Principal Proposed Natural Treatments

The herb milk thistle and the supplement SAMe have been recommended for protecting the liver from alcohol-induced damage. However, neither of these has been conclusively proven effective; abstinence is undoubtedly more effective than any treatment. For additional information, see the articles on Alcoholic Hepatitis and Cirrhosis .

In addition to damaging the liver, alcoholism causes a general depletion of nutrients. People who drink to excess (either because they have not quit drinking or because they are in the process of quitting) may benefit from supplementation.

Other Proposed Natural Treatments

In a double-blind study of 64 people, use of an extract made from the skin of the fruit of the prickly pear cactus Opuntia ficus indica significantly reduced hangover symptoms as compared to placebo. 38 The greatest improvements were seen in symptoms of nausea, loss of appetite, and dry mouth. Overall, the rate of severe hangover symptoms was 50% lower in the treatment group as compared to the placebo. The researchers involved in this study hypothesized that hangovers are caused by inflammation and that the herb reduced inflammation.

Artichoke leaf is much better known than prickly pear cactus as a means of preventing hangover symptoms. However, the one double-blind study on the subject failed to find artichoke any more effective than placebo. 39

The supplement trimethylglycine (TMG) stimulates the formation of SAMe and might be helpful for alcoholic liver disease. 14-17 However, no meaningful double-blind, placebo-controlled clinical trials have been reported.

The supplement phosphatidylcholine has been advocated as a treatment for early alcohol-related liver damage (especially fatty liver), but the results of highly preliminary studies have been inconsistent. 18-22 One study in baboons even found evidence of increased liver toxicity. 19

Other herbs and supplements that have been proposed for protecting the liver, but only on the basis of extremely weak evidence, include andrographis , barberry , beet leaf, boldo , dandelion , inositol , licorice , lipoic acid , liver extracts, N-acetylcysteine , Picrorhiza kurroa , schisandra , taurine , thymus extract , and turmeric .

The herb kudzu has been widely advocated as an aid for quitting alcohol, based on studies using hamsters or rats. 23 However, small, double-blind studies in humans have yielded inconsistent results at best . 24,41

Acupuncture has also been proposed as an aid to alcohol withdrawal. However, study results have been contradictory, and the largest trial failed to find any benefit. This 3-week, single-blind trial study of 503 alcoholics failed to find any difference between real ear acupuncture and placebo ear acupuncture. 25 In addition, a 10-week, single-blind, placebo-controlled study of 72 alcoholics found no difference in drinking patterns or cravings between sham acupuncture and real acupuncture groups. 26 Negative results were also seen in a similar trial of 56 participants, 27 and in one of 48 people. 40 A study of 109 people compared acupuncture against aromatherapy (intended by these researchers as a placebo) and failed to find that acupuncture was more effective. 43 However, a single-blind trial of 54 people did find acupuncture more effective than a placebo, 28 as did a single-blind trial of 80 people. 29

The herb passionflower has been proposed as an aid to alcohol withdrawal, primarily on the basis of the study of people addicted to opiates. 30

One study suggests that honey consumption might increase the body's ability to metabolize alcohol, thereby limiting intoxication and more rapidly reducing blood alcohol levels down to a safer (or legal) zone. 20

Herbs and Supplements to Avoid

High doses of the supplements beta-carotene and vitamin A might cause alcoholic liver disease to develop more rapidly in people who abuse alcohol. 31,32 Nutritional supplementation at the standard daily requirement level should not cause a problem. See the articles on Vitamin A and Beta-carotene for more information.

All forms of vitamin B 3 , including niacin, niacinamide (nicotinamide), and inositol hexaniacinate, may damage the liver when taken in high doses. (Again, nutritional supplementation at the standard daily requirement level should not cause a problem.)

One animal study suggests that the herb kava may have value as an aid to alcohol withdrawal. 33 However, people who abuse alcohol should probably not take kava at all; even in healthy people, the herb has caused severe liver damage.

Numerous herbs and supplements have known or suspected liver-toxic properties, including, but not limited to, barberry , borage, chaparral , coltsfoot , comfrey , germander , germanium (a mineral), greater celandine , kombucha , mistletoe , noni , pennyroyal , pokeroot , sassafras , and various herbs and minerals used in traditional Chinese herbal medicine . In addition, herbs that are not liver-toxic in themselves are sometimes adulterated with other herbs of similar appearance accidentally harvested in a misapprehension of their identity (for example, germander found in skullcap products). Other forms of contamination are possible as well. Blue-green algae species, such as spirulina , may at times be contaminated with liver-toxic substances called microcystins (for which no highest safe level is known).

Some articles claim that the herb echinacea is potentially liver-toxic, but this concern appears to have been based on a misunderstanding of its constituents. (Echinacea contains substances in the pyrrolizidine alkaloid family. However, while many pyrrolizidine alkaloids are liver toxic, those found in echinacea are not believed to have that property.)

Whole valerian contains liver-toxic substances called valepotriates. However, valepotriates are thought to be absent from most commercial valerian products, 35 and case reports suggest that even very high doses of valerian do not harm the liver. 36,37

Herbs and supplements with the potential to irritate the stomach, such as white willow and arginine , should be used only with caution by people who consume excessive alcohol.