Condition
Alcohol Use Disorder
Alcohol use disorder is a medical condition where people can't stop or control drinking despite harm, while long-term alcohol use damages the liver and brain and depletes nutrients. B vitamins and NAC have the strongest evidence ratings among supplements, and a small trial found acetyl-L-carnitine improved alcohol dependence symptoms. That carnitine result came from one pilot study of 64 people, so the evidence is limited.
Sources: PMID 20595193
- Supplements studied
- 5
- Graded outcomes
- 8
- Trials
- 4
- People studied
- 211
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Alcohol Level Reduction In small human crossover trials, Hovenia dulcis extract combinations significantly reduced blood alcohol concentrations at early timepoints (0.25h and 0.5h) and blood acetaldehyde levels at 6h post-drinking. Animal studies in rats and mice show enhanced ADH and ALDH enzyme activity, though one study (Mahesh et al. 2021) found DHM did not impact ADH activity, suggesting the mechanism may be more complex. | Changes; see studies | Small effect | 4 studies | 51 people | ||
Studies that measured blood alcohol level reduction | ||||||
| Hangover Symptom Reduction In small randomized crossover trials (n=26 and n=25), Hovenia dulcis extract significantly reduced hangover symptom scores, gastrointestinal symptoms, and improved inflammatory markers (IL-6, IL-10) compared to placebo. However, one double-blind placebo-controlled trial (Verster et al. 2021) found DHM did not significantly reduce overall hangover severity, indicating mixed results. | Improves (the measure goes down) | Moderate effect | 3 studies | 76 people | ||
Studies that measured hangover symptom reduction
| ||||||
| Anti-Alcohol Intoxication Effects In a landmark rat study (Shen et al. 2012), DHM (1 mg/kg i.p.) counteracted acute alcohol intoxication, withdrawal signs, tolerance, increased anxiety, and seizure susceptibility. DHM antagonized alcohol-induced potentiation of GABA-A receptors and inhibited benzodiazepine-site binding. These intoxication-reducing effects have not yet been directly replicated in human trials. | Changes; see studies | Moderate effect | 2 studies | |||
Studies that measured anti-alcohol intoxication effects | ||||||
| Voluntary Alcohol Consumption In rodent models, DHM greatly reduced voluntary alcohol consumption in rats through GABA-A receptor modulation (Shen et al. 2012). This effect has not been studied in human trials and remains purely preclinical. | Improves (the measure goes down) | Moderate effect | 1 study | |||
Studies that measured voluntary alcohol consumption | ||||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Alcohol Dependence Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 1 study | 64 people | ||
Studies that measured alcohol dependence symptoms | ||||||
| Subjective Well-Being | Improves (the measure goes up) | 2 studies | 64 people | |||
Yohimbine
- Alcohol Dependence Symptoms: worsens
- Cortisol: changes; see studies
- Anxiety Symptoms: worsens
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Alcohol Dependence Symptoms ADVERSE: Small worsening of symptoms | Worsens (the measure goes up) | Small effect | 35 people | |||
| Cortisol | Changes; see studies | 1 study | 35 people | |||
| Anxiety Symptoms | Worsens (the measure goes up) | 35 people | ||||
Curcumin
- Anti-Oxidant Enzyme Profile: improves
- Oxidative Stress Biomarkers: improves
- Liver Enzymes: changes; see studies
L-Cysteine
- Alcohol-Induced Oxidative Damage: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Alcohol-Induced Oxidative Damage In rodent models, L-cysteine (often combined with ascorbate and L-methionine) reduced alcohol-induced oxidative stress in the brain, stomach, testes, ovary, kidney, and lung of chronically alcohol-treated rats. | Improves (the measure goes down) | Moderate effect | 3 studies | |||
Studies that measured alcohol-induced oxidative damage
| ||||||
Key findings
- Blood Alcohol Level ReductionChanges; see studies
- Hangover Symptom ReductionImproves (the measure goes down)
- Alcohol Dependence SymptomsImproves (the measure goes down)
Safety notes in the studies
- ADVERSE: Small worsening of symptoms
The Alcohol Use Disorder Recovery Support protocol
2 primary supplements · 7 supporting supplements
- N-Acetyl Cysteine (NAC)1,200–2,400 mg daily in divided doses
- B Vitamins (High-Dose Complex)B-complex with thiamine 100 mg, B6 50 mg, B12 1,000 mcg, folate 800 mcg daily
Studies cited
100 studies from PubMed
- Effect of curcumin on inflammatory markers and disease activity in patients with rheumatoid arthritis: A meta-analysis.
- The Effect of Antioxidant Polyphenol Supplementation on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis.
- The Effectiveness of Curcumin, Resveratrol, and Silymarin on MASLD: A Systematic Review and Meta-Analysis.
- Clinical Evaluation of Hovenia dulcis Extract Combinations for Effective Hangover Relief in Humans
- Efficacy of Hovenia dulcis Fruit Extract in Hangover Mitigation: Double-Blind Randomized Clinical Evaluation
- Effects of Hovenia dulcis fruit and peduncle extract on alcohol metabolism
- Hovenia dulcis: a Chinese medicine that plays an essential role in alcohol-associated liver disease
- Dihydromyricetin supplementation improves ethanol-induced lipid accumulation and inflammation
- Mechanism of Dihydromyricetin on Inflammatory Diseases
- Does Dihydromyricetin Impact on Alcohol Metabolism
- Dihydromyricetin Protects the Liver via Changes in Lipid Metabolism and Enhanced Ethanol Metabolism
- Hepatoprotective effects of Hovenia dulcis seeds against alcoholic liver injury and related mechanisms investigated via network pharmacology
- Dihydromyricetin Ameliorates Nonalcoholic Fatty Liver Disease by Improving Mitochondrial Respiratory Capacity and Redox Homeostasis Through Modulation of SIRT3 Signaling
- Curcumin alleviates postprandial glycaemic response in healthy subjects: A cross-over, randomized controlled study
- Substantial Variability Across Individuals in the Vascular and Nutrigenomic Response to an Acute Intake of Curcumin: A Randomized Controlled Trial
- Protective effects and possible molecular mechanism of Hovenia dulcis Thunb. extract on acetaminophen-induced hepatotoxicity
- Curcumin supplementation improves vascular endothelial function in healthy middle-aged and older adults by increasing nitric oxide bioavailability and reducing oxidative stress
- A standardized extract of the fruit of Hovenia dulcis alleviated alcohol-induced hangover in healthy subjects with heterozygous ALDH2: A randomized, controlled, crossover trial
- Novel Form of Curcumin Improves Endothelial Function in Young, Healthy Individuals: A Double-Blind Placebo Controlled Study
- Dihydromyricetin improves glucose and lipid metabolism and exerts anti-inflammatory effects in nonalcoholic fatty liver disease: A randomized controlled trial
- Dihydromyricetin As a Novel Anti-Alcohol Intoxication Medication
- 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
- Effect of different curcuminoid supplement dosages on total in vivo antioxidant capacity and cholesterol levels of healthy human subjects
- Effects of Curcuma longa (turmeric) on postprandial plasma glucose and insulin in healthy subjects
- Combined inhibitory effects of soy isoflavones and curcumin on the production of prostate-specific antigen
- Effect of NCB-02, atorvastatin and placebo on endothelial function, oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus: a randomized, parallel-group, placebo-controlled, 8-week study
- Protective effects of cysteine, methionine and vitamin C on the stomach in chronically alcohol treated rats.
- L-cysteine supplementation prevents exercise-induced alterations in human erythrocyte membrane acetylcholinesterase and Na+,K+-ATPase activities.
- Chili, but not turmeric, inhibits iron absorption in young women from an iron-fortified composite meal
- The beneficial effect of L-cysteine supplementation on DNA oxidation induced by forced training.
- L-cysteine supplementation protects the erythrocyte glucose-6-phosphate dehydrogenase activity from reduction induced by forced training.
- Does ascorbate/L-Cys/L-Met mixture protect different parts of the rat brain against chronic alcohol toxicity?
- Alcohol-induced oxidative stress and reduction in oxidation by ascorbate/L-cys/L-met in the testis, ovary, kidney, and lung of rat.
- Effect of simultaneous administration of vitamin C, L-cysteine and vitamin E on the melanogenesis.
- Transsulfuration, protein synthesis rate and follicle mRNA in the skin of young Merino lambs in response to infusions of methionine and serine.
- L-carnitine ameliorated fasting-induced fatigue, hunger, and metabolic abnormalities in patients with metabolic syndrome: a randomized controlled study
- L-Carnitine's Effect on the Biomarkers of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy
- Comparative study to evaluate the effect of l-carnitine plus glimepiride versus glimepiride alone on insulin resistance in type 2 diabetic patients
- Effects of simvastatin and carnitine versus simvastatin on lipoprotein(a) and apoprotein(a) in type 2 diabetes mellitus
- Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients
- Effects of combination of sibutramine and L-carnitine compared with sibutramine monotherapy on inflammatory parameters in diabetic patients
- L-Carnitine supplementation reduces oxidized LDL cholesterol in patients with diabetes
- Effect of L-carnitine on plasma glycemic and lipidemic profile in patients with type II diabetes mellitus
- Effect of carnitine-orotate complex on glucose metabolism and fatty liver: a double-blind, placebo-controlled study
- Efficacy and tolerability of combined treatment with L-carnitine and simvastatin in lowering lipoprotein(a) serum levels in patients with type 2 diabetes mellitus
- Blood Pressure and Metabolic Effects of Acetyl-l-Carnitine in Type 2 Diabetes: DIABASI Randomized Controlled Trial
- The effects of oral L-carnitine treatment on blood lipid metabolism and the body fat content in the diabetic patient
- The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus
- The effects of L-carnitine supplementation on cardiovascular risk factors in participants with impaired glucose tolerance and diabetes: a systematic review and dose-response meta-analysis.
- Effects of acetyl-L-carnitine and methylcobalamin for diabetic peripheral neuropathy: A multicenter, randomized, double-blind, controlled trial
- Effect of oral L-carnitine administration on insulin sensitivity and lipid profile in type 2 diabetes mellitus patients
- The effects of L-carnitine supplementation on glycemic markers in adults: A systematic review and dose-response meta-analysis.
- L-carnitine improves glucose disposal in type 2 diabetic patients
- Caloric restriction and L-carnitine administration improves insulin sensitivity in patients with impaired glucose metabolism
- Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes
- Acetyl-l-carnitine versus placebo for migraine prophylaxis: A randomized, triple-blind, crossover study
- The effects of magnesium, L-carnitine, and concurrent magnesium-L-carnitine supplementation in migraine prophylaxis
- Effects of carnitine on glucose and lipid metabolic profiles and fertility outcomes in women with polycystic ovary syndrome: A systematic review and meta-analysis.
- Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial
- Effects of Carnitine Administration on Carotid Intima-media Thickness and Inflammatory Factors in Patients with Polycystic Ovary Syndrome: A Randomized, Double-blind, Placebo-controlled Trial
- Effects of L-carnitine supplementation for women with polycystic ovary syndrome: a systematic review and meta-analysis
- Effect of glycine propionyl-L-carnitine on aerobic and anaerobic exercise performance
- Influence of L-carnitine administration on maximal physical exercise
- Effects of nine weeks L-Carnitine supplementation on exercise performance, anaerobic power, and exercise-induced oxidative stress in resistance-trained males
- l-Carnitine l-tartrate supplementation favorably affects biochemical markers of recovery from physical exertion in middle-aged men and women
- Glycine propionyl-L-carnitine produces enhanced anaerobic work capacity with reduced lactate accumulation in resistance trained males
- Chronic oral ingestion of L-carnitine and carbohydrate increases muscle carnitine content and alters muscle fuel metabolism during exercise in humans
- The effect of oral supplementation with L-carnitine on maximum and submaximum exercise capacity
- Effect of intravenous L-carnitine on carnitine homeostasis and fuel metabolism during exercise in humans
- Effects of prolonged L-carnitine administration on delayed muscle pain and CK release after eccentric effort
- l-Carnitine Supplementation in Older Women. A Pilot Study on Aging Skeletal Muscle Mass and Function
- Effects of L-carnitine L-tartrate supplementation on muscle oxygenation responses to resistance exercise
- The effects of L-carnitine L-tartrate supplementation on hormonal responses to resistance exercise and recovery
- Levocarnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigue
- Oxidative stress in response to aerobic and anaerobic power testing: influence of exercise training and carnitine supplementation
- Effect of L-carnitine on submaximal exercise metabolism after depletion of muscle glycogen
- Androgenic responses to resistance exercise: effects of feeding and L-carnitine
- Carbohydrate, protein, and fat metabolism during exercise after oral carnitine supplementation in humans
- Effects of four weeks L-carnitine L-tartrate ingestion on substrate utilization during prolonged exercise
- L -Carnitine and the recovery from exhaustive endurance exercise: a randomised, double-blind, placebo-controlled trial
- Effects of carnitine coingested caffeine on carnitine metabolism and endurance capacity in athletes
- Effects of L-carnitine supplementation on physical performance and energy metabolism of endurance-trained athletes: a double-blind crossover field study
- Clinical Effects of L-Carnitine Supplementation on Physical Performance in Healthy Subjects, the Key to Success in Rehabilitation: A Systematic Review and Meta-Analysis from the Rehabilitation Point of View.
- L-Carnitine/Simvastatin Reduces Lipoprotein (a) Levels Compared with Simvastatin Monotherapy: A Randomized Double-Blind Placebo-Controlled Study
- Effect of lysine, vitamin B(6), and carnitine supplementation on the lipid profile of male patients with hypertriglyceridemia: a 12-week, open-label, randomized, placebo-controlled trial
- L-carnitine infusion does not alleviate lipid-induced insulin resistance and metabolic inflexibility
- Effects of acute versus chronic L-carnitine L-tartrate supplementation on metabolic responses to steady state exercise in males and females
- Liver-Oriented Acute Metabolic Effects of A Low Dose of L-Carnitine under Fat-Mobilizing Conditions: Pilot Human Clinical Trial
- The effects of L-carnitine supplementation on glycemic control: a systematic review and meta-analysis of randomized controlled trials
- The effect of L-carnitine on inflammatory mediators: a systematic review and meta-analysis of randomized clinical trials
- Single dose administration of L-carnitine improves antioxidant activities in healthy subjects
- Comparison of pre-workout nitric oxide stimulating dietary supplements on skeletal muscle oxygen saturation, blood nitrate/nitrite, lipid peroxidation, and upper body exercise performance in resistance trained men
- Glycine propionyl-L-carnitine modulates lipid peroxidation and nitric oxide in human subjects
- L-carnitine supplementation to diet: a new tool in treatment of nonalcoholic steatohepatitis--a randomized and controlled clinical trial
- Effects of carnitine supplementation on flow-mediated dilation and vascular inflammatory responses to a high-fat meal in healthy young adults
- The effect of l-carnitine on fat oxidation, protein turnover, and body composition in slightly overweight subjects
- Effects of exercise intensity and altered substrate availability on cardiovascular and metabolic responses to exercise after oral carnitine supplementation in athletes
- Safety measures of L-carnitine L-tartrate supplementation in healthy men
- Effects of oral L-carnitine supplementation on insulin sensitivity indices in response to glucose feeding in lean and overweight/obese males