Phyllanthus niruri: traditional herb for treating and cleansing the liver

Phyllanthus niruri is an annual herb from the Phyllanthaceae family, found throughout the world in tropical and subtropical regions. It usually grows only about 30 to 60 cm high and is recognisable by its small green leaflets arranged in two rows along slender stems and by the small round fruits growing beneath the leaves. It is known by many names. In Sanskrit it is called Bhumyamalaki (earth amla), in Hindi Bhumi amla or Hazarmani, in Tamil Keezhanelli and in Chinese zhen zhu cao. Its many names bear witness to its long history of use in traditional medicine and in different cultures. It is especially renowned as “the one that breaks stones”, since it has been used to ease problems with kidney and gallstones. Today, it is mainly in the spotlight because of its hepatoprotective properties.

In what follows you will read how this plant has been used over the centuries in traditional systems of medicine for the treatment of liver diseases, what its chemical composition is, which scientific studies support its reputation, what its possible mechanisms of action are and how safe it is to use.

Traditional Use

Phyllanthus niruri has an important place in traditional medical systems, especially in Indian and East Asian medicine. For centuries it has been recommended in jaundice, hepatitis and other liver diseases, as well as in kidney and gallstones and various infections.

In Ayurveda, Phyllanthus niruri is known under the name Bhumyamalaki and is considered one of the most important herbs for liver support. The plant is classified among the rasayanas for the liver (a plant that “rejuvenates” liver tissue).

The Ayurvedic pharmacological classification of the medicinal plant Bhumyamalaki is well defined. Its rasa (taste) is bitter (tikta), astringent (kashaya) and slightly sweet (madhura). Because of these properties it reduces pitta and kapha dosha, while in higher doses it can slightly increase vata dosha. Ayurvedic physicians use it for a broad spectrum of liver problems, in hepatitis, in enlarged liver and spleen, in digestive disturbances, as a “raktashodhaka” (that which purifies the blood) in fever, inflammation and detoxification of the body.

The plant Phyllanthus niruri is also used as a diuretic and in the treatment of the urinary tract and kidneys.

Phytochemical composition

Scientific analyses have shown that the plant Phyllanthus niruri contains numerous bioactive compounds that can explain its medicinal effects. From various parts of the plant, lignans, flavonoids, alkaloids, tannins and other phenolic compounds have been isolated. Among the most important active substances are lignans, especially phyllanthin and hypophyllanthin. These are unique compounds that are largely responsible for the hepatoprotective action. Research shows that these compounds have antioxidant properties and can protect liver cells from damage. Other lignans (for example niranthin, nirurinin), which also contribute to the therapeutic effects of the plant, are also present.

The plant is also rich in flavonoids such as rutin, quercetin and luteolin derivatives. Flavonoids are known for their anti inflammatory and antioxidant activity in the liver. Tannins, for example geraniin and ellagic acid, give the plant its astringent taste, act as astringents and are thought to bind to crystals of calcium salts in the urinary tract and prevent their growth.

It is important to note that it is probably the synergy of several compounds acting together that contributes to the medicinal effects of the plant. The combination of lignans, flavonoids, tannins and other molecules creates an effect that has been shown to provide effective liver protection.

Scientific evidence

Because of the promising traditional claims, the effects of the plant Phyllanthus niruri on the liver have in recent decades also been studied in scientific laboratories, in animals and in clinical trials.

Laboratory experiments on in vitro cell cultures show that extract of Phyllanthus niruri can inhibit the growth of hepatitis B virus. Already in 1987 researchers found that extract of this plant inhibits hepatitis B viral polymerase and binds to the surface antigen of the virus, which prevented its replication. In addition to antiviral activity, cell experiments have also shown antioxidant effects. Anti inflammatory action has also been demonstrated, as it inhibits the formation of inflammatory cytokines in damaged liver cells.

Numerous experiments in rodents have confirmed hepatoprotective activity. In rats and mice, extract of P. niruri effectively protected the liver from various chemical poisons and damaging agents. For example, in a model using carbon tetrachloride (CCl₄), a known hepatotoxin, treated animals had significantly lower serum levels of liver enzymes ALT and AST and less liver tissue damage compared to the control group. Similar findings were made in experiments with other toxins. The mechanism includes increased levels of antioxidant enzymes (glutathione, SOD) in the liver and stabilisation of hepatocyte membranes, which makes the cells more resistant to toxic damage.

The experiments confirming lithotriptic effects (“stone breaking”) are also interesting. In rats, P. niruri prevented the growth of calcium oxalate crystals in the kidneys and increased their excretion in urine. There is a high probability that the plant may also prevent the formation of gallstones or facilitate their elimination.

Mechanisms of action in the liver

The diverse phytochemical composition of Phyllanthus niruri means that it acts on liver cells through several simultaneous mechanisms. The most important mechanisms of action identified in scientific studies are:

Antiviral activity. Lignans phyllanthin, hypophyllanthin and some tannins act on hepatitis viruses. In vitro, phyllanthin has been shown to inhibit the activity of HBV viral polymerase, which can prevent viral replication. In addition, plant extract is thought to interfere with viral binding to liver cells.

Phyllanthin and hypophyllanthin have a pronounced antioxidant effect. They act as free radical scavengers and increase the activity of endogenous antioxidants in liver cells. In this way they protect hepatocyte membranes from lipid peroxidation and other toxin induced damage. Phyllanthin is also believed to stabilise hepatocyte membranes, which prevents leakage of enzymes and the entry of toxic substances into the cells.

Anti inflammatory activity. In liver diseases, inflammation is often present. Flavonoids from P. niruri (for example rutin, quercetin) and other compounds have shown the ability to inhibit inflammatory pathways such as COX 2 and inducible nitric oxide synthase and to reduce the release of inflammatory cytokines. In animal models, treatment led to less inflammatory infiltrate in the liver and lower TNF α levels.

Antioxidant activity. The plant is rich in antioxidants. It protects liver cells from oxidative stress caused by toxins (for example alcohol, chemicals) or viral infection. By reducing oxidative damage, Phyllanthus prevents cell death (apoptosis) of hepatocytes. The increase in total antioxidant capacity of the blood observed in a clinical trial in alcoholic hepatitis confirms that active constituents of the plant enter the circulation and strengthen the antioxidant defence of the organism.

Immunomodulatory activity. There is evidence that P. niruri modulates the immune response. In chronic viral hepatitis it is thought to mildly stimulate cellular immunity against the virus (activation of natural killer cells and T cells), while at the same time inhibiting an excessive inflammatory response that damages the liver.

Effect on liver enzymes and metabolism. Interestingly, compounds in the plant can also affect liver enzymes involved in the metabolism of drugs and toxins. Phyllanthin and hypophyllanthin have shown inhibitory effects on cytochrome P450 enzymes in studies, particularly on the key isoenzyme CYP3A4.

Recommended forms of use and dosage

When dosing, it is always advisable to start with a lower dose and monitor the response, especially with concentrated extracts. In clinical studies in humans, relatively safe doses have been used, for example 600 mg of extract daily. This suggests that the plant is not toxic within the range of traditional doses. Nevertheless, it is recommended that use in more serious diseases take place under medical supervision, and that the recommended amounts are strictly followed.

Safety, side effects and interactions with medicines

Common mild side effects. In sensitive individuals high doses may cause digestive disturbances such as mild nausea or diarrhoea. These problems usually subside if the dose is reduced or the preparation is taken with food.

Because of the lack of research, use is not recommended for pregnant and breastfeeding women.

Interactions with medicines. Phyllanthus niruri can affect the metabolism of certain medicines. As already mentioned in the mechanisms of action, the plant inhibits the activity of liver cytochrome P450 (CYP) enzymes, especially CYP3A4. This means that it can slow the breakdown of drugs metabolised via these enzymes and thereby increase their concentrations in the body. If taken together with medicines such as some statins, immunosuppressants, benzodiazepines or oral contraceptives (which are CYP3A4 substrates), the effect of these medicines could theoretically be enhanced or prolonged.

Although the plant has anti inflammatory effects, stimulation of the immune system can worsen the condition in autoimmune diseases.

Literatura:

Baiguera, C., Boschetti, A., Raffetti, E., Zanini, B., Puoti, M., and Donato, F. (2018). Phyllanthus niruri versus Placebo for Chronic Hepatitis B Virus Infection: A Randomized Controlled Trial. Complementary Medicine Research, 25(6), 376–382.
Rani, P., and Pooja. (2025). Phyllanthus niruri: A Comprehensive Review of Its Botanical, Phytochemical, and Therapeutic Potential. Journal of Advances in Biology & Biotechnology, 28(8), 1688–1697.
Sowjanya, K., Girish, C., Bammigatti, C., and Lakshmi, N. C. P. (2021). Efficacy of Phyllanthus niruri on improving liver functions in patients with alcoholic hepatitis: A double blind randomized controlled trial. Indian Journal of Pharmacology, 53(6), 448–456.
Taesotikul, T., Dumrongsakulchai, W., Wattanachai, N., Navinpipat, V., Somanabandhu, A., Tassaneeyakul, W., and Tassaneeyakul, W. (2011). Inhibitory effects of Phyllanthus amarus and its major lignans on human microsomal cytochrome P450 activities: Evidence for CYP3A4 mechanism based inhibition. Drug Metabolism and Pharmacokinetics, 26(2), 154–161.
Venkateswaran, P. S., Millman, I., and Blumberg, B. S. (1987). Effects of an extract from Phyllanthus niruri on hepatitis B and woodchuck hepatitis viruses: in vitro and in vivo studies. Proceedings of the National Academy of Sciences of the United States of America, 84, 274–278