Spring is here, and a friend tells you about their liver cleanse: a day of Epsom salts, olive oil with grapefruit juice in the evening and, supposedly, “hundreds of stones” in the toilet the next morning. You type “liver cleanse” into a search engine and find instructions, cleanse kits and lots of personal stories. It sounds tempting. But what is behind it?
This article explains what your liver does every day, what is behind popular cleanses, what studies say about them and what is proven to be good for your liver.
At a glance
- What it's about: Liver cleanses promise a “cleansed” liver and expelled gallstones. What is behind them, and what do studies show?
- Possible causes: The liver is mainly put under strain by alcohol, excess weight with fatty liver and some medicines or concentrated herbal products.
- What you can do: Cut down on alcohol, look at weight and exercise, avoid Epsom salt flushes without medical advice, and have warning signs checked by a doctor.
- What can be measured: The liver values ALT, GGT and ALP in the blood, together with blood lipids and the inflammation marker hs-CRP.
What your liver does every day
The liver is something like the body's metabolic control centre. It processes nutrients from the gut and makes important proteins. It converts substances such as alcohol, medicines or by-products of your own metabolism so that the body can excrete them via bile or urine.
The liver also produces bile. This is a fluid that is stored in the gallbladder and flows into the gut after a meal, where it is needed to digest fat. This work goes on around the clock without you having to do anything. Medical textbooks do not describe a liver that needs to be “flushed out” like a pipe.
Liver and gallbladder cleanse: what is behind the oil flush
Similar instructions have been circulating for years under terms such as “liver and gallbladder cleanse” or “liver flush”. The best known is associated with the name Andreas Moritz. The process usually looks like this:
- For a few days beforehand, people drink apple juice and eat low-fat meals.
- On the day of the flush, Epsom salts dissolved in water are drunk several times. Epsom salts are magnesium sulphate, a laxative.
- In the evening, a mixture of olive oil and grapefruit juice follows.
- The next morning brings diarrhoea. Greenish, soft lumps appear in the stool and are interpreted as expelled gallstones.
These lumps are why many people believe the flush has worked. However, doctors questioned early on whether they are gallstones at all. A case letter in The Lancet asks the question in its title: “Could these be gallstones?” (PubMed 15836886). A case letter in the German medical weekly Deutsche Medizinische Wochenschrift also puts a question mark after “liver purging” and “gallbladder lavage” (PubMed 19718602).
We are not aware of any controlled studies showing that such a flush removes gallstones. Even a review in a journal of alternative medicine concludes that there is only minimal scientific evidence for the so-called gallbladder flush, with only anecdotal reports (PubMed 19803550).
Not as harmless as it sounds
Epsom salts are a laxative, and a flush with them is not a harmless experiment. One case report describes severe liver injury in connection with a naturopathic use of Epsom salts (PubMed 28970193). If you have or have had gallstones, have heart, kidney or bowel disease, are pregnant or take medication regularly, do not start a flush like this without talking to your doctor. Do not stop a prescribed medication without talking to your doctor first.
Liver cleanses and home remedies: what studies show
Besides the oil flush there are many other offers. Teas, capsules, juice cleanses and whole programmes are sold with the promise of “cleansing” the liver and gallbladder. The idea is almost always the same: the body is supposed to get rid of harmful substances that have allegedly built up.
A critical review looked at programmes of this kind that claim to remove toxins. The result: there are only a few clinical studies, and they have methodological flaws and small numbers of participants. The authors found no randomised controlled trials of commercial programmes of this kind in humans (PubMed 25522674).
For popular home remedies for a liver cleanse, such as lemon water in the morning, warm compresses on the liver or bitter herbs, we are not aware of any meaningful studies showing an effect on the liver. They can still be a pleasant ritual. You can read what is in a liver tea and what studies show about milk thistle and dandelion in the article Liver tea: what is in it, and what can it really do?
Liver cleanse experiences: how to interpret them
Many personal stories say that people feel lighter and clearer after a cleanse. That deserves to be taken seriously. But there are obvious explanations: during a cleanse many people drink no alcohol, eat lighter meals, sleep more and take time for themselves. That alone can feel good. Whether the cleanse itself contributes anything cannot be judged from individual experiences.
On top of that, “herbal” does not automatically mean harmless. In US research data, about 20 per cent of recorded cases of liver injury caused by medicines and other products are due to herbal products and dietary supplements, mostly concentrated products with many ingredients (PubMed 27677775).
Supporting your liver: what does that actually mean?
How to “strengthen” or support the liver is one of the most common questions about it. To be honest: there are no authorised claims that products, teas or cleanses strengthen the liver. What is backed by evidence is something else: what harms the liver and which everyday changes are proven to be good for it.
A common form of liver disease is fatty liver. Fat builds up in the liver cells, often together with excess weight, diabetes or raised blood lipids. The European guideline recommends lifestyle changes here: losing weight, changing your diet, moving more and avoiding alcohol as far as possible (PubMed 38851997).
How much this can matter is shown by a study of people with inflammatory fatty liver: the more weight they lost over a year through everyday changes, the more their liver tissue improved. The effect was clearest from around ten per cent weight loss (PubMed 25865049).
- Less alcohol, with alcohol-free days during the week.
- Exercise that fits into your day: brisk walking, cycling, taking the stairs.
- Few sugary drinks and highly processed foods.
- No supplements on a hunch, especially no high-dose extracts without advice.
Warning signs: when to see a doctor
- Yellowish skin or yellowing of the whites of the eyes (jaundice)
- Dark urine or very pale stools
- Pain or pressure in the upper right abdomen
- Fever, especially together with abdominal pain
- Severe nausea, vomiting or persistent diarrhoea after a cleanse
With signs like these, your first step is a doctor's surgery, not the next cleanse. Severe pain with fever or jaundice is a reason to seek medical help quickly.
Measure instead of guessing: checking your liver values
You cannot feel how your liver is doing, but you can measure part of it. The OM Vital blood test includes the liver values ALT, GGT and ALP, as well as blood lipids, high-sensitivity CRP and several vitamins. ALT is an enzyme from liver cells, GGT responds to alcohol among other things, and ALP gives clues about the bile ducts. A full blood count is not included.
The results are building blocks for a conversation, not a diagnosis. Fatty liver, for example, does not always show up in blood values.
Support instead of self-experiment
The ORY team of experts or your doctor can help you interpret your results. If you are interested in a cleanse programme and would rather not do it alone, you can have support. The Natura Heilpraxis in Berlin-Grunewald offers a supervised programme over several days which, according to the practice, can include juice fasting and colon hydrotherapy. The practice clarifies in a preliminary conversation whether the programme is suitable for you.
Transparency: the Natura Heilpraxis is connected to ORY. Yesha Karmeli, the founder of ORY, works there as a naturopathic practitioner (Heilpraktiker).
In brief
- The liver converts substances so the body can excrete them, and it produces bile. It does not need a cleanse for this.
- With the well-known oil flush, it is unclear whether the expelled lumps are gallstones at all; evidence of benefit is minimal.
- There are no randomised trials in humans of commercial cleanses that claim to remove toxins.
- Epsom salts and concentrated herbal products are not automatically harmless.
- What is proven to matter is less alcohol, a healthy weight and exercise.
Frequently asked questions
What is a liver cleanse?
A liver cleanse usually means a regime of Epsom salts, olive oil and fruit juice, or a programme of teas, capsules and juices. For none of these has an effect on the liver been shown in controlled studies (PubMed 19803550).
Can a liver and gallbladder cleanse dissolve gallstones?
There is no reliable evidence for this. Doctors doubt that the expelled lumps are gallstones (PubMed 15836886). If you have gallstones, discuss what to do with your doctor.
What should I make of liver cleanse experiences?
Personal stories are individual cases. Feeling better during a cleanse may also be due to less alcohol, lighter meals and more rest. Controlled studies of such cleanses are lacking (PubMed 25522674).
Which home remedies are used for a liver cleanse?
Lemon water, bitter herbs or warm liver compresses are often mentioned. We are not aware of meaningful studies showing an effect on the liver. As a ritual, they can still be enjoyable.
How can I support my liver?
There are no authorised claims for products or cleanses. What is proven: less alcohol, a healthy weight and more exercise are good for the liver, especially with fatty liver (PubMed 38851997).
When should I have my liver values checked?
If you drink alcohol regularly, are overweight, take medicines or supplements, or simply want to know where you stand. Warning signs such as jaundice or pain in the upper right abdomen need a doctor straight away.
Important note: This article does not replace medical advice, diagnosis or treatment. It is for general information only. If your symptoms are persistent or severe, please contact your doctor.
Sources
- Sies CW, Brooker J. Could these be gallstones? Lancet. 2005. PubMed 15836886
- Ewald N, Hardt PD. [Flushing stones? „Liver purging“ and „gallbladder lavage“]. Dtsch Med Wochenschr. 2009. PubMed 19718602
- Gaby AR. Nutritional approaches to prevention and treatment of gallstones. Altern Med Rev. 2009. PubMed 19803550
- Philips CA et al. Severe liver injury due to Epsom salt naturopathy. BMJ Case Rep. 2017. PubMed 28970193
- Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet. 2015. PubMed 25522674
- Navarro VJ et al. Liver injury from herbal and dietary supplements. Hepatology. 2017. PubMed 27677775
- EASL, EASD, EASO. Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024. PubMed 38851997
- Vilar-Gomez E et al. Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis. Gastroenterology. 2015. PubMed 25865049
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Colon hydrotherapy in Berlin: procedure, costs, risks – and who it is not suitable for
Colon hydrotherapy in Berlin: procedure, costs, risks – and who it is not suitable for