For how we live.
Feeding studies find that when fructose replaces other carbohydrate at equal calories, liver fat barely moves. The liver damage tracks the extra energy, not the sugar's molecular identity.
A Cochrane review of 18 trials and an NIH-funded randomised trial both failed to show that milk thistle improves liver disease. Product quality is also inconsistent, with some pills contaminated or mislabelled.
No randomised controlled trial has tested a commercial detox diet in people, and the reviews that exist find no compelling evidence they remove toxins or aid weight. Some carry real risks.
MASLD is excess fat in the liver unrelated to alcohol, and about 30% of adults have it. The best-evidenced way to reverse the inflamed form is weight loss — and how much you lose tracks how much the liver recovers.
Raised liver enzymes are common and mean the liver may be under strain, not that a disease is confirmed. The pattern, degree and duration of the change are what a clinician reads, not a single flag.
The two dominant causes of chronic liver disease are alcohol and metabolic fat. For alcohol, cirrhosis risk climbs exponentially with intake — and in women it was already raised at about one drink a day.