Several supplements have genuine evidence behind them for supporting liver health, though the strength of that evidence varies widely. The most studied options include milk thistle, NAC, curcumin, choline, TUDCA, and artichoke leaf extract. Each works through a different mechanism, and which one makes sense for you depends on what your liver actually needs help with.
Milk Thistle
Milk thistle is the most widely recognized liver supplement, and for good reason. Its active compound, silymarin, works on multiple fronts: it blocks inflammatory signaling molecules that cause cell death, it acts as an antioxidant, and it appears to alter liver cell membranes in a way that prevents toxins from entering. Perhaps most notably, silymarin stimulates enzymes that promote the growth of new liver cells, which is unusual for a supplement.
Preliminary research suggests milk thistle can improve liver function markers in people with alcoholic liver disease or chronic viral hepatitis. It’s widely available, generally well tolerated, and has decades of use in European medicine. That said, if you take blood thinners like warfarin, anti-anxiety medications like diazepam, or other drugs processed by certain liver enzymes (specifically CYP2C9), milk thistle can change how your body handles those medications. It may raise or lower drug levels in your blood, so it’s worth flagging with your pharmacist.
NAC (N-Acetyl Cysteine)
NAC is the supplement form of a building block your body uses to make glutathione, its most important internal antioxidant. Glutathione is essential for neutralizing toxic byproducts in the liver, and NAC helps your body produce more of it. This is why NAC is actually used in hospitals as the standard treatment for acetaminophen (Tylenol) poisoning: when someone overdoses, their liver gets overwhelmed producing a harmful metabolite, and NAC both reduces the amount of that metabolite and supplies what’s needed to neutralize it.
Outside of emergency settings, people take NAC as a daily supplement to support the liver’s general detoxification capacity. It’s especially popular among people who drink alcohol regularly or take medications known to stress the liver. The logic is straightforward: if glutathione is the liver’s main cleanup tool, giving your body more raw material to make it should help. NAC is one of the better-supported supplements for this purpose, though much of the strongest evidence comes from the acetaminophen poisoning context rather than everyday use.
Curcumin (Turmeric Extract)
Curcumin, the active compound in turmeric, has solid clinical data behind it for reducing liver inflammation. A meta-analysis of 31 randomized controlled trials found that curcumin supplementation significantly lowered two key markers of liver stress: ALT dropped by about 4 units per liter on average, and AST dropped by nearly 4 units per liter. Those aren’t dramatic shifts, but for people with mildly elevated liver enzymes, they represent a meaningful move in the right direction.
The challenge with curcumin is absorption. Plain turmeric powder passes through the gut without much reaching the bloodstream. Most effective supplements use formulations designed to improve bioavailability, such as those combined with black pepper extract or lipid-based delivery systems. If you’re buying a turmeric supplement and it doesn’t address absorption in some way, you’re likely wasting your money.
Choline
Choline is less flashy than the other supplements on this list, but it may be the most important one for people at risk of fatty liver disease. Your liver needs choline to package and export fat. Without enough of it, fat accumulates in liver cells, which is the defining feature of nonalcoholic fatty liver disease (NAFLD).
The adequate intake is 550 mg per day for men and 425 mg per day for women, and most people fall well short of that. Eggs, beef liver, and soybeans are the richest food sources. Some people are also genetically more susceptible to choline deficiency due to a variation in a gene involved in choline production. In studies, people with this variation developed fatty liver when their choline intake dropped below 10% of the recommended amount. If you’ve been told you have a fatty liver and your diet is low in eggs, meat, or other choline-rich foods, this is one of the simplest and most evidence-backed changes you can make.
TUDCA
TUDCA (tauroursodeoxycholic acid) is a bile acid that your body produces in tiny amounts naturally. It’s used medically to treat cholestasis, a condition where bile fails to flow properly from the liver to the small intestine. When bile backs up, its acids become toxic to liver cells. TUDCA and related bile salts counteract that toxicity, and TUDCA is considered the reference drug for this effect.
As a supplement, TUDCA has gained popularity among people concerned about liver health during periods of extra stress, such as while using certain medications or during aggressive dietary protocols. It helps keep bile flowing and may reduce a type of cellular stress called ER stress, though a clinical trial of 1,750 mg per day in obese adults didn’t show measurable changes in ER stress markers after four weeks. TUDCA is best suited for people with specific bile flow concerns rather than as a general liver tonic.
Artichoke Leaf Extract
Artichoke leaf extract works primarily by stimulating bile production, which helps the liver clear toxins more efficiently. It also contains luteolin, an antioxidant that appears to inhibit cholesterol formation. Research suggests artichoke extract may help the body process cholesterol more efficiently, leading to lower overall levels, which indirectly benefits the liver since excess cholesterol contributes to fatty liver progression.
Artichoke leaf extract also shows some ability to protect liver cells from damage and promote the growth of new tissue. It’s a gentler option than some of the others on this list and is often a good fit for people looking for mild, broad-spectrum liver support without strong pharmacological effects.
One Supplement to Avoid
Green tea extract deserves a specific warning. Despite being marketed for everything from weight loss to liver health, concentrated green tea extract is actually a documented liver toxin. The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has linked it to liver damage severe enough to require transplant or cause death. Because supplements aren’t screened by the FDA for safety before they hit shelves, green tea extract remains widely available despite these risks. Drinking green tea as a beverage is fine. Taking concentrated extract capsules is a different calculation entirely.
Choosing the Right Supplement
The best liver supplement depends on your situation. If you have mildly elevated liver enzymes or general inflammation, curcumin and milk thistle have the broadest evidence. If you’re concerned about toxin exposure or take medications that stress the liver, NAC directly supports your liver’s main detox pathway. If you’ve been diagnosed with fatty liver and your diet lacks choline-rich foods, choline supplementation addresses one of the most common nutritional gaps behind that condition. TUDCA is more specialized, best for bile flow issues. Artichoke leaf extract is a solid mild option for general support.
Stacking multiple liver supplements is common but not well studied. If you’re taking prescription medications, milk thistle in particular can alter how your body processes other drugs. And no supplement compensates for the basics: reducing alcohol, maintaining a healthy weight, and limiting unnecessary medications remain the most powerful things you can do for your liver.