This is the body’s most powerful detoxifying antioxidant, which helps the body repair damage from alcohol and other drugs. People with reasonably good diets (who are not abusing alcohol) have an adequate supply of glutathione, which is constantly being used up and replenished. Alcoholics, on the other hand, invariably suffer from glutathione depletion. Liver disease and dysfunction are strongly associated with long-term glutathione deficiency. People with chronic hepatitis C also tend to have lower glutathione levels and, as a consequence, they are at greater risk of developing liver cirrhosis and cancer of the liver.
Glutathione is made in the body from three amino acids (specifically, cysteine, glutamate and glycine) and supplementing with these amino acids, including glutamate’s precursor amino acid, glutamine, helps to increase your glutathione levels. Glutathione itself can be supplemented, but it is not absorbed efficiently orally, so we recommend supplementing with other glutathione-producing nutrients such as NAC (n-acetyl cysteine), SAM, L-glutamine, glycine (as found in TMG), and plants such as milk thistle and turmeric that help to promote glutathione levels (read on for specific indications for supplementing these nutrients and herbs). We regularly add glutathione in its reduced active form into intravenous drips to speed up recovery (see Chapter 30 of How to Quit Without Feeling S**t).
This amino acid has many functions in our body, including increasing brain levels of key neurotransmitters GABA and glutamate, healing the ‘leaky’ lining of the gut (found commonly in alcoholics and substance abusers), reducing cravings for alcohol, increasing the release of human growth hormone, and increasing the production of detoxifying enzyme glutathione.
Glutamine is found in large amounts in all animal protein, but when you cook it, at least 95 per cent of this is destroyed, and when you are stressed, either physically or emotionally, your body needs much more glutamine than can be provided by the diet. In these cases, we recommend supplementing 8–24g daily. One heaped teaspoon is approximately 4g.
One study of alcoholics found that 10–15g daily helped 75 per cent of alcoholics control their drinking. In addition to this, glutamine supplementation has been shown to improve liver healing and can be used as a treatment in early stage liver cirrhosis.
However, those with advanced liver cirrhosis or a history of a risk of liver failure must not take large amounts of glutamine, unless under the supervision of a medical practitioner. This is because glutamine is the only amino acid that contains an additional nitrogen molecule, which the liver has to process. Taking large amounts of amino acids, especially glutamine, can further tax the liver in advanced cases of liver cirrhosis.
N-Acetyl Cysteine (NAC)
This is one of the most powerful naturally occurring antioxidants, which, when supplemented, dramatically increases glutathione levels in the body. Animal studies have shown that treating a damaged liver with NAC not only works directly as an antioxidant to decrease dangerous lipid oxidation, but it also increases the levels of beneficial glutathione. Similarly, many studies in humans have shown that treatment with NAC improves liver function following liver damage and may even offer protection against cancerous liver cells. A 2007 study found that NAC reduces the urge to gamble in 59 per cent of pathological gamblers, presumably by regulating glutamate levels in the brain. The effective dose of NAC ranged from 1,100 to 1,700mg per day.
We advise taking 500–1,000mg mid-morning and again in the mid-afternoon. Although there are a few known side effects at this dosage, a recent research study questioned the safety of high doses of NAC, suggesting that it may raise blood pressure. Although this is not our experience, you might also want to monitor your blood pressure.
S-adenosyl Methionine (SAM)
Like NAC, SAM helps to make glutathione in the liver. If you do not have enough SAM, the liver is susceptible to damage from toxic substances such as alcohol and drugs. SAM supplementation can reduce alcoholic liver disease by decreasing oxidative stress, reducing inflammation and preventing the destruction of normal liver cells while destroying liver cancer cells. In one study, a group of alcoholics supplementing SAM had a 30 per cent reduction in deaths and liver transplants, compared with a group of patients who did not receive the supplement. Another trial found that in patients with alcoholic liver disease, long-term SAM supplementation improved survival rates or delayed liver transplantation. Research has also shown that patients with alcoholic liver disease and other liver disorders have abnormal methionine metabolism, which depletes SAM. Taking therapeutic doses of SAM may reverse this.
A plant native to the Mediterranean region, milk thistle has been used for thousands of years as a remedy for a variety of illnesses, especially liver problems. Milk thistle contains silymarin, which has a number of unique functions and is a particularly powerful antioxidant. Silymarin also increases glutathione levels. Another way the liver can be damaged is through the action of substances known as leukotrienes. Silymarin prevents these leukotrienes from attacking the liver.
Recently, milk thistle has been shown to have anti-cancer effects. Specifically, the researchers found that a compound in milk thistle called silybinin can significantly reduce the growth of several human liver cancer cells. Other studies have indicated that milk thistle is specifically beneficial for the treatment of hepatitis C. For example, researchers have found that milk thistle extract normalises levels of damaging liver enzymes, raised in hepatitis C.
A meta-analysis of six studies of milk thistle and chronic alcoholic liver disease, found that four reported significant improvement in at least one measurement of liver function with milk thistle compared with a placebo. One study specifically looking at acute viral hepatitis showed significant improvement in liver enzyme levels after 28 days of milk thistle supplementation.
Milk thistle is generally well tolerated and has shown few side effects in clinical trials. It may however cause a laxative effect, and occasionally nausea, diarrhoea, abdominal bloating, fullness and pain. Milk thistle can produce allergic reactions, which tend to be more common among people who are allergic to plants in the same family (for example, ragweed, chrysanthemum, marigold and daisy). This is not common but worth bearing in mind.
We recommend taking 600mg milk thistle twice a day (ideally taken in the high-absorption formula combining standard milk thistle with phospholipids to enhance its absorption ).
The Indian spice, turmeric has been used for years in traditional medicines. It contains an ingredient called curcumin, a powerful anti-inflammatory and antioxidant, which increases glutathione levels, our most powerful antioxidant, detoxifying and liver-protective enzyme. Curcumin also has the ability to reduce homocysteine levels. A recent scientific review of all the research on turmeric, concludes that curcumin not only regulates immune cells but can also reduce harmful pro-inflammatory substances, which contribute to the formation of cancer cells. Specific studies in the liver have demonstrated that curcumin can decrease the levels of liver enzymes and markers of fat oxidation usually increased in alcoholic liver disease. In addition, levels of beneficial antioxidants such as glutathione, vitamin C and vitamin E, are increased when curcumin is given. We recommend taking 900mg of curcumin twice daily.
James Braly treated a 50 year-old chronic alcoholic man who had liver failure and was on a waiting list for a liver transplant. James’s treatment used a combination of SAM, turmeric, NAC, fish oil and milk thistle complexed with phospholipids. In less than three months, the client’s liver enzymes were at or near normal, the fluid that had accumulated in his abdomen (ascites) and ankles had disappeared, and the pronounced jaundice was no longer apparent.
This Japanese herbal formula has been used to reduce the symptoms and severity of liver cirrhosis. The mixture of seven herbs helps prevent liver fibrosis or ‘scarring’ by preventing oxidative stress in liver cells. The formula has also been shown to have anti-cancer properties in animals, decreasing the growth of cancer cells. The active components of sho-saiko-to appear to be flavonoids, which have a similar structure to silybinin found in milk thistle.
A key ingredient in the formula is the herb bupleurum. Bupleurum has been found to reduce symptoms and blood liver enzyme levels in children and adults with chronic active viral hepatitis. Most of these studies were in people with hepatitis B infection, although one preliminary human trial has also shown a benefit in people with hepatitis C. Sho-saiko-to was also found to decrease the risk of people with chronic viral hepatitis developing liver cancer. Another trial found that sho-saiko-to could reduce the rate of liver cancer in people with liver cirrhosis.
We recommend 500–2,000mg of bupleurum dry root, taken three times daily in capsules, or making a tea using 4g (or about 1g per cup of tea), and drinking this three times a day. Ideally take the whole sho-saiko-to formula as a capsule (1.8–2.5g) three times per day.
Side effects of sho-saiko-to and bupleurum include upset stomach, but this is lessened by taking them with food or in capsules. Bupleurum and sho-saiko-to are not recommended during pregnancy or while breastfeeding.
High in the omega-3 fatty acids EPA and DHA, fish oil may also protect your liver. In an animal study published in 2006, sections of damaged liver were treated with fish oil or vitamin E (a known potent antioxidant). The livers treated with fish oil and vitamin E showed more regeneration than the control group, and this was most significant in the fish oil group. When examined for glutathione levels, these were increased in the fish oil group and the vitamin E group, indicating that they both improve the antioxidant system of the liver. Supplementing 1–3g of EPA- and DHA-rich fish oil may therefore be beneficial.
Find out more
For further information and some delicious recipes, plus a more comprehensive plan if you want to detox for longer, read The 9 Day Liver Detox Diet .
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