Liver Cirrhosis And Supplements: The Dangerous Vs. The Beneficial

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Exploring the role of nutritional supplements in managing liver cirrhosis unveils a promising avenue for enhancing liver and overall health. While medical interventions are vital, integrating specific supplements into your diet can complement traditional treatments and support liver function. In this article, we delve into the science-backed benefits of incorporating certain nutritional supplements into the regimen of persons grappling with liver cirrhosis. From antioxidants to essential vitamins and minerals, understanding how these supplements can positively impact liver health is crucial for those navigating this challenging condition.

What Is Liver Cirrhosis?

Liver cirrhosis is a condition where healthy liver tissue gradually turns into scar tissue, slowly undermining the liver’s ability to function. This change typically unfolds quietly over many years, often without noticeable symptoms until the disease is well advanced. When signs do start to appear, they might include persistent fatigue, weakness, and unexplained weight loss. Other symptoms such as swelling in the abdomen from fluid buildup, yellowing of the skin and eyes, and a tendency to bruise or bleed easily can also emerge, signaling more severe damage.

The most common causes of liver cirrhosis are chronic alcohol abuse and infections from hepatitis B or C. However, other factors like non-alcoholic fatty liver disease, autoimmune hepatitis, and genetic conditions such as hemochromatosis and Wilson’s disease also play roles. Early detection and understanding of liver cirrhosis are critical for preventing serious damage and managing the disease effectively.

As the disease progresses, it can lead to complex health issues. For instance, toxins may build up in the brain, leading to confusion and mood swings, a condition known as hepatic encephalopathy. Another serious problem is portal hypertension, which happens when scar tissue blocks blood flow through the liver, causing blood to back up in other vessels. This can lead to enlarged veins in the esophagus and stomach that are prone to bleeding.

Managing liver cirrhosis involves tackling the root cause to slow its progress. Stopping alcohol use is essential in alcohol-related cirrhosis, while antiviral drugs might be needed for hepatitis-induced cirrhosis. Adapting a healthier lifestyle, including a balanced diet and regular check-ups, is vital. In severe cases, a liver transplant may be considered. Given the complexity of liver cirrhosis, staying proactive with treatment and regular medical care is key to maintaining a good quality of life.

What Food and Lifestyle Factors Are Important For Managing Liver Cirrhosis?

  • Maintain a Balanced Diet: Emphasize a diet rich in fruits, vegetables, whole grains, and lean proteins. Limit saturated fats, refined sugars, and processed foods, which can exacerbate liver inflammation and contribute to liver damage.
  • Control Portion Sizes: Monitoring portion sizes helps manage weight and reduces the strain on the liver. Opt for smaller, frequent meals to ease digestion and prevent overloading the liver.
  • Limit Sodium Intake: Restricting sodium helps alleviate fluid retention and swelling associated with cirrhosis-related complications like ascites. Choose fresh, unprocessed foods and avoid adding salt to meals.
  • Stay Hydrated: Adequate hydration is essential for liver function and overall health. Aim to drink plenty of water throughout the day, as dehydration can exacerbate liver damage and hinder toxin elimination.
  • Moderate Alcohol Consumption: Abstain from alcohol or limit intake to the recommended guidelines to prevent further liver damage. Even small amounts of alcohol can exacerbate cirrhosis and increase the risk of complications.
  • Monitor Medication Use: Consult with healthcare professionals before taking any over-the-counter medications, supplements, or herbal remedies, as they may interact with liver function or existing treatments.
  • Engage in Regular Exercise: Incorporate moderate physical activity into your routine to improve circulation, promote weight management, and enhance overall health.
  • Practice Safe Sex and Hygiene: Reduce the risk of hepatitis transmission by practicing safe sex and avoiding sharing personal items such as razors or toothbrushes. Vaccinations for hepatitis A and B are also recommended for persons with liver cirrhosis.
  • Manage Stress: Implement stress-reduction techniques such as mindfulness, meditation, or yoga to alleviate psychological stress, which can exacerbate liver inflammation and impact overall health.
  • Attend Regular Medical Check-ups: Stay proactive in monitoring liver health by attending regular medical appointments and undergoing recommended screenings. Early detection of complications allows for timely intervention and management of cirrhosis-related issues.

By integrating these food and lifestyle factors into daily life, people can empower themselves to better manage liver cirrhosis and improve quality of life. Consulting with healthcare professionals and adhering to personalized treatment plans are essential components of effective cirrhosis management.

Supplements To Avoid for Those with Liver Cirrhosis

People with liver cirrhosis should be extremely cautious when considering supplements, as certain supplements may easily worsen liver damage or interfere with liver function. Some supplements that should generally be avoided or used with caution in persons with liver cirrhosis include:

  • Iron: Excessive iron supplementation can be harmful to persons with liver cirrhosis, as it may contribute to iron overload and worsen liver damage.
  • High Doses of Vitamins A, D, E, and K: High doses of fat-soluble vitamins, such as vitamin A, D, E, and K, can possibly lead to toxicity and worsen liver damage in persons with cirrhosis.
    • Vitamin E: While vitamin E supplementation has been studied for its potential benefits in liver disease, high doses of vitamin E may increase the risk of bleeding in persons with cirrhosis, particularly those with advanced disease.
  • Niacin at High Doses: High doses of niacin can cause liver toxicity and may worsen liver function in persons with cirrhosis.
  • Herbal Supplements: Sourcing of herbal supplements is critical for people with liver disease to ensure that the supplements are free from contaminants, such as heavy metals or pesticides, which could worsen liver damage or interfere with liver function.
    • St. John’s Wort: St. John’s Wort is an herbal supplement commonly used for depression. However, it may interact with certain medications metabolized by the liver and could worsen liver function in persons with cirrhosis.
    • Kava: Kava supplements have been associated with liver toxicity and should be avoided in persons with liver cirrhosis.
    • Comfrey: Comfrey supplements have been linked to liver damage and should be avoided in persons with liver cirrhosis.
    • Skullcap: Skullcap supplements have been reported to cause liver toxicity and should be used with caution or avoided in persons with liver cirrhosis.
    • Saw Palmetto: Saw palmetto is often used for prostate health in men. While there isn’t strong evidence linking it directly to liver damage, persons with liver cirrhosis should use caution as some reports suggest it may have adverse effects on liver function.
    • Ginkgo Biloba: Ginkgo biloba is an herbal supplement used for cognitive function and memory enhancement. There have been rare reports of liver toxicity associated with ginkgo biloba use, so persons with liver cirrhosis should use it cautiously and under medical supervision.
    • Green Tea Extract: Green tea extract supplements, which contain high concentrations of catechins, may be harmful to the liver in person with cirrhosis, especially in large doses.
    • Excessive Protein Supplements: While moderate protein intake is generally recommended for persons with liver cirrhosis, excessive protein supplementation may strain the liver and worsen hepatic encephalopathy.
    • Cascara Sagrada: Cascara sagrada is an herbal laxative that may cause liver damage, particularly when used in high doses or for extended periods. Persons with liver cirrhosis should avoid using cascara sagrada without medical supervision.
    • Ephedra (Ma Huang): Ephedra is an herb used for weight loss and athletic performance enhancement. It contains ephedrine alkaloids, which can stress the liver and may worsen liver function in persons with cirrhosis.
    • Valerian Root: Valerian root is commonly used as a natural remedy for sleep disorders and anxiety. While it’s generally considered safe for most people, persons with liver cirrhosis should use caution as it may affect liver enzymes and could worsen liver function.
    • Black Cohosh: Black cohosh is a herbal supplement commonly used for menopausal symptoms. While it’s generally considered safe for most people, there have been rare reports of liver toxicity associated with its use, so persons with liver cirrhosis should use it cautiously and under medical supervision.
    • Licorice Root: Licorice root is used in traditional medicine for various purposes, including digestive issues and sore throat relief. However, it contains glycyrrhizin, which can cause potassium loss and fluid retention, possibly worsening complications of cirrhosis such as ascites and electrolyte imbalances.
    • Red Yeast Rice: Red yeast rice is a supplement used for cholesterol management. It contains compounds similar to statin drugs and may affect liver enzymes, so persons with liver cirrhosis should use it cautiously and under medical supervision.
    • Astragalus: Astragalus is an herb often used in traditional Chinese medicine for immune support and overall health. While it’s generally considered safe for most people, persons with liver cirrhosis should use it cautiously as it may interact with certain medications and affect liver function.
    • Chaparral: Chaparral is an herbal supplement sometimes used for its purported antioxidant and anti-inflammatory properties. However, it has been associated with cases of liver toxicity and should be avoided by persons with liver cirrhosis.
    • Pennyroyal: Pennyroyal is an herb that has been historically used for menstrual and digestive issues. However, it contains compounds that can be toxic to the liver and should be avoided by persons with liver cirrhosis.
    • Greater Celandine: Greater celandine is an herb used in traditional medicine for various purposes, including liver and gallbladder support. However, it has been associated with liver toxicity and should be used with caution, if at all, by persons with liver cirrhosis.
    • Lobelia: Lobelia is an herb sometimes used for respiratory and digestive issues. However, it contains alkaloids that can be toxic to the liver and should be avoided by persons with liver cirrhosis.
    • Yohimbe: Yohimbe is an herb often used for its purported aphrodisiac effects. However, it contains yohimbine, which can have stimulant effects and may affect liver function, particularly in persons with liver cirrhosis.
  • Creatine: Creatine supplements are metabolized in the liver and may worsen liver damage in persons with cirrhosis.
  • DHEA (Dehydroepiandrosterone): DHEA is a hormone supplement often promoted for its anti-aging effects. It can be metabolized by the liver and may affect liver function in persons with cirrhosis.

Dietary supplements are not designed to diagnose, treat, cure, or prevent any disease. This article aims to offer valuable insights into which nutritional supplements have undergone scientific study and shown promise in supporting specific health conditions. We break down the research, so you can work with your medical providers to make informed decisions about adding supplements to your health regimen. For personalized advice tailored to your needs, we recommend consulting with a registered dietitian in addition to your primary care provider.

Check with your physician when adding supplements. While supplements are generally safe for most people, do not add nutritional supplements without your physician’s specific approval if you are pregnant or nursing, are undergoing cancer treatment, have a history of organ transplant, liver or kidney disease, or take medications that interact with supplements.


Several nutritional supplements are recommended for persons with liver cirrhosis to support liver and overall health. These supplements may help address nutrient deficiencies, reduce inflammation, and support liver function. Here are some supplements that may be beneficial for persons with liver cirrhosis:

  • Milk Thistle (Silymarin): Milk thistle is a botanical supplement commonly used for liver support. Silymarin, the active compound in milk thistle, has antioxidant and anti-inflammatory properties that may help protect liver cells from damage and promote regeneration. It’s often recommended for persons with liver cirrhosis to support liver function. [PMC7140758]
  • Omega-3 Fatty Acids: Omega-3 fatty acids, found in fish oil supplements, have anti-inflammatory properties and may help reduce inflammation and fibrosis in the liver. [PMID: 31799687] But oxidized fish oil was found to be harmful. [PMC7468239] Be cautious because omega-3 is associated with bleeding risk.
  • N-acetylcysteine (NAC): NAC is a precursor to glutathione, a powerful antioxidant that plays a crucial role in liver detoxification. NAC supplementation may help increase glutathione levels, reduce oxidative stress, and support liver function in persons with cirrhosis. [PMID: 18622472]
  • Probiotics: Gut health is critical to liver health. Probiotics are beneficial bacteria that help maintain gut health and may have anti-inflammatory effects. Supplementing with probiotics may help improve gut microbiota balance, reduce gut-derived toxins, and support liver health in persons with cirrhosis. [PMC8473492]
  • Multivitamin:
    • Vitamin E: Vitamin E is an antioxidant that helps protect cells from oxidative damage. Supplementing with vitamin E may help reduce liver inflammation and improve liver function in persons with cirrhosis. However, high doses of vitamin E should be avoided due to the risk of bleeding.
    • Zinc: Zinc is an essential mineral that plays a role in immune function and wound healing. Persons with liver cirrhosis are at risk of zinc deficiency, which may contribute to impaired immune function and liver regeneration. Supplementing carefully with zinc may help improve liver function and reduce complications in persons with cirrhosis.
    • B-complex Vitamins: B vitamins, including B12, B6, and folate, are important for liver function and overall health. Supplementing with a B-complex vitamin may help address deficiencies and support energy metabolism and nervous system function in persons with cirrhosis.
    • Vitamin D: Vitamin D deficiency is common in persons with liver cirrhosis and may contribute to bone loss and other complications. Supplementing with vitamin D may help maintain bone health and support immune function in persons with cirrhosis.

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Are These Supplements Safe?

For those with liver cirrhosis, it’s important to assess the general safety of specific supplements, given their condition. Milk Thistle, Omega-3 fatty acids, N-acetylcysteine (NAC), probiotics, multivitamins, and protein supplements are safe for use. However, because liver function can be compromised in cirrhosis, it’s crucial for those affected to consult with healthcare providers before starting any new supplements. This ensures the supplements do not interfere with their overall treatment plan or exacerbate their condition.

Medication Interactions:

  • Anticoagulants (e.g., warfarin, heparin): Omega-3 fatty acids may increase the risk of bleeding due to their antiplatelet effects. Similarly, vitamin E, often found in multivitamins with Omega-3s, can also increase bleeding risks.
  • Antibiotics (e.g., amoxicillin, ciprofloxacin): Probiotics may be less effective when taken alongside antibiotics because the antibiotics can kill beneficial gut bacteria. Additionally, zinc can bind to certain antibiotics, reducing their absorption and effectiveness. It’s best to take zinc supplements at least 2 hours before or 4-6 hours after taking antibiotics.
  • Antidiabetic Drugs (e.g., metformin, insulin): Omega-3 fatty acids can influence blood glucose levels and may require adjustments in antidiabetic medication dosages to ensure blood sugar control. Monitoring by a healthcare provider is recommended to adjust therapy as necessary.
  • Immunosuppressants (e.g., cyclosporine, tacrolimus): Probiotics might theoretically increase the risk of infections, which is a concern when taking immunosuppressive medications. It’s advisable to consult with a healthcare provider before using probiotics in this context.

Supplement Interactions:

  • Milk Thistle (Silymarin): When taken concurrently with certain anticoagulant medications like warfarin, milk thistle may potentiate the anticoagulant effects, increasing the risk of bleeding complications.
  • Omega-3 Fatty Acids: Combining omega-3 fatty acid supplements with blood thinners or antiplatelet medications may enhance the blood-thinning effect, and could increase the risk of bleeding.
  • N-acetylcysteine (NAC): NAC supplementation may interact with nitroglycerin medications, causing blood pressure to drop excessively, leading to dizziness or fainting.
  • Probiotics: Probiotic supplements may enhance the absorption of certain antibiotics, and can reduce their effectiveness in treating bacterial infections.
  • Zinc: Zinc supplements may interfere with the absorption of antibiotics like tetracycline or fluoroquinolones, reducing their effectiveness in combating bacterial infections.
  • Vitamin D: High doses of vitamin D supplements may interact with certain corticosteroid medications, possibly increasing calcium levels in the blood and leading to hypercalcemia.
  • Protein Supplements: When taken with certain medications like levothyroxine for thyroid disorders, protein supplements may reduce the absorption of the medication, affecting thyroid hormone levels.

Food First!

Although this article discusses supplements in detail, don’t forget that we are absolutely committed to the “Food First” approach to nutrition. When it comes to your health, the totality of your eating habits far surpasses the impact of individual nutrients or any single supplement you consume. Even though this article doesn’t delve into the broader picture of your overall diet, it’s crucial to keep this element at the forefront of our minds. Your food needs to provide all the vitamins, minerals, fiber, and phytochemicals to nourish your body systems down to the cellular level.

Food choices, rather than supplements, are the most critical factors for a healthy gut microbiome. These trillions of tiny inhabitants in your gut affect your brain waves; they orchestrate your immune system. They possess the power to create molecules that can switch genes on or off and are even capable of synthesizing neurotransmitters. Opting for organic foods and steering clear of plastic packaging (including those labeled BPA-free) is a smart move to limit toxin exposure. The sum of all these parts leads to a powerful conclusion: the ultimate key to your health lies in the quality and balance of the food you consume. Supplements are secondary.

To Sum It Up

Nutritional supplements offer valuable support in managing liver cirrhosis, providing a complementary approach to conventional treatments. From antioxidants like milk thistle to essential nutrients such as omega-3 fatty acids and protein supplements, these interventions have shown promise in promoting liver health, reducing inflammation, and alleviating cirrhosis-related complications. However, it’s essential to approach supplementation with caution and under the guidance of healthcare professionals, as interactions with medications and individual variability may impact e and safety. Also, while nutritional supplements can be beneficial, they can’t replace a balanced diet or prescribed medical treatments.

This Article is Not a Substitute for Medical Advice

Dietary supplements are not designed to diagnose, treat, cure, or prevent any disease. The Supplement Sciences website seeks to provide comprehensive access to the most relevant supplement information along with convenient online ordering. We do not provide medical advice and cannot guarantee that every product suggested is completely without risk. Since each person is unique in their health history and medication use, it is important to discuss supplements with your personal physician. Specifically, pregnant women and individuals being treated for cancer or liver or kidney problems must consult their physician about every nutritional supplement they plan to take. People taking medications for the treatment of HIV or with a history of organ transplant must not take supplements without consulting with their physician.

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