Liver
What the NHS, NICE and Liver UK say about milk thistle, omega-3, turmeric, green tea extract and vitamin E, and which supplements have been linked to liver damage.
The NHS says fatty liver disease is very common and can usually be managed with healthy lifestyle changes, and that a liver specialist may use vitamin E once the liver is damaged. NICE's guideline finds not enough evidence on omega-3 for it. Liver UK, the UK's liver health charity, says no complementary or alternative medicine has been shown to work for fatty liver disease, that some supplements can harm the liver, and that anyone with a liver condition should talk to their medical team before trying one. Below is what UK and US health bodies say about each supplement, with links to read them in full.
NHS: Apart from healthy lifestyle changes, fatty liver disease needs no other treatment unless it has progressed and damaged the liver.
Each line below is a short summary of what the named source says, with a link to read it in full. None of it is medical advice.
Advised
Vitamin E
A group of compounds found in plant oils such as rapeseed, sunflower and olive oil, and in nuts, seeds and wheatgerm.
- NHS: In fatty liver disease that has damaged the liver, specialist treatment may include vitamin E.
- NICE: In hospital specialist care only, considered for adults with advanced liver scarring.
Also covered by NICE.
No good evidence
Milk thistle
A tall plant with large purple flowers, native to Europe. The main part of its extract is silymarin, a mixture of compounds.
Omega-3
Fats found in oily fish, and in some plant oils, nuts and seeds; supplements come from fish, krill or algae.
- NICE: Not enough evidence on it for fatty liver disease.
Advised against
Green tea extract
A concentrated extract of the leaves of the tea plant, Camellia sinensis, sold as tablets and capsules.
- Liver UK: Supplements containing green tea extract have been reported as causing liver damage.
- NCCIH: Liver injury is uncommon but reported, mainly with extract tablets or capsules.
Also covered by Liver UK.
Turmeric and curcumin
A spice from the underground stem of a plant in the ginger family. Curcumin, a major component, gives it its yellow colour.
Things to check
- NHS: Do not take herbal medicines if you have kidney or liver problems.
- Liver UK: With a liver condition, always talk to your medical team before trying a new supplement.
- Liver UK: Complementary, alternative and natural medicines can sometimes harm the liver; the risk is higher with a liver condition.
- Liver UK: Liver injury can be caused by alternative, natural, traditional Chinese and herbal medicines; tell your doctor about any you take.
- Liver UK: Supplements containing vitamin A, kava, conjugated linoleic acid or noni juice have been reported as causing liver damage.
- Liver UK: Weight loss supplements can contain herbs that can damage the liver.
- Liver UK: Milk thistle can be dangerous with some medicines, such as some immunosuppressants and diabetes medicines; not for pregnancy or breastfeeding.
- NCCIH: Stop turmeric or curcumin and see a doctor if you get tiredness, nausea, poor appetite, dark urine or yellowing skin.
- NHS: 540mg (800 IU) or less a day of vitamin E from supplements is unlikely to cause any harm.
If you take medication, are pregnant, or have a health condition, check with a pharmacist or GP first.
Sources
- Non-alcoholic fatty liver disease (NAFLD)Fatty liver disease: symptoms, diagnosis, stages, lifestyle changes and treatment from a liver specialist.
- MASLD: assessment and management (NG49), pharmacological treatmentNICE's guideline on medicines for advanced liver scarring in fatty liver disease, including vitamin E.
- MASLD: assessment and management (NG49), assessment for advanced liver fibrosis and healthy livingNICE's guideline on testing for liver scarring, and on diet, activity, alcohol and omega-3 in fatty liver disease.
- Metabolic dysfunction-associated steatotic liver disease: Scenario: ManagementNICE's summary for GPs on managing fatty liver disease (MASLD), and the medicines specialists may use.
- Complementary and alternative therapyComplementary and alternative therapies with a liver condition, including milk thistle and supplements linked to liver damage.
- Supplements and vitaminsVitamins and supplements to think about with a liver condition, including herbal supplements and green tea extract.
- How is MASLD treated?Lifestyle changes, medicines for related conditions, and complementary medicines for fatty liver disease (MASLD).
- What causes drug-induced liver injury?What raises the chance of liver injury from medicines, including herbal and other supplements.
- Herbal medicines and complementary therapiesWho should not take herbal medicines, including people with liver problems, and checking them with a pharmacist.
- Vitamin EWhere vitamin E comes from, how much people need, and how much is safe to take.
- Turmeric: potential adverse effectsSide effects reported with turmeric and curcumin, and who should avoid them, for advising patients.
- Milk ThistleWhat milk thistle is, the evidence on it for liver disease and other conditions, and its safety.
- Green TeaGreen tea and its extracts: the evidence, side effects, reports of liver injury and medicine interactions.
- TurmericTurmeric and curcumin: the evidence, including on fatty liver disease, and reports of liver damage.
Sources checked 28 September 2026. Prices checked 20 October 2026, ranked purely by price per dose. Which sources these pages use.