liver
14 interactions related to liver
sertraline + kava
Kava (Piper methysticum) has central nervous system depressant effects and a documented risk of hepatotoxicity, and combining it with sertraline raises the risk of additive sedation and liver injury. Sertraline itself is associated with hepatic adverse effects in a small subset of users, and stacking hepatotoxic agents is discouraged.
alcohol + warfarin
Alcohol affects warfarin in two opposing ways: acute heavy drinking inhibits hepatic CYP2C9 metabolism of warfarin, raising INR and bleeding risk, while chronic heavy drinking induces enzymes that lower INR and increase clot risk. Alcohol also damages the liver and platelets, compounding bleeding hazards.
acetaminophen + n-acetylcysteine
N-acetylcysteine (NAC) replenishes hepatic glutathione, which the liver uses to detoxify the toxic acetaminophen metabolite NAPQI. NAC is the standard antidote for acetaminophen overdose, and routine co-use at supplement doses is considered protective rather than harmful.
choline + vitamin b12
Choline (via its metabolite betaine) and vitamin B12 power the two parallel pathways that remethylate homocysteine to methionine: the choline-betaine-BHMT route and the folate-B12-methionine-synthase route. Adequate choline can compensate for low B12 or folate status by maintaining methylation through the BHMT pathway, supporting healthy homocysteine and SAMe levels.
glutathione + vitamin c
Vitamin C reduces oxidized glutathione (GSSG) back to reduced glutathione (GSH) via the ascorbate-glutathione cycle, while glutathione in turn regenerates oxidized vitamin C (dehydroascorbate) back to ascorbate. The two antioxidants mutually recycle each other and maintain cellular redox balance.
nac + vitamin c
NAC supplies cysteine for glutathione synthesis while vitamin C reduces oxidized glutathione (GSSG) back to its active form (GSH) and directly scavenges aqueous-phase free radicals. The two work together to maintain a high GSH:GSSG ratio inside cells.
milk thistle + alpha-lipoic acid
Silymarin from milk thistle stabilizes hepatocyte membranes and inhibits toxin uptake while alpha-lipoic acid regenerates intracellular glutathione and recycles vitamins C and E. Their hepatoprotective mechanisms are complementary rather than overlapping.
nac + selenium
NAC supplies cysteine for glutathione synthesis while selenium is the obligate cofactor in glutathione peroxidase enzymes, which use glutathione to neutralize peroxides. Without adequate selenium, the glutathione that NAC helps produce cannot be fully utilized in peroxide detoxification.
alcohol + statins
Statins and alcohol are both metabolized by the liver and can independently raise transaminases; combined heavy use increases the risk of hepatotoxicity and, in some cases, myopathy or rhabdomyolysis. Atorvastatin plasma levels rise sharply in patients with alcoholic liver disease.
rooibos tea + liver enzymes
Rooibos (Aspalathus linearis) is generally well tolerated, but rare case reports describe transient elevations in liver enzymes (AST, ALT) and one report describes acute liver injury after heavy consumption. Rooibos can also modulate hepatic CYP450 enzymes in vitro, creating a theoretical risk of altering metabolism of co-administered drugs.
nac + glutathione
NAC (N-acetylcysteine) provides the rate-limiting cysteine substrate the body uses to synthesize new glutathione intracellularly, while supplemental glutathione directly replenishes the circulating and extracellular pool. The two work through complementary upstream-and-downstream mechanisms to support antioxidant defense and phase II liver detoxification.
choline + inositol
Choline and inositol are classic lipotropic nutrients: choline is required to package triglycerides into VLDL particles for export from the liver, while inositol contributes to phosphatidylinositol signaling and supports lipid metabolism. Combined, they reduce hepatic fat accumulation more than either alone in animal and small human studies.
alcohol + nac
N-acetylcysteine (NAC) is a glutathione precursor that supports the liver's primary antioxidant defense against acetaldehyde — the toxic intermediate of alcohol metabolism. Animal studies and small human trials show NAC reduces alcohol-induced oxidative stress and may modestly reduce hangover symptoms, though it does not prevent liver damage from heavy drinking.
acetaminophen + milk thistle
Milk thistle's active component silymarin reduces CYP2E1 activity and supports hepatic glutathione, both of which limit formation of the toxic acetaminophen metabolite NAPQI. Animal studies show clear protection, and the combination is considered low-risk; clinical benefit in humans is plausible but not firmly established.