Nutrition in Clinical Practice

 

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Nutrition in Clinical Practice, Vol. 21, No. 3, 255-272 (2006)
DOI: 10.1177/0115426506021003255
© 2006 The American Society for Parenteral and Enteral Nutrition

Invited Review

The Use of Selected Nutrition Supplements and Complementary and Alternative Medicine in Liver Disease

A. James Hanje, MD*, Brett Fortune, MD*, Ming Song, PhD{dagger}, Daniell Hill, MD{dagger} and Craig McClain, MD{dagger},{ddagger}

* Departments of Medicine, The Ohio State University, Columbus, Ohio; {dagger} University of Louisville, Louisville, Kentucky; and the{ddagger} Louisville VA Medical Center, Louisville, Kentucky

Correspondence: Craig J. McClain, MD, Department of Internal Medicine, Professor of Internal Medicine, Pharmacology and Toxicology, University of Louisville Medical Center, 550 S Jackson St, ACB 3rd Floor, Louisville, KY 40292. Electronic mail may be sent to craig.mcclain{at}louisville.edu.

Almost all patients with liver disease, especially advanced liver disease, have some evidence of malnutrition, including mineral/vitamin deficiency. A major health trend in the United States has been the significant growth in the use of complementary and alternative medicine (CAM), including nutrition supplements and herbal agents. In the 1990s, the United States government created the National Center for Complementary and Alternative Medicine (NCCAM), as well as the Office on Dietary Supplements, to extend our knowledge in these areas. CAM users are often highly educated and frequently use CAM therapy for chronic diseases, including chronic liver disease. Indeed, most studies suggest that patients with chronic liver disease frequently use nutrition supplements and CAM agents in addition to their traditional medicines. The purpose of this review is to provide an update on the role of nutrition supplements and herbals in liver disease. This article will focus mainly on 7 selected agents (vitamin E, zinc, magnesium, S-adenosylmethionine, betaine, silymarin, and glycyrrhizin), for which there have been not only in vitro and animal studies but also human clinical trials, and we will review both potential efficacy and safety issues.


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