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A Few Herbs to Aid Detoxification Through Liver Support
By Maureen Williams, ND
Among the tissues that make up the immune system, the liver is paramount. The immune response to both foreign and endogenous substances is largely determined by the liver, making it a key regulator of inflammation in the body. Through its many biochemical functions, the liver plays a critical role in protecting the body from the damaging effects of all kinds of toxins, including the toxic bi-products of daily biochemical activity and toxins from the environment that are encountered in ordinary and extraordinary circumstances, and requires powerful antioxidants to do this work.
A number of medicinal herbs have been identified as strong potentiators of detoxification. Often rich in antioxidants and constituents that stimulate immune activity, these herbs can stimulate and support the liver’s detoxifying capacity. A few outstanding examples of these important medicinal herbs are presented below.
Picrorhiza/Picrorhiza kurroa
The rhizome of this Himalayan plant has been an important medicinal in the Ayurvedic system for centuries, used primarily to treat gastrointestinal ailments such as indigestion, constipation, and chronic diarrhea. Picrorhiza has gained attention more recently for its hepatoprotective and anti-toxic effects.
Animal studies have shown that picrorhiza protects liver cells from damage due to many known hepatotoxins including carbon tetrachloride, [i] [ii] [iii] [iv] Amanita phalloides (“death cap” mushroom) toxin, [v] [vi] paracetamol, [vii] [viii] galactosamine, [ix] thioacetamide, [x] [xi] [xii] monocrotaline, [xiii] aflatoxin B1, [xiv] [xv] [xvi] [xvii] alcohol, [xviii] [xix] cadmium, [xx] oxytetracycline, [xxi] and other chemicals. [xxii] [xxiii] A preliminary trial in people with acute hepatitis B virus yielded promising results: treatment with 375 mg picrorhiza root three times per day for two weeks was associated with a 61% drop in serum bilirubin, 85% drop in serum glutamic pyruvic transaminase (sGPT), and 83% drop in serum glutamic oxalocetic transaminase (sGOT), while these decreases were 19%, 53%, and 61%, respectively, in the placebo group. [xxiv] Picrorhiza has also been found to protect renal and testicular cells from injury due to cadmium toxicity, [xxv] [xxvi] and cardiac muscle cells from adriamycin-induced injury in in vitro studies using animal cell lines. [xxvii]
The antioxidant activities of picrorhiza’s constituents were found in one study to stimulate superoxide dismutase, promote metal ion chelation, and inhibit xanthine oxidase. [xxviii] In addition, picrorhiza appears to regenerate reduced glutathione. These antioxidant actions might contribute to the anti-cholestatic effect picrorhiza has demonstrated in a number of animal studies. [xxix] [xxx] [xxxi] [xxxii] Its observed ability to protect against ischemia-reperfusion injury in animals has been attributed to its antioxidant activity, [xxxiii] [xxxiv] [xxxv] as well as its stimulating effect on insulin-like growth factors, which are thought to be involved in tissue repair and regeneration after hypoxic injury. [xxxvi] Picrorhiza has prevented free-radical renal cell damage [xxxvii] [xxxviii] and had a direct beneficial effect on serum glucose levels in diabetic rats, [xxxix] and has prevented hyperlipidemia in several rodent studies. [xl] [xli] [xlii]
Picrorhiza has demonstrated complex immunomodulatory effects. [xliii] [xliv] It has been shown to enhance the immune response to certain antigenic proteins [xlv] [xlvi] [xlvii] and mitigate immune-overreactions, quieting the inflammatory response. [xlviii] In animal research, several mechanisms for its anti-inflammatory [xlix] [l] [li] [lii] [liii] [liv] and anti-anaphylactic [lv] [lvi] effects have been identified [more detail?]. Although picrorhiza inhibits cyclooxygenase (COX) 2, [lvii] [lviii] [lix] it appears not to do so at the expense of the stomach lining: in one animal study, picrorhiza protected the gastric mucosa from the damaging effects of the COX-inhibiting drug, indomethacin. [lx]
Artichoke/Cynara scolymus
The globe artichoke might be more familiar to us boiled and dipped in butter than as part of a medicinal formula for the liver, but research suggests that artichoke has powerful antioxidants with health-promoting properties. Antioxidant phenolic compounds from artichoke can act as hydrogen donors and metal ion chelators, [lxi] [lxii] [lxiii] [lxiv] and in vitro studies have found that artichoke can protect against the effects of toxins [lxv] and spare glutathione in liver cells. [lxvi] Artichoke has been found to increase glutathione peroxidase activity in animals [lxvii] and total antioxidant capacity in athletes after strenuous exercise. [lxviii]
Extracts from artichoke leaves have been found to prevent cholestasis [lxix] and inhibit cholesterol synthesis [lxx] [lxxi] in animals. In a controlled clinical trial, people taking 1,800 mg of artichoke extract daily for six weeks saw decreases of 18.5% in total cholesterol and 22.9% in LDL-cholesterol levels. [lxxii] Several studies suggest that artichoke’s antioxidant activity might have beneficial effects on vascular endothelium as well. [lxxiii] [lxxiv] [lxxv] [lxxvi]
Rehmannia/Rehmannia glutinosa
Commonly called Chinese foxglove, rehmannia has been used in the traditional Chinese medical system to treat a range of conditions including anemia, palpitation, insomnia, dizziness, and irregular menstrual cycles, and interest has recently grown in rehmannia’s antioxidant effects. Rehmannia extracts have been shown to increase antioxidant enzyme activity including superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GSR), and glutathione peroxidase (GSX), [lxxvii] [lxxviii] and to prevent toxin-induced brain damage in animals. [lxxix] In a number of in vitro studies, rehmannia extracts and constituents protected brain cell cultures from oxidative damage induced by a variety of neurotoxins. [lxxx] [lxxxi] [lxxxii] [lxxxiii] [lxxxiv] In addition, rhemannia extracts have been found to protect against toxic damage caused by cisplatin in auditory cells and caused by adriamycin in cardiac cells in vitro. [lxxxv] [lxxxvi] Results from animal studies suggest that rehmannia might reduce levels of C-reactive protein [lxxxvii] and serum glucose in diabetic rats. [lxxxviii]
Schizandra/Schizandra chinensis
The fruit of the schizandra plant, sometimes called magnolia vine, is a tonic and adaptogen from the Chinese medical pharmacy. Schizandra berries and their constituents have been widely studied for their antioxidant and hepatoprotective properties. Animal research has found that schizandra protects liver cells from toxic and free radical injury, [lxxxix] [xc] [xci] [xcii] [xciii] [xciv] [xcv] [xcvi] [xcvii] [xcviii] and stimulates liver regeneration in rats that have undergone hepatic resection. [xcix] [c] [ci] Its ability to raise antioxidant activity has been noted in liver cells [cii] [ciii] and in cellular mitochondria. [civ] [cv] [cvi] [cvii]
Researchers have noted that schizandra may be helpful to people with viral hepatitis. Schizandra was active against hepatitis C virus (HCV) in vitro, [cviii] and in a preliminary trial, treatment with a combination of herbs and nutrients that included schizandra resulted in serologic and histologic improvements in people with HCV over a 30-week period. [cix] Changes seen in immune markers of people with hepatitis B virus (HBV) suggest that a schizandra-containing traditional Chinese herbal combination might reduce the immune injury to hepatocytes that is the hallmark of this disease. [cx] This same herbal formula reduced viral activity in HBV-infected rats and inhibited hepatocarcinoma cell proliferation in vitro. [cxi]
Extracts of schizandra have demonstrated anti-inflammatory effects by inhibiting COX-2, nitrous oxide (NO), and inflammatory prostaglandins and leukotrienes. [cxii] [cxiii] [cxiv] There is speculation that schizandra might prevent the dangerous side effects of some drugs: in vitro studies found that schizandra could protect cardiac muscle cells from damage due to the chemotherapeutic agent, adriamycin, [cxv] and renal cells from injury due to the antibiotic, gentamicin. [cxvi] In addition, schizandra increased sensitivity and improved efficacy of two chemotherapeutic agents, vincristine and doxorubicin, in cancer cells both in vitro and in mice. [cxvii]
Dandelion/Taraxacum officionale
This pervasive weed has been known to herbalists for centuries as a medicinal for treating inflammatory, edematous, urinary, and digestive difficulties. Extracts from dandelion have demonstrated diuretic, choleretic, anti-inflammatory, antioxidant, anticarcinogenic, analgesic, hypoglycemic, and anticoagulant properties. [cxviii] Its anti-inflammatory effects have been attributed to its ability to inhibit NO synthesis and COX-2, as well as the antioxidant activity of its phenolic compounds. [cxix] [cxx] [cxxi] [cxxii] Dandelion has been found to induce cytotoxicity in liver cancer cells in vitro, [cxxiii] and in preliminary animal research, dandelion extract was found to modulate phase I and phase II hepatic detoxifying enzymes. [cxxiv]
Turmeric/Curcuma longa
The root of this Asian plant is widely used as a culinary and medicinal herb. Turmeric’s yellow-orange constituent, curcumin, has received considerable attention for its strong anti-inflammatory and antioxidant actions, as well as the anti-HIV and anti-cancer properties it has demonstrated. [cxxv] [cxxvi] Curcumin has been found to increase the activity of SOD, CAT, and enzymes involved in glutathione restoration, protecting liver cells in animals and in vitro from toxic damage, [cxxvii] [cxxviii] [cxxix] [cxxx] [cxxxi] [cxxxii] [cxxxiii] [cxxxiv] cancerous change, [cxxxv] [cxxxvi] [cxxxvii] and ischemia-reperfusion injury. [cxxxviii] [cxxxix] Its ability to modulate the activity of hepatic detoxifying enzymes might further contribute to its anti-toxin and anti-cancer properties. [cxl] [cxli] [cxlii] [cxliii] Although researchers have primarily focused on curcumin, a crude extract of turmeric root demonstrated stronger immunomodulatory and antioxidant effects than purified curcumin in one animal study. [cxliv]
Animal and in vitro research point to a possible role for curcumin in preventing steatohepatitis (fatty liver) that can result from alcoholism, toxic damage, diabetes, obesity, and hyperlipidemia [cxlv] [cxlvi] and hepatic fibrosis that can result from chronic inflammation, toxic exposure, or biliary tract obstruction. [cxlvii] [cxlviii] [cxlix] [cl] [cli] [clii] [cliii] [cliv] [clv] Other evidence suggests that curcumin might stimulate liver regeneration. [clvi]
In human research, a turmeric-containing combination demonstrated anti-hepatotoxic effects in people taking medications to treat tuberculosis. [clvii] Turmeric also reduced symptoms in people with gall bladder disease, [clviii] irritable bowel syndrome, [clix] and in people with peptic ulcer disease [clx] in pilot studies, and curumin reduced the rate of recurrence and improved clinical measures in people with ulcerative colitis in a controlled trial. [clxi] Preliminary evidence suggests that turmeric might improve antioxidant status and slow disease progression in people with colon cancer, [clxii] and enhance the response to chemotherapy in people with chronic lymphocytic leukemia. [clxiii] In a trial that included 25 people with various types of high-risk and premalignant lesions who were treated with up to 8 grams per day of curcumin, only two developed frank malignancies, while 16 remained stable and seven had improvement or resolution of their lesions after three months. These findings point to a possible general chemopreventive effect for curcumin. [clxiv] The bioavailability of curcumin is limited by poor absorption, but absorption might be enhanced by the presence of phospholipids such as phosphatidylcholine. [clxv] [clxvi]
Milk Thistle/Silybum marianum
Milk thistle is a well-known medicinal used to prevent and treat toxic liver damage and liver diseases for centuries, and recent research suggests that it also has anti-cancer, anti-diabetic, and cardioprotective effects. [clxvii] Many researchers have shown that milk thistle and some of its constituents have both antioxidant and anti-inflammatory activities [clxviii] [clxix] [clxx] [clxxi] [clxxii] [clxxiii] [clxxiv] [clxxv] [clxxvi] [clxxvii] and its ability to prevent cholestasis, protect liver cells and reverse toxic damage has been demonstrated in a number of animal and in vitro studies. [clxxviii] [clxxix] [clxxx] [clxxxi] [clxxxii] [clxxxiii]
Milk thistle has demonstrated antiviral activity against the hepatitis C virus (HCV) in vitro [clxxxiv] and in a pilot trial in which 20 people with HCV were treated with high doses of intravenous silibinin (a milk thistle constituent). [clxxxv] Oral dosing of milk thistle extract, however, has not yet been shown to improve disease markers in people with HCV. [clxxxvi] [clxxxvii] Milk thistle’s iron-chelating effect is one mechanism by which it might benefit people with HCV, as high iron levels are associated with advanced fibrosis and increased risk of hepatic cancer in people with HCV. [clxxxviii] [clxxxix]
Milk thistle appears to be effective in treating chronic liver diseases in addition to HCV. In people with non-alcoholic fatty liver disease, treatment with a milk thistle extract conjugated with vitamin E and phospholipids led to improvements in liver parameters. [cxc] In a controlled trial including 170 people with cirrhosis of the liver, treatment with a milk thistle extract was associated with a higher 4-year survival rate. [cxci]
There is strong preliminary evidence for milk thistle's hepatoprotective and anticarcinogenic effects, including inhibition of cancer cell growth in human liver, laryngeal, bladder, lung, prostate, skin, breast, and cervical cells. [cxcii] [cxciii] [cxciv] [cxcv] [cxcvi] Its role as an adjunctive cancer treatment for preventing the toxic side effects of chemotherapeutic agents has been proposed, [cxcvii] [cxcviii] and findings from in vitro research suggest that milk thistle might have synergistic anti-cancer effects with conventional cytotoxic agents. [cxcix] [cc]
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