Liver Cleansing Imposters: An Analysis Of Popular Online Liver Supplements.

Background: The liver supplement market is rapidly expanding, yet the efficacy and safety of these products remain largely unsubstantiated. This study aimed to analyze the best-selling liver "cleansing" supplements on Amazon®, the leading online retailer in the United States.

Methods: We identified the top 20 liver cleanse supplements on Amazon® using specific search criteria. Product composition, marketing claims, customer reviews, sales data, and revenue were analyzed. AMZScout® was used for sales analytics, and FakeSpot® for review authenticity assessment. The most common ingredients were identified, and their scientific evidence evaluated through structured PubMed searches with predefined criteria for evidence quality assessment.

Results: The 20 top-selling supplements generated total annual sales of 1,420,584 units with a revenue of $38,783,937. All products claimed to "eliminate toxins" or provide "liver detox/cleanse," while 85% claimed to "enhance liver function." The average product rating was 4.4/5 stars, with review reliability averaging 73% ± 20%. Milk thistle was the most common ingredient (19/20 products), followed by dandelion and turmeric root (13/20 each). Scientific evidence supporting these ingredients' efficacy in liver health was limited and inconclusive.

Conclusions: This study reveals a thriving market for liver supplements despite limited scientific evidence supporting their efficacy. The prevalence of bold health claims, high consumer satisfaction, and significant sales highlight the need for more rigorous evaluation and regulation of these products. Healthcare providers should be aware of these trends to better counsel patients on evidence-based approaches to liver health.