Complementary and Integrative Medicine

Nonalcoholic steatohepatitis, or NASH, is a liver condition where fat buildup in the liver leads to inflammation and liver damage. While conventional medical treatments are available, many people also look into complementary and integrative options to support their health.

Research is growing about which of these options are helpful for liver health. Here are some promising methods that may help manage NASH.

Coffee

Studies suggest that drinking coffee can reduce liver inflammation and prevent liver damage from getting worse. The antioxidants and compounds found in coffee help protect liver cells from damage.¹

For those with NASH, drinking 2 to 4 cups of drip coffee – black, with no added cream or sugar – per day may improve liver function. Many studies have found that coffee is linked to:¹

• Reduced fat buildup in the liver
• Slowed progression of fibrosis (liver scarring)
• Less frequent cirrhosis (severe, permanent scarring of the liver)
• Decreased risk of liver cancer
• Lower overall liver-associated deaths

Interestingly, espresso and Turkish coffee do not have the same liver benefits as drip coffee. And neither does decaffeinated coffee.¹

Vitamin E

Vitamin E is a powerful antioxidant. It helps reduce oxidative stress, which is a major factor in liver damage. Getting enough vitamin E may reduce the risk of fatty liver disease and reduce liver inflammation. Eating more foods rich in vitamin E is especially helpful for people without high cholesterol.²

You can get more vitamin E through your diet or by taking supplements. But vitamin E supplements may not be suitable for everyone. Check with your doctor before taking vitamin E supplements because increased vitamin E intake is also associated with prostate cancer and may increase your likelihood of other health complications.

Herbs

Several herbs have shown promise in supporting liver health and managing NASH symptoms. Indigenous people around the world have used herbs to treat various illnesses for thousands of years. Here are a few that may show promise for NASH:^1,3,4

• Milk thistle – This herb contains silymarin, a compound known for its liver-protective properties. Silymarin helps reduce liver inflammation. It also helps liver cells regenerate.
• Berberine – This is a compound found in several plants. It has anti-inflammatory and antioxidant effects. It shows promise in managing NASH by reducing fat in the liver, reducing obesity, and improving how the body processes insulin.
• Turmeric – Curcumin is an ingredient in turmeric. It has potent anti-inflammatory and antioxidant effects. Adding turmeric to your diet or taking curcumin supplements may help reduce liver inflammation.
• Green tea – Rich in antioxidants, green tea can help reduce liver fat and improve liver function. Drinking a few cups of green tea daily or taking green tea extract supplements may benefit liver health.

Traditional Chinese medicine

Traditional Chinese medicine (TCM) offers a holistic approach to managing NASH. It focuses on restoring balance and harmony in the body. More research is needed to prove any direct benefits of TCM for NASH. But here are a few TCM practices that may support liver health.^3,5

Herbal remedies

TCM uses a variety of herbal formulations to support liver function. These are combinations of herbs. They are made to:^3,5

• Support different organ functions
• Improve blood flow
• Reduce stagnation in the body

For example, the herbs in Xiao Yao San powder are believed to detoxify the liver and help with inflammation.⁵

Acupuncture

This is an ancient practice that involves inserting thin needles into specific points on the body. The needles stimulate energy flow and promote healing. Acupuncture may help:⁵

• Reduce fat buildup in the liver
• Reduce liver inflammation
• Improve how the liver metabolizes fat
• Improve overall liver function

Diet and nutrition

The TCM diet, Yao-Shan, emphasizes using food as medicine to promote health. It is an ancient way of nourishing the body. It has been used to benefit people with health conditions like diabetes.⁶

For NASH, Yao-Shan focuses on leafy greens, bitter vegetables, and whole grains. These foods support liver function and reduce inflammation. TCM practitioners also recommend avoiding foods that are difficult for the liver to process. These include fatty, greasy, and processed foods.⁶

Things to know about supplements and vitamins

Supplements are not regulated by the US Food and Drug Administration (FDA) the same way other drugs are. This means that no outside agency confirms the ingredients or suggested dose.^7,8

For example, a fish oil supplement may have more or less fish oil than listed on the label. A supplement may also contain ingredients that are not labeled correctly or at all. This can be dangerous. It can lead to taking too much or taking unwanted ingredients, some of which can cause liver damage.^7,8

The FDA created good manufacturing practices (GMPs) to help this situation. GMPs are guidelines for companies to follow when making supplements. But the FDA rarely inspects facilities making supplements in the United States. Companies outside the United States do not have these inspections at all.^7,8

Many more supplements are sold than are tested. Your doctor can help you decide if a supplement is safe.

Talk to your doctor

When combined with other treatments, complementary and integrative medicine can help manage NASH. Always talk with your healthcare provider before starting any new supplement or therapy.