Supplements for liver health

NAC is the antidote for acetaminophen toxicity and has small trial evidence for non-alcoholic fatty liver. Milk thistle (silymarin) has long traditional use, modest modern evidence, and may interact with chemotherapy. Choline supports liver phospholipid synthesis. Avoid: high-dose green tea extract (can cause hepatotoxicity), kava (FDA warning), comfrey/coltsfoot (pyrrolizidine alkaloids → veno-occlusive disease), high-dose niacin without medical supervision, and 'liver detox' blends — none have evidence and many contain hepatotoxic herbs.