Index of Herbs

Concern guide

Herbs for Liver Health

Herbs traditionally used for liver health, from milk thistle to dandelion, what research shows, and which herbs to avoid.

5 herbs reviewed

Updated October 7, 2026

Your liver works quietly around the clock, processing nutrients, making bile to digest fats, storing energy and clearing alcohol, medicines and other substances from the blood. The most common liver problems today are fatty liver disease, which is linked to carrying extra weight and type 2 diabetes, alcohol-related liver disease, and viral hepatitis B and C. Most types cause no symptoms in the early stages, which is why blood tests and check-ups matter; by the time symptoms appear, the liver may already be scarred, a stage called cirrhosis.

Herbs have a long history as companions for the liver and digestion, and milk thistle in particular has been used for centuries and studied for decades. The steps that protect the liver most are not herbal, though: limiting or stopping alcohol, reaching a healthy weight, staying active, managing diabetes and cholesterol, getting vaccinated against hepatitis A and B, and treating hepatitis C, which modern antiviral medicines can now clear in most people. No herb reverses alcohol damage or replaces treatment for hepatitis, fatty liver disease or cirrhosis, but a well-chosen herb can sit alongside that care with your doctor’s knowledge. Just as important, some herbs and supplements can injure the liver, and the safety section explains which ones.

The list is ordered by strength of evidence for the liver, then by how commonly each herb is used. Ratings run from good clinical evidence to long traditional use, and for liver health the best-supported herbs currently sit at mixed, meaning trials are early, small or conflicting. Liver research is especially demanding, because the outcomes that matter most, such as scarring, liver failure and survival, take years to measure, so many studies track liver enzymes instead. Every herb links to its full monograph, and the safety section gathers the herbs and supplements that can harm the liver.

02 The shortlist

The herbs, from best studied to time-honored

How to read the ratings

  • Good clinical evidence
  • Promising clinical evidence
  • Early or mixed evidence
  • Long traditional use

Ratings show how much research backs each herb for this particular concern. Every herb links to its full monograph, with preparations, safety notes, and sources.

  1. 01 Milk Thistle

    Early or mixed evidence

    Silybum marianum

    Milk thistle is the classic liver herb, used for centuries and the most studied, and EMA accepts it as a traditional remedy to support liver function once a doctor has ruled out serious disease. Its most encouraging finding comes from a 48-week trial in 99 people with fatty liver inflammation (NASH), where fibrosis improved in 22% on silymarin versus 6% on placebo. Results overall are mixed, as a Cochrane review and two US trials found no clear benefit on their main outcomes. It is well tolerated; avoid it with ragweed-family allergy.

    Read the milk thistle monograph →

  2. 02 Black Seed

    Early or mixed evidence

    Nigella sativa

    Black seed (Nigella sativa) is a revered remedy in Islamic and South Asian traditional medicine, and MSKCC lists small trials suggesting benefit in fatty liver disease. Pooled trials also show modest falls in blood sugar, cholesterol and weight, the same metabolic picture that drives fatty liver. Trials are still small and short, so larger studies would help. Black seed can interact with diabetes drugs, warfarin and cyclosporine, and a rare case report linked black seed oil taken by mouth to liver, kidney and muscle injury.

    Read the black seed monograph →

  3. 03 Dandelion

    Long traditional use

    Taraxacum officinale

    Dandelion is a familiar bitter whose leaves and roasted root have long been used across Europe and Asia, and EMA accepts dandelion root as a traditional remedy for mild digestive complaints such as fullness and slow digestion, and for temporary loss of appetite. Its reputation as a liver herb comes from bitters traditionally thought to stimulate bile flow, an idea still awaiting human trials. It is best enjoyed as a gentle digestive tea rather than a treatment for liver disease. Avoid it with daisy-family allergy, bile-duct obstruction or complicated gallstones.

    Read the dandelion monograph →

  4. 04 Burdock

    Long traditional use

    Arctium lappa

    Burdock root is a Japanese vegetable (gobo) and a traditional European herbal medicine, and it appears in many liver blends. Laboratory and animal studies suggest liver-protective effects, but human liver trials are still to come, and EMA’s traditional uses are for appetite, minor urinary complaints and seborrheic skin rather than the liver. Choose a single-herb, identity-tested root: a multi-herb liver cleanse tea containing burdock was linked to acute liver injury, and a contaminated “burdock” tea once caused atropine poisoning. Avoid it with daisy-family allergy.

    Read the burdock monograph →

  5. 05 Licorice

    Long traditional use

    Glycyrrhiza glabra

    Licorice root has a long history in Asian and European medicine, and in Japan an injectable glycyrrhizin medicine has been used for decades under medical supervision for chronic hepatitis. That prescription injection is not comparable to licorice supplements or teas taken by mouth. The key caution matters especially here: sustained glycyrrhizin raises blood pressure and lowers potassium, and it is contraindicated in cirrhosis with portal hypertension, severe liver impairment, heart or kidney disease and pregnancy. Deglycyrrhizinated licorice (DGL) avoids most of these effects.

    Read the licorice monograph →

03 Caution

Using these herbs safely

Most liver herbs are well tolerated, and a few precautions help keep them that way. Liver trouble needs prompt medical care, not a stronger tea. See a doctor quickly for yellowing of the skin or the whites of the eyes (jaundice), dark urine, pale or clay-colored stools, itching without a rash, pain or discomfort in the upper right side of the abdomen, swelling of the abdomen, legs or ankles, easy bruising, or unusual tiredness with nausea and poor appetite. Vomiting blood, black stools, confusion or extreme drowsiness need emergency care. If any of these appear while you are taking a herb or supplement, stop it, keep the bottle and tell your doctor, because herb-related liver injury usually improves when the product is stopped early. Suspected mushroom poisoning is an emergency: call poison control (1-800-222-1222 in the US) or emergency services right away, even before symptoms start.

Some herbs and supplements can harm the liver, and herb-induced liver injury is a recognized cause of hepatitis and, rarely, liver failure. Ashwagandha is rated a likely cause of liver injury, usually jaundice two to twelve weeks after starting, rarely leading to liver failure or transplant. Kava has been linked to rare but severe liver injury, including liver failure and transplants, and black cohosh has been implicated in many cases of acute liver injury, some needing emergency transplant. Liver damage has been reported with turmeric and curcumin supplements, especially enhanced-absorption formulas, and concentrated green tea extract capsules (unlike green tea as a drink) have caused liver injury, particularly in people with a common gene variant. Comfrey must never be taken by mouth, because its pyrrolizidine alkaloids block the small veins of the liver; it is for short-term use on unbroken skin only. Gotu kola, high-coumarin cassia cinnamon supplements and, more rarely, valerian, horse chestnut, echinacea and saw palmetto also have liver injury reports, and multi-ingredient “liver cleanse” blends add to the uncertainty.

People who already have liver disease face higher risks and should talk with their liver specialist before taking any herb. Ashwagandha liver injury has rarely been fatal, especially in people with cirrhosis, and kava should be avoided entirely with liver disease or heavy drinking. Glycyrrhizin-containing licorice is contraindicated in cirrhosis with portal hypertension, peppermint oil capsules are not advised with liver disease or bile-duct problems, turmeric and dandelion should not be used with bile-duct obstruction, and black seed should be used only with a doctor’s knowledge. A diseased liver also clears medicines more slowly, which makes interactions more likely. Milk thistle has case reports of interactions with sirolimus, warfarin (through a liver cleanse product) and several antipsychotics; black seed slowed drug-metabolizing enzymes in a small human study, may raise warfarin levels and lowered cyclosporine in animals; licorice is dangerous with diuretics, digoxin and corticosteroids; dandelion and burdock can add to diuretics and diabetes medicines; and hepatitis has been reported when cinnamon or black cohosh was taken with a statin. Never stop or change prescribed hepatitis, liver or transplant medicines in favor of a herb.

Pregnancy and breastfeeding: EMA does not recommend milk thistle or burdock because safety has not been established, glycyrrhizin-containing licorice should be avoided, and medicinal doses of dandelion and black seed are best avoided unless a clinician agrees. EMA does not recommend milk thistle or burdock under age 18, and children should not be given liver herbs or cleanse products. Product quality matters a great deal: testing of milk thistle supplements found silymarin content far from label claims and contamination with mold toxins, pesticides and microbes, and a commercial “burdock” tea once caused atropine poisoning, probably from contamination with belladonna. Choose single-herb products that name the plant part, the extract and its standardized content, ideally with independent quality certification, and skip unlabeled multi-herb liver cleanses.

04 Questions

Frequently Asked Questions

Milk thistle is the most studied liver herb, and EMA accepts it as a traditional remedy to support liver function once a doctor has ruled out serious disease. Its most encouraging result is a 48-week trial in people with NASH in which more people on silymarin saw their liver scarring improve, though other trials, including two funded by NCCIH, found no clear benefit on their main outcomes. Dandelion root is a gentle traditional digestive bitter. The proven liver protectors are limiting alcohol, a healthy weight, hepatitis vaccination and treatment, and herbs can sit alongside them.

No herb has been shown to reverse liver damage. In fatty liver inflammation (NASH), one trial found that more people on milk thistle extract saw fibrosis improve, a promising signal that needs confirming, while two other trials missed their main goals. A Cochrane review of milk thistle in alcohol-related and viral liver disease found no effect on deaths or complications. For fatty liver, weight loss, activity and managing diabetes and cholesterol are the proven approach, with medicines for some people; for alcohol-related damage, stopping drinking is the most important step of all.

The best-documented risks are ashwagandha, rated a likely cause of liver injury; kava, linked to rare liver failure and transplants; black cohosh, implicated in many cases of acute liver injury; turmeric and curcumin supplements, especially enhanced-absorption formulas; concentrated green tea extract capsules; and comfrey taken by mouth, which should never be done. Gotu kola and high-coumarin cassia cinnamon supplements also have liver reports. Stop any supplement and see a doctor if you notice jaundice, dark urine, pale stools or itching.

Your liver clears waste from the body on its own, and there is no good evidence that cleanse products help it do so. Some have caused harm: a multi-herb liver cleanse tea containing burdock was linked to acute liver injury, and a cleanse supplement containing milk thistle raised the blood-thinning effect of warfarin. Blends also make it impossible to know which ingredient caused a problem. If you are worried about your liver, a simple blood test from your doctor is the place to start, and a single, clearly labeled herb is a safer choice than a multi-ingredient cleanse.

Only with your liver specialist’s agreement, because a diseased liver handles herbs and medicines less predictably. Milk thistle was well tolerated in trials of people with liver disease, even at high doses for 48 weeks, but it can interact with some medicines. Ashwagandha and kava should be avoided, and glycyrrhizin-containing licorice is contraindicated in cirrhosis with portal hypertension. Never stop or delay antiviral treatment for hepatitis or other prescribed care in favor of a herb, and report any new jaundice, swelling or confusion right away.

05 References

Sources

These references support the claims in this guide. Each herb’s monograph carries its own full source list.

  1. Milk Thistle: Usefulness and Safety

    National Center for Complementary and Integrative Health (NIH), 2025

    Federal summary noting conflicting or limited trial results in liver disease, negative NCCIH-funded hepatitis C and NASH trials, good tolerability, product contamination and ragweed-family allergy.

  2. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases

    Cochrane Database of Systematic Reviews (PubMed 17943794), 2007

    Eighteen trials with 1,088 patients showing no significant effect of milk thistle on mortality, complications or liver histology in alcohol-related and viral liver disease.

  3. A Randomized Trial of Silymarin for the Treatment of Nonalcoholic Steatohepatitis

    Clinical Gastroenterology and Hepatology (PubMed 28419855), 2017

    The 99-person, 48-week NASH trial that missed its primary end point but found fibrosis improved in 22.4% on silymarin versus 6.0% on placebo.

  4. Symptoms & Causes of Cirrhosis

    National Institute of Diabetes and Digestive and Kidney Diseases (NIH), 2023

    Source for the warning signs of liver disease on this page, including jaundice, dark urine, itching, upper right abdominal pain, swelling, easy bruising and confusion.

  5. Ashwagandha

    LiverTox, National Institute of Diabetes and Digestive and Kidney Diseases (NIH), 2024

    Rates ashwagandha a likely cause of clinically apparent liver injury, typically two to twelve weeks after starting, with rare liver failure or transplant, especially with existing liver disease.

  6. Kava: usefulness and safety

    National Center for Complementary and Integrative Health (NIH), 2025

    Supports the warning that kava has been linked to liver injury, including with water-prepared drinks.

  7. Turmeric

    National Center for Complementary and Integrative Health (NIH), 2025

    Reports liver damage in some people taking turmeric or curcumin supplements with enhanced bioavailability, and the symptoms that mean stopping right away.

  8. Green Tea

    National Center for Complementary and Integrative Health (NIH), 2025

    Notes uncommon liver injury, mainly with green tea extract tablets or capsules rather than the drink, with higher susceptibility in people carrying a specific gene variant.

Related guides

All guides →