, although it might not increase muscle strength.
- Some studies suggest that longer use of L‑carnitine could help patients live longer, especially those with more severe liver problems.
- These possible benefits need more strong research to confirm them fully.
Browse 3 studies
RCTThe Effects of L-Carnitine on Echocardiographic Changes in Patients With β-Thalassemia Major and Intermedia2020
In β-thalassemia major patients, L-carnitine 1 g/day improved echocardiographic parameters and reduced heart failure markers versus baseline over 6 months.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 1 g/day
- Population
- Heart failure patients
Can L-Carnitine supplementation and exercise improve muscle complications in patients with liver cirrhosis who receive branched-chain amino acid supplementation?2019n=18
A study in liver cirrhosis patients on branched-chain amino acid supplementation where L-carnitine (1 g/day) plus added daily steps (≈2000 steps) for 6 months improved muscle volume (via bioelectrical impedance), muscle strength (hand dynamometer) and reduced muscle cramps compared with baseline.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 12.45 g/day
- Population
- Cirrhosis patients
- Participants
- 18
- Avg age
- ~68
ObservationalL-Carnitine Suppresses Loss of Skeletal Muscle Mass in Patients With Liver Cirrhosis2018n=158
In 158 cirrhosis patients, L-carnitine supplementation was associated with reduced skeletal muscle mass loss versus non-supplemented patients in an observational analysis.
- Effect
- Benefit
- Population
- Patients with liver cirrhosis
- Participants
- 158
AstragalusView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Studies mainly from China suggest that injections combining astragalus and danshen might help reduce liver scarring in people with liver cirrhosis.
- Astragalus components are believed to lower inflammation and protect liver cells.
- More research is needed to determine which ingredient is responsible for the benefits.
Browse 1 study·1 meta-analysis
RCTMeta-analysis of the clinical value of Danshen injection and Huangqi injection in liver cirrhosis2013n=1,086
A meta-analysis of 11 low-quality RCTs in 1,086 cirrhosis patients found danshen plus astragalus (Huangqi) injection improved treatment response and reduced fibrosis markers versus control.
- Effect
- Benefit
- Population
- Patients with cirrhosis
- Participants
- 1,086
CocoaView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In people with cirrhosis, blood pressure inside the liver's veins (called portal pressure) usually rises after eating, which can worsen complications.
- A small clinical trial tested whether dark chocolate, known for its antioxidant compounds, could help.
- Twenty-two patients ate a meal with either dark chocolate (85% cocoa) or white chocolate (which has no beneficial flavonoids).
- After eating, the white chocolate group had a strong rise in liver vein pressure, while the dark chocolate group had a much smaller increase.
- Dark chocolate also slightly raised normal blood pressure, while white chocolate did not.
- This study suggests that dark chocolate may help reduce harmful pressure changes in the liver after meals in patients with cirrhosis, although the trial was small and short-term.
Browse 1 study
RCTPostprandial effects of dark chocolate on portal hypertension in patients with cirrhosis: results of a phase 2, double-blind, randomized controlled trial2012n=11
In 22 cirrhosis patients, dark chocolate 0.55 g/kg blunted the post-meal rise in hepatic venous pressure gradient versus white chocolate.
- Effect
- Benefit
- Dose
- 0.55 g/kg
- Population
- Healthy adults
- Participants
- 11
N-Acetyl Cysteine (NAC)View supplement →
Reconsider purchase·★★★★★
How we scored this▸
- There is not enough evidence to determine if N-acetyl cysteine has any benefit for cirrhosis.
Browse 1 study
RCTThe effects of N-acetylcysteine on hepatic, hematologic, and renal parameters in cirrhotic patients: a randomized controlled trial2023n=60
An RCT of 60 adults (ages 18–70) found 600 mg/day NAC improved hepatic, hematologic, and renal safety parameters during long-term use versus placebo.
- Effect
- Benefit
- Dose
- 600 mg/day
- Population
- Adults
- Participants
- 60
- Ages
- 18–70
SAMeView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- For people with cirrhosis having liver cancer surgery, giving SAMe through a vein every day for 7 days after surgery does not lower the chance of liver problems after the operation compared to not receiving SAMe.
Browse 1 study
RCTBeneficial effects of S-adenosyl-L-methionine on post-hepatectomy residual liver function: a prospective, randomized, controlled clinical trial2013n=39
In 79 post-hepatectomy cirrhosis patients, postoperative IV SAMe improved residual liver function versus control after resection.
- Effect
- Benefit
- Dose
- 1000 mg/day SAMe IV
- Population
- Patients with liver disease
- Participants
- 39
TaurineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In people with cirrhosis, taking taurine supplements might help reduce muscle cramps and lower high blood pressure in the liver (portal hypertension).
- One small study showed fewer and less severe cramps after taking taurine for 4 weeks.
- Another study found taurine reduced liver blood pressure compared to no treatment, but it’s not known if this helps prevent serious complications like bleeding or fluid buildup.
- More research is needed.
Browse 2 studies
Clinical trialEffectiveness of 4-Week Oral Taurine Treatment for Muscle Cramps in Patients with Liver Cirrhosis: A Single-Arm Pilot Study2021
In 10 cirrhotic patients with muscle cramps, 4 weeks of oral taurine reduced cramp frequency and severity versus baseline in this pilot study.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 3 g/day
- Population
- Patients with cirrhosis
- Ages
- 18+
RCTRandomised clinical study: the effects of oral taurine 6g/day vs placebo on portal hypertension2018n=30
In cirrhotic patients with varices, taurine 6 g/day for 4 weeks did not significantly change portal pressure or hepatic venous pressure gradient versus baseline.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 6 g/day
- Population
- Patients with cirrhosis
- Participants
- 30
- Avg age
- 52±11
SeleniumView supplement →
Do not purchase·★★★★★
How we scored this▸
- Selenium supplements have not been tested by themselves for cirrhosis.
- In one small study of people with primary biliary cirrhosis, taking selenium together with certain vitamins and nutrients for 12 weeks did not help with tiredness or other symptoms compared to a placebo.
Browse 1 study
RCTOral antioxidant supplementation for fatigue associated with primary biliary cirrhosis: results of a multicentre, randomized, placebo-controlled, cross-over trial2003
In 44 primary biliary cirrhosis patients with fatigue, 12-week antioxidant supplementation including selenium did not improve fatigue scores versus placebo in this crossover trial.
- Effect
- No Benefit
- Duration
- 12 weeks
- Population
- Patients with primary biliary cirrhosis
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| L-Carnitine | ★★★★★48% | 3 | 0 | 23% |
| Milk Thistle | ★★★★★52% | 3 | 1 | 23% |
| Taurine | ★★★★★44% | 2 | 0 | 15% |
| Astragalus | ★★★★★44% | 1 | 1 | 8% |
| Cocoa | ★★★★★44% | 1 | 0 | 8% |
| N-Acetyl Cysteine (NAC) | ★★★★★44% | 1 | 0 | 8% |
| SAMe | ★★★★★44% | 1 | 0 | 8% |
| Selenium | ★★★★★32% | 1 | 0 | 8% |