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The Herbal Medicines Which Treat Non

Alcoholic Fatty Liver Disease (NAFLD)

Naturally, According to Studies
By Kyle J. Norton

Nonalcoholic fatty liver disease (NAFLD) is a chronic condition caused by fat

accumulated in the liver over time, in the absence of excessive alcohol use. The
disease can be classified into the types of non-inflammatory fatty liver (NAFl)
and inflammatory nonalcoholic steatohepatitis (NASH)(1).

Nonalcoholic fatty liver disease (NAFLD) is one of the major causes of

cirrhosis and liver cancer.

According to world statistics, nonalcoholic fatty liver disease (NAFLD) is

normally known as a disease of the Western world(2). However, due to the
economic prosperity of Southeast Asian(3), the disease also was found in a
large number of population in the cities, causing concerns of many scientists in
the region(4)(6).

According to the joint assessment of the prevalence of non-alcoholic fatty liver

disease and risk factors for advanced fibrosis and mortality in the US, led by
the Stanford University School of Medicine, "The prevalence of NAFLD in the
United States (U.S.) has risen from 18% in 1988–1991 to 31% in 2011–2012.
Estimates of NAFLD prevalence for adults in Western countries is 20–30%,
with much higher prevalence in adults with obesity (80–90%), diabetes (30–
50%), and hyperlipidemia (90%)"(5).

Among the more affluent regions of China, the prevalence rate of non-alcoholic
fatty liver disease (NAFLD) is approximately 15%(6). The number may
decrease substantially if the poor rural populations where obesity is non-
existence are also taking into account(7).

The exact causes of NAFLD aren't well understood. Some researchers

suggested that certain risk factors such as long-term use of certain
medications(8), genetic preposition(8), insulin resistance(8), high cholesterol(8)
and triglycerides(8) in the blood, polycystic ovary syndrome(8), metabolic
syndrome(8), obesity(8), and type 2 diabetes(8) are associated with the onset of
the disease.
Recent studies also found that people with obstructive sleep apnea(11),
underactive thyroid (hypothyroidism(10) and underactive pituitary gland
(hypopituitarism) (9) also at an increased risk of the NALFD.

Some researchers suggested that unhealthy diet such as high-fat diet may also
have a strong implication on NAFLD(12)(13).

Dr. Jensen VS, the lead scientist in the study high-fat diet-induced non-
alcoholic fatty liver disease, wrote, "In humans and animal models, excessive
intake of dietary fat, fructose, and cholesterol has been linked to the
development of non-alcoholic fatty liver disease (NAFLD)"(13).

And, " Only HFr-fed rats developed dyslipidemia as characterized by higher

levels of plasma triglycerides compared to all other groups (p < 0.0001).
Hepatic dysfunction and inflammation was confirmed in HFD-fed rats by
elevated levels of hepatic MCP-1 (p < 0.0001), TNF-alpha (p < 0.001) and
plasma β-hydroxybutyrate (p < 0.0001), and in NASH-fed rats by elevated
levels of hepatic MCP-1 (p < 0.01), increased hepatic macrophage infiltration
(p < 0.001), and higher plasma levels of alanine aminotransferase (p < 0.0001)
aspartate aminotransferase (p < 0.05), haptoglobin (p < 0.001) and TIMP-1 (p <
0.01) compared to Control"(13).

According to the statistics, in the US, over 100 million people have non-
alcoholic fatty liver disease and the condition is more double over the past 20
years(14). The disease also is the most prevalent liver disease in children(14).

The prevalence rate of NAFLD is varied among different ethnic groups in the
US. Dr. Rich NE, the lead scientist in the investigation of the ethnicity and
NAFLD, wrote, "NAFLD prevalence was highest in Hispanics, intermediate in
Whites, and lowest in Blacks, although differences between groups were
smaller in high-risk cohorts (range 47.6%-55.5%) than population-based
cohorts (range, 13.0%-22.9%)(15)".

And, "Among patients with NAFLD, the risk of NASH was higher in Hispanics
(relative risk, 1.09; 95% CI, 0.98-1.21) and lower in Blacks (relative risk, 0.72;
95% CI, 0.60-0.87) than Whites"(15).

The progression of NAFLD and NASH led to cirrhosis, the late stage of liver
scarring are well defined, as the liver tries to heal itself by halting
inflammation(16), leading to symptoms of ascites(16)(18), swell esophageal
varices(16)(19), hepatic encephalopathy(16)(17) and complications of liver
cancer(16)(17) and liver failure(16)(17).

Most people at the early stage NAFLD are asymptomatic, however, as the
disease progression into the later stage, most patients experience symptoms of
right upper abdominal discomfort(20), fatigue(20), and/or malaise(20), and
jaundice(20) with yellowing of the skin and eyes(20).

Most patients with NAFLD have elevated levels of liver enzymes gamma-
glutamyl transferase (GGT)(21) and/or Aspartate Aminotransferase (AST)(21)
to platelet ratio index (APRI) score(21), and/or Alanine Aminotransferase
(ALT) (21) which are the markers used to predict the severity of liver disease
including the fatty liver. A blood test is required if you suspected to have
developing nonfatty liver disease.

Conventionally, as of today, there is no effective treatment of NAFLD(22)(23).

Weight loss for overweight and obese patients(22) has been recommended
through our the industry accompanied by the change of lifestyles(22) such as
moderate exercise and reduced intake of alcohol, depending on individuals.

Patients who are hepatitis virus B and C carriers are also recommended to be

Given the nature of the nonalcoholic fatty liver disease, the search for effective
treatment for NAFLD from the natural sources used over thousands of years in
traditional medicine for the treatment of liver disease has been intensified(23).
Many secondary metabolites, whole foods, and herbal medicine have been
found to be effective in vivo, vitro and small human trials(24). However, most
of them were stopped due to a simple reason. Who will spend billions to prove
the thing which has no commercial values? Secondary metabolites, whole
foods, and herbal medicine cannot be patented.

Herbal medicines
Herbal medicines have been used as medicines over thousands of year in
human history.
1. Herbal Anise
Herbal anise is a flowering plant of the species of Pimpinella anisum, genus
Pimpinella, belongings to the family Apiaceae native to Egypt and the
Mediterranean region, used in traditional herbal medicine as a fragrance in
soaps, oils, and mouth fresheners and stomachic, antiseptic, anti-spasmodic

In animal NAFLD induced by choline-deficient diet for 90 days, 30 days

treatment with hydroethanolic extract (AE) at 25, 50, 100, and 200 mg/kg/day
and essential oil (AO) at 0.125, 0.25, and 0.5 mg/kg/day, reversed plasma levels
of total cholesterol962), low-density lipoprotein(62), and triacylglycerol(62)
and decrease in high-density lipoprotein level(62) caused by choline-deficient
diet in dose-dependent manner.

AE and AO also reduced the elevated levels of enzymes aspartate transaminase

(AST)(62) and alanine transaminase (ALT)(62) which are considered as an
indication of either liver injury or damage caused by the acute inflammation.

Additionally, anise AE and AO demonstrated a strong effect in ameliorated

lipid peroxidation induced by oxidative stress(62) indicated by elevation of
plasma level of 8-isoprostane(62) which is correlated to the prevalence of non-
alcoholic fatty liver disease (NAFLD).

2. Hawthorn Fruit
Hawthorn is shrubs and trees of the genus Crataegus, belonging to the family
Rosaceae, native to temperate regions of the Northern Hemisphere in Europe,
Asia and North America(63) used in traditional medicine to treat heart disease
and symptoms of heart diseases(63) such as irregular heartbeat(63), high blood
pressure(63), chest pain(63), hardening of the arteries(63), circulatory disorders
and respiratory illnesses(63).
Researchers at The First Affiliated Hospital of Wenzhou Medical College, in
the concerns that nonalcoholic fatty liver disease (NAFLD) is emerging as a
widespread condition worldwide, and reaffirm the natural treatments of
nonalcoholic fatty liver disease (NAFLD) in the traditional Chinese medicine
(TCM), launched an investigation to find natural medicines for the treatment of
NAFLD without prominent side effects, suggested that hawthorn fruit was one
the favorite herb used in TCM for the treatment of NAFLD compared to other

Furthermore, the search of the database of PubMed and China National

Knowledge Infrastructure from January 1995 to June 2010 for RCTs comparing
either traditional Chinese medicine (TCM) formulations alone or in
combination with placebo, a formula containing hawthorn normalized alanine
aminotransferase(65) and disappearance of radiological steatosis(65) in patients
with NAFLD, without inducing any side effects(65).

3. Sida rhomboidea Roxb

Sida rhomboidea Roxb is a shrubby weed found growing throughout India
belonging to the Malvaceae family, used in North-East India for the treatment
of hypolipidemia and diabetes properties(66).

In a high-fat diet (HFD) induced insulin resistance in C57BL/6J mice, Sida

rhomboidea ROXB. (S. rhomboidea ROXB., SR) compared to mice fed with
rosiglitazone (ROS) lowered the plasma(67) and hepatic TC(67), TG(67)
and FFA(67) were also significantly lowered (p<0.05) in HFD+SR groups.

According to the efficient clearance of glucose in intraperitoneal glucose

tolerance test (IPGTT), Sida rhomboidea ROXB also lowered the plasma
insulin(67) and fasting insulin resistance(67) levels in HFD+SR groups.

Furthermore, In vivo, sida rhomboidea. Roxb leaf extract (SRLE)

supplementation with SRLE significantly prevented HFD induced increment in
body weight(68), plasma lipids(68) and leptin(68), visceral adiposity(68)and
adipocyte hypertrophy(68) by modulation of related genes expression(68).

In vitro, Roxb leaf extract (SRLE) decreased triglyceride accumulation(68),

leptin release(68) and glyceraldehyde-3-Phosphate dehydrogenase activity(68)
along with higher glycerol release(68) without significant alteration of the
viability of 3T3L1 pre-adipocytes(68).

4. Teucrium polium (Golden Germander)

Teucrium polium, known popularly as felty germander, is a sub-shrub and herb,
belonging to the Lamiaceae family, native to the western Mediterranean, found
abundantly in South-Western Asia, Europe, and North Africa. and used in
traditional medicine for the treatment of abdominal pain, indigestion, common
cold, and type 2 diabetes(69).

In nonalcoholic steatohepatitis induced in male N‐Mary rats by a

methionine/choline‐deficient (MCD) diet, ethyl acetate (EtOAc) extract of
Teucrium polium, inhibited inflammation(70) and ballooning degeneration by
80%(70) of the rats treated by MCD diet.
Furthermore, EtOAc extract also lowered the lipoprotein profiles(70) and levels
of liver oxidative stress(70) markers such as alkaline phosphatase(70), aspartate
aminotransferase(70), and alanine aminotransferase(70) by improving the liver
superoxide dismutase(70), glutathione peroxidase(70), and glutathione
reductase enzymes(70).

Moreover, in N-Mary rats induced NASH by methionine and choline-deficient

(MCD) diet for 8 weeks, injection of ethyl acetate fraction of T. polium orally
for 3 weeks, lowered the elevated levels of proteins(71) associated with
inflammation and malondialdehyde (MDA)(71) in the liver.

The extract increased the levels of antioxidants enzymes activities such as

superoxide dismutase (SOD)(71), glutathione peroxidase (GPx)(71) and hepatic
glutathione (GSH)(71).

In other words, the ethyl acetate fraction of T. poium effectively protected the
liver by reversing NASH(71), through its strong antioxidant(71) and anti-
inflammatory properties(71).

5. Grape seed extract

Grape Seed Extract is the commercial extracts from whole grape seeds that
contains many concentrations, including vitamin E, flavonoids, linoleic acid,
oligomeric proanthocyanidins(OPCs), and used in traditional medicine as
antioxidant, anti-inflammatory agents and to treat skin wounds with less
scarring, allergies, macular degeneration, arthritis, enhance circulation of blood
vessels, lower cholesterol(72)

In rats fed a high-fat diet induced non-alcoholic fatty liver disease(NAFLD),

resveratrol (RSV) administration reversed the abdominal obesity(73),
NAFLD(73), and insulin resistance (IR)(73) by 10 weeks.

In vitro, RSV treatment inhibited the triacylglycerol (TG) accumulation(73) in

HepG2 cells incubated with a high concentration of glucose(73) and

In other words, resveratrol (RSV) improved NAFLD(73) and IR(73) by

suppressing the 2 lipogenesis genes(73) associated with the elevation of
NAFLD(73) and IR expression (73).
Additionally, injection of resveratrol (RSV) also found to induced production
of hepatic low-density lipoprotein(74) which has been found to process
similarly activity as high-density lipoprotein that returns cholesterol to the liver.

6. Milk thistles
Milk Thistle is a flowering plant, in the genus Silybum Adans, belonging to the
family Asteraceae, native to the Mediterranean. The herb has been used in
traditional medicine for the treatment of liver, kidney, and gall bladder

According to the study lead by First Hospital of Jilin University in the review
of eight RCTs involving 587 patients with NAFLD, Silymarin (SIL), an active
extraction of milk thistle, significantly reduced liver oxidative stress(76)
associated with the AST(76) and ALT levels(76).

In other words, SIL improved the liver parameters(76) by reducing

transaminases levels(76) in NAFLD patients.

Furthermore, on hepatic steatosis and oxidative stress during the development

of nonalcoholic fatty liver disease (NAFLD), administration of SMO
decreased the histological injury of the liver(77) and the levels of hepatic
triglyceride(77), cholesterol(77) and free fatty acid(77) in HFD-fed mice.

Moreover, SMO administration elevated the activities of superoxide dismutase

(SOD)(77) and catalase (CAT)(77) and reduced the level of malondialdehyde
(MDA)(77) and lowered the levels of proteins(77) involved in the production
of pro-inflammatory cytokines(77) in the liver, thus preventing the onset of

7. Acanthopanax senticosus (Siberian Ginseng)

Acanthopanax senticosus or Siberian Ginseng is an oriental herb belonging to
the Araliaceae family commonly distributed throughout the North Eastern parts
of Asia, used in traditional Chinese medicine for the treatment of arthritis,
hypertension, heart disease, gastric ulcers, and tumors(78).

In obesity in 10 C57BL/6J mice of 10 fed either a normal diet (10 kcal fat%) or
high fat diet (60 kcal fat%) given with or without oral administration of A.
senticosus extract (ASE; 0.5 g/kg of body weight) for 12 weeks, restored the
significantly higher low-density lipoprotein (LDL)-cholesterol in serum(79)
and higher triglyceride accumulation in liver(79), of mice high fat diet without
altering the levels of carnitine status(79).

Collectively, oral administration of ASE lowered the weight gain(79), serum

LDL-cholesterol concentration(79), and liver triglycerides accumulation(79) in
mice with obesity induced by high-fat diets.

In insulin-resistant ob/ob mice with fatty livers, 50% ethanol extract

ofAcanthopanax senticosus stem bark (ASSB) reversed the hepatomegaly(80),
bt reducing the % liver weight/body weight ratio(80) in 8 weeks.

The ASSB ethanol extract also specifically lowered circulating glucose(80) and
lipids(80) and enhanced insulin(80) action in the liver and triglyceride
synthesis(80) in non-adipose tissues including liver and skeletal muscle(80).

Genes expression of glucose 6-phosphatase and lipogenic enzymes associated

with the development of hepatic steatosis(80) also were reduced by the
injection of ASSB ethanol extract.

8. Alisma Orientalis (Alismatis rhizome) or Ze Xie in traditional Chinese

Ze Xie is also known as Alisma. The sweet, bland and cold herb has been used
in TCM as anti-pyretic, as anti-bacterial, hypoglycemic, hypotensive,
antitumor, and anti-allergic medicine(81).

On rats fed with high‐fat diet for six weeks induced nonalcoholic fatty liver
disease (NAFLD), followed by AOME for another six weeks, administration of
AOME (150,300 and 600 mg kg−1) markedly decreased the serum and liver
lipids(82), fasting serum glucose(82) and improved insulin resistance(82).

AOME lessened the lipid peroxidation(82) and activated antioxidant

enzymes(82) through inhibiting the oxidative stress in the liver(82).

Furthermore, according to the tested assays, AOME also protected the liver
against injury(82) by reducing the aminotransferase abnormalities(82) and
enhanced the hepatomegaly(82).

9. Cissus quadrangularis (Asthisamharaka)

Cissus quadrangularis is a perennial plant, belonging to the grape family, native
to India, Srilanka, Malaysia, Thailand, and Africa used in the traditional
medicine for the treatment of obesity, diabetes, and metabolic syndrome(83)

On oxidant-antioxidant balance and insulin resistance (IR) in rats fed high fat–
high fructose diet (HFFD) and free-radical scavenging property in vitro, CQEt
addition for for 45 days restored insulin sensitivity (84), liver damage(84), and
oxidative changes(84), on (HFFD) rats by and bring back the antioxidants and
lipids towards normal(84).

Furthermore, CQEt protected the liver by improving the histopathology(84)of

the liver.

In vivo, CQEtin also exerted liver protective effect(84) comparable with that of
standard drug, metformin.

In vitro, CQEt exhibited radical scavenging ability(84) in a dose-dependent


In other words, dietary supplementation of CQ extract (10%) for 45 days

significantly improved insulin sensitivity(84), reduced liver damage(84),
prevented oxidative changes(84).

10. Clerodendron glandulosum

Clerodendron glandulosum is comprised of small trees, shrub sand herbs
belonging to the Verbenaceae family, native the tropical and sub-tropical
regions of the world us in the traditional medicine for the treatment of
hypertension, fever, diabetes, and abdominal pain(85).

On hyperlipidemic chronically rat fed by a high-fat diet (HL), administration

of aqueous extract of Clerodendron glandulosum. Caleb (CG) (400 mg/kg/day)
for 90 days, showed to improve the levels of LDL-C (81.36%) (86)and VLDL-
C (43%)(86) along with an increase in HDL-C (52.84%)(86).

On alteration in lipid and cholesterol metabolism in high-fat diet fed

hyperlipidemic rats, compared to hypolipidemic drug Lovastatin (LVS),
injection of ECG exerted a strong effect in experimental hyperlipidemia(86) by
a significant alteration in plasma and tissue lipid profiles(86).
Further differentiation of the efficacy of researchers found that ECG reduced
absorption(86), improved elimination(86) and augmented catabolism(86) of
lipids and cholesterol.

11. Curcuma longa (Turmeric)

Turmeric, principal curcuminoid of the popular Indian spice, a rhizomatous
herbaceous perennial plant of the ginger family, Zingiberaceae, native to
tropical South Asia used in traditional medicine for the treatment of varies
illness, including metabolic syndrome and inflammatory conditions(87).

On C57BL/6 mice fed an HFD for 16 weeks, daily oral administration (os) of
the NDS restored the steatosis(88), aortic lesions(88) or carotid artery
thickening(88) induced by the HFD.

Furthermore, NDS inhibited dyslipidemia(88) compared to untreated animals.

In other words, NDS prevented the onset of NAFLD and atherogenesis(88) by

modulating the expression of different genes(88) involved in NAFLD.

According to the double-blind randomized controlled clinical trial conducted

on 46 patients with NAFLD (21males and 25 females) aged 20-60 years old
and body mass index (BMI) between 24.9 and 40 kg/m2, turmeric group (n =
23) given six turmeric capsules daily for 12 weeks with each capsule contained
500 mg turmeric powder (6×500 mg) showed the decreased serum levels of
glucose(89), insulin(89), HOMA-IR(89), and leptin(89) compared to the
placebo group without affecting the weight, BMI and liver enzymes.

Collectively, turmeric supplementation inhibited NAFLD complications by

improving glucose indexes(89) and serum leptin levels(89).

12. Ginkgo biloba (Maidenhair Tree)

Ginkgo biloba is the oldest living tree species, genus Ginkgo, belonging to the
family Ginkgoaceae, native to China, from the temperate zone to subtropical
zone and some parts of North America. It Has been used in traditional herbal
medicine in treating impotence, memory loss, respiratory diseases, circulatory
disorders, and deafness as well as preventing drunkenness, and bedwetting(90).

In vivo, on Male Wistar rats divided into 4 groups (the control group, GBE
group, high-fat diet [HFD] group, and HFD + GBE group) researchers
examined the effect of Ginkgo biloba extract (GBE) on nonalcoholic fatty liver
disease (NAFLD).
According to the experimental results, GBE reduced the elevations of hepatic
triglyceride contents(91) and the increased hepatic fatty acids(91) in rat livers
caused by HFD.

Furthermore, GBE also enhanced the expression palmitoyltransferase I

(CPT I) and total activity of the fatty acid β-oxidation rate-limiting enzyme, in
the regulation of whole-body metabolism, inflammatory vigor, and
pathogenesis of nonalcoholic fatty liver disease(91).

The effects of GBE was attributed to its chemical compounds GBE and its
ingredients, quercetin, kaempfero, and isorhamnetin worked synergistically to
decrease the cellular triglyceride content(91) and promote the expression and
total activity of CPT1A(91) in converting fat to energy.

Based on the finding, researchers wrote, "The triglyceride-lowering effect of

GBE on the HFD rat liver is closely associated with the increased expression
and activity of CPT1A, and the flavonoid ingredients are the major contributors
of GBE".

13. Linum usitatissimum (Linseed/Flaxseed)

Flaxseed is native to the region of the eastern Mediterranean to India and also
known as common flax or linseed. Flax is an erect annual plant, it can grow to
1.2 m tall. The leaves are 20–40 mm long and 3 mm broad, used in traditional
medicine for the treatment of constipation(92).

A double-blinded, randomized, and placebo-controlled study in moderately

hypercholesterolemic men suggested that oral administration of SDG (20 or
100 mg) decreases the level of blood cholesterol(93) and liver disease risk
factors(93) induced by hypercholesterolemia in humans.

In a study of 30 men with total cholesterol levels of 4.65 to 6.21 mmol/L (180-
240 mg/dL), SDG exhibited a significant reduction in the ratio of low-density
lipoprotein/high-density lipoprotein cholesterol(93) compared to baseline at
week 12.

Furthermore, injection of SDG also showed a significant percentage decrease

in the levels of glutamic pyruvic transaminase(93) and γ-glutamyl
transpeptidase(93) associated with liver injury markers relative to the levels at
In other words, daily administration of 100 mg SDG may be effective in
reducing the levels of blood cholesterol(93) and hepatic diseases risk(93) in
moderately hypercholesterolemic men.

In the testing of 7-d diets including a low-fiber control diet (Control), a diet
with flaxseed fiber drink (3/day) (Flax drink), and a diet with flaxseed fiber
bread (3/day) (Flax bread), researchers found that compared to control, Flax
drink lowered fasting total-cholesterol and LDL-cholesterol by 12 and
15%(94), respectively.

Fecal fat and energy excretion increased by 50 and 23% with Flax drink
consumption compared to control(94).

In other words, Flax drink decreased plasma total and LDL-cholesterol(94) and
increased fat excretion(94).

14. Nelumbo nucifera (Lotus)

Nelumbo nucifera (Lotus) is a perennial plant belonging to the Nymphaeaceae
family produced individual leaves and flowers directly from the root system
and used in traditional medicine for the treatment of respiratory, hepatic,
digestive, and reproductive diseases(95).

In 3T3-L1 preadipocytes and high-fat diet (HFD)-induced obese SD rats,

injection of N. nucifera leaves extract. N. nucifera alkaloid (NNA) decreased
cell population growth of 3T3-L1 preadipocytes(96) and increased the
apoptotic cells(96) in a time- and dose-dependent manner and reduced the body
weight(96), the lee's index(96), adipose tissue weight(96), and plasma lipid
levels((96) in HFD-induced obese rats.

In vivo, C57BL/6 mice induced obesity by a high-fat diet (HFD), oral

administration of NLFE reduced the body weight(97), body lipid
accumulation(97), and activities of fatty acid synthase (FAS)(97), glutamic
oxaloacetic transaminase(97), and glutamic pyruvic transaminase(97)
associated with the risk of NAFLD.

Additionally, NLFE efficacy in the attenuation of body lipid accumulation(97)

and prevention of obesity(97) was associated with the inhibition of lipid-
regulated enzymes involved in synthesizing lipids right in the cell(97).

Taken altogether, phytochemicals, herbal medicines, healthy foods found in the
research paper may be considered remedies for the prevention and treatment of
non-alcoholic fatty liver disease, pending to large sample size and
multicenter human study.

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Author Biography
Kyle J. Norton (Scholar, Master of Nutrition, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers
have been written and published online, including worldwide health, ezine
articles, article base, health blogs, self-growth, best before it's news, the karate
GB daily, etc.,.
by Named 50 of the best health Tweeters Canada - Huffington
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as
international journal Pharma and Bioscience, ISSN 0975-6299.

(1) Histopathology of Nonalcoholic Fatty Liver Disease and Nonalcoholic
Steatohepatitis by G. Thomas Brown, M.D., Ph.D., and David E. Kleiner, M.D.,
Ph.D. (PMC)
(2) Non-alcoholic fatty liver disease in 2015 by Monjur Ahmed. (PMC)
(3) The Global Pattern of Urbanization and Economic Growth: Evidence from
the Last Three Decades by Mingxing Chen, Hua Zhang, 2 Weidong Liu, 1 and
Wenzhong Zhang. (PMC)
(4) Non-alcoholic Fatty Liver Disease in South Asians: A Review of the
Literature by Sital Singh,1 Gabriela N. Kuftinec,2 and Souvik Sarkar. (PMC)
(5) Prevalence of non-alcoholic fatty liver disease and risk factors for advanced
fibrosis and mortality in the United States by Michael H. Le,1 Pardha Devaki,2
Nghiem B. Ha,3,4 Dae Won Jun,5 Helen S. Te,6Ramsey C. Cheung,4,7 and
Mindie H. Nguyen. (PMC)
(6) Epidemiology of non-alcoholic fatty liver disease in China by Fan JG1,
Farrell GC. (PubMed)
(7) Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an
exponential increase in the burden of disease by Chris Estes, 1 Homie Razavi,
1 Rohit Loomba, 2 Zobair Younossi, 3 and Arun J. Sanyal. (PMC)
(8) Symptoms & Causes of NAFLD & NASH by NIH
(9) Nonalcoholic fatty liver disease in adult hypopituitary patients with GH
deficiency and the impact of GH replacement therapy. by Nishizawa H1, Iguchi
G, Murawaki A, Fukuoka H, Hayashi Y, Kaji H, Yamamoto M, Suda K,
Takahashi M, Seo Y, Yano Y, Kitazawa R, Kitazawa S, Koga M, Okimura Y,
Chihara K, Takahashi Y. (PubMed)
(10) Non-alcoholic fatty liver disease and thyroid dysfunction: A systematic
review by Ahad Eshraghian and Alireza Hamidian Jahromi. (PMC)
(11) Obstructive sleep apnea syndrome and fatty liver: Association or causal
link? by Mohamed H Ahmed and Christopher D Byrne, (PMC)
(12) Diets and nonalcoholic fatty liver disease: The good and the bad by
Mohamed Asrih, François R. Jornayvaz. (El Sevier)
(13) Dietary fat stimulates the development of NAFLD more potently than
dietary fructose in Sprague-Dawley rats by Jensen VS1,2, Hvid H2, Damgaard
J2, Nygaard H2, Ingvorsen C3, Wulff EM4, Lykkesfeldt J1, Fledelius C.
(14) Non-Alcoholic Fatty Liver Disease by NICK G. (The American Liver
(15) Racial and Ethnic Disparities in Nonalcoholic Fatty Liver Disease
Prevalence, Severity, and Outcomes in the United States: A Systematic Review
and Meta-analysis by Rich NE1, Oji S1, Mufti AR1, Browning JD1, Parikh
ND2, Odewole M1, Mayo H3, Singal AG. (PubMed)
(16) Emerging Trends Conference: EMERGING TRENDS IN NON-
(17) Hepatic Encephalopathy by the Canadian Liver Foundation
(18) LIVER DISEASE AND ASCITES by Sequana Medical
(19) Nonalcoholic fatty liver disease manifesting esophageal variceal bleeding
by Tang CP1, Huang YS, Tsay SH, Chang FY, Lee SD. (PubMed)
(20) Non-alcoholic fatty liver disease by Genetic Home Reference. (NIH)
(21) Systematic review: the diagnosis and staging of non-alcoholic fatty liver
disease and non-alcoholic steatohepatitis by J K Dowman,*† J W Tomlinson,‡
and P N Newsome. (PMC)
(22) Current treatment options for nonalcoholic fatty liver disease and
nonalcoholic steatohepatitis by Melanie D Beaton, MD FRCPC. (PMC)
(23) Herbal medicines and nonalcoholic fatty liver disease by Hong Yao, Yu-Jie
Qiao, Ya-Li Zhao, Xu-Feng Tao, Li-Na Xu, Lian-Hong Yin, Yan Qi, and Jin-
Yong Peng. (PMC)
(24) An Overview of Herbal Products and Secondary Metabolites Used for
Management of Type Two Diabetes by Ajda Ota and Nataša P. Ulrich.
(61) Popular #Herbs - Anise Kyle J. Norton
(62) Pimpinella anisum L. fruit: Chemical composition and effect on a rat
model of nonalcoholic fatty liver disease by Asadollahpoor A1, Abdollahi M2,
Rahimi R3,(PubMed)
(63) Popular Herbs - Hawthorn (Crataegus)
(64) 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)
(65) The relationship between obesity and the severity of non-alcoholic fatty
liver disease: systematic review and meta-analysis by Lu FB1, Hu ED1, Xu
LM1, Chen L1, Wu JL1, Li H1, Chen DZ2, Chen YP. (PubMed)
(66) Sida rhomboidea. Roxb Leaf Extract Down-Regulates Expression of
PPARγ2 and Leptin Genes in High Fat Diet-Fed C57BL/6J Mice and Retards in
Vitro 3T3L1 Pre-Adipocyte Differentiation by Menaka C. Thounaojam,1
Ravirajsinh N. Jadeja,1 Umed V. Ramani,2 Ranjitsinh V. Devkar,1,*and A. V.
Ramachandran. (PMC)
(67) Prevention of High Fat Diet-Induced Insulin Resistance in C57BL/6J Mice
by Sida rhomboidea ROXB. Extract by Menaka Chanu Thounaojam,
Ravirajsinh Navalsinh Jadeja, Ansarullah, Ranjitsinh Vijaysinh Devkar, A. V.
Ramachandran. (Journal of Health Science)
(68) Sida rhomboidea. Roxb Leaf Extract Down-Regulates Expression of
PPARγ2 and Leptin Genes in High Fat Diet-Fed C57BL/6J Mice and Retards
inVitro 3T3L1 Pre-Adipocyte Differentiation
Menaka C. Thounaojam 1, Ravirajsinh N. Jadeja 1, Umed V. Ramani 2,
Ranjitsinh V. Devkar 1,* and. V. Ramachandran. ( International Journal of
Molecular Science)
(69) Phytochemistry and medicinal properties of Teucrium polium L.
(Lamiaceae) by Bahramikia S1, Yazdanparast R. (PubMed)
(70) Teucrium polium in the prevention of steatohepatitis in rats by Rahim
Amini, Narges Nosrati, Razieh Yazdanparast, Mahsa Molaei. ( Liver
(71) Teucrium polium reversed the MCD diet-induced liver injury in rats by
Rahim Amini, Razieh Yazdanparast and Safiyeh Aghazadeh. (Sage Journal)
(72) Popular Herbs - Grapefruit Seed Extract by Kyle J. Norton
(73) Resveratrol improves non-alcoholic fatty liver disease by activating AMP-
activated protein kinase by Shang J1, Chen LL, Xiao FX, Sun H, Ding HC,
Xiao H. (PubMed)
(74) SIRT1 as a potential therapeutic target for the treatment of nonalcoholic
fatty liver disease by Colak Y1, Ozturk O, Senates E, Tuncer I, Yorulmaz E,
Adali G, Doganay L, Enc FY. (PubMed)
(75) Popular #Herbs - Milk Thistle by Kyle J. Norton
(76) The therapeutic effect of silymarin in the treatment of nonalcoholic fatty
disease: A meta-analysis (PRISMA) of randomized control trials by Zhong S1,
Fan Y, Yan Q, Fan X, Wu B, Han Y, Zhang Y, Chen Y, Zhang H, Niu J.
(77) Silybum marianum oil attenuates hepatic steatosis and oxidative stress in
high fat diet-fed mice by Zhu SY1, Jiang N2, Yang J3, Tu J4, Zhou Y3, Xiao
X3, Dong Y. (PubMed)
(78) Popular #Herbs - #Ginseng, Asian (Panax ginseng) and Ginseng, North
America by Kyle J. Norton
(79) Acanthopanax senticosus Extract Prepared from Cultured Cells Decreases
Adiposity and Obesity Indices in C57BL/6J Mice Fed a High Fat Diet by Youn-
Soo Cha, Soon-Jae Rhee, and Young-Ran Heo. (Journal of Medicinal Food)
(80) Acanthopanax senticosus reverses fatty liver disease and hyperglycemia in
ob/ob mice by Sang, Hyun Park, Sang Gil Lee, Sung Keel Kang, and Sung
Hyun Chung. (Springer Link)
(81) Chinese Herbs – Ze Xie by Kyle J. Norton
(82) Protective effects of the Alisma Orientalis extract on the experimental
nonalcoholic fatty liver disease byXuezhi Hong, Huiqing Tang, Limao Wu,
and Lianda Li. (Wiley Online Library)
(83) Cissus quadrangularis by Wikipedia
(84) Cissus quadrangularis stem alleviates insulin resistance, oxidative injury
and fatty liver disease by Chidambaram, Jaya, Carani Venkatraman, and
Anuradha. (Science Direct)
(85) Cissus quadrangularis - Wikipedia
(86) Clerodendron glandulosum Coleb., Verbenaceae, ameliorates high fat diet-
induced alteration in lipid and cholesterol metabolism in rats by Jadeja RN;
Thounaojam MC; Ansarullah; Devkar RV*; Ramachandran AV. (Scielo)
(87) Popular #Herbs - Turmeric (Curcuma longa) by Kyle J. Norton
(88) NAFLD and Atherosclerosis Are Prevented by a Natural Dietary
Supplement Containing Curcumin, Silymarin, Guggul, Chlorogenic Acid and
Inulin in Mice Fed a High-Fat Diet by Amato A1, Caldara GF2, Nuzzo D3,
Baldassano S4, Picone P5, Rizzo M6, Mulè F7, Di Carlo M. (PubMed)
(89) Turmeric Supplementation Improves Serum Glucose Indices and Leptin
Levels in Patients with Nonalcoholic Fatty Liver Diseases by Navekar R1,
Rafraf M1, Ghaffari A1, Asghari-Jafarabadi M2, Khoshbaten M. (PubMed)
(90) Popular Herbs - Ginkgo biloba by Kyle J. Norton
(91) Inhibitory effect of Ginkgo biloba extract on fatty liver: Regulation of
carnitine palmitoyltransferase 1a and fatty acid metabolism by Shi Dong Wang,
Zuoquan Xie, Jia Chen and Ke Wang. (Research Gate)
(92) Superfoods - Flaxseed oil by Kyle J. Norton
(93) Flaxseed lignan lowers blood cholesterol and decreases liver disease risk
factors in moderately hypercholesterolemic men by Fukumitsu S1, Aida K,
Shimizu H, Toyoda K. (PubMed)
(94) Flaxseed dietary fibers lower cholesterol and increase fecal fat excretion,
but the magnitude of the effect depends on food type by Kristensen M1, Jensen
MG, Aarestrup J, Petersen KE, Søndergaard L, Mikkelsen MS, Astrup A.
(95) A comprehensive review on Nymphaea stellata: A traditionally used bitter
by M. K. Mohan Maruga Raja, Neeraj Kumar Sethiya, and S. H. Mishra.
(96) Nelumbo nucifera alkaloid inhibits 3T3-L1 preadipocyte differentiation
and improves high-fat-diet-induced obesity and body fat accumulation in rats
by Xie Bin, Wan Jin, Wang Wenqing, and Shi Chunyang. (Research Gate)
(97) Improvement in High-Fat Diet-Induced Obesity and Body Fat
Accumulation by a Nelumbo nucifera Leaf Flavonoid-Rich Extract in Mice by
Cheng-Hsun Wu, Mon-Yuan Yang, Kuei-Chuan Chan, and Pei-Jun
Chung. (Research Gate)