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Supplements for liver health

NAC, milk thistle, choline — what supports a healthy liver vs what stresses it.

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.
76
Nicotinic acid (Niacin, flush form)
Lipids · Cardiovascular · Vitamin B3
Tier 2
75
Algal DHA (vegan omega-3)
Brain health · Pregnancy · Vegan omega-3
Tier 2
74
Citrulline (L-citrulline, pure form)
Blood flow · Exercise · Blood pressure
Tier 1
74
Niacinamide (nicotinamide)
Knee OA · NAD precursor · Skin · No flush · B3 form
Tier 2
73
Vitamin A (retinol, low-dose)
Vision · Immunity · Skin
Tier 2
73
Vitamin K1 (phylloquinone)
Blood clotting · Bone health
Tier 2
72
MCT oil (medium chain triglycerides)
Energy · Ketosis · Cognition
Tier 2
70
Choline bitartrate
Cognition · Liver · Methylation
Tier 2
70
Olive polyphenol complex (EVOO)
Cardiovascular · Mediterranean diet · Antioxidant
Tier 2
69
Lactobacillus crispatus
Vaginal health · UTI · BV prevention
Tier 2
69
Caprylic acid C8 (targeted MCT)
Ketosis · Cognition · Gut antimicrobial
Tier 2
68
Ashwagandha (KSM-66)
Stress · Anxiety · Sleep
Tier 2
68
Artichoke extract (Cynara scolymus)
Liver · Digestion · Cholesterol
Tier 2
68
Betaine TMG (trimethylglycine)
Methylation · Homocysteine · Liver
Tier 2
68
Pyridoxal 5-phosphate (P5P)
Vitamin B6 · Neurotransmitters · Homocysteine
Tier 2
67
Dihydromyricetin (DHM)
Hangover · Liver protection · Alcohol metabolism
Tier 2
67
Butterbur (Petasites hybridus)
Migraine prevention · Allergies
Tier 2
66
Choline
Cognition · Liver · Methylation
Tier 2
66
Phosphatidylcholine
Liver · Cell membrane · Cognition
Tier 2
66
L-Cysteine
Hair · Skin · Glutathione · Detox
Tier 2
65
Butyrate (calcium/magnesium)
Gut barrier · IBD · Microbiome
Tier 2
65
Butyrate tributyrin (odourless)
Gut integrity · Colon health · Microbiome
Tier 2
65
Tributyrin (gut barrier, targeted)
Gut barrier · IBS · Microbiome support
Tier 2
64
Milk thistle (Silymarin)
Liver protection · NAFLD
Tier 2
64
Niacin (Vitamin B3)
Lipids · Skin · Energy metabolism
Tier 2
Educational reference, not medical advice. Discuss any supplement change with a qualified clinician before acting on this list.
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