Love Your Liver (Dr. Greger)
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Are there any (accurate) kits one can collect micro amounts of blood from home rather than venipuncture at a lab?
@RTHR anyone suggest NAC for the usual relate limiting part of making more glutathione? Did you have any symptons besides a vague osin after one iof the supplements?
You might look at this:
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Thank you very much. Looks promising. Had I known I might have tried this instead of the order i just placed for ZRT cardiometabolite panel (not sure i trust ZRT accuracy on dried blood. For saliva they are good).
On your links, looks like sone can be ordered just twice a year and i think one of them just once. The tests i want look like i would need are only in the complete most expensive panel. (All the liver enzymes plus albumin) is 249 each minimum of 2 but then it looks like theres a coupon for 150 off. So basically 350 for two tests which isnt bad except I am not fond of not getting the second kit 6 mo after i pay for it rather than whenever i want it.
One smallish red flag is for sone tests, can choose finger stick or shoulder device. From what i read though in papers, dried blood on Dried Blood Spot and from microtainer do not give identical results. Good Reference ranges on tests are often hard to cone by.
I posted i recently tested with Iollo (uses shoulder draw byTasso). While it has some interesting metabolic markers, i cannot recommend it at this time. Greedy company that cares little for accuracy and false advertising on what you get for the hefty $400 price tag.
More is not better. In fact, combining has its own dangers. Check liver Tox information on everything especially plants, herbs.
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After many more liver blood tests, an ultrasound (indicating possible fatty liver), a fibroscan (indicating no fatty liver but probable moderate to severe fibrosis), and a liver biopsy (gold standard that showed there is absolutely no liver fibrosis F0-F0.25 and no fatty liver) … Turns out the most likely culprit was Cymbalta causing DILI. However, my ALT remains high Two months after stopping Cymbalta (ALT went from 170 to 66) so it is possible that Retatrutide also had a negative impact on my liver function tests. Currently doing a challenge to that by removing size and returning to appetite, which never had a Tirz impact on liver function test.
I have been on 15 different supplements when the first liver test result came back elevated, on gastroenterologist device. I stopped them all, but continued NAC, milk, and toy. It was only when I stopped Cymbalta that my test results started going down significantly, but never returned to normal range. We will if a one month break, followed by a return to Tirz get them back to normal and even optimal range.
All that said, I was not initially getting the comprehensive metabolic panel with liver function test because of any symptoms, but because it was affordable and seem to support given my supplement load. I strongly suggest that everyone get CMP and other common panels done especially when working in the longevity and health pan supplement space
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Rechecked the labels: it is the starch blocker that has Chromium, not the Acarbose. I had it totally backwards!
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My ALT has gradually been rising, tripling, followed by a rise in AST, with both arriving at the highest part of the reference range.
I checked each of my 30+ supplements, and quit the three that in a minority can cause liver toxicity.
It didn´t help so I gave my perplexity pro the prompt
“Could the cause of my rising AST and ALT be the sheer volume of supplements that I use, even though none individually is liver toxic?”
Answer: Yes, this is a real, documented phenomenon — it is called supplement-induced polypharmacy hepatotoxicity, and your regimen is a textbook example of the conditions where it can occur.
The evidence for cumulative supplement load causing liver injury
- The US Drug-Induced Liver Injury Network reports that herbal and dietary supplement (HDS)-induced liver injury has risen from 7% of all DILI cases in 2005 to 20% in 2014, and many of these cases involve multi-ingredient products rather than single known hepatotoxins.
- A dedicated review on “dietary supplement polypharmacy” concludes that even individually benign supplements can combine to overwhelm the liver’s detoxification capacity, especially via competitive saturation of CYP450 enzymes, competition for glutathione, and additive oxidative stress.
- Multi-ingredient products like Hydroxycut and OxyELITE Pro caused acute liver failure despite containing several ingredients that individually showed acceptable safety profiles; the injury was synergistic.
- A 2011 review specifically titled “Polypharmacy, multiple natural health products and hepatotoxicity” highlights that no individual ingredient needs to be classically hepatotoxic — the sheer metabolic burden, competitive enzyme inhibition, and depletion of shared detoxification cofactors is sufficient.
Why your specific situation is at heightened risk
- You are taking 30+ supplements plus 6–8 prescription/OTC drugs simultaneously, all requiring hepatic processing.
- Several items in your stack are known to interact with or compete for CYP3A4 and CYP2C9 (e.g., gemfibrozil, melatonin, possibly reishi), creating non-linear enzyme saturation.
- Polypharmacy in the presence of even mild pre-existing liver stress (which you now have) is associated with accelerated liver disease progression and worse outcomes.
Practical implication
This means that even after removing AFA algae, aloe macroclada, and gemfibrozil, if your total supplement burden remains at 30+, you may still see persistently elevated enzymes simply because the liver cannot comfortably process everything. The most rational next step, alongside stopping the likely hepatotoxins, is a deliberate supplement holiday — stopping all non-essential supplements for 4–6 weeks to let enzymes fully reset, then reintroducing only the highest-priority ones (perhaps 5–8 total) one by one at intervals"
I have quit all supplements and drugs except five,
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I’m now on a 30 day washout from all supplements. Want to see how it’s going to affect my labs.
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The reason is actually pretty simple: your liver function was probably already compromised to begin with. Back when I first got into biohacking right out of my teens, I was taking way more compounds than Bryan Johnson in pursuit of a comprehensive protocol, and I was often pushing extreme maximum doses. On top of that, because I was lifting weights to build muscle, I was taking a ton of supplements that had nothing to do with anti-aging—like whey protein, casein, EAAs, you name it. Despite all that, my blood work came back completely flawless.
Also, I’ve seen a lot of people bringing up Ashwagandha. If you’re otherwise healthy, Ashwagandha won’t damage your liver; Bryan Johnson has been taking it for years. Another plausible explanation is that you have a specific genetic mutation that prevents you from metabolizing certain compounds properly. It’s a rare possibility, but it definitely exists.
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Ashwagandha is a well-studied herb. Liver injury is rare but documented; rare enough that it doesn’t present in the many published clinical trials as noted by the NIH. The most recent published clinical study was a larger-scale trial with about 500 people each in the placebo and treatment groups and there was no evidence of elevated liver enzymes after two months at a substantial dose of 600 mg/daily of KSM-66. The rate of reported adverse effects was almost twice as high in the placebo group as it was in the Ashwagandha group.
In these published studies they are going to be using quality extracts. Some concern has been raised about heavy metals and contaminants in poorly sourced Ayurvedic products. I would only use KSM-66. Some of the case reports of liver injury involved home preparation of the herb using parts of the plant not used in KSM-66.
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To my relief, already just over three weeks after quitting all supplements/drugs except five, my AST returned fully to its previous low number, ALT almost returned fully, while CGT which lags the others, had normalized by 60%. Will add two or three supps at a time to monitor my liver numbers. A good moment to prioritize supps and decide which truly matter. Might add TUDCA or silymarin which have liverprotective effects.
A supp researcher at the Berkeley event said that aside from the number of supps, one possible cause or contributor to my high liver numbers could have been contaminants or non-disclosed substances in my supplements.
I take my tests just prior to my gym, i.e. putting a maximum of time between test and previous gym session since strenuous exercise can raise liver numbers transiently.
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Honestly highest chances are plant extracts. Particularly ashwaganda which I am not a fan of.
If I were you I’d stop all of those and maybe stop acarbose and retest.
Rapamycin is more likely to cause blood sugar and cholesterol issues, how is HbA1C and cholesterol panel (HDL, LDL, ApoB and Lp(a))?
Also I’d consider adding in TUDCA for liver protection, and possibly NAC.
Just take pure melatonin, don’t get supplements with anything else. Ashwaganda can negatively impact some people, and overdoing selenium is a bad idea.
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