Want to get loose at happy hour -- and still show up fresh for work the next day? How about saying yes to a night out with friends -- college style -- without canceling your next-morning workout? You know you'd rather enjoy an evening on your couch with a bottle of wine if you knew you'd wake up sans regret.
Such scenarios sure sound appealing -- and an increasing number of supplement and other companies know it, as the proliferation of products that claim to support the liver in its work metabolizing alcohol have shown.
Take Thrive+ After-Alcohol Aid, for example, a supplement that aims to combat the negative of effects of short-term alcohol withdrawal (read: a hangover) by supplying your body with the vitamins and other substances shown to help rehydrate the body and support liver health.
There's also drinkwel ("the multivitamin for people who drink") and blowfish ("the hangover remedy that's guaranteed to make you feel human again.") "It's a great marketing concept," admits Marianne Marchese, a naturopathic physician in Phoenix.
[See: Natural Hangover Cures.]
But whether or not they "work" or are safe is another story. In theory, products that contain synthetic versions of L-cysteine -- part of the body's natural mechanism for counteracting the toxic byproducts of overdrinking -- would be most helpful, explains Mohamed Jalloh, an assistant professor of clinical sciences at Touro University California and a spokesman for the American Pharmacists Association.
Vitamins B and C also support the activity of L-cysteine, so it makes sense they're often included in liver health and hangover prevention supplements, though that's a far cry from saying the products are recommended or evidence-based, Jalloh adds.
There's also very limited evidence suggesting ingredients including panax ginseng, prickly pear cactus and Siberian ginseng could be beneficial to ease or prevent hangovers, Jalloh says.
One study also tested the traditional Chinese hangover cure of ginger, tangerine citrus and brown sugar, and found that when taken before drinking, people experienced significantly less nausea, vomiting and diarrhea, and reported significantly better "well-being" than folks who drank remedy-free.
Still, Jalloh emphasizes, "they're small studies, have major flaws and no health organization that I'm aware of has endorsed any of these (products)."
Other herbs like milk thistle and turmeric also often come recommended by naturopathic doctors to support the liver's detoxification processes, though Jalloh didn't find any evidence behind them. Such ingredients, says Revée Barbour, a naturopathic physician and life coach in Sacramento, California, help reduce inflammation in the body. Using them, she says, allows the natural detoxification "assembly line" to work more efficiently.
But there are many "buts." For one, just because some of the products' ingredients have limited scientific support, the products themselves don't appear to have been studied in humans using randomized controls, which would be necessary for physicians to endorse them, Jalloh says. In other words: The whole is likely less than the sum of its parts. "In medicine, we recommend interventions that have data supporting they work," he says.
What's more, even supplements of a single ingredient like milk thistle aren't endorsed in the medical community since they're not regulated by the FDA and there's no telling that what you think you're purchasing is actually what you're getting, says Dr. Amon Asgharpour, an assistant professor of medicine and liver diseases at the Icahn School of Medicine at Mount Sinai in New York City.
And because you're asking your liver to process both the supplement and the alcohol, you could be adding insult to injury. Plus, as with any supplement, they can interact with medications and cause harm.
How"Is there a magic pill to clean up your liver? No," Asgharpour says. "In fact, those pills are quite dangerous." A 2017 article in the journal Hepatology even reports that liver injury caused by herbal and dietary supplements as innocent as multivitamins and green tea extract are on the rise in the U.S., contributing to 20% of liver toxicity cases. In addition, several mixtures of herbs and botanicals, including ginseng and green tea, were counted among the riskiest supplement ingredients in that study.
Finally, there's the moral question that such products bring up. "I'd be cautious as to whether they would promote more alcohol abuse behaviors," Barbour says, although Thrive+, for one, sees itself like a seatbelt for drivers or a sunscreen for beach-goers: a safety precaution taken by responsible people in situations that pose health threats, the company's website says. (Thrive+ did not respond to requests for comment.)
Fortunately, there are plenty of totally non-controversial (and effective) ways to show your liver some love, both in the immediate aftermath of overindulgence, and longer term. "The neatest thing about the liver is that it's very forgiving," Asgharpour says.
Here's how to ask for that forgiveness, in a way :
1. Booze less (or not at all).
Liver damage is often reversible -- if you ease up on or cut out what caused it to begin with, in this case, alcohol, Asgharpour says. And while it's not entirely clear why some people experience liver damage from drinking and others don't, nor exactly how much booze is "safe," it's best to stick to government recommendations of no more than one drink a day for women and two for men, he says.
As Barbour puts it: "We're always looking for the quick fix, but sometimes the quick fix is taking it easy. Stop doing some of those behaviors that got you in the hot seat to begin with."
2. Drink coffee.
Good news, java lovers: More and more research shows that your liver loves good-old caffeinated coffee. Not only may it help reduce the risk of liver disease by as much as 70%, it may also help protect against alcohol-related cirrhosis.
One 2016 meta-analysis including over 430,000 people, for instance, linked a cup of coffee a day with a 22% reduced risk of developing the condition. Further, while four cups a day decreased the risk by a whopping 65%, perhaps due to the drink's anti-inflammatory properties. "There's no magic pill, however, there is a wealth of information on coffee," Asgharpour says. "As a doctor, I tell people 'don't, don't, don't,' but coffee is a 'do.'"
3. 'Detox' via foods.
It might be attractive to reach for a pill to correct any health issue, but Barbour says "But you don't need that product in order to get those benefits because you'll get those benefits from eating a healthy diet."
Drink green tea and water instead of sugary soda, for instance, and cook with anti-inflammatory spices like turmeric and ginger rather than popping them in supplement form.
4. Limit other insults to the liver.
Alcohol isn't the only thing that can damage your liver -- a sedentary lifestyle and unhealthy diet can also cause fat to build up around the liver and lead to liver disease, even if you've never had a cocktail in your life, Asgharpour says. (Intravenous and intranasal drugs can also transmit hepatitis C, he adds, so you're not exactly doing your liver a favor if you choose drugs over drinks.)
Instead, do what you already know is healthy: Practice eating in moderation and exercising regularly rather than rolling the dice on liver detox products.
"You're putting your money into something that you're unclear will help and may in fact harm you," Asgharpour says. "It's a no-win situation. I'd rather focus on spending that money on going to the gym." Plus, Jalloh says, muscle absorbs alcohol better than fat, so hit the weights while you're there to better prevent hangovers if you resume drinking.
5. Get guidance.
Another problem with hangover-prevention products? They're one-size-fits all. "All of us have different circumstances; our bodies react differently to stressors and toxins and other factors," Barbour says. As such, efforts to support your liver should be tailored to your lifestyle and genetic risk factors.
Visit your doctor for routine blood work or a new, non-invasive ultrasound test called FibroScan that can help your healthcare provider assess your liver's condition in a more quantifiable way. "The liver doesn't tell you something bad is going on until late in the game," Asgharpour says, so if you're worried, have it checked out.
Working with an addiction specialist or hepatologist can also be important to better understand and address why you're turning to alcohol in the first place, and to put a plan in place that manages the potentially deadly symptoms of alcohol withdrawal.
"If you're drinking pretty often," Asgharpour says, "you should see a specialist to talk to about underlying depression and how to (detox) safely so it doesn't become deadly."