It’s probably not possible to completely prevent any damage, but the question asks how to “mitigate” the damage, and that, I believe, can be accomplished. Also, there’s no need to do everything on the list. It isn’t all or nothing. Even trying one thing can help.

What is Liver Regeneration?

The Liver Regenerates

The Liver is the only visceral organ with high Regenerative capacity. It can regenerate after a chemical injury or after surgical removal, a little of 25% of the liver mass can regenerate back to its full size [1]. The Regeneration process allows the liver to recover lost mass without harming the viability of the entire organism [2].

Liver Toxicity

Liver toxicity is a serious complication in HIV patients taking HAART (Highly Active Antiretroviral Therapy). In patients, the treatment of suspected HAART-related liver toxicity should first involve a withdrawal of the therapy. It is also concluded that nucleoside-induced mitochondrial damage to the liver may improve with riboflavin or thiamine therapy [3].

How to Regenerate Your Liver

Step 1) Protect Your Liver With Supplements

Here’s what to take right before drinking for liver protection: 

Take Milk thistle, NAC (300mg if you are also taking milk thistle), Taurine (500 mg), Vit C (500 mg), B vitamins (low dosages), ALCAR and Lipoic acid. No need for mega-doses of the vitamins. Carnosine is also good.

There are lots of hepatoprotective (liver protecting) herbs and supplements, but some of them also contain liver toxins.

Below is a list of herbs that have a protective effect on liver backed by scientific research. I wouldn’t take some of these on the list, however, because of some damage the liver at the same time as protecting it since they have many chemical constituents.

Step 2) Protect Your Liver by Incorporating Certain Foods and Common Food Herbs

IMO, what you eat and take while you aren’t drinking is more important. Foods and common food herbs to eat that are hepatoprotective in rat studies and possibly aid in regeneration:

Fish has taurine and omega 3’s and also PUFA’s (Poly Unsaturated Fatty Acids) that are essential for the proper functioning of the liver [4, 5].

Choline that is abundant in Egg yolks helps detoxification of the liver through the processing of fats and cholesterol. Hence it might be helpful to prevent NAFLD (Non-Alcoholic Fatty Liver Disease) [6]. Most common available choline supplement is lecithin which is derived from egg yolks.

Chicken has carnosine, which protects the liver against injury [7].

Blueberries have protective effects on acute liver injury induced by d-galactosamine and lipopolysaccharide [8]. Also, proanthocyanidin from blueberry leaves suppresses the replication of the hepatitis C virus [9].

Beets contain a pigment called betalain which protects the liver from oxidative stress and chronic inflammation such as liver disease [10].

An Olive Oil rich diet decreases the accumulation of Triglycerides (TGs) in the liver and therefore might be helpful for NAFLD patients who have high TGs [11].

Biofortified Carrot intake increases liver antioxidant capacity and Vitamin A status in animals [12]. Carrots also protect against hepatic liver injury [13]. Carrot consumption modifies bile acid excretion and increases antioxidant status [14].

Several studies have shown that Garlic can protect the liver from toxic agents. Human studies have shown that garlic protects against Acetaminophen-induced liver toxicity [15].

Ginger was effective against alcohol-induced liver toxicity in rats. Ginger consumption normalized the levels of SOD (Superoxide dismutase), catalase and GSH in rats [16]. It was also effective against liver cancer in rats [17].

According to one study conducted by Japanese researchers, Avocados contain potent liver protectants which may reduce liver damage [18].

A number of experimental studies have mentioned that Coffee has protective effects on the liver, could be used to prevent chronic liver diseases (from steatosis to fibrosis) and also liver cancer. Moderate daily unsweetened coffee can be used as adjuvant therapy for such patients [19, 20, 21].

A meta-analysis has shown that Green Tea intake reduces the risk of liver disease [22]. Individuals who consumed more than 10 cups of green tea/day showed a remarkable reduction in relative risk for liver cancers [23].

The seed coat of the Cocoa seed is used for liver ailments. Consuming a liquid meal along with dark chocolate (85% cocoa) can improve liver function after cirrhosis, but there is insufficient evidence for this.

In Ayurvedic medicine, Turmeric is a well-documented treatment for liver disorders [24]. Curcumin the most important and active component in turmeric may help prevent liver inflammation and damage according to lab studies.

Extracts of Artichoke are commonly found in liver detoxification supplements. Artichoke may also act on the liver to lower cholesterol levels. A number of studies of the potential benefits of artichoke for the liver [25].

Stay away from sugar (inhibits liver regeneration).

Vegetables like broccoli [26], onions [27], dandelion greens, cabbage, cauliflower and brussels sprouts [28] have a cleansing effect on the liver.

Asparagus roots and shoots have a stimulating effect on both the liver and kidney and increase the flow of liquids from the body. Extracts from A. officinalis had a protective effect on liver cells from toxic substances [29].

Walnuts contain high levels of l-arginine, an amino acid, glutathione, and omega-3 fatty acids, also help detoxify the liver of disease-causing ammonia. Walnuts also help oxygenate the blood, and extracts from their hulls are often used in liver-cleansing formulas [30].

Fruits like Apples, Plums, Grapefruit, Oranges, and lemons are helpful in cleansing the Liver.

Step 3) Hasten Regeneration of the Liver

Below is a list of herbs and supplements that aid in regeneration, without liver toxins. Remember, this is experimental. These work on rats, but it isn’t proven to work on humans, though it’s worth trying out since they are healthy even if you didn’t have a liver issue. If I knew your history, I would be able to optimize a specific plan for you, but since I don’t this is a general approach. Some have been shown to be helpful for liver disorders in clinical trials as well. I would try half of these for 2 weeks and cycle with the other half for 2 weeks. Take breaks as well.

Principal Proposed Natural Treatments

First line Regenerative Therapy:

Milk Thistle (also protective): The herb Milk thistle has shown promise for a wide variety of liver conditions, and, for this reason, it is often said to have general liver protective properties. Silymarin acts as an antioxidant by reducing free radical production and lipid peroxidation. Additionally, it has antifibrotic activity and may act as a toxin blockade agent by inhibiting binding of toxins to the liver cell membrane receptors.

In animals, silymarin reduces liver injury caused by acetaminophen, carbon tetrachloride, radiation, iron overload, phenylhydrazine, alcohol, cold ischemia, and Amanita phalloides. Silymarin has been used to treat alcoholic liver disease, acute and chronic viral hepatitis and toxin-induced liver diseases [31].

Chemotherapy for cancer treatment is often toxic to the liver. One randomized study of milk thistle in children undergoing aggressive chemotherapy for acute leukemia suggested that giving Milk thistle improved liver function in some children [32].

Milk thistle may also effectively treat Hepatitis C when given intravenously [32].

In some open studies, the long-term use of Milk thistle significantly increased the survival time of patients with alcohol-induced liver cirrhosis [33].

Other supplements or herbs which are effective for first line regenerative therapy include Rooibos (also protective) Dandelion root (also protective), Ginseng (also protective), ALCAR (also protective), Goji berries (also protective) Lipoic Acid (also protective), Vitamin C and E (also protective), UridineBCAACholine and/or PPC. Most of these substances are also neuroprotectants so you are hitting two birds with one stone.

S-adenosylmethionine The body manufactures S-adenosylmethionine (SAMe) for use in converting certain chemicals to other chemicals (specifically, through the processes of transmethylation and transsulfuration). Some evidence suggests that SAMe taken as an oral supplement may have value in the treatment of various liver diseases, including chronic viral hepatitis, liver cirrhosis and jaundice of pregnancy, and liver toxicity caused by drugs or chemicals.

Perhaps the best evidence regards cholestasis (backup of bile in the liver) caused by serious liver disease. In a 2-week, double-blind study of 220 people with cholestasis, use of SAMe (1,600 mg daily) significantly improved liver-related symptoms as compared to placebo. Most participants in this study had chronic viral hepatitis.

Another large study evaluated the potential benefits of SAMe for the treatment of people with alcoholic liver cirrhosis. This 2-year, double-blind, placebo-controlled study of 117 people failed to find SAMe helpful for the group as a whole. However, in a subgroup of those with less advanced disease, treatment with SAMe appeared to reduce the number of people who needed a liver transplant, or who died.

Gilbert’s syndrome is an unexplained but harmless condition in which levels of bilirubin rise in the body, causing an alarming yellowing of the skin (jaundice). Weak evidence hints that SAMe may help reduce bilirubin levels in this condition.

Other Proposed Natural Treatments

Probiotics have been studied as a possible treatment for liver disease. In one such study, 84 adults (aged 18-65) with liver disease ( cirrhosis or hepatitis) were randomized to receive yogurt (1 cup, 3 times daily) with or without the probiotics B. bifidus, L. acidophilus, L. bulgaricus, and S. thermophilus. After 2 weeks, the people in the probiotics group experienced an improvement in their symptoms, including less debilitation and better appetite. Chronic liver disease with cirrhosis can lead to a potentially life-threatening brain abnormality, called hepatic encephalopathy. A 2011 review of 7 randomized trials involving 550 people found inconclusive evidence to support the use of probiotics as a treatment for this condition.

One double-blind study found evidence that a beverage made from sweet potato could improve measures of liver function in people with mild hepatitis of unspecified cause.

Very preliminary evidence suggests that the supplement betaine (trimethylglycine, or TMG—not to be confused with betaine hydrochloride) may be helpful for treating fatty liver caused by alcohol and other causes, and also for protecting the liver from toxins in general.

Despite early promise, the herb phyllanthus does not appear to be helpful for viral hepatitis.

Regenerative, But Use Caution:

Treatment of alcohol-induced acute liver injury in rats with either Glycine or Vitamin E causes an increase in total SOD (Superoxide dismutase) activity and a decrease in TBARS (Thiobarbituric acid reactive levels) showing a protective effect in liver regeneration [34].

Licorice (very small amount. Large amount is toxic to the liver.)

Oregano oil (be careful with dosing. Large amounts are toxic.)

Andrographis (Be careful with dosing, as this is a powerful herb.)

(The last three are powerful antimicrobials)

In mice, Resveratrol reduced inflammation and kupffer cell activation leading to a decrease in fibrosis and promotion of liver cell regeneration in cholestatic liver injury [35].

Resveratrol and melatonin can be effective for oxidative damage (with Resveratrol showing higher antioxidative properties than melatonin) like an ischemia-reperfusion injury in mice, however, studies are required in which regeneration is critical because of their adverse effects on apoptosis and proliferation [36].

Step 4) Replete the Nutrients that have been depleted (general advice, but won’t necessarily help your liver)

B vitamins in general, are depleted by alcohol and Acetaldehyde (Specifically B12 and Folate)

Magnesium is also depleted by alcohol.

Step 5) Take breaks from alcohol use. Try to break 2-3 days a week if possible.

Step 6) Slow alcohol’s absorption by drinking after meals.

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