Hepatitis
Supplements studied for hepatitis.
Overview
Four supplements are tracked for hepatitis (9 studies). Taurine has the strongest profile (medium effect size, medium evidence, medium trust, WA 60; 3 studies), with doses of 1.5–4 g daily for up to three months possibly improving liver function in acute or chronic hepatitis.
N-Acetyl Cysteine (NAC; WA 48; 4 studies) did not help acute viral hepatitis and did not improve hepatitis C treatment success, though it may delay reinfection after interferon therapy. Aloe (1 study) and Milk Thistle (1 study) have low-rated evidence suggesting possible enzyme or symptom improvements, but findings are preliminary and inconsistent.
See the heatmap and evidence reviews below for details.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Taurine | ★★★★★ | Medium |
| N-Acetyl Cysteine (NAC) | ★★★★★ | Low |
| Caffeine | ★★★★★ | Low |
| SAMe | ★★★★★ | Low |
| Nattokinase | ★★★★★ | Low |
| Milk Thistle | ★★★★★ | Low |
| L-Carnitine | ★★★★★ | Low |
| Berberine | ★★★★★ | Low |
| Artichoke | ★★★★★ | Low |
| Aloe | ★★★★★ | Low |
| Reishi | ★★★★★ | Low |
| Selenium | ★★★★★ | Very Low / None |
| Phosphatidylcholine | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
13 supplements for , and rated at least stars. All purchase bands. No minimum star filter.
TaurineView supplement →
Consider purchase·★★★★★
How we scored this▸
- Taking taurine supplements may help improve liver function in people with acute or chronic hepatitis.
- Studies show that doses between 1.5 and 4 grams daily for up to three months can improve liver health compared to not taking taurine supplements.
Browse 3 studies
Controlled trialDietary amino acid taurine ameliorates liver injury in chronic hepatitis patients2008
In chronic hepatitis patients over 3 months, dietary taurine 12 g/day reduced ALT and AST versus baseline in this open study.
- Effect
- Benefit
- Duration
- 4 months
- Dose
- 12 g/day
- Population
- Patients with chronic hepatitis
RCTEffects of ursodeoxycholic acid and taurine on serum liver enzymes and bile acids in chronic hepatitis1990n=24
In chronic hepatitis patients, ursodeoxycholic acid and taurine each lowered liver enzymes versus baseline, with combined effects on bile acid profiles.
- Effect
- No Benefit
- Dose
- 600 mg/day
- Population
- Patients with chronic hepatitis
- Participants
- 24
The effect of taurine administration on patients with acute hepatitis1983
In acute hepatitis patients, taurine administration was associated with improved liver function tests versus baseline in this early clinical study.
- Effect
- Benefit
- Population
- Patients with acute hepatitis
CaffeineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Caffeine may help protect the liver in people with hepatitis C by reducing liver inflammation and fibrosis.
- A large review of several studies found that regular caffeine intake was linked to about a 50% lower risk of severe liver scarring in hepatitis C patients.
- Another study of over 200 patients showed that drinking more than 400 mg of caffeine daily was associated with less liver damage on tissue tests.
- These findings suggest caffeine could be beneficial for managing liver health in hepatitis C, but more research is needed to confirm these effects.
Browse 2 studies·1 meta-analysis
MetaImpact of caffeine in hepatitis C virus infection: a systematic review and meta-analysis2017
A meta-analysis in hepatitis C patients found regular caffeine consumption associated with lower odds of advanced liver fibrosis (OR 0.48) and a non-significant trend toward less moderate-to-severe inflammation (OR 0.61).
- Effect
- Benefit
- Population
- HCV patients
ObservationalAssociation of caffeine intake and histological features of chronic hepatitis C2011n=60
In 238 treatment-naïve chronic hepatitis C patients, caffeine intake >408 mg/day (about 3+ cups) was associated with lower histologic activity grade (OR 0.19 for moderate/severe activity) but not fibrosis stage.
- Effect
- Benefit
- Dose
- 678 mg/day
- Population
- Healthy adults
- Participants
- 60
- Ages
- 18–65
N-Acetyl Cysteine (NAC)View supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Taking N-acetylcysteine by mouth does not help treat acute viral hepatitis.
- For hepatitis C, combining N-acetylcysteine with interferon does not improve treatment success but might delay the return of the infection after treatment.
Browse 4 studies
Controlled trialN-acetyl cysteine therapy in acute viral hepatitis2003
A controlled trial found NAC (600 mg/day) improved liver enzyme normalization in acute viral hepatitis patients versus standard care.
- Effect
- No Benefit
- Dose
- 600 mg/day
- Population
- ALL patients
RCTAssociation of alpha-interferon and acetyl cysteine in patients with chronic C hepatitis2000
An RCT found combined alpha-interferon and NAC improved biochemical response in chronic hepatitis C versus interferon alone.
- Effect
- Benefit
- Population
- Adults with chronic hepatitis C
RCTCombination therapy with interferon-alpha plus N-acetyl cysteine for chronic hepatitis C: a placebo controlled double-blind multicentre study2000n=139
A 6-month RCT of 139 chronic hepatitis C patients found interferon-alpha plus NAC (1800 mg/day) improved virologic response versus interferon alone.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 1800 mg/day
- Population
- Adults with chronic hepatitis C
- Participants
- 139
Controlled trialEffect of N-acetyl-cysteine on lymphomonocyte glutathione and response to interferon treatment in C-virus chronic hepatitis1998n=25
A controlled trial found NAC raised lymphocyte glutathione and improved interferon response in chronic hepatitis C patients.
- Effect
- Benefit
- Population
- Adults with chronic hepatitis C
- Participants
- 25
AloeView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Taking a specific aloe extract by mouth might help reduce liver scarring and improve liver enzyme levels in people with hepatitis B or C. This is based on one small study.
Browse 1 study
RCTAntifibrotic effect of Aloe vera in viral infection-induced hepatic periportal fibrosis2012n=15
In a 12-week RCT of 40 liver fibrosis patients given 0.15 g/day aloe, oral supplementation significantly improved fibrosis, inflammation, liver enzymes, and fibrosis markers versus placebo.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 0.15 g/day
- Population
- Healthy adults
- Participants
- 15
ArtichokeView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is uncertain if artichoke helps hepatitis C. One small study found that taking 3200 mg of artichoke leaf extract daily for 12 weeks did not improve liver tests or reduce the virus.
- Some symptoms improved early but not over time.
- A study reported that drinking wild artichoke tea three times a day for 3 months improved liver tests and virus levels in most patients, but this study didn’t compare against a placebo.
Browse 2 studies
Clinical trialThe wild Egyptian artichoke as a promising functional food for the treatment of hepatitis C virus as revealed via UPLC-MS and clinical trials2016n=15
A pilot trial in 15 HCV patients found wild Egyptian artichoke water extract cleared HCV RNA in 12/15 and normalized ALT, AST, and bilirubin, with CYP inhibitory activity in vitro.
- Effect
- Benefit
- Population
- Patients with hepatitis C
- Participants
- 15
Clinical trialArtichoke leave extract for chronic hepatitis C - a pilot study2009n=17
In 17 chronic hepatitis C patients, artichoke leaf extract 3200 mg/day for 12 weeks did not normalize ALT or reduce viral load, though fatigue and joint symptoms briefly improved.
- Effect
- No Benefit
- Duration
- 12 weeks
- Dose
- 3200 mg/day
- Population
- Patients with hepatitis
- Participants
- 17
BerberineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is uncertain if berberine helps liver function in hepatitis B. One early study found that taking berberine daily for 2 months lowered blood sugar, fat levels, and liver enzymes indicating liver damage in people with type 2 diabetes and hepatitis B.
Browse 1 study
RCTBerberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression2010
Clinical and cell studies found berberine increased insulin receptor expression and lowered fasting glucose and HbA1c in type 2 diabetes patients with efficacy similar to metformin or rosiglitazone.
- Effect
- Benefit
- Population
- Diabetic patients
L-CarnitineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In people with hepatitis B, taking a vitamin complex with L-carnitine along with the antiviral medicine entecavir helped more patients normalize a liver enzyme (ALT) faster and more completely than entecavir alone.
- However, it did not improve other liver enzymes or reduce the amount of virus.
- It is not clear if L-carnitine alone is responsible for these benefits or if other ingredients play a role.
Browse 4 studies
RCTEfficacy and safety of entecavir plus carnitine complex (GODEX®) compared to entecavir monotherapy in patient with ALT elevated chronic hepatitis B: randomized, multicenter open-label trials. The GOAL study2013n=130
In 130 chronic hepatitis B patients, entecavir plus carnitine complex improved liver enzymes and fatigue versus entecavir alone over 12 months.
- Effect
- Benefit
- Duration
- 12 months
- Population
- Adults
- Participants
- 130
RCTL-carnitine supplementation improves hematological pattern in patients affected by HCV treated with Peg interferon-α 2b plus ribavirin2011n=35
In 35 chronic hepatitis C patients on IFN plus ribavirin, L-carnitine reduced anemia and dose reductions versus standard therapy over 12 months.
- Effect
- Benefit
- Duration
- 12 months
- Population
- Hepatitis patients
- Participants
- 35
RCTL-carnitine treatment reduces steatosis in patients with chronic hepatitis C treated with alpha-interferon and ribavirin2008n=70
In 70 chronic hepatitis C patients, L-carnitine 2 g/day for 12 months reduced hepatic steatosis versus IFN/ribavirin alone during antiviral therapy.
- Effect
- Benefit
- Duration
- 12 months
- Dose
- 2 g/day
- Population
- Hepatitis patients
- Participants
- 70
Clinical trialL-carnitine decreases severity and type of fatigue induced by interferon-alpha in the treatment of patients with hepatitis C2003n=50
In 50 HCV patients on interferon, L-carnitine 2 g/day for 1 year reduced fatigue severity versus standard therapy alone.
- Effect
- Benefit
- Duration
- 1 year
- Dose
- 2 g/day
- Population
- Patients with depressive disorders
- Participants
- 50
Milk ThistleView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Some small studies suggest milk thistle extract might help improve symptoms like jaundice and dark urine in people with hepatitis.
- Taking milk thistle 140 mg three times a day for 4 weeks helped reduce these symptoms but did not improve liver test results.
- Other formulations of milk thistle showed some improvements in liver tests, but the evidence is not strong.
- It is still unclear if milk thistle can improve liver function.
Browse 14 studies·3 meta-analyses
Clinical trialBeneficial Effects of Silybin Treatment After Viral Eradication in Patients With HCV-Related Advanced Chronic Liver Disease: A Pilot Study2022n=16
A 12-month pilot study of 16 patients with advanced HCV-related liver disease after viral eradication found silybin improved liver stiffness, MELD score, and inflammatory markers.
- Effect
- Benefit
- Duration
- 12 months
- Population
- Adults
- Participants
- 16
- Avg age
- ~68
Clinical trialEffect of Silymarin as an Adjunct Therapy in Combination with Sofosbuvir and Ribavirin in Hepatitis C Patients: A Miniature Clinical Trial2022n=15
A small study of 15 HCV patients on sofosbuvir plus ribavirin found adding 400 mg/day silymarin improved biochemical liver markers and reduced oxidative stress versus standard therapy alone.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 400 mg/day
- Population
- Adults
- Participants
- 15
- Ages
- 18–50
MetaEffects and tolerance of silymarin (milk thistle) in chronic hepatitis C virus infection patients: a meta-analysis of randomized controlled trials2014n=167
A meta-analysis of 5 RCTs (167 chronic HCV patients) found silymarin modestly improved ALT and AST but did not produce significant virologic responses.
- Effect
- No Benefit
- Population
- Adults
- Participants
- 167
RCTEffect of silymarin (milk thistle) on liver disease in patients with chronic hepatitis C unsuccessfully treated with interferon therapy: a randomized controlled trial2012
A 24-week multicenter double-blind RCT found high-dose silymarin (1260–2100 mg/day) did not significantly improve ALT in chronic HCV patients previously unresponsive to interferon therapy.
- Effect
- No Benefit
- Duration
- 24 weeks
- Dose
- 1260–2100 mg/day
- Population
- Adults
RCTSpirulina platensis versus silymarin in the treatment of chronic hepatitis C virus infection. A pilot randomized, comparative clinical trial2012n=66
A 6-month pilot RCT of 66 chronic HCV patients found both spirulina and silymarin improved liver enzymes, with spirulina showing slightly greater benefit.
- Effect
- Benefit
- Duration
- 6 months
- Population
- Adults
- Participants
- 66
RCT[Effects of supplementation with the antioxidant flavonoid, silymarin, in chronic hepatitis C patients treated with peg-interferon + ribavirin. A placebo-controlled double blind study]2009n=16
A 3-month double-blind RCT of 16 HCV genotype-1 patients on peg-interferon plus ribavirin found adding 166 mg/day silymarin improved liver enzymes and oxidative stress markers.
- Effect
- No Benefit
- Duration
- 3 months
- Dose
- 166 mg/day
- Population
- Adults
- Participants
- 16
RCTA randomized controlled trial to assess the safety and efficacy of silymarin on symptoms, signs and biomarkers of acute hepatitis2009
An RCT of acute hepatitis patients found 140 mg/day silymarin significantly improved clinical symptoms and reduced liver enzyme levels versus placebo.
- Effect
- Benefit
- Dose
- 140 mg/day
- Population
- Patients with acute hepatitis
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
RCTRandomised double-blinded trial evaluating silymarin for chronic hepatitis C in an Egyptian village: study description and 12-month results2004
A 12-month double-blind RCT of 177 Egyptian villagers with chronic HCV found silymarin improved symptoms and some biochemical markers but not significant virologic benefit.
- Effect
- No Benefit
- Duration
- 1 year
RCTA pilot study on the liver protective effect of silybin-phosphatidylcholine complex (IdB1016) in chronic active hepatitis1993n=20
A pilot RCT of 20 chronic active hepatitis patients found silybin-phosphatidylcholine (240 mg twice daily) improved liver enzymes and oxidative markers versus placebo after 7 days.
- Effect
- Benefit
- Duration
- 7 days
- Dose
- 480 mg/day
- Population
- Adults
- Participants
- 20
- Avg age
- ~50
RCT[Results of a double blind study on the effect of silymarin in the treatment of acute viral hepatitis, carried out at two medical centres (author's transl)]1978n=29
A double-blind multicenter study of 57 acute viral hepatitis patients found silymarin (70 mg three times daily) accelerated bilirubin, GOT, and GPT normalization versus placebo.
- Effect
- Benefit
- Duration
- 3 weeks
- Dose
- 70 mg 3×/day
- Population
- Adults
- Participants
- 29
Controlled trial[Results of two double-blind studies on the effect of silymarine in chronic hepatitis (author's transl)]1977n=12
Two double-blind studies in 36 chronic hepatitis patients found silymarin produced some histological improvement, but laboratory values did not differ significantly from placebo.
- Effect
- No Benefit
- Population
- Adults
- Participants
- 12
Controlled trial[Silymarin for the treatment of acute viral hepatitis? Report of a controlled trial (author's transl)]1977n=151
A controlled trial of 151 acute viral hepatitis patients found silymarin shortened illness duration and improved biochemical recovery versus no treatment.
- Effect
- No Benefit
- Duration
- 5–7 days
- Population
- ALL patients
- Participants
- 151
NattokinaseView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- There is not enough evidence to determine if nattokinase has any benefit for hepatitis C.
Browse 1 study
RCTEffect of soy protein supplementation in patients with chronic hepatitis C: a randomized clinical trial2012n=80
In 160 chronic hepatitis C patients, 32 g/day soy supplement for 12 weeks significantly reduced ALT and lowered odds of hepatic steatosis vs casein control.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 32 g/day
- Population
- Diabetic patients
- Participants
- 80
SAMeView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear if taking SAMe by mouth helps people with hepatitis C. Taking 1600 mg daily for 2 weeks between usual treatments may help lower the virus early in patients who did not respond before.
- Taking SAMe with betaine increased early virus response in some patients, but long-term clearance of the virus was low.
Browse 2 studies
Clinical trialS-adenosyl methionine improves early viral responses and interferon-stimulated gene induction in hepatitis C nonresponders2011n=24
In 24 hepatitis C genotype 1 prior nonresponders, adding SAMe 1600 mg/day to peginterferon and ribavirin improved phase-2 viral decline and interferon-stimulated gene induction vs control.
- Effect
- Benefit
- Duration
- 48 weeks
- Dose
- 1600 mg/day
- Population
- Adults
- Participants
- 24
RCTS-adenosyl-methionine and betaine improve early virological response in chronic hepatitis C patients with previous nonresponse2010n=29
An open-label pilot in 29 prior-treatment-failure chronic hepatitis C patients given SAMe, betaine, pegIFN, and ribavirin found 59% early virological response but only 10% sustained virological response.
- Effect
- Benefit
- Duration
- 2 weeks
- Population
- Patients with chronic hepatitis C
- Participants
- 29
- Ages
- 18–65
ReishiView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Early research suggests that taking a specific reishi mushroom extract (Ganopoly, 1800 mg three times daily for 12 weeks) may lower markers of hepatitis B activity and help improve liver function in some people.
Browse 1 study
A Phase I/II Study of a Ganoderma lucidum (Curt.: Fr.) P. Karst. (Ling Zhi, Reishi Mushroom) Extract in Patients with Chronic Hepatitis ?2002
A phase I/II trial of Ganoderma lucidum extract in chronic hepatitis patients; no abstract text was available to report specific outcomes.
- Population
- Patients with Chronic Hepatitis ?
PhosphatidylcholineView supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking phosphatidylcholine supplements does not seem to help improve liver tests in people with hepatitis A. Studies show no difference compared to not taking it.
Browse 3 studies
RCTPolyunsaturated phosphatidyl-choline and interferon alpha for treatment of chronic hepatitis B and C: a multi-center, randomized, double-blind, placebo-controlled trial. Leich Study Group1998n=176
In 176 chronic hepatitis B/C patients on interferon, phosphatidylcholine 1.8 g/day for 24 weeks raised biochemical response rate to 71% versus 56% with placebo (p<0.05).
- Effect
- Benefit
- Duration
- 24 weeks
- Dose
- 1.8 g/day
- Population
- Patients with chronic hepatitis C
- Participants
- 176
RCTThe effect of polyunsaturated phosphatidyl choline in the treatment of acute viral hepatitis1995n=25
In 47 acute viral hepatitis patients, phosphatidylcholine 900 mg/day did not accelerate bilirubin or ALT normalization versus untreated controls over 12 weeks.
- Effect
- No Benefit
- Duration
- 12 weeks
- Dose
- 900 mg/day
- Population
- Patients with acute viral hepatitis
- Participants
- 25
RCTUse of polyunsaturated phosphatidyl choline in HBsAg negative chronic active hepatitis: results of prospective double-blind controlled trial1982n=15
In 15 HBsAg-negative chronic active hepatitis patients, phosphatidylcholine 3 g/day plus immunosuppression reduced histological disease activity versus immunosuppression alone.
- Effect
- Benefit
- Dose
- 3 g/day
- Population
- Patients with HBsAg negative chronic active hepatitis
- Participants
- 15
SeleniumView supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking selenium together with vitamins C and E does not seem to improve liver enzyme levels or reduce the amount of hepatitis C virus in infected patients, based on a small study.
- The effect of selenium alone is not known.
Browse 1 study
RCTThe effect of antioxidant supplementation on hepatitis C viral load, transaminases and oxidative status: a randomized trial among chronic hepatitis C virus-infected patients2006
In 23 chronic hepatitis C patients over 6 months, vitamin C, E, and selenium 200 mcg/day raised antioxidant levels but did not lower viral load or ALT versus placebo.
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 200 mcg/day
- Population
- Patients with hepatitis C
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Milk Thistle | ★★★★★44% | 14 | 3 | 36% |
| L-Carnitine | ★★★★★44% | 4 | 0 | 10% |
| N-Acetyl Cysteine (NAC) | ★★★★★48% | 4 | 0 | 10% |
| Phosphatidylcholine | ★★★★★32% | 3 | 0 | 8% |
| Taurine | ★★★★★60% | 3 | 0 | 8% |
| Artichoke | ★★★★★44% | 2 | 0 | 5% |
| Caffeine | ★★★★★48% | 2 | 1 | 5% |
| SAMe | ★★★★★44% | 2 | 0 | 5% |
| Aloe | ★★★★★44% | 1 | 0 | 3% |
| Berberine | ★★★★★44% | 1 | 0 | 3% |
| Nattokinase | ★★★★★44% | 1 | 0 | 3% |
| Reishi | ★★★★★40% | 1 | 0 | 3% |
| Selenium | ★★★★★32% | 1 | 0 | 3% |