Condition
Alcoholic Hepatitis
Alcoholic hepatitis is severe liver inflammation caused by heavy drinking, which can bring jaundice, belly pain and fever. Among supplements, research is thin: Japanese raisin tree extract lowered liver enzymes in small trials, though the evidence is limited, while resveratrol showed no clear difference in bilirubin. Those enzyme findings came mostly from animal studies and people with fatty liver or hangovers, not alcoholic hepatitis itself.
Sources: PMID 26032587; PMID 32655267
- Supplements studied
- 4
- Graded outcomes
- 4
- People studied
- 1,278
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Hepatoprotection One human RCT (n=60 NAFLD patients) demonstrated significant liver-protective effects of DHM including reduced hepatic inflammation markers (cytokeratin-18, TNF-alpha) and improved insulin resistance. Multiple robust animal studies show hepatoprotection across alcohol-induced, high-fat diet, and acetaminophen-induced liver injury models via Nrf2/HO-1 antioxidant pathway activation, CYP2E1 inhibition, and enhanced antioxidant enzyme activity (SOD, GSH-Px). | Improves (the measure goes up) | Moderate effect | 8 studies | 60 people | ||
Studies that measured hepatoprotection | ||||||
| Liver Enzyme Levels A randomized double-blind RCT in 60 NAFLD patients found DHM (300mg/day for 3 months) significantly reduced ALT, AST, and gamma-GT versus placebo (Chen et al. 2015). A crossover hangover trial (n=26) also showed significant ALT/AST improvements with Hovenia dulcis extract. Multiple animal studies confirm reductions in liver transaminases across alcoholic and acetaminophen-induced liver injury models. | Improves (the measure goes up) | Moderate effect | 5 studies | 86 people | ||
Studies that measured liver enzyme levels
| ||||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Alcohol-Induced Liver Damage In rats, hederagenin supplementation (50 mg/kg/day for 21 days) decreased serum AST, ALT, triglycerides, TNF-α, and IL-6 following chronic ethanol exposure, while reducing hepatic apoptosis markers. However, an earlier mouse study found hederagenin did NOT protect against CCl4- or acetaminophen-induced hepatotoxicity, indicating the hepatoprotective effect may be specific to alcohol-induced injury. | Improves (the measure goes down) | Small effect | 2 studies | |||
Studies that measured alcohol-induced liver damage | ||||||
Resveratrol
- Bilirubin
- Liver Enzymes: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Bilirubin No effect | NoneNo effect | 208 people | ||||
| Liver Enzymes | Changes; see studies | 2 studies | 714 people | |||
Studies that measured liver enzymes | ||||||
Silymarin
- Liver Enzymes: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Liver Enzymes | Changes; see studies | 6 studies | 564 people | |||
Studies that measured liver enzymes
| ||||||
Key findings
- HepatoprotectionImproves (the measure goes up)
- Liver Enzyme LevelsImproves (the measure goes up)
- Alcohol-Induced Liver DamageImproves (the measure goes down)
The Alcoholic Hepatitis Supportive Care protocol
2 primary supplements · 6 supporting supplements
- Milk Thistle (Silymarin)420–600 mg silymarin daily in divided doses
- N-Acetyl Cysteine (NAC)600–1,200 mg twice daily
Studies cited
19 studies from PubMed
- Hovenia dulcis: a Chinese medicine that plays an essential role in alcohol-associated liver disease
- Dihydromyricetin supplementation improves ethanol-induced lipid accumulation and inflammation
- Hepatoprotective effects of Hovenia dulcis seeds against alcoholic liver injury and related mechanisms investigated via network pharmacology
- Dihydromyricetin Protects the Liver via Changes in Lipid Metabolism and Enhanced Ethanol Metabolism
- Dihydromyricetin Ameliorates Nonalcoholic Fatty Liver Disease by Improving Mitochondrial Respiratory Capacity and Redox Homeostasis Through Modulation of SIRT3 Signaling
- Protective effects and possible molecular mechanism of Hovenia dulcis Thunb. extract on acetaminophen-induced hepatotoxicity
- A standardized extract of the fruit of Hovenia dulcis alleviated alcohol-induced hangover in healthy subjects with heterozygous ALDH2: A randomized, controlled, crossover trial
- Hederagenin Supplementation Alleviates the Pro-Inflammatory and Apoptotic Response to Alcohol in Rats
- Dihydromyricetin improves glucose and lipid metabolism and exerts anti-inflammatory effects in nonalcoholic fatty liver disease: A randomized controlled trial
- Preliminary characterization, antioxidant activity in vitro and hepatoprotective effect on acute alcohol-induced liver injury in mice of polysaccharides from the peduncles of Hovenia dulcis
- The effects of 10 triterpenoid compounds on experimental liver injury in mice
- Effects and tolerance of silymarin (milk thistle) in chronic hepatitis C virus infection patients: a meta-analysis of randomized controlled trials.
- An updated systematic review with meta-analysis for the clinical evidence of silymarin.
- Effect of Medicinal Plants and Natural Products on Liver Enzymes in Non-alcoholic Fatty Liver Patients in Iran: A Systematic Review and Meta-Analysis.
- The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials
- Impact of Silymarin in individuals with nonalcoholic fatty liver disease: A systematic review and meta-analysis
- Effect of silymarin on biochemical indicators in patients with liver disease: Systematic review with meta-analysis.
- Efficacy of resveratrol supplementation on liver enzymes in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis
- Effects of resveratrol supplementation on liver enzymes: A systematic review and meta-analysis of randomised controlled trials.