Liver Detox and Liver Cleanse: What Really Helps Your Liver

Dr. Josh Axe · Free quiz

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A liver detox, or liver cleanse, supports the work your liver already does every day: clearing toxins, used-up hormones and the by-products of food, alcohol and medications. The steps with the strongest human evidence behind them are simple: cut sugary drinks and alcohol, lose extra weight if you carry it, and move every day. Certain foods, coffee and a couple of herbs add support.134

In Heal Your Cells, Dr. Will Cole and I describe real cellular detoxification as a two-step process that happens deep in your liver, and that's the detox worth supporting, rather than juice cleanses or trendy teas.2 Your liver packages what your body doesn't need, bile carries much of it into your gut, and your bowels, kidneys, lymph and skin move it out.28

The plan on this page follows my three steps for helping your liver heal: lighten its load, feed it and keep bile moving, and keep the exits open.1 If heavy metals are part of your concern, our heavy metal detox guide covers them in detail.

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What is a liver cleanse, and what does it really do?

Your liver runs this process all day. Phase 1 makes a toxin, a medication or a used-up hormone reactive, and phase 2 packages it with glutathione or another small molecule so it dissolves in water and can leave. Bile then carries much of it into your gut, where fiber and regular bowel movements finish the job.81

Who needs a liver detox?

Everyone's liver benefits from these steps, and a fatty liver makes them urgent. About one in three adults worldwide has one: a 2022 analysis of 72 studies covering 1,030,160 adults in 17 countries put the rate at 32.4%, rising from 25.5% in studies done through 2005 to 37.8% in those from 2016 on, and higher in men (39.7%) than in women (25.6%).10

You may see it under a newer name. In 2023, liver societies renamed nonalcoholic fatty liver disease (NAFLD) as metabolic dysfunction-associated steatotic liver disease (MASLD), and its inflamed form, NASH, as MASH.11

A standard liver panel can miss it. In the Dallas Heart Study, a population study that measured liver fat with a magnetic resonance scan in 2,287 adults, almost a third had a fatty liver, and 79% of them had a normal ALT, the liver enzyme most blood panels check.12 The signs section below covers what to track instead.

How do you detox your liver naturally?

Each step below leads with the pieces that have been tested in people. Commercial detox diets have little trial evidence behind them as a package,13 so the plan rests on studies of its parts: less sugar and alcohol, weight loss, exercise, a Mediterranean-style diet, coffee and a few herbs.

Step 1: How do you lighten your liver's load?

Start with what your liver handles every day. Sugar, alcohol, extra body fat and long hours of sitting all add to its work, and studies in people show what happens when you cut each one back.

Cut sugary drinks and added sugar

Sugar is where I start. Alcohol is a close second, and soda is one of the biggest sources of the excess sugar people take in today.1

Cutting back works quickly. In a randomized trial of 40 boys aged 11 to 16 with fatty liver, families received meals for the whole household so the boys kept free sugar, meaning added sugar and fruit juice, under 3% of their calories; people knew which diet they got. After 8 weeks, liver fat fell from 25% to 17%, against 21% to 20% on their usual diet, and ALT fell from 103 to 61 U/L.3

Adding sugar works the other way. In a 6-month randomized trial, 47 overweight adults drank a liter a day of regular cola, semi-skim milk, diet cola or water, and liver fat rose 132% to 143% more on the cola than on the other three drinks, with blood triglycerides up 32% more.14 Swap soda, sweet tea and juice for water, sparkling water with a squeeze of lemon, or unsweetened tea, and read labels for high-fructose corn syrup and other added sugars.

Skip alcohol, especially with a liver problem

If you know you have a liver issue, I recommend avoiding alcohol altogether.1 I call alcohol a direct liver toxin, and even moderate drinking ages the liver.2

A modest amount still slows healing. In a study that followed 285 adults with fatty liver through two liver biopsies about 4 years apart, those who had up to 2 drinks on a drinking day, most of them once a month or less, saw less improvement in liver fat than those who didn't drink; among the 182 who started with NASH, those who kept drinking had about a third of the odds of it resolving, compared with those who didn't drink at all.15 The Mitochondrial Longevity Protocol takes alcohol out completely for its first 30 days.16 If you drink heavily now, read the safety section before you stop.

Lose extra weight, steadily

If you carry extra weight, losing some of it lowers liver fat, and the more you lose, the more your liver heals. In Havana, 293 adults with NASH followed a year-long program of diet and exercise, and 261 had a liver biopsy at both the start and the end; the study had no comparison group. NASH resolved in 25% of everyone, in 58% of those who lost at least 5% of their weight, and in 90% of those who lost at least 10%, and liver scarring improved in 45% of that last group.4

Randomized trials agree. In 31 adults with NASH, an intensive 48-week program of diet, exercise and coaching took off 9.3% of body weight on average, against 0.2% with education alone; of the 28 who had a second liver biopsy, 72% of the program group reached the trial's target improvement, against 30% of the education group.17 In 96 adults with type 2 diabetes, a year of intensive lifestyle change cut liver fat by 50.8%, against 22.8% with diabetes education and support.18

Go steady. For weight loss, I recommend a moderate deficit of about 300 calories a day below what you burn, with plenty of protein.19

Move every day

Exercise lowers liver fat even before the scale moves. In a 4-week randomized trial of 19 sedentary adults with obesity, the 12 who cycled at guideline levels lowered their liver fat by 21% and their visceral (deep belly) fat by 12%, with no change in body weight, while the other 7 did stretching instead.20 In a placebo-controlled trial of 48 inactive adults with overweight or obesity (47 finished), three different aerobic programs over 8 weeks all lowered liver fat, by 0.84 to 2.62 percentage points, while it rose 1.10 points in the placebo group, and the dose and intensity of the exercise didn't change the result.21

Almost any regular exercise helps the liver, and cardio outdoors, such as a jog, a bike ride or a walk, is what I recommend most. Strength training helps indirectly, because building muscle supports insulin, which takes stress off the liver.1 Aim for 20 to 30 minutes of movement every day; the protocol's first phase sets a goal of 8,000 steps.216

Finish dinner early

I consider an early dinner, and nothing more to eat until morning, essential for liver health.1 The Mitochondrial Longevity Protocol builds this in as a 12-hour overnight fast, with dinner done by 7 p.m.16 If you're pregnant or nursing or take medication for blood sugar, read the safety section before you stretch your overnight fast.

Lower your toxin exposure

Your liver handles what you breathe and drink too. Don't smoke, which is very hard on the liver, drink filtered water, and store food and drinks in glass instead of plastic.116

Step 2: What foods help detox your liver?

Eat Mediterranean-style, with extra virgin olive oil

In 12 adults with fatty liver who each tried both diets for 6 weeks, a Mediterranean diet lowered liver fat by 39%, against 7% on a low-fat, high-carbohydrate diet, and improved insulin sensitivity, though weight loss didn't differ between the two.22 Make extra virgin olive oil your everyday fat; if you roast vegetables instead of steaming them, I'd use a little olive oil and sea salt.1

Steamed cruciferous vegetables

Cruciferous vegetables, such as bok choy, broccoli, cauliflower, cabbage, kale and Brussels sprouts, are hero foods for your liver, and steaming is the cleanest way to cook them.1 They feed your detox enzymes, and compounds in them such as indole-3-carbinol are thought to help your liver break down excess estrogen, which matters for women and men alike.21 Broccoli sprouts are a liver superfood most of us don't eat much of, and their extract has a trial of its own in the herbs and supplements section.1

Bitter greens and sour foods

Bitter greens such as arugula, dandelion greens and watercress support bile production and flow. Sour foods help too, especially a little lemon juice in your water or apple cider vinegar in a salad dressing.1

Beets, garlic, onions, berries and seeds

Round out the plate with beets, garlic and onions, artichokes, berries, green apples, and flax and chia seeds for their fiber.12 Bone broth and soups belong on the list, because broth contains glycine, an amino acid your liver uses in phase 2.18 I recommend 30 to 40 grams of protein at each meal to support the liver.1

Coffee, if you tolerate it

Coffee drinkers have less liver disease in large observational studies, which show a link rather than proof. Across 9 studies with 432,133 people, every 2 extra cups a day went with a 44% lower risk of cirrhosis.23 In the UK Biobank, which followed 494,585 adults for a median of 10.7 years, coffee drinkers had a 21% lower risk of chronic liver disease and a 49% lower risk of dying from it than people who didn't drink coffee, and ground, instant and decaf coffee all showed it. The lower risk grew with each cup up to about 3 to 4 cups a day and then leveled off.5

If you tolerate coffee, I recommend 1 to 2 cups a day, up to 3, in the morning with or after food.24 Matcha is my other pick, 2 to 3 cups a day.2

Beef liver, once a week

I recommend about 3 ounces of grass-fed beef liver once a week, unless bloodwork shows your vitamin A running high.25 It's one of the richest foods in B vitamins and iron, which support detoxification and energy.30 The World Health Organization's cancer agency classifies processed meat as Group 1, carcinogenic to humans, and red meat as Group 2A, probably carcinogenic.26 As I've said on my show, the studies that link red meat to poor health mostly reflect grain-fed and processed meat, not the fresh, grass-fed red meat I recommend.27

Step 3: How do you help toxins leave your body?

Keep the exits open: fiber, daily bowel movements, water and sweat carry out what your liver has packaged.

Get 30 to 40 grams of fiber a day. It binds toxins in your gut so they leave in your stool; otherwise they can be reabsorbed and come back to the liver for another round.12 Feed your gut good bacteria too, with coconut yogurt or a probiotic supplement, so the toxins your liver releases are carried out instead of recirculating.1 Our guide to how much fiber per day shows how to reach it with vegetables, berries, flax and chia. Aim for a bowel movement every day, and if you need help there, 300 to 600 mg of magnesium glycinate in the evening is what I suggest.1 Drink water through the day; my rule of thumb is about half your body weight in ounces.2

Sweat is another exit. I recommend an infrared sauna 3 to 5 days a week, for 20 to 40 minutes, to support your liver's detox pathways, then rehydrate with filtered water.12

Castor oil packs, a traditional practice

Castor oil packs over the liver are another detox practice I recommend for the liver, gallbladder and gut.1 Put about a tablespoon of castor oil on a cloth, place it over your liver, at the lower part of your right rib cage, and leave it on for about 40 minutes; I like to warm the area with a heating pad for about 20 minutes first.1 During a cleanse, my Candida Cleanse Protocol uses them three times a week.28 For a liver pack, the castor oil goes on the skin; I don't recommend taking it by mouth.1

Their human research so far is about the bowels: in a small before-and-after study of older adults with constipation, with no comparison group, 3 days of packs on the abdomen didn't change how often people went, but they eased straining and improved stool consistency.29

Which herbs and supplements support your liver?

What about a liver or gallbladder flush?

A liver or gallbladder flush usually means a day of juice, then a large dose of olive oil with lemon or grapefruit juice at night, and many versions add Epsom salt. The next morning, people often pass small green lumps and take them for gallstones.

Those lumps were analyzed in a case reported in The Lancet in 2005. A 40-year-old woman with small gallstones on ultrasound drank apple and vegetable juice until 6 p.m., then 600 milliliters (about 2½ cups) of olive oil with 300 milliliters of lemon juice over several hours, and passed many soft green "stones" the next morning. They had no crystal structure, melted into an oily green liquid after 10 minutes at 104°F (40°C), and contained no cholesterol, bilirubin or calcium, the usual makings of gallstones; fatty acids made up 75% of them. When the researchers mixed oleic acid, the main fat in olive oil, with lemon juice and a little potassium hydroxide, they made similar balls in the lab. They concluded that digestive enzymes break the olive oil into fatty acids, which then form "soap stones" in the gut. Her real gallstones were still in her gallbladder, and they were removed by surgery.7 Versions with Epsom salt use the same olive-oil step.

If your gallbladder has been removed or isn't working well, I recommend bile support, such as about 500 mg of TUDCA with meals that contain fat; our guide to bile salts covers the options.1 With known gallstones or gallbladder pain, see the safety section first.

How do stress and emotions affect your liver?

In my approach, emotional health is part of liver health: anger and resentment burden the liver, and forgiveness and emotional release belong in a liver plan.2 Traditional Chinese medicine links the liver to anger, resentment, unforgiveness and especially frustration, and describes a pattern called liver qi stagnation, in which energy and blood don't flow smoothly. Its advice is to release those emotions in healthy ways, by talking them through, confessing them or working them out with exercise.1

On my show, I've connected this to Proverbs 14:30, which the King James Version renders: "A sound heart is the life of the flesh: but envy the rottenness of the bones."141 Forgive where you can, talk it out, and move your body; your liver plan is about more than food.

How do you know your liver detox is working?

Metabolic markers can tell you a lot about a fatty liver, often before the standard liver enzymes move, and triglycerides, fasting insulin, glucose, hemoglobin A1C and HDL cholesterol are the ones I look at.1 Since a normal ALT doesn't rule out a fatty liver, an ultrasound or a liver stiffness scan shows what the blood tests can't.121 Test before you start and again after a few months of steady changes, so you can see where you stand.

Who should be careful with a liver detox?

The food, movement and sleep steps fit nearly everyone. These are the situations where the plan should change:

• Liver disease or its warning signs. If you've been diagnosed with hepatitis, cirrhosis or another liver disease, or you notice yellowing of your skin or the whites of your eyes, dark urine, pale stools, pain under your right ribs, a swelling belly or confusion, see a doctor promptly; these call for testing and medical care, not a cleanse. With a diagnosed liver condition, check any concentrated supplement with your doctor first.

• Supplements that can injure the liver. In a U.S. network that tracks drug-induced liver injury, supplements caused 130 of 839 cases from 2004 to 2013, and their share rose from 7% to 20%; bodybuilding products caused long-lasting jaundice in young men.45 The six botanicals most often implicated in that network are concentrated turmeric or curcumin, green tea extract, Garcinia cambogia, black cohosh, red yeast rice and ashwagandha.48 Brewed green tea is generally safe, and the concern centers on concentrated extracts, where 800 mg or more of EGCG a day raised liver enzymes in trials.49 Milk thistle hasn't been implicated in liver injury.50 Stop any supplement and get tested if you notice yellow skin or eyes or dark urine.

• Fasting. People with an eating disorder, women who are pregnant or breastfeeding, and people with conditions that can drop blood sugar or blood pressure too far shouldn't fast; keep to regular meals and an early dinner.46 If you take medication that lowers blood sugar, plan any overnight fast with your prescriber.

• Pregnancy and breastfeeding. Keep to the food and movement steps, check with your OB before you eat liver, since it's very high in vitamin A, and save the concentrated herbs and supplements on this page for later.

• Heavy drinking. If you've been drinking heavily for a long time, get medical help to plan how you stop, because quitting suddenly can set off a dangerous withdrawal.51

• Gallstones. With known gallstones or gallbladder pain, see your doctor before trying any flush.

• Heart disease and the sauna. Hydrate well, ease in, and get your practitioner's clearance before using a sauna if you have heart disease.47

The bottom line

Liver detox: frequently asked questions

References

1. Axe J. Hidden Signs Your Liver Is Sluggish (And What To Do Before It Becomes Serious). The Dr. Josh Axe Show. 2026 (solo episode on YouTube, https://www.youtube.com/watch?v=PiOaEva8EBc: sugar as the single biggest driver of liver fat and alcohol a close second at 12:10–12:31; Chinese medicine, emotions and the liver, and Proverbs 14:30, at 21:13–25:02; avoiding alcohol with a liver issue at 32:34; an early dinner at 33:50 and smoking at 33:54; bile, sour foods, steamed cruciferous vegetables (roasting in a little extra virgin olive oil and sea salt at 34:55), bitter greens and sprouts at 34:00–36:45; beets, garlic, onions, artichokes, berries, flax, chia, extra virgin olive oil and bone broth (glycine) at 36:45–37:31; 30–40 g of protein per meal at 38:13; 30–40 g of fiber, regular bowel movements and 300–600 mg of magnesium glycinate in the evening at 38:26–39:05; milk thistle, artichoke, dandelion and schisandra at 39:20–39:56; NAC at 39:58–40:44; TUDCA about 500 mg with meals containing fat at 45:42; infrared sauna and exercise at 48:07–48:50; castor oil packs at 48:50–50:18; liver scans and metabolic markers at 51:05–52:41; the three steps at 54:01–56:44).
2. Axe J, Cole W. Heal Your Cells. Avery; 2026. ISBN 9798217181353 (chapter "Chemical Chaos at the Cellular Level": real cellular detoxification happens deep in the liver, in a two-step process, not juice cleanses or trendy teas; the detox plan on pp. 64–68: p. 65 "Feed your detox enzymes" with cruciferous vegetables and sulfur-rich onions, garlic and eggs, and "Promote healthy bile flow and elimination"; Step 2 "Support daily elimination" (half your body weight in ounces of water, 30–40 g of fiber, a sauna three to five times a week, 20–30 minutes of daily movement); Step 3 bitter herbs milk thistle, dandelion root, burdock and artichoke. "Precision Healing Protocols", detox health, pp. 343–345: "Foods for a Younger Detox System" (cooked cruciferous vegetables, leafy greens including dandelion greens, green apples, beets, liver, apple cider vinegar, lemons, turmeric and rosemary); p. 343 milk thistle 300–600 mg/day standardized to 70–80% silymarin and dandelion root tea 1–2 cups/day; p. 344 NAC or liposomal glutathione 600–1,200 mg/day and matcha 2–3 cups/day; p. 345 forgiveness and emotional release ("Anger and resentment burden the liver") and "Alcohol is a direct liver toxin; even moderate intake accelerates liver aging.").
3. Schwimmer JB, Ugalde-Nicalo P, Welsh JA, Angeles JE, Cordero M, Harlow KE, et al. Effect of a Low Free Sugar Diet vs Usual Diet on Nonalcoholic Fatty Liver Disease in Adolescent Boys: A Randomized Clinical Trial. JAMA. 2019;321(3):256-265. doi:10.1001/jama.2018.20579
4. Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L, Torres-Gonzalez A, Gra-Oramas B, Gonzalez-Fabian L, et al. Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis. Gastroenterology. 2015;149(2):367-78.e5; quiz e14-5. doi:10.1053/j.gastro.2015.04.005
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6. Wah Kheong C, Nik Mustapha NR, Mahadeva S. A Randomized Trial of Silymarin for the Treatment of Nonalcoholic Steatohepatitis. Clin Gastroenterol Hepatol. 2017;15(12):1940-1949.e8. doi:10.1016/j.cgh.2017.04.016
7. Sies CW, Brooker J. Could these be gallstones? Lancet. 2005;365(9468):1388. doi:10.1016/S0140-6736(05)66373-8
8. Hodges RE, Minich DM. Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application. J Nutr Metab. 2015;2015:760689. doi:10.1155/2015/760689
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12. Browning JD, Szczepaniak LS, Dobbins R, Nuremberg P, Horton JD, Cohen JC, et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology. 2004;40(6):1387-95. doi:10.1002/hep.20466
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14. Maersk M, Belza A, Stødkilde-Jørgensen H, Ringgaard S, Chabanova E, Thomsen H, et al. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Am J Clin Nutr. 2012;95(2):283-9. doi:10.3945/ajcn.111.022533
15. Ajmera V, Belt P, Wilson LA, Gill RM, Loomba R, Kleiner DE, et al. Among Patients With Nonalcoholic Fatty Liver Disease, Modest Alcohol Use Is Associated With Less Improvement in Histologic Steatosis and Steatohepatitis. Clin Gastroenterol Hepatol. 2018;16(9):1511-1520.e5. doi:10.1016/j.cgh.2018.01.026
16. Axe J. Heal Your Cells: The Mitochondrial Longevity Protocol. DrAxe.com. 2026 (Phase 1, Clear, days 1–30: cut ultra-processed food, sugar and alcohol; alcohol "completely for 30 days"; 12-hour overnight fast with dinner done by 7 pm; 8,000 steps; filtered water, glass instead of plastic).
17. Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology. 2010;51(1):121-9. doi:10.1002/hep.23276
18. Lazo M, Solga SF, Horska A, Bonekamp S, Diehl AM, Brancati FL, et al. Effect of a 12-month intensive lifestyle intervention on hepatic steatosis in adults with type 2 diabetes. Diabetes Care. 2010;33(10):2156-63. doi:10.2337/dc10-0856
19. Axe J. Burn Fat, Build Muscle, Live a LOT Longer. The Dr. Josh Axe Show. 2026 ("The sweet spot is a moderate deficit of around 300 calories below maintenance, with also high protein.").
20. Johnson NA, Sachinwalla T, Walton DW, Smith K, Armstrong A, Thompson MW, et al. Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss. Hepatology. 2009;50(4):1105-12. doi:10.1002/hep.23129
21. Keating SE, Hackett DA, Parker HM, O'Connor HT, Gerofi JA, Sainsbury A, et al. Effect of aerobic exercise training dose on liver fat and visceral adiposity. J Hepatol. 2015;63(1):174-82. doi:10.1016/j.jhep.2015.02.022
22. Ryan MC, Itsiopoulos C, Thodis T, Ward G, Trost N, Hofferberth S, et al. The Mediterranean diet improves hepatic steatosis and insulin sensitivity in individuals with non-alcoholic fatty liver disease. J Hepatol. 2013;59(1):138-43. doi:10.1016/j.jhep.2013.02.012
23. Kennedy OJ, Roderick P, Buchanan R, Fallowfield JA, Hayes PC, Parkes J. Systematic review with meta-analysis: coffee consumption and the risk of cirrhosis. Aliment Pharmacol Ther. 2016;43(5):562-74. doi:10.1111/apt.13523
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26. Bouvard V, Loomis D, Guyton KZ, Grosse Y, Ghissassi FE, Benbrahim-Tallaa L, et al. Carcinogenicity of consumption of red and processed meat. Lancet Oncol. 2015;16(16):1599-600. doi:10.1016/S1470-2045(15)00444-1
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28. Axe J. The Candida Cleanse Protocol: The 30-Day Healing Protocol. DrAxe.com. 2026 (p. 17, Phase 2 drainage: "Liver support — milk thistle, NAC, warm lemon water on waking, castor oil packs over the liver 3× weekly"; milk thistle (silymarin) 300–600 mg daily; NAC 600–1,200 mg daily).
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31. Navarro VJ, Belle SH, D'Amato M, Adfhal N, Brunt EM, Fried MW, et al. Silymarin in non-cirrhotics with non-alcoholic steatohepatitis: A randomized, double-blind, placebo controlled trial. PLoS One. 2019;14(9):e0221683. doi:10.1371/journal.pone.0221683
32. Ferenci P, Dragosics B, Dittrich H, Frank H, Benda L, Lochs H, et al. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol. 1989;9(1):105-13. doi:10.1016/0168-8278(89)90083-4
33. Rambaldi A, Jacobs BP, Gluud C. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. Cochrane Database Syst Rev. 2007;2007(4):CD003620. doi:10.1002/14651858.CD003620.pub3
34. Shahsavari K, Ardekani SS, Ardekani MRS, Esfahani MM, Kazemizadeh H, Jamialahmadi T, et al. Are alterations needed in Silybum marianum (Silymarin) administration practices? A novel outlook and meta-analysis on randomized trials targeting liver injury. BMC Complement Med Ther. 2025;25(1):134. doi:10.1186/s12906-025-04886-y
35. Ladas EJ, Kroll DJ, Oberlies NH, Cheng B, Ndao DH, Rheingold SR, et al. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL). Cancer. 2010;116(2):506-13. doi:10.1002/cncr.24723
36. Khoshbaten M, Aliasgarzadeh A, Masnadi K, Tarzamani MK, Farhang S, Babaei H, et al. N-acetylcysteine improves liver function in patients with non-alcoholic Fatty liver disease. Hepat Mon. 2010;10(1):12-6.
37. Panahi Y, Kianpour P, Mohtashami R, Atkin SL, Butler AE, Jafari R, et al. Efficacy of artichoke leaf extract in non-alcoholic fatty liver disease: A pilot double-blind randomized controlled trial. Phytother Res. 2018;32(7):1382-1387. doi:10.1002/ptr.6073
38. Kamel AM, Farag MA. Therapeutic Potential of Artichoke in the Treatment of Fatty Liver: A Systematic Review and Meta-Analysis. J Med Food. 2022;25(10):931-942. doi:10.1089/jmf.2022.0025
39. Kikuchi M, Ushida Y, Shiozawa H, Umeda R, Tsuruya K, Aoki Y, et al. Sulforaphane-rich broccoli sprout extract improves hepatic abnormalities in male subjects. World J Gastroenterol. 2015;21(43):12457-67. doi:10.3748/wjg.v21.i43.12457
40. Axe J. If You Do One Detox a Year — Do It Now, And Here's How. The Dr. Josh Axe Show. 2025 (solo episode on YouTube, https://www.youtube.com/watch?v=b9uN39KCW24: "milk thistle is my single favorite herb for detoxification" at 24:36; dandelion a little stronger and the herb for a more serious spring detox at 24:40–25:00; a dandelion and milk thistle tea, three bags in a big container of water through the day, at 25:40).
41. The Holy Bible, King James Version. Proverbs 14:30. Project Gutenberg eBook #10.
42. Axe J. The 25 Root-Cause Bloodwork Markers That Matter Most. DrAxe.com protocol. 2026 (optimal ranges: fasting insulin 2 to 8 µIU/mL; HbA1c 4.8% to 5.3%).
43. Voroneanu L, Nistor I, Dumea R, Apetrii M, Covic A. Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Diabetes Res. 2016;2016:5147468. doi:10.1155/2016/5147468
44. Soleimani V, Delghandi PS, Moallem SA, Karimi G. Safety and toxicity of silymarin, the major constituent of milk thistle extract: An updated review. Phytother Res. 2019;33(6):1627-1638. doi:10.1002/ptr.6361
45. Navarro VJ, Barnhart H, Bonkovsky HL, Davern T, Fontana RJ, Grant L, et al. Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network. Hepatology. 2014;60(4):1399-408. doi:10.1002/hep.27317
46. Axe J. Benefits of Fasting (And How to Do It). The Dr. Josh Axe Show. 2024 (who should not fast: people with eating disorders, women who are pregnant or breastfeeding, people with medical conditions that can lead to dangerously low blood sugar, and people with heart conditions in which blood pressure can drop too much).
47. Axe J. The Type 2 Diabetes Protocol. DrAxe.com. 2026 (advanced therapies, infrared sauna or heat therapy: "Hydrate well, ease in, and get clearance if you have heart disease").
48. Likhitsup A, Chen VL, Fontana RJ. Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults. JAMA Netw Open. 2024;7(8):e2425822. doi:10.1001/jamanetworkopen.2024.25822
49. EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS); Younes M, Aggett P, Aguilar F, Crebelli R, Dusemund B, Filipič M, et al. Scientific opinion on the safety of green tea catechins. EFSA J. 2018;16(4):e05239. doi:10.2903/j.efsa.2018.5239
50. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Milk Thistle. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012–. Updated January 21, 2020.
51. National Institute on Alcohol Abuse and Alcoholism. Should You Cut Down or Quit? Rethinking Drinking. Bethesda (MD): NIAAA.
52. Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011;54(10):2506-14. doi:10.1007/s00125-011-2204-7

Dr. Josh Axe, DC, DNM, CNS

Doctor of Natural Medicine · Founder, DrAxe.com

Dr. Axe is a certified doctor of natural medicine, clinical nutritionist, and multiple New York Times bestselling author. He has spent 20+ years in clinical practice helping people heal at the root cause and founded one of the most-visited natural-health platforms in the world.

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