Liver supplements popularity on the rise despite limited evidence

The market for liver supplements is rapidly growing despite lacking scientific evidence to support their efficacy claims, reveals a study.

“The prevalence of bold health claims, high consumer satisfaction, and significant sales highlight the need for more rigorous evaluation and regulation of these products,” the researchers said.

“Healthcare providers should be aware of these trends to better counsel patients on evidence-based approaches to liver health,” they added.

Using specific search criteria, the research team identified the top 20 liver cleansing supplements on Amazon and analysed the product composition, marketing claims, customer review, sales data, and revenue. They used AMZScout for sales analytics and FakeSpot for review authenticity assessment.

Furthermore, the researchers identified the most common ingredients of these supplements and examined their scientific evidence through structured searches of PubMed, with predefined criteria for evidence quality assessment.

The total annual sales generated by the leading liver supplements in the market were 1,420,584 units, with a revenue of $38,783,937. These products claimed to “eliminate toxins” or offer “liver detox/cleanse,” while most supplements (85 percent) claimed to “enhance liver function.” [Am J Gastroenterol 2026;121:171-178]

In terms of product rating, the average score given by reviewers was 4.4 out of 5 stars. The reliability of these reviews had an average score of 73 percent.

Nearly all liver supplements contained milk thistle (19/20 products). Other common ingredients were turmeric root and dandelion (13/20 each). Notably, the scientific evidence supporting the efficacy of these ingredients in liver health was lacking or inconclusive.

“[O]ur study highlights the need for greater scrutiny of the liver supplement market,” the researchers said. “Despite generating nearly $40 million in annual revenue, the scientific evidence supporting these supplements remains limited and inconclusive.”

Billion-dollar market

By 2034, the market for liver supplements is expected to reach $17.1 billion. Unfortunately, the regulatory oversight under the Dietary Supplement Health and Education Act remains minimal, allowing these products to enter the market without US FDA approval. [https://www.fda.gov/food/dietary-supplements; https://www.futuremarketinsights.com/reports/liver-health-supplements-market]

“This regulatory framework differs significantly from other regions,” according to the researchers.

For instance, the European Union’s Food Supplements Directive mandates premarket safety assessment, while the Natural Health Product Regulations in Canada require premarket licensing based on evidence for claims. [J Eur Communities 2002;L183:51-57; https://laws-lois.justice.gc.ca/eng/regulations/SOR-2003-196/]

“These stricter approaches have been associated with fewer adverse events,” the researchers said. [J Dietary Supplements 2022;19:589-607]

Misleading

Products claims to eliminate toxins or provide liver detox/cleanse without conclusive evidence may “mislead consumers and potentially delay evidence-based interventions,” according to the researchers, adding that drug-induced liver injury (DILI) remains a significant concern with dietary supplements.

In the US, herbal and dietary supplements are responsible for about one in five (20 percent) DILI cases, according to the DILI Network. [Gastroenterology 2015;148:1340-1352.e7]

Furthermore, hepatoxicity has been reported in some products containing green tea extract (found in 10 percent of the current cohort). [Arch Toxicol 2015;89:1175-1191]

“Without stringent manufacturing and testing requirements, liver supplements may pose risks beyond their listed ingredients,” the researchers said.