Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
Alkaline phosphatase isoenzymes, aqueous liver, bovine liver extract, crude liver extract, cyanocobalamin, hydrolyzed liver extract, hydroxocobalamin, iron, LEx, liquid liver extract, liver, liver concentrate, liver extract lysate, liver factors, liver fractions, liver glandular products, liver hydrolysate, liver substance, purified liver extract, raw liver, Solcohepsyl®, Solcohepsyl® extralysate, subcellular liver fractions, vitamin B12.
Note: Although liver extract contains many constituents, such as vitamin B12, this monograph focuses on liver extract research.
Liver extract and desiccated (dried) liver have been marketed as iron supplements for over a century. The extract is processed cow or pig liver that may either be a freeze-dried brownish powder or a concentrated liquid that has had most of the fat and cholesterol removed.
Preliminary clinical studies indicate that liver extract may be helpful in treating hepatic (liver) dysfunction. In addition, liver extract seems to work synergistically with interferon in treating hepatitis C and other viral infections. More research is needed in these areas.
Laboratory studies indicate that liver extract may have some effects that could be useful in treating certain forms of cancer, such as the ability to direct migration of metastasizing cells and the inhibition of DNA, RNA, and protein formation. More research is needed in these areas to quantify liver extract's properties.
Some concern has been raised about the safety of liver extract, as it is made of animal liver, which may be infected with parasites, bacteria, or prion diseases. Although there are currently no available reports of diseases such as bovine spongiform encephalitis (BSE, or "mad cow disease") being transmitted by liver extract, the U. S. Food and Drug Administration (FDA) still cautions against the use of any animal organ extract. It is not clear how the processing of liver extract affects the transmission of these organisms.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Ingestion of liver increases red blood cell counts, and liver extract (by mouth or by injection) has the same effect. Both liver and liver extract have high vitamin B12 content. Today, pernicious anemia is typically treated with vitamin B12 injections.
Chronic fatigue syndrome
An injectable solution of bovine liver extract containing folic acid and cyanocobalamin has been an advocated treatment of chronic fatigue syndrome. Preliminary study indicates that patients with chronic fatigue syndrome positively reacted to intramuscular bovine liver extract. Additional study is needed to make a firm recommendation.
Chronic hepatitis (hepatitis C)
Hepatitis impairs liver function; liver extract has shown liver stimulatory and protective effects. The combination of liver extract and interferon may increase patients' response to interferon therapy alone. However, additional study is needed.
Liver extract seems to stimulate liver function. In two studies, liver extract increased the liver function of patients with impaired liver function. More research is needed to compare liver extract to other hepatostimulatory treatments.
Surgical uses (urological operation adjunct)
Liver extract may help maintain liver function during urological surgery. More research is needed to define the importance of this normalization of liver function.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Allergies, anemia, antioxidant, antiviral, blood clots, cardiovascular disease, celiac disease, corneal abrasions/ulcers, deficiency (vitamin B12), detoxification, drug addiction, enhanced muscle mass/strength, gastric acid secretion stimulation, hematopoiesis (stimulation of blood cell production), hepatoprotection, herpes simplex virus type 1, influenza virus infection, malabsorption (familial selective B12), methylmalonic aciduria, multiple sclerosis, obstetric and gynecological disorders, physical endurance, poisoning, renal failure (uremia), rheumatoid arthritis, stamina enhancer, tonic, tuberculosis, wound healing.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
There is no proven safe or effective dose for liver extract. A dose that has been used is 500 milligrams of liver extract 1-3 times per day. As an injection, 2 milliliters of liver extract has been administered daily for up to five days, although injections should only be given under the supervision of a qualified healthcare professional, including a pharmacist.
Children (under 18 years old)
There is no proven safe or effective dose for liver extract in children, and use is not recommended.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid in individuals with a known allergy or hypersensitivity to liver extract or its constituents. Liver extract therapy has caused severe anaphylactic shock. Symptoms of sensitivity may include itching, slight flushing, tachycardia, cough, nasal and ocular discharges, and localized to generalized urticaria ("hives"), weakness, faintness, nausea, vomiting, bronchospasm, asthmatic reaction, substernal pain, collapse, rigor, profound shock, and rarely, death.
Side Effects and Warnings
Few adverse effects have been reported for liver extract, including anaphylactic shock and blood clotting changes. However, raw liver may contain liver flukes or the bacterium Vibrio fetus. The U. S. Food and Drug Administration (FDA) cautions against the consumption of any dietary supplement made from animal glands or organs, especially from cows and sheep from countries with known cases of bovine spongiform encephalitis (BSE, or "mad cow" disease) or scrapie. It is thought that these extracts may contain viable prions that could infect humans. It is not clear how the processing of liver extract affects the transmission of these organisms. Currently, there are no available reports of transmission of BSE through liver extract.
Other possible adverse effects of liver extract may include itching, slight flushing, tachycardia (fast heart rate), cough, nasal and ocular (eye) discharges, urticaria ("hives"), weakness, faintness, nausea, vomiting, bronchospasm, asthmatic reaction, substernal pain, collapse, rigor, profound shock, and rarely, death.
Use cautiously in patients taking antacids or with acid reflux as liver extract may increase gastric acid or pepsin output. Also use cautiously in patients with compromised immune function as liver extract may inhibit lymphocyte proliferation. Use cautiously in hepatopathic patients with reduced human growth hormone metabolic clearance rate, as liver extract may tend to normalize its metabolism.
Use cautiously in patients with clotting disorders as liver extract may stimulate production of red blood cells, affect blood clotting, or improve hemoglobin concentration in patients with impaired hepatic function.
Avoid liver extract in patients with iron metabolism disorders or iron shortage disorders, such as hemochromatosis (a metabolic disorder that causes increased absorption of iron).
Pregnancy and Breastfeeding
Liver extract is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Raw liver may be a possible source of Vibrio fetus septicemia in humans, although there are no available reports of liver extract causing Vibrio fetus septicemia.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Liver extract may increase gastric acid and pepsin outputs. Study results are unclear and caution is advised.
Liver extract may affect blood clotting and may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Liver extract may improve plasma cholesterol levels in patients with impaired hepatic function. Patients taking any cholesterol-lowering medications should use cautiously, as dosing adjustments may be necessary.
Liver extract may reversibly inhibit thymidine and uridine incorporation into DNA and RNA during cell growth and dose-dependently catalyze the removal of O6-methylguanine.
Liver extract may tend to normalize the metabolic clearance rate of human growth hormone in hepatopathic patients. Caution is advised in patients taking human growth hormones. Monitoring may be necessary.
Liver extract inhibits lymphocyte proliferation. Caution is advised when combining liver extract with immunomodulating drugs.
Liver extract may increase the antiviral activity of interferon. It may also inhibit herpes simplex virus type-1 and influenza virus type A when used in combination with other antiviral agents.
Liver extract may have a high content of heme iron and antioxidant superoxide dismutase.
Interactions with Herbs and Dietary Supplements
Liver extract may increase gastric acid and pepsin outputs. Study results are unclear and caution is advised.
Liver extract may affect blood clotting, which may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Liver extract may improve plasma cholesterol levels in patients with impaired hepatic (liver) function. Patients taking any cholesterol-lowering herbs, such as red yeast rice, should use cautiously, as dosing adjustments may be necessary.
Liver extract may interact with herbs used as cancer therapies. Although not well studied in humans, caution is advised.
Liver extract may tend to normalize the metabolic clearance rate of human growth hormone in hepatopathic patients. Caution is advised in patients taking herbs or supplements similar to human growth hormones. Monitoring may be necessary.
Liver extract inhibits lymphocyte proliferation. Caution is advised when combining liver extract with immunomodulating herbs.
Liver extract may increase the antiviral activity of interferon. It may also inhibit herpes simplex virus type-1 and influenza virus type A when used in combination with other antiviral herbs.
Liver extract may have a high content of heme iron and antioxidant superoxide dismutase. Liver extract and vitamin B12 may have a therapeutic effect in patients with liver diseases and rheumatoid arthritis.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Castellani, A., Colafelice, M., and Fichera, M. [Hepatoprotective effect of a combination of UDPG, vitamin B 12 and liver extract in psychiatric patients with liver diseases]. Clin.Ter. 9-30-1978;86(6):567-576. View Abstract
Dahm, K. [Severe anaphylactic shock in liver hydrolysate therapy]. Med.Klin. 9-29-1967;62(39):1510-1511. View Abstract
Ebinuma, H., Saito, H., Tada, S., Masuda, T., Kamiya, T., Nishida, J., Yoshioka, M., and Ishii, H. Additive therapeutic effects of the liver extract preparation mixture adelavin-9 on interferon-beta treatment for chronic hepatitis C. Hepatogastroenterology 2004;51(58):1109-1114. View Abstract
Fichtelius, K. E. and Kullgren, B. Cell dispersing liver extract influencing blood clotting. Nature 1-8-1966;209(19):167-169. View Abstract
Fukuda, Y., Sawata, M., Washizuka, M., Higashino, R., Fukuta, Y., Tanaka, Y., and Takei, M. [Effect of liver hydrolysate on hepatic proliferation in regenerating rat liver]. Nippon Yakurigaku Zasshi 1999;114(4):233-238. View Abstract
Grabner, P., Semb, L. S., Schrumpf, E., and Myren, J. The intestinal phase of gastric secretion. Response to liver extract infusion into the proximal jejunum of healthy human subjects. Scand.J.Gastroenterol. 1976;11(4):415-419. View Abstract
Kaslow, J. E., Rucker, L., and Onishi, R. Liver extract-folic acid-cyanocobalamin vs placebo for chronic fatigue syndrome. Arch.Intern.Med. 1989;149(11):2501-2503. View Abstract
Kondoh, K., Imaide, Y., Uchida, M., and Watanabe, H. [Effect of the administration of liver extract after surgical operations in urology]. Hinyokika Kiyo 1986;32(1):163-167. View Abstract
Pallotti, S., Paolucci, D., and Isidori, A. Hepatic activity in the generation of somatomedins: effects of administration of a liver extract. Int.J.Clin.Pharmacol.Biopharm. 1978;16(8):351-356. View Abstract
Pallotti, S., Paolucci, D., Santoro, S., and Rotolo, A. [Metabolism of somatotropin in severe liver diseases. Influence of the therapeutic administration of a liver extract]. Minerva Med. 11-14-1978;69(55):3779-3783. View Abstract
Preziosi, P., Nistico, G., and Marano, V. Double-blind study of a total liver extract in patients with hepatic dysfunction. Int.J.Clin.Pharmacol.Biopharm. 1975;11(3):210-215. View Abstract
Saito, H., Ebinuma, H., Tada, S., Tsunematsu, S., Atsukawa, K., Masuda, T., Tsuchiya, M., and Ishii, H. Enhancing effect of the liver extract and flavin adenin dinucleotide mixture on anti-viral efficacy of interferon in patients with chronic hepatitis C. Keio J.Med. 1996;45(1):48-53. View Abstract
Soonattrakul, W., Andersen, B. R., and Bryner, J. H. Raw liver as a possible source of Vibrio fetus septicemia in man. Am.J.Med.Sci. 1971;261(5):245-249. View Abstract
Taira, N., Yoshifuji, H., and Boray, J. C. Zoonotic potential of infection with Fasciola spp. by consumption of freshly prepared raw liver containing immature flukes. Int.J.Parasitol. 1997;27(7):775-779. View Abstract
Yokochi, S., Ishiwata, Y., Saito, H., Ebinuma, H., Tsuchiya, M., and Ishii, H. Stimulation of antiviral activities of interferon by a liver extract preparation. Arzneimittelforschung. 1997;47(8):968-974. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017