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
90 studies from PubMed
- Hederagenin reduces Aβ-induced oxidative damage, decreases Aβ deposition and promotes cell survival by the PI3K/Akt signaling pathway
- Hederagenin promotes lung cancer cell death by activating CHAC1-dependent ferroptosis pathway
- 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
- Advances in the anti-tumor potential of hederagenin and its analogs
- Hederagenin improves Alzheimer's disease through PPARα/TFEB-mediated autophagy
- Dihydromyricetin supplementation improves ethanol-induced lipid accumulation and inflammation
- Hederagenin Exerts Potential Antilipemic Effect via p38MAPK Pathway in Oleic Acid-induced HepG2 cells and in Hyperlipidemic Rats
- Mechanism of Dihydromyricetin on Inflammatory Diseases
- Resveratrol: A Potential Therapeutic Natural Polyphenol for Neurodegenerative Diseases Associated with Mitochondrial Dysfunction
- Resveratrol: An Overview of Clinical Trials in Human Cancer Prevention and Treatment
- Does Dihydromyricetin Impact on Alcohol Metabolism
- Resveratrol and Its Analogs: Potent Agents to Reverse Epithelial-to-Mesenchymal Transition in Tumors
- Resveratrol and Sirtuins: A Story of Living Long Healthy Life
- Therapeutic Potential of Resveratrol in Alzheimer's Disease: A Review of the Evidence
- Resveratrol as a Chemopreventive Agent: A Promising Molecule for Fighting Cancer
- Hederagenin potentiated cisplatin- and paclitaxel-mediated cytotoxicity by impairing autophagy in lung cancer cells
- Hederagenin Attenuates Cerebral Ischaemia/Reperfusion Injury by Regulating MLK3 Signalling
- 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
- Resveratrol and Health - A Comprehensive Review of Human Clinical Trials
- Resveratrol: A Double-Edged Sword in Health Benefits
- Resveratrol and Caloric Restriction: The Role of Sirtuins in Aging and Age-Related Diseases
- The Multitarget Activity of Natural Bioactive Compounds in Parkinson's Disease: Role of Resveratrol
- Resveratrol: A New Treatment for Diseases Associated with Oxidative Stress
- Dihydromyricetin Ameliorates Nonalcoholic Fatty Liver Disease by Improving Mitochondrial Respiratory Capacity and Redox Homeostasis Through Modulation of SIRT3 Signaling
- Resveratrol-Based Compounds and Neurodegeneration: Recent Insight in Multitarget Neuroprotection
- An Overview of the Anticancer Properties of Resveratrol
- A hederagenin saponin isolated from Clematis ganpiniana induces apoptosis in breast cancer cells via the mitochondrial pathway
- Protective effects and possible molecular mechanism of Hovenia dulcis Thunb. extract on acetaminophen-induced hepatotoxicity
- An Update on Resveratrol and Diabetes: From Metabolism to Clinical Trial Results
- Hederagenin Induces Apoptosis in Cisplatin-Resistant Head and Neck Cancer Cells by Inhibiting the Nrf2-ARE Antioxidant Pathway
- Hederagenin Supplementation Alleviates the Pro-Inflammatory and Apoptotic Response to Alcohol in Rats
- Hederagenin and alpha-hederin promote degradation of proteins in neurodegenerative diseases and improve motor deficits in MPTP-mice
- 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, a major component of Clematis mandshurica Ruprecht root, attenuates inflammatory responses in RAW 264.7 cells and in mice
- Experimental Study of Antiatherosclerosis Effects with Hederagenin in Rats
- Hederagenin as a novel antidepressant-like compound identified from Clematis chinensis Osbeck
- Dihydromyricetin improves glucose and lipid metabolism and exerts anti-inflammatory effects in nonalcoholic fatty liver disease: A randomized controlled trial
- Hederagenin from the leaves of ivy (Hedera helix L.) induces apoptosis in human LoVo colon cells through the mitochondrial pathway
- Resveratrol Blunts the Positive Effects of Exercise Training on Cardiovascular Health in Aged Men
- 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
- The effects of 10 triterpenoid compounds on experimental liver injury in mice
- Cardioprotection by resveratrol: A human clinical trial in patients with stable coronary artery disease
- The effects of resveratrol on glycemic control and cardiometabolic parameters in patients with T2DM: A systematic review and meta-analysis.
- Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis.
- Can resveratrol supplement change inflammatory mediators? A systematic review and meta-analysis on randomized clinical trials.
- Resveratrol supplementation efficiently improves endothelial health: A systematic review and meta-analysis of randomized controlled trials.
- Trans-resveratrol alters mammary promoter hypermethylation in women at increased risk for breast cancer
- Effects of resveratrol on cerebral blood flow variables and cognitive performance in humans: a double-blind, placebo-controlled, crossover investigation
- Resveratrol improves insulin sensitivity, reduces oxidative stress and activates the Akt pathway in type 2 diabetic patients
- The efficacy of resveratrol supplementation on inflammation and oxidative stress in type-2 diabetes mellitus patients: randomized double-blind placebo meta-analysis.
- Pilot Study of Resveratrol in Older Adults With Impaired Glucose Tolerance
- Effect of resveratrol on glucose control and insulin sensitivity: a meta-analysis of 11 randomized controlled trials.
- Resveratrol supplementation and type 2 diabetes: a systematic review and meta-analysis
- Influence of Age and Dose on the Effect of Resveratrol for Glycemic Control in Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis.
- Resveratrol treatment as an adjunct to pharmacological management in type 2 diabetes mellitus--systematic review and meta-analysis.
- Effects of Resveratrol on Metabolic Indicators in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.
- Efficacy of resveratrol supplementation in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis of clinical trials
- The effects of resveratrol supplementation in patients with type 2 diabetes, metabolic syndrome, and nonalcoholic fatty liver disease: an umbrella review of meta-analyses of randomized controlled trials
- Effect of Resveratrol on Blood Lipid Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.
- Fine wine or sour grapes? A systematic review and meta-analysis of the impact of red wine polyphenols on vascular health
- The effects of resveratrol supplementation on biomarkers of inflammation and oxidative stress among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials.
- Resveratrol supplementation significantly influences obesity measures: a systematic review and dose-response meta-analysis of randomized controlled trials.
- Resveratrol may mildly improve renal function in the general adult population: A systematic review and meta-analysis of randomized controlled clinical trials.
- Calorie restriction-like effects of 30 days of resveratrol supplementation on energy metabolism and metabolic profile in obese humans
- Effects of resveratrol supplementation on liver enzymes: A systematic review and meta-analysis of randomised controlled trials.
- The Effects of Resveratrol Supplementation on Endothelial Function and Blood Pressures Among Patients with Metabolic Syndrome and Related Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
- Resveratrol supplementation does not augment performance adaptations or fibre-type-specific responses to high-intensity interval training in humans
- Resveratrol-containing gel for the treatment of acne vulgaris: a single-blind, vehicle-controlled, pilot study
- Efficacy of Resveratrol Supplementation on Glucose and Lipid Metabolism: A Meta-Analysis and Systematic Review
- Efficacy of resveratrol in women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized clinical trials.
- Effects of resveratrol on polycystic ovarian syndrome: a systematic review and meta-analysis of randomized controlled trials.
- The effect of dietary (poly)phenols on exercise-induced physiological adaptations: A systematic review and meta-analysis of human intervention trials
- Efficacy of resveratrol supplementation on liver enzymes in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis
- Efficacy and safety of biophenol-rich nutraceuticals in adults with inflammatory gastrointestinal diseases or irritable bowel syndrome: A systematic literature review and meta-analysis
- Effects of resveratrol supplementation on renal function in adults: a systematic review and dose-response meta-analysis.
- Oral resveratrol in adults with knee osteoarthritis: A randomized placebo-controlled trial (ARTHROL).
- Effects of Nasal Solution Incorporating Resveratrol and Carboxymethyl-Β-Glucan in Preschool Non-Atopic Children with Wheezing.
- A Systematic Review and Meta-Analysis of Randomized Controlled Trials on the Impact of Resveratrol Supplementation on Anthropometric Indices in Patients With Type 2 Diabetes.
- Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic 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.
- Impact of Silymarin in individuals with nonalcoholic fatty liver disease: 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
- Effect of Medicinal Plants and Natural Products on Liver Enzymes in Non-alcoholic Fatty Liver Patients in Iran: A Systematic Review and Meta-Analysis.
- An updated systematic review with meta-analysis for the clinical evidence of silymarin.
- Effects and tolerance of silymarin (milk thistle) in chronic hepatitis C virus infection patients: a meta-analysis of randomized controlled trials.