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Liver (ALT / AST)
ADAPT BLOODWORKIN DEVELOPMENT

Liver (ALT / AST)

Four ingredients for when a blood test shows raised liver enzymes, ALT and AST, without an active liver disease behind them: milk thistle, choline, artichoke and a little vitamin E, taken with dinner. It is still in development, and the test it depends on is not yet part of the blood panel we run. We would rather tell you that here than let the page suggest otherwise.

WHENNight, with dinner
WITH FOODYes, preferably. With your dinner
DOSE VOLUME1.6 ml, in eight 0.2 ml pulses
INGREDIENTS4 active, 0 fillers
CARTRIDGE45 ml · up to 28 nights
SLOT1 of the 6 in your device
See if it is in your plan Back to the library

WHAT IS IN IT

Four actives. Nothing else.

These are the reference doses of the formula, at the full 1.6 ml. Your device pours in steps of 0.2 ml, but the plan on file for this one is the full dose every night for 12 weeks. Three points on these doses are still open, and we say which below.

INGREDIENTFORMPER DOSE% NRVWHAT IT IS THERE FOR
Milk thistleSilybum marianum, 70% silymarin400 mg—Traditional use for liver support in its EMA monograph. Its EU claim is still on hold
CholineBitartrate400 mg—Maintenance of normal liver function, the claim this formula is filed under
ArtichokeCynara scolymus200 mg—Traditional use for indigestion in its EMA monograph. Its EU claim is still on hold
Vitamin EMixed tocopherols15 mg125%Protection of cells from oxidative stress
Total volume1.6 mlEight pulses of 0.2 ml, the smallest step the device can serve
Milk thistleSilybum marianum, 70% silymarin400 mg—

Traditional use for liver support in its EMA monograph. Its EU claim is still on hold

CholineBitartrate400 mg—

Maintenance of normal liver function, the claim this formula is filed under

ArtichokeCynara scolymus200 mg—

Traditional use for indigestion in its EMA monograph. Its EU claim is still on hold

Vitamin EMixed tocopherols15 mg125% NRV

Protection of cells from oxidative stress

Total volume 1.6 ml 

Eight pulses of 0.2 ml, the smallest step the device can serve

No proprietary blends, no "complex" hiding the amounts, no bulking agents. If an ingredient is in the bottle it is in this table, with its form and its dose.

No proprietary blends, no bulking agents. If an ingredient is in the bottle it is in this table, with its form and its dose.

THE SCIENCE BEHIND IT

Two of these four have an authorised claim. Two do not.

In the EU, only a short list of health claims is authorised, and most botanical claims sit on hold. Choline is on that list for normal liver function, and vitamin E for the protection of cells. Milk thistle and artichoke are not. None of these claims says anything about bringing your ALT or AST back into range.

Milk thistle

ON HOLD IN THE EU REGISTER

WHAT WE ARE ALLOWED TO SAY

Nothing yet. Botanical claims are suspended pending review.

The EMA monograph on file recognises milk thistle for traditional use in supporting the liver. That is not the same as an authorised EFSA claim. The extract here is standardised to 70% silymarin, while our regulatory file names a form with at least 80%, and that gap is one of the points still open. The monograph also asks you to see a doctor if your symptoms last longer than 2 weeks. If the register ever resolves the claim, we will update this page and say what changed.

EMA/HMPC monograph · Cochrane review on file · 6 sources on file · claim on hold

Choline

AUTHORISED CLAIM

WHAT WE ARE ALLOWED TO SAY

“Choline contributes to the maintenance of normal liver function.”

Regulation (EU) 432/2012. Two more choline claims sit on the same line in our file: “Choline contributes to normal lipid metabolism” and “Choline contributes to normal homocysteine metabolism.” It is the claim this formula is filed under. Our file records 400 mg of choline bitartrate, which provides roughly 41% choline, but it does not yet record the minimum amount the claim needs, so we have not checked the dose against it yet. The upper limit on file for choline is 3,500 mg a day, far above this.

Reg. 432/2012 · EFSA Journal 2016 on choline · UL 3,500 mg · 1 source on file

Artichoke

ON HOLD IN THE EU REGISTER

WHAT WE ARE ALLOWED TO SAY

Nothing yet. Botanical claims are suspended pending review.

Its EMA monograph covers traditional use for indigestion with a feeling of fullness and wind, not the liver. It is here because our library records it and milk thistle as a documented pair that complement each other. 200 mg sits below the daily amounts in the monograph, and we would rather say that than round it up. That is a reason to include it, not a permission to promise anything.

EMA/HMPC monograph · 4 sources on file · claim on hold

Vitamin E

AUTHORISED CLAIM

WHAT WE ARE ALLOWED TO SAY

“Vitamin E contributes to the protection of cells from oxidative stress.”

Regulation (EU) 432/2012, on a product that is at least a source of vitamin E. 15 mg is 125% of the 12 mg NRV, as mixed natural tocopherols, the form our regulatory file asks for over the synthetic one. EFSA sets the upper limit at 300 mg a day, and the German BfR suggests no more than 30 mg in a supplement: this formula stays under both. Vitamin E acts on your platelets, so even this small amount counts in the engine's bleeding check.

Reg. 432/2012 · EFSA Journal 2010;8(10):1816 · NRV 12 mg · UL 300 mg · 10 sources on file

HOW IT IS POURED

Eight pulses. Set by your blood test, not by last night.

The full dose of this formula is 1.6 ml, which the device serves as eight pulses of 0.2 ml. For some formulas, your band decides how many. For this one, no wearable marker in our library moves the dose: the plan on file is the full dose every night for 12 weeks, then a new test.

TONIGHT'S POUR

12345678
1.6 ml of 1.6 mlset by your blood test, not your band

NIGHT, WITH DINNER

Why then

The artichoke is there for the digestion of your evening meal, so the reason on file is to pour it before or during dinner, not after it. The rest of the formula goes out in the same pour.

WITH YOUR DINNER

Why with food

Milk thistle and vitamin E dissolve in fat, and our files ask for both to be taken with a meal. Our ingredient files would also split milk thistle and artichoke across two or three doses a day. This formula serves them once, at dinner, and we would rather flag that than hide it.

45 ML CARTRIDGE

How long it lasts

At 1.6 ml a night it is up to 28 nights. One 12-week cycle is 84, so the cycle takes three cartridges, and the app orders each refill from what you actually took.

HOW IT ENTERS YOUR PLAN

An ADAPT formula starts with a blood test. It ends with another.

ADAPT is the part of your plan that follows your bloodwork. It goes in when a result is out of range, runs for a fixed period at a fixed dose, and comes out when a new test says so. This one is still in development, and one piece is missing: the blood panel we run today does not include ALT or AST.

  1. 01

    It starts with raised liver enzymes

    Our file writes it for raised ALT and AST without an active liver disease, for example with a fatty liver or after exposure to a toxin. Our file does not yet set the exact result that starts it. ALT, AST and GGT are not yet in the VION blood panel or in our biomarker library, so for now this step cannot start from our own test.

  2. 02

    It runs for 12 weeks

    84 days at the full dose, every night. Our file takes 12 weeks as the standard point to re-check the liver, because ALT and AST need 8 to 12 weeks to show a change. Nothing about this formula moves inside that window.

  3. 03

    The next test decides what follows

    At 12 weeks you repeat ALT, AST and GGT, with a liver ultrasound if your enzymes are more than twice the upper limit of normal. The goal on file is ALT, AST and GGT back in range. If they respond, the rule on file moves you to a CORE maintenance plan. If they have not moved after 12 weeks, the rule is a referral to a liver specialist, to rule out viral or autoimmune hepatitis and haemochromatosis.

  4. 04

    No fixed pause, no yearly cap

    The cycle can be repeated, under regular review. We looked for a required break in the EMA monographs for milk thistle, artichoke and dandelion, the EFSA opinion on choline, the NIH fact sheet on choline, ANSES and the Cochrane review on milk thistle, and no document sets one. No official document sets a yearly limit either. So we do not invent either of them.

SAFETY AND INTERACTIONS

What it is never served close to.

Every pair of ingredients in our library is checked against the others before a plan is built. Inside this formula, one of the six pairs is documented: milk thistle with artichoke, as complementary. This is what the check keeps away from it.

KEPT APART

Iron

Milk thistle binds iron in laboratory studies. When Iron is on your plan for low iron stores, the two are kept at least 2 hours apart. Iron goes out in the morning and this one at night, so they never share a pour.

COUNTED TOGETHER

Curcumin, ginkgo & resveratrol

The vitamin E here counts in the engine's bleeding check. If your plan would also carry the curcumin and resveratrol in Systemic inflammation, the curcumin in Muscle damage (CK) or Anti-inflammatory & recovery, the ginkgo in Cognitive & focus, or the resveratrol in Oxidative cardiovascular, the plan is flagged for bleeding risk, and blocked outright if you take an anticoagulant. Next to the vitamin K2 in D3 / K2, Cardiovascular and Bones & joints, our file keeps vitamin E at 100 mg a day or less. This formula carries 15 mg.

TALK TO A DOCTOR FIRST

Not for everyone

Ruled out if you take a vitamin K antagonist such as warfarin or acenocoumarol; if you have a diagnosed, active liver disease; if you have a blocked bile duct or gallstones that give you symptoms (artichoke increases bile flow and can bring on biliary colic); if you are allergic to plants of the daisy family (Asteraceae), such as daisies, chamomile or ragweed; if you have had a haemorrhagic stroke or have a bleeding disorder; or if you have a vitamin K deficiency from poor absorption. Not for use in pregnancy or breastfeeding, where there is not enough data, or if you are under 18. If you take tamoxifen, avoid it and talk to your oncologist first: milk thistle may reduce its effect. Stop it before planned surgery: at least 1 week before for the milk thistle, 2 weeks for the vitamin E. Stop it and see a doctor if you notice yellowing skin or eyes, unusual tiredness, abdominal pain or dark urine, or if your symptoms last longer than 2 weeks. Talk to a doctor first if you have had breast or endometrial cancer or another oestrogen-sensitive condition; have severe cholestasis or a heart condition; are in chemotherapy or radiotherapy; or take other anticoagulants (apixaban, dabigatran) or antiplatelets, statins, ciclosporin, tacrolimus, indinavir, phenytoin, sildenafil, raloxifene, glibenclamide or other glucose-lowering medicines: milk thistle changes how your liver handles some of them. Artichoke is high in fructans, so it may not suit you on a low-FODMAP diet or with fructose intolerance. The vitamin E is usually made from soy: if you are allergic to soy, talk to a doctor first. Above 3,500 mg a day, choline can cause a fishy body odour, low blood pressure and heavier sweating; this formula is far below that. Do not exceed the recommended daily dose. Food supplements should not be used as a substitute for a varied and balanced diet. Keep the cartridge out of reach of young children. The app asks before it ever assigns this one.

WHERE THIS COMES FROM

Regulation (EU) 432/2012 on permitted health claims · Regulation (EU) 1169/2011 on nutrient reference values · EFSA Journal 2010;8(10):1816 on vitamin E and protection of cells from oxidative stress · EFSA 2016 dietary reference values for choline · EFSA 2024 tolerable upper intake level for vitamin E · EMA/HMPC monographs on Silybum marianum and Cynara scolymus. Every line on this page is tied to one of the 810 sources on file, and 443 of the 9,730 possible ingredient pairs in our library are documented so far.

WHERE IT COMES FROM

You can check every line of this page.

Eight sources hold up this formula: the regulation that lets us make two of the claims, the reference values we measure against, the EFSA opinion behind the vitamin E claim, the EFSA reference values for choline, the EFSA upper limit for vitamin E, the stricter German reference we also stay under, and the two EMA monographs for the botanicals.

REGULATIONRegulation (EU) 432/2012 — list of permitted health claims made on foodsclaims for choline and vitamin E
NRVRegulation (EU) 1169/2011, Annex XIII Part A — nutrient reference valuesthe 125% above
EFSAEFSA Journal 2010;8(10):1816 — Vitamin E and protection of cells from oxidative stress (DOI 10.2903/j.efsa.2010.1816)behind the vitamin E claim
EFSA DRVEFSA Journal 2016 — Dietary Reference Values for choline (DOI 10.2903/j.efsa.2016.4484)reference intakes for choline
EFSA ULEFSA Journal 2024 — Scientific opinion on the tolerable upper intake level for vitamin E (DOI 10.2903/j.efsa.2024.8953)300 mg a day; we serve 15 mg
BfRBfR-Wissenschaft 03/2018 — Höchstmengenvorschläge für Vitamine und Mineralstoffe in Nahrungsergänzungsmittelnvitamin E 30 mg; we serve 15 mg
EMAEMA/HMPC — European Union herbal monograph on Silybum marianum (L.) Gaertn., fructus (2018)traditional use, the 12-week plan and the 2-week rule; claim on hold
EMAEMA/HMPC — European Union herbal monograph on Cynara scolymus folium (2010)traditional use for indigestion; claim on hold

Reviewed by VION nutrition team · last reviewed 16 September 2026

WHAT IS NOT PROVEN YET

This formula is still in development and has not been through clinical validation. Two of its four ingredients carry authorised EU claims, but none of those claims is about your ALT or AST, and the combination has not been tested by us in a trial. Several points are still open: ALT and AST are not yet in our blood panel, the silymarin content of the milk thistle, the artichoke dose below its monograph, and the minimum choline dose the claim asks for. When they are settled, and when the formula is tested, the result goes on this page, whatever it says.

Others in the same area

See all 29 formulas  →
Glucose & metabolismADAPTBloodworkGlucose & metabolismSystemic inflammationADAPTBloodworkSystemic inflammationMuscle damage (CK)ADAPTBloodworkMuscle damage (CK)IronADAPTBloodworkIron

YOU DO NOT PICK YOUR FORMULAS

Your data does.

The questionnaire and your first weeks of data decide which six of the 29 end up in your device. This page exists so you can read what one of them is before that happens.

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Food supplement. Does not replace a varied diet or a healthy lifestyle. VION does not diagnose or treat any condition. Nothing here replaces a healthcare professional.

Food supplement. Does not replace a varied diet or a healthy lifestyle. VION does not diagnose or treat any condition.