Liver cleanse: a safe way to shed pounds?

If you’ve researched fast and easy ways to lose bloating and weight, you may have come across recommendations to do a liver cleanse or liver detox. 

Liver cleansing or liver detoxification may seem like they work for weight loss. And if you’ve struggled with weight management or bloating, the thought of cleansing and detoxing probably sounds pretty good too!

Before doing a cleanse, let’s go through what the liver does, what liver cleanses do, and if they can help you with your weight loss. 

The liver is responsible for more than 500 different bodily processes. It is so important to your life that it even has the word “live” in it. 

A healthy liver does a lot of essential things. Here are just some of the liver’s jobs (Vernon, 2020):

1. Metabolizes nutrients from your digestive system for optimal absorption, and stores vitamins and minerals like iron and vitamin A

2. Breaks down medications—whether over-the-counter, prescribed, or recreational

3. Processes alcohol

4. Removes toxins and dismantles old red blood cells from circulation

5. Assists in maintaining blood sugar levels through glycogen production and release

6. Filters the blood supply, removing ammonia, bilirubin, and other harmful substances 

7. Produces and stores blood cell clotting factors

8. Balances cholesterol and some hormones

9. Manufactures substances necessary for the immune system

What can affect your liver function?

The liver is pretty good at detoxifying itself. You may have even heard that people can receive a partial liver transplant, and their livers regrow or regenerate. That regrowth speaks to the liver's incredible ability to take care of itself to keep it functioning normally. However, certain medical conditions or environmental/lifestyle habits can hurt, and in some cases, permanently damage, the liver (Vernon, 2020).

Cirrhosis is a condition that affects the liver and, in some cases, can permanently damage it. Cirrhosis causes nodules to form inside the liver and fibrosis, a form of scar tissue that is hard. When a liver becomes cirrhotic (hardened), good and bad substances get stuck in these narrowed, hardened, and closed-off pathways. They have nowhere to go. Vitamins, minerals, glycogen, blood clotting factors stay stuck inside the liver, not reaching the rest of the body to provide energy and fuel as they should. Harmful substances from medications or the by-products of bodily functions build up, and the liver can't excrete or remove them (Sharma, 2020).

The risk of liver disease and cirrhosis can come from many different factors, including (Sharma, 2020):

• Infections—including hepatitis B, hepatitis C, and hepatitis D 

• Non-alcoholic fatty liver disease (NAFLD)—This is also known as obesity-related fatty liver disease, and it is increasing. About 20–30% of people in Western countries have some form of this condition. Scientists estimate that 80–90% of adults with obesity and 40–70% of children with obesity have NAFLD. NAFLD is a silent disease, with most people having no symptoms. However, this disease can progress to fibrosis, cirrhosis, and even liver cancer (Kudaravalli, 2020). 

• Chemicals—Alcohol, drugs, oral medications (including over-the-counter ones—especially over-doing acetaminophen/Tylenol), IV drug use, and exposure to chemicals harmful to the liver

• Genetic and hereditary liver diseases—including blood blockages to the liver, high triglycerides, or chronically low potassium levels

• Liver cancer

What symptoms do people with liver damage have?

Some people don’t show any symptoms and only discover they have a problem with their livers when they have a physical exam, scan, or blood work. Others can have many symptoms, such as (Sharma, 2020):

• An enlarged liver

• Chronic pancreatitis and gallstones

• Anemia and clotting disorders

• Kidney problems

• Jaundice or yellowing of the skin and eyes

• Spider veins and redness of the skin

• Finger and toenail changes

• Irregular menstruation for women; impotence in men

Proponents of liver cleanses include other symptoms as a sign that the liver is sluggish and could do with liver detoxification. Some of these symptoms they list have multiple causes, and the liver may not be directly responsible. These include:

• Bloating

• Acid reflux

• Constipation

• Depression and exhaustion 

• Poor appetite

• Feeling sweaty all the time

Liver cleanses are sold as supplements, drinks, or teas. They say they help you clean your liver from the residue of the many jobs it does. 

Medicinal plants have been used for treating and preventing diseases, including liver diseases, since ancient times. Most liver cleanses contain herbal plant materials. They may include the entire plant, leaves, stems, roots, or seeds. They are sourced worldwide, with many coming from India and China (Adewusi, 2010). 

Most people believe that “natural” liver detoxification automatically means safe and harmless, but that’s not necessarily the case (Mengual-Moreno, 2015).

Let’s look at what many of these cleanses contain.

What are the ingredients in a liver cleanse? 

Some of the herbs found in liver detoxes include:

Milk thistle or silymarin is known to have anti-inflammatory, antioxidant, liver, and heart-protective effects. Scientists continue to research this plant for liver and other health issues (Del Prete, 2012). This product is available as "Milk Thistle." You'll see it in almost any liver supplement, liver cleanse powder, or liver cleansing tea. 

Licorice root, similar to milk thistle, is known for its anti-inflammatory effects on the liver (Del Prete, 2012). This product is sold as “licorice” and is found in many different herbal products, not just liver detoxes.

Phyllanthus, especially phyllanthus amarus, is used in Indian Ayurvedic medicine. It’s historically known to help digestive issues as an antiseptic (Del Prete, 2012). Very few supplements are sold as phyllanthus only. It is found in combination formulas, including Life Extension NAD and Gundry MD Bio-Complex.

Turmeric has been tested and shows safety even at high doses (Del Prete, 2012). Turmeric can be found as a supplement, tea, and in combination supplements, powders, and teas.

Betaine, usually called digestive enzymes, comes from sugar beets and may help people whose liver problems are caused by circulatory issues (Del Prete, 2012). This is sold as homocysteine or “super digestive enzymes.”

Quercetin, found in apples and onions, is anti-inflammatory and helps with blood vessel-related problems of the liver (Del Prete, 2012). This product is sold on its own. 

Dandelion has been long described as a natural detoxing herb. Dandelion is part of many liver cleanses and other detoxifying supplements (Lis, 2019). Dandelion is available on its own, along with other herbs in supplements and formulas, and as a tea. 

Burdock root, similar to dandelion, is also considered by some to be a helpful detox, especially in Traditional Chinese Medicine (TCM). This product is available as a supplement by itself or in combined preparations or as a tea (Romualdo, 2020). 

Most liver cleanses combine all or some of these liver support ingredients into their liver detox. Others may add green tea or vitamin C.

Why liver cleanses may be dangerous

The use of herbal supplements for liver cleanses, flushes, and detoxification has increased in the US and around the world. At the same time, the rate of herbal and dietary supplement-induced injury (HDS) has increased as well. Currently, scientists from the National Institute of Health (NIH) and liver specialists estimate that 20% of liver damage is directly caused by injury from herbal and dietary supplements (Navarro, 2017, Koenig, 2021).

Liver cleanses are mostly made of herbs and plants. Plant strength and quality differ because of growing environments, harvest practices, preparation, and extraction of the herbs. This means it's hard to know the amount of potency of the herbs inside your liver detox (Del Prete, 2012). 

There is virtually no barrier for people to get liver detoxes. Liver cleanses and other detoxifying products can be purchased at drug stores, supermarkets, health food stores, and on the internet. People may be sensitive to some of the herbs inside liver cleanses and may not even know the quality or quantity inside. The supplement industry is not well regulated, and the FDA does not formally evaluate these products for safety and effectiveness (Mengual-Moreno, 2015).  

Treating HDS liver injuries can be challenging. Healthcare professionals recommend immediately stopping use of the product. Researchers are working toward improving or introducing new technologies to help with these liver injuries (Mengual-Moreno, 2015, Koenig, 2021).

There are several lifestyle tweaks you can do to help detox your liver without resorting to dangerous cleanses.

Change your diet 

Most people recognize how hard it is to lose weight. Some will even try liver cleanses to drop those unwanted pounds. Scientists and healthcare professionals recognize the clear association between non-alcoholic fatty liver disease and obesity. Currently, there is no medication treatment for non-alcoholic fatty liver disease, a growing problem around the world (Perdomo, 2019). 

Researchers are studying the effects of several healthy diets, including the Mediterranean diet, and incorporating healthy fats, whole grains, fiber, and more vegetables for sustained weight loss (Plaz Torres, 2019). 

Virtually all liver cleanse or liver detoxification programs recommend removing food and drinks that might burden the body and the liver, as part of the pre-cleanse protocol. This includes processed foods, sugar, caffeine, trans fats, and alcohol. These lifestyle modifications are helpful to everyone and should be done whether or not you plan to go on a cleanse for your liver or any other organ.

There is a connection between the liver and other organs of digestion, known as the gut-liver axis. Scientists recommend increasing dietary fiber to positively alter the digestion and metabolism of food to increase liver health (Kieffer, 2016). 

Decrease your chemical intake

Limit or decrease your alcohol intake. Men under 65 can have two standard drinks per day totaling 28 g of alcohol; over 65 years, just one drink per day is recommended. Women of any age should limit themselves to one standard drink totaling 14 g of alcohol per day. Your liver processes alcohol, and it's best to drink in moderation to keep your liver healthy (Kalinowski, 2018).

Healthcare professionals caution only using prescription and over-the-counter drugs as directed. Your liver is one of the main organs to metabolize all medications, so choose your medications carefully and only take those recommended by your healthcare provider. Acetaminophen, commonly known as Tylenol or paracetamol, can cause severe liver damage when taken in excess. Be aware that some prescription pain relievers have added acetaminophen to their formula. Seek medical advice on what a safe acetaminophen limit is for you. If you regularly take any medication, speak with your healthcare provider to see whether it is safe to consume alcohol while taking your medicine (Yoon, 2016).

Be proactive

Get vaccinated against hepatitis. There are vaccines for hepatitis A and B (not C, D, or E) to protect your liver against these viruses. Blood carries hepatitis viruses (A through E), so be careful with anything that can carry even microscopic particles of blood, such as poorly disinfected manicure tools, tattoo needles, shared razors, or toothbrushes. Do not share your needles for any injectable drugs, whether prescribed or not (Hodgens, 2021).

Practice safe sex, as bodily fluids can also carry viruses that may attack the liver (Hodgens, 2021).

The bottom line is most liver cleanses can be dangerous and actually harm the liver. Though some of the herbs and plants in the supplements, powders, tinctures, or teas have some evidence that they work, none of these products are regulated. They may contain too much or too little of the herbs purported to help. In addition, the herb and plant origins and extraction process affect the quality and efficacy of the product. Protect your liver by eating right, decreasing alcohol, and being careful with all your medications.

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Current version

April 27, 2021

Written by

Tobi Ash, MBA, RN, BSN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.