Protocol · Liver & Detoxification
Alcoholic Hepatitis Supportive Care Protocol
Milk Thistle (Silymarin) and N-Acetyl Cysteine (NAC) are the core of this stack, with 6 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in Alcoholic Hepatitis Supportive Care.
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
8 supplements · 1 graded
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file | Shop |
|---|---|---|---|---|---|
| Primary stackThe core of this protocol | |||||
| Milk Thistle (Silymarin) | Amount listed: 420–600 mg silymarin daily in divided doses | Hepatoprotective; stabilizes liver cell membranes, promotes regeneration, antioxidant effects | Not graded yet | ||
| N-Acetyl Cysteine (NAC) | Amount listed: 600–1,200 mg twice daily | Glutathione precursor; antioxidant that supports liver detoxification; shown to improve outcomes when combined with standard treatment | Not graded yet | ||
| Supporting stackListed as additions to the core | |||||
| Resveratrol | Amount listed: 150–500 mg daily | Activates SIRT1 and AMPK; reduces liver inflammation and oxidative stress
| Grade D for Bilirubin208 people | ||
| Zinc | Amount listed: 30–50 mg daily | Deficiency common and contributes to liver dysfunction; zinc supplementation may improve outcomes | Not graded yet | ||
| SAMe (S-Adenosyl Methionine) | Amount listed: 400–1,600 mg daily in divided doses | Methyl donor that supports liver function; depleted in liver disease | Not graded yet | ||
| B Vitamins | Amount listed: B-complex with thiamine 100 mg, folate 800 mcg daily | Multiple deficiencies common in alcoholic liver disease; support liver metabolism | Not graded yet | ||
| Vitamin E | Amount listed: 400–800 IU daily (mixed tocopherols) | Antioxidant that protects liver cells from oxidative damage | Not graded yet | ||
| Protein Supplementation | Amount listed: 1.2–1.5 g protein per kg body weight daily | Addresses protein-calorie malnutrition common in alcoholic hepatitis; supports liver regeneration | Not graded yet | ||
Shop this protocol
Support alongside medical care. These supplements are not a treatment for Alcoholic Hepatitis. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
Each opens third-party tested products, matched to the dose above where we can.
- Grade D
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How this protocol works
In plain language
Alcoholic hepatitis is severe liver inflammation caused by heavy alcohol use. It can develop after years of heavy drinking or sometimes after binge drinking in people with existing liver disease. Symptoms include jaundice (yellow skin and eyes), abdominal pain, fever, nausea, and an enlarged, tender liver. Severe alcoholic hepatitis can be life-threatening, with mortality rates up to 50% at 30 days in the most serious cases.
CRITICAL: Alcoholic hepatitis is a serious medical condition requiring hospital care for moderate-to-severe cases. Treatment depends on severity (assessed by Maddrey's discriminant function or MELD score). Corticosteroids may be used for severe cases. COMPLETE ABSTINENCE from alcohol is essential - continuing to drink dramatically worsens outcomes. Nutrition support is critical as malnutrition is nearly universal. These supplements support liver recovery but don't replace medical treatment or the absolute need for alcohol cessation.
Milk Thistle (Silymarin)* is the most studied hepatoprotective herb. It stabilizes liver cell membranes, acts as an antioxidant, and may promote liver cell regeneration.
N-Acetyl Cysteine (NAC)* is a precursor to glutathione, the liver's primary antioxidant. A randomized trial showed NAC combined with prednisolone improved survival in severe alcoholic hepatitis compared to prednisolone alone.
Resveratrol* activates pathways (SIRT1, AMPK) that reduce liver inflammation and oxidative stress. It may help protect liver cells from alcohol-induced damage.
Zinc* deficiency is extremely common in alcoholic liver disease and contributes to liver dysfunction. Supplementation may improve liver function and reduce inflammation.
SAMe* is a methyl donor that becomes depleted in liver disease. It supports glutathione production and liver cell function.
B Vitamins* are commonly depleted in alcoholism. Thiamine is critical to prevent Wernicke's encephalopathy. B vitamins support liver metabolism and repair.
Vitamin E* provides antioxidant protection for liver cells under oxidative stress.
Protein Supplementation* addresses the protein-calorie malnutrition that is nearly universal in alcoholic hepatitis. Adequate protein is essential for liver regeneration.
Expected timeline: Mild alcoholic hepatitis may improve within weeks to months with abstinence and nutrition. Severe cases have high short-term mortality even with treatment. Long-term liver recovery depends on complete alcohol abstinence and may take 6-12 months or longer.