Non-alcoholic Fatty Liver Disease is a liver disease characterized by fat accumulated in the liver, not caused by abusive alcohol consumption.
The disease is also manifested by steatosis, steatohepatitis, cirrhosis.
Nonalcoholic fatty liver disease (NAFLD) is emerging as a widespread condition in US due to increase obesity in adult population.
Obesity is associated linearly to the prevalent risk of nonalcoholic fatty liver disease (NAFLD).
In conventional medicine, treatments of NAFLD are mainly focus on weight loss accompanied to pharmacologic therapy in control of insulin resistance and dyslipidemia.
As of today, there are no effective pharmacologic therapy approved specifically and directly for treatment of nonalcoholic fatty liver disease (NAFLD).
Finding the natural treatments for less or no side effects have become an urgency in many scientific communities, including researchers at the Universities.
Alternative medicines for the treatment of NAFLD have been expressed in numbers of successful histories.
1. Turmeric
Turmeric is a perennial plant in the genus Curcuma, belongings to the family Zingiberaceae, native to tropical South Asia.
Turmeric has long been used in herbal medicine in treating numbers of disease.
Today, its curcuminoid, curcumin has attracted interests from researchers in many parts of the world.
Curcumin, as an antihyperlipidemic agent, has been found to lower the "bad cholesterol" low density lipoprotein (LDL), and increase high density lipoprotein (HDL) of which reduce the risk of fat accumulated in the tissues in the liver.
In the support of the above, the water-soluble curcumin derivative was tested for its efficacy against steatohepatitis which is an inflammation of the liver with concurrent fat accumulation in liver, researchers found that the derivative not only significantly alleviates fibrosis but also decreases the grade of liver steatosis.
2. Hawthorn
Hawthorn is a shrubs and trees of the genus Crataegus, belongings to the family Rosaceae, native to temperate regions of the Northern Hemisphere in Europe, Asia and North America.
The herb has been used in traditional medicine to treat heart disease and symptoms of heart diseases such as irregular heartbeat, high blood pressure, chest pain, hardening of the arteries, etc., circulatory disorders and respiratory illnesses.
Out of 246 kinds of Chinese herb, hawthorn fruit is found in the list of many formulas for treatments of Nonalcoholic fatty liver disease (NAFLD).
3. Phytochemical Berberine and Resveratrol
Berberine and resveratrol, the phytochemical found abundantly in many vegetables and fruits as well as herbs and herbal formulas such as Polygonum hypoleucum Ohwi, and Artemisia sacrorum Ledeb., and formulae including Yinchenhao Decoction (, YCHD), Qushi Huayu Decoction (, QSHYD), and Danning Tablet.
According to studies, these formulas not only improved biochemical and histological change in nonalcoholic fatty liver disease, but also inhibited lipid accumulation by up regulating low-density lipoprotein receptor (LDLR) expression, alleviating lipid peroxidation, and reducing the production of inflammatory cytokines.
In such instance, Berberine and resveratrol, may be considered as a potential treatment for nonalcoholic fatty liver disease in the future.
5. Phytochemical Triterpenoid
Triterpenoid is a various unsaturated hydrocarbons, found in essential oils and oleoresins of plants, including Ilex hainanensis Merr.
In the study to test the effect of Triterpenoid-rich fraction (TP) from Ilex hainanensis Merr. on NAFLD with Male Sprague-Dawley (SD) fed with a normal diet (control) or high fat diet (NAFLD model), after 4 weeks, then orally administrated TF (250 mg/kg) for another two weeks, researchers showed that TP not only improves the symptoms of the subjects, but also decreases the levels of triglyceride, total cholesterol, low-density lipoprotein cholesterol, abnormality of lipid accumulation, levels of inflammation and infection and apoptosis response in the liver.
Of these results, TF is effective in protecting liver against NAFLD by regulating lipids metabolism and alleviating insulin resistance, inflammation and oxidative stress.
6. Peony
Mu Dan Pi or Dan Pi (Cortex Moutan Radicis) is also known as peony.
The acrid, bitter and mild cool herb has been used in TCM as anti micro organism, anti inflammatory agent and to enhance circulation and immune system, etc., as it clears heat and cools the blood, clears fire of yin deficiency, clear blood stasis and rid of clots, etc., by enhancing the functions of heart, liver and kidney channels.
Peony, a very popular Chinese herb is emerging as in many study for its anti-inflammatory, anticoagulative, anti-microbial and cytokine modulating effects, as well as properties as treatments of arthritis and asthma.
In the study of the effects of peony in non alcoholic liver disease caused by insulin resistance with Adult SD rats fed on high-fat-sugar-salt diet for 56 days, divided randomly into nonalcoholic fatty liver model group, metformin group (0.2 g x kg(-1)) and total glucosides of peony group, scientists at end of experiment showed that oral administration of total glucosides not only inhibit hyperinsulinaemia but also decrease levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C).
Further analysis also found that peony also raises levels of high-density lipoprotein cholesterol (HDL-C)] and ameliorates the over expression of activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), cholinesterase (ChE) and superoxide dismutase (SOD) as well as contents of malondialdehyde (MDA).
These results suggested that paeony may consist a potential effect in protecting liver function by modulating serum lipid and decreasing oxidative stress caused by lipid peroxidation in induction of fatty liver.
7. Bay berry
Bay berry is a species of Myrica gale, genus Myrica, belongings to the family Myricaceae.
The herbal medicine contains numbers of bioactive chemical constituents, including gallic acid, quercetin hexoside, quercetin deoxyhexoside, quercetin, anthocyanins, flavonols, and elllagitannins.
In a randomized, placebo-controlled, double-blind, crossover study of 44 participants (ages 18-25 y) given 250 mL of either bayberry juice or placebo twice daily for 4 wk, researchers found that intake of bay berry juice decreases inflammation and infection, liver cell apoptosis, and death of liver tissues as well as reducing risk of steatosis progression in precipitated NALFD.
8. Green Tea
Green tea, a precious drink processes numbers of health benefit known to almost everyone in Asia and Western world.
According to the University of Connecticut, Storrs, the efficacy of green tea for treatment of obese patients with nonalcoholic fatty liver disease is associated to its antioxidant compound polyphenolic catechins in induction of hypolipidemic, thermogenic, antioxidant, and anti-inflammatory activities.
These chemical compounds are also found to mitigate the occurrence and progression of NAFLD.
Dr. Masterjohn C(7), the lead author said, "(The phytochemical compounds are) demonstrating the hepatoprotective properties of green tea and its catechins and the proposed mechanisms by which these targeted dietary agents protect against NAFLD".
In mice fed on a high-fat diet for 24 weeks, then injected with EGCG (10, 20 and 40 mg·kg(-1)·d(-1), ip), for 4 weeks, researchers found that treated mice show a significant improvement of body weight, grade 2 or 3 liver fatty degeneration (steatosis, lobular inflammation and ballooning), severe hyperlipidemia, hyperglycemia, hyperinsulinemia and insulin resistance caused by high-fat diet.
The phytocheimcal EGCG, in dose-dependent also enhanced insulin clearance and upregulated IDE protein expression and enzyme activity in regulated levels of glucose in the liver of treated mice.
In fact EGCG not only promoted weigh loss but also attenuated symptoms of mice with nonalcoholic fatty liver disease.
Administration of green tea polyphenols (GTP) on non-alcoholic fatty liver disease (NAFLD) in Zucker fatty (ZF) rats, not only decreased weight gain and visceral fat but also reduced fasting serum insulin, glucose and lipids levels, through ameliorated expression of hepatic TG accumulation and cytoplasmic lipid droplet as well as diminished hepatic lipogenesis and triglycerides out flux from liver.
9. Anise
Arnica is a herbaceous species, genus perennial, belongings to the family Asteraceae, antive to Europe and Asia, used in herbal medicine for centuries in treatment of strains, sprains, and bruises.
Wound healing is process of repairing after damage of skin, tissues, organs, etc.
In the comparison the effect of anise fruit essential oil and extract and risk of nonalcoholic fatty liver disease, researchers at the Islamic Azad University conducted an study of 60 rats randomly divided into ten groups, six in each group with NAFLD induced by using choline-deficient diet for 90 days and followed by 30 days of treatment with 25, 50, 100, and 200 mg/kg/day of hydroethanolic extract (AE) as well as 0.125, 0.25, and 0.5 mg/kg/day of essential oil (AO).
At the end of the experiment, researchers found that both applications exert a significantly reverse activities in increased plasma levels of total cholesterol, low-density lipoprotein, and triacylglycerol and decreased in high-density lipoprotein level caused by choline-deficient diet in dose-dependent manner.
Additional differentiation also found that AE and AO reduced the elevated levels of enzymes aspartate transaminase (AST) and alanine transaminase (ALT) which are considered as an indication of either liver injure or damage caused by the acute inflammation..
Observation of injection anise AE and AO also exerted a powerful antioxidant activity in significant lower over expression of ROS in exhibited free radical chain reaction in induction of oxidative stress to precipitated liver toxicity.
According to the histological findings, researchers concluded that both AE and AO display a substaintial effect in reduced macrovesicular steatohepatitis which is the leading cause of liver cancer.
Further analysis also addressed that both anise AE and AO demonstrated a strong effect in ameliorated lipid peroxidation induced by oxidative stress indicated by elevation of plasma level of 8-isoprostane which is correlated to the prevalence of non-alcoholic fatty liver disease (NAFLD).
Taken together, remedies indicated may be considered as functional foods for treatment of non-alcoholic fatty liver disease (NAFLD).
However, additional data collection on clinical studies performed with human consumption on large sample size and multi canters during the course of diseases will be necessary to complete the picture of above natural remedies' effects in complete the treatment possibilities.
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Author biography
Kyle J. Norton, Master of Nutritions
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.
Sources
(1) Curcumin and liver disease.Vera-Ramirez L, PĂ©rez-Lopez P, Varela-Lopez A, Ramirez-Tortosa M, Battino M, Quiles JL.(PubMed)
(2) [The effects of curcumin derivative on experimental steatohepatitis].[Article in Chinese] by Zeng CH, Zeng P, Deng YH, Shen N, Peng ML, Liu Q, Ren H.(PubMed)
(3) Methodologies for investigating natural medicines for the treatment of nonalcoholic fatty liver disease (NAFLD) by Kim MS, Kung S, Grewal T, Roufogalis BD.(PubMed)
(4) Traditional Chinese medicines benefit to nonalcoholic fatty liver disease: a systematic review and meta-analysis by Shi KQ, Fan YC, Liu WY, Li LF, Chen YP, Zheng MH.(PubMed)
(5) Non-alcoholic fatty liver disease and liver transplantation: Outcomes and advances by Said A.(PubMed)
(6) The effects of ezetimibe on non-alcoholic fatty liver disease and glucose metabolism: a randomised controlled trial by Takeshita Y, Takamura T, Honda M, Kita Y, Zen Y, Kato KI, Misu H, Ota T, Nakamura M, Yamada K, Sunagozaka H, Arai K, Yamashita T, Mizukoshi E, Kaneko S.(PubMed)
(7) Pharmacokinetic study of major bioactive components in rats after oral administration of extract of Ilex hainanensis by high-performance liquid chromatography/electrospray ionization mass spectrometry by Jie Yanga,1, Fang Lva, 1, Xiao-qing Chenb, Wei-xi Cuia, Li-hong Chenc, Xiao-dong Wena, Qiang Wanga(Science direct)
(8) Triterpenoid-rich fraction from Ilex hainanensis Merr. attenuates non-alcoholic fatty liver disease induced by high fat diet in rats by Cui WX, Yang J, Chen XQ, Mao Q, Wei XL, Wen XD, Wang Q.(PubMed)
(9) Chinese Herbs – Mu Dan Pi or Dan Pi (Cortex Moutan Radicis)
(10) [Effects of total glucosides of paeony on enhancing insulin sensitivity and antagonizing nonalcoholic fatty liver in rats].[Article in Chinese] by Zheng LY, Pan JQ, Lv JH.(PubMed)
(11) Therapeutic potential of green tea in nonalcoholic fatty liver disease by Masterjohn C1, Bruno RS.(PubMed)
(12) Green tea polyphenol epigallocatechin-3-gallate ameliorates insulin resistance in non-alcoholic fatty liver disease mice by Gan L1, Meng ZJ1, Xiong RB2, Guo JQ1, Lu XC1, Zheng ZW1, Deng YP1, Luo BD1, Zou F3, Li H1.(PubMed)
(13) Green tea polyphenols ameliorate non-alcoholic fatty liver disease through upregulating AMPK activation in high fat fed Zucker fatty rats by Tan Y1, Kim J1, Cheng J1, Ong M1, Lao WG1, Jin XL1, Lin YG1, Xiao L1, Zhu XQ1, Qu XQ1.(PubMed)
(14) Pimpinella anisum L. fruit: Chemical composition and effect on rat model of nonalcoholic fatty liver disease by Asadollahpoor A1, Abdollahi M2, Rahimi R3,(PubMed)
(2) [The effects of curcumin derivative on experimental steatohepatitis].[Article in Chinese] by Zeng CH, Zeng P, Deng YH, Shen N, Peng ML, Liu Q, Ren H.(PubMed)
(3) Methodologies for investigating natural medicines for the treatment of nonalcoholic fatty liver disease (NAFLD) by Kim MS, Kung S, Grewal T, Roufogalis BD.(PubMed)
(4) Traditional Chinese medicines benefit to nonalcoholic fatty liver disease: a systematic review and meta-analysis by Shi KQ, Fan YC, Liu WY, Li LF, Chen YP, Zheng MH.(PubMed)
(5) Non-alcoholic fatty liver disease and liver transplantation: Outcomes and advances by Said A.(PubMed)
(6) The effects of ezetimibe on non-alcoholic fatty liver disease and glucose metabolism: a randomised controlled trial by Takeshita Y, Takamura T, Honda M, Kita Y, Zen Y, Kato KI, Misu H, Ota T, Nakamura M, Yamada K, Sunagozaka H, Arai K, Yamashita T, Mizukoshi E, Kaneko S.(PubMed)
(7) Pharmacokinetic study of major bioactive components in rats after oral administration of extract of Ilex hainanensis by high-performance liquid chromatography/electrospray ionization mass spectrometry by Jie Yanga,1, Fang Lva, 1, Xiao-qing Chenb, Wei-xi Cuia, Li-hong Chenc, Xiao-dong Wena, Qiang Wanga(Science direct)
(8) Triterpenoid-rich fraction from Ilex hainanensis Merr. attenuates non-alcoholic fatty liver disease induced by high fat diet in rats by Cui WX, Yang J, Chen XQ, Mao Q, Wei XL, Wen XD, Wang Q.(PubMed)
(9) Chinese Herbs – Mu Dan Pi or Dan Pi (Cortex Moutan Radicis)
(10) [Effects of total glucosides of paeony on enhancing insulin sensitivity and antagonizing nonalcoholic fatty liver in rats].[Article in Chinese] by Zheng LY, Pan JQ, Lv JH.(PubMed)
(11) Therapeutic potential of green tea in nonalcoholic fatty liver disease by Masterjohn C1, Bruno RS.(PubMed)
(12) Green tea polyphenol epigallocatechin-3-gallate ameliorates insulin resistance in non-alcoholic fatty liver disease mice by Gan L1, Meng ZJ1, Xiong RB2, Guo JQ1, Lu XC1, Zheng ZW1, Deng YP1, Luo BD1, Zou F3, Li H1.(PubMed)
(13) Green tea polyphenols ameliorate non-alcoholic fatty liver disease through upregulating AMPK activation in high fat fed Zucker fatty rats by Tan Y1, Kim J1, Cheng J1, Ong M1, Lao WG1, Jin XL1, Lin YG1, Xiao L1, Zhu XQ1, Qu XQ1.(PubMed)
(14) Pimpinella anisum L. fruit: Chemical composition and effect on rat model of nonalcoholic fatty liver disease by Asadollahpoor A1, Abdollahi M2, Rahimi R3,(PubMed)
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