Liv52 by Ray Sahelian, M.D.

An internet search reveals Liv 52 has these ingredients and the claims made by the company selling it. Capers (Capparis spinosa) - Well-documented hepatic stimulant and protector. Improves the functional efficiency of the liver. Wild Chicory (Cichorium intybus) - Powerful hepatic stimulant, increases bile secretion, acts on liver glycogen and promotes digestion. Black Nightshade (Solanum nigrum) – Promotes liver and kidney health and has shown hepatoprotective activity in cases of toxicity induced by drugs and chemicals. Arjuna (Terminalia arjuna) – Tonic for heart and liver. Regulates hepatic cholesterol biosynthesis. Negro Coffee (Cassia occidentalis) – Digestive and hepatic tonic.  Yarrow (Achillea millefolium) – Stimulative tonic for the liver. Tamarisk (Tamarix gallica) - Hepatic stimulant; also provides digestive support.
   We have reviewed some of the studies with Liv 52 and the results do not seem to be consistent. Some studies show positive outcomes for Liv52 while others do not show Liv52 to be beneficial in liver disease.

Evaluation of the radioprotective effect of Liv 52 in mice.
Environ Mol Mutagen. 2006 Aug;47(7):490-502. Department of Radiobiology, Kasturba Medical College, Manipal, Karnataka, India.
Liv 52 is a mixture of botanicals that is used clinically to treat various liver disorders. In this study, the radioprotective activity of Liv 52 was evaluated in mice given whole-body exposure to different doses of gamma-radiation. Radioprotection was evaluated by the ability of Liv 52 to reduce both the frequency of bone marrow micronucleated erythrocytes and the lethality produced by (60)Co gamma-radiation. Mice were treated by oral gavage once daily for seven consecutive days with 500 mg/kg body weight Liv 52 or carboxymethylcellulose vehicle prior to radiation. The results of this study indicate that pretreatment with Liv 52 reduces the genotoxic and lethal effects of gamma-irradiation in mice and suggest that this radioprotection may be afforded by reducing the toxic effects of the oxidative products of irradiation.

Natural and complementary therapies for substance use disorders.
Curr Opin Psychiatry. 2005 May;18(3):271-6. Dean AJ. Kids in Mind Research, Mater Child and Youth Mental Health Service and Mater Pharmacy Services, Mater Hospital, South Brisbane, Queensland, Australia.
To review recent studies that have examined the efficacy of natural and complementary therapies as treatments for substance use disorders and their complications. Neither vitamin E nor Liv 52 had a useful effect in alcohol-related liver disease.

The efficacy of Liv-52 on liver cirrhotic patients: a randomized, double-blind, placebo-controlled first approach.
Phytomedicine. 2005 Sep;12(9):619-24. Department of Pharmacology, Institute of Medicinal Plants, No. 97, Bozorgmehr St., Ghods St., Enghelab Ave., Tehran, Iran.
In the present study, the efficacy of herbal medicine Liv-52 (consisting of Mandur basma, Tamarix gallica and herbal extracts of Capparis spinosa, Cichorium intybus, Solanum nigrum, Terminalia arjuna and Achillea millefolium) on liver cirrhosis outcomes was compared with the placebo for 6 months in 36 cirrhotic patients referred to Tehran Hepatic Center. The outcome measures included child-pugh score, ascites, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total billirubin, albumin, prothrombin time, platelet and white blood cells counts. The indices were recorded in all patients before and after 6 months of drug or placebo treatment. The results demonstrated that the patients treated with Liv-52 for 6 months had significantly better child-pugh score, decreased ascites, decreased serum ALT and AST. In placebo administered patients all the clinical parameters recorded at beginning of the study were not significantly different than after 6 months. We conclude that Liv-52 possess hepatoprotective effect in cirrhotic patients. This protective effect of Liv-52 can be attributed to the diuretic, anti-inflammatory, anti-oxidative, and immunomodulating properties of the component herbs.

Effect of spirulina and Liv-52 on cadmium induced toxicity in albino rats.
Indian J Exp Biol. 2005 Sep;43(9):773-81. Department of Biochemistry, Dr NGPArts & Science College, Kovai Medical Center Research & Educational Trust, Coimbatore 641 014, India.
Oral administration of cadmium (6mg/kg body weight/day) as cadmium chloride (CdCl2) for 30 days resulted in a significant increase in thiobarbituric acid reactive substances (TBARS) level and a decrease in the levels of copper, zinc, iron, selenium, glutathione, superoxide dismutase, catalase, glutathione peroxidase when compared to normal control. Administration of either Liv-52 alone or in combination with spirulina produced a well pronounced protective effect in respect to these parameters in cadmium intoxicated rats. The protective effect of spirulina and Liv-52 in respect to biochemical changes were also confirmed by histopathological study in the liver and kidney sections.

Herbal medicines for liver diseases.
Dig Dis Sci. 2005 Oct;50(10):1807-12. Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Herbal medicines have been used in the treatment of liver diseases for a long time. A number of herbal preparations are available in the market. This article reviews four commonly used herbal preparations: (1) Phyllanthus, (2) Silybum marianum (milk thistle), (3) glycyrrhizin (licorice root extract), and (4) Liv 52 (mixture of herbs). Phyllanthus has a positive effect on clearance of HBV markers and there are no major adverse effects; there are no data from randomized controlled trials on clinically relevant outcomes, such as progression of chronic hepatitis to cirrhosis and/or liver cancer, and on survival. Silymarin does not reduce mortality and does not improve biochemistry and histology among patients with chronic liver disease; however, it appears to be safe and well tolerated. Stronger neominophagen C (SNMC) is a Japanese preparation that contains 0.2% glycyrrhizin, 0.1% cysteine, and 2% glyceine. SNMC does not have antiviral properties; it primarily acts as an anti-inflammatory or cytoprotective drug. It improves mortality in patients with subacute liver failure and improves liver functions in patients with subacute hepatic failure, chronic hepatitis, and cirrhosis with activity. SNMC does not reduce mortality among patients with cirrhosis with activity. SNMC may prevent the development of hepatocellular carcinoma in patients with chronic hepatitis C, however, prospective data are lacking. Liv 52, an Ayurvedic hepatoprotective agent, is not useful in the management of alcohol-induced liver disease.

Liv.52 in alcoholic liver disease: a prospective, controlled trial.
J Ethnopharmacol. 2003 Jan;84(1):47-50. Department of Pharmacology, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama, Sri Lanka.
Liv.52, a hepatoprotective agent of herbal origin, is used empirically for the treatment of alcoholic liver disease in Sri Lanka. We conducted a controlled trial to assess the efficacy of Liv.52 in patients with alcoholic liver disease. Patients with evidence of alcoholic liver disease attending outpatient clinics were included in a prospective, double blind, randomized, placebo controlled trial. During the trial period, 80 patients who fulfilled inclusion criteria were randomly assigned Liv.52 (cases; n = 40) or placebo (controls) the recommended dose of three capsules twice daily for 6 months. All patients underwent clinical examination (for which a clinical score was computed), and laboratory investigations for routine blood chemistry and liver function before commencement of therapy (baseline). Thereafter, clinical assessments were done monthly for 6 months, while laboratory investigations were done after 1 and 6 months of therapy. There was no significant difference in the age composition, alcohol intake and baseline liver function between the two groups. The two-sample t-test was used to analyze data obtained after 1 and 6 months of therapy against baseline values. There was no significant difference in clinical outcome and liver chemistry between the two groups at any time point. There were no reports of adverse effects attributable to the drug. Our results suggest that Liv.52 may not be useful in the management of patients with alcohol induced liver disease.

Hepatoprotective effects of Liv-52 on ethanol induced liver damage in rats.
Indian J Exp Biol. 1999 Aug;37(8):762-6. Department of Biochemistry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
The mechanism of protective effects of Liv-52, a multiherbal hepatoprotective drug, on ethanol induced hepatic damage has been investigated. The results indicate that Liv-52 treatment prevents ethanol induced increase in the activity of the enzyme gamma-glutamyl transpeptidase. Concomitantly there was also a decrease in ethanol accentuated lipid peroxidation in liver following Liv-52 treatment. The activity of antioxidant enzymes; superoxide dismutase, glutathione peroxidase and the levels of glutathione were decreased following ethanol ingestion. Liv-52 treatment was found to have protective effects on the activity of superoxide dismutase and the levels of glutathione. The results obtained from the study indicate hepatoprotective nature of Liv-52 which might be attributed to its ability to inhibit lipid peroxidation.

[The effect of the heptoprotective agent LIV 52 on liver damage]
Cas Lek Cesk. 1997 Dec 17;136(24):758-60. interni klinika 1, LF UK a VFN, Praha.
The action of hepatoprotective drugs is a steady subject of discussions. Despite the equivocal character of action hepatoprotective drugs are used, despite the fact that the effect is partly a placebo effect. In the literature are reports on preparation LIV 52 which is a mixture of substances of plant origin and improves the subjective complaints of patients as well as the objective condition of patients with liver disease. The effect of preparation LIV 52 was investigated in a retrospective study in 19 patients with liver damage. In the majority liver damage caused by alcohol was involved, steatosis and persisting hepatitis without the finding of chronic hepatitis B and C. The authors investigated biochemical parameters (bilirubin, ALT, AST, ALP, TZR, cholesterol). The size of the liver was assessed by ultrasonography and the subjective status of the patients was recorded. Within one year of administration of the preparation subjective improvement occurred, hepatomegaly diminished and the activity of aminotransferases declined. CONCLUSIONS: Administration of LIV 52 can improve the subjective condition and clinical parameters in patients with liver damage, in particular in alcoholic liver damage and in steatosis. The effect is certainly due also to better motivation on the patients part, better lifestyle and dietary measures. After one year of treatment no undesirable side-effects were detected.