Exploring Herbal and Indian Traditional Remedies in the Management of Non-Alcoholic Fatty Liver Disease: Recent Advances and Clinical Trial Insights

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is one of the metabolic conditions that contribute to chronic liver illnesses, and about 25% of the world's general population is estimated to be affected with this condition. If it is not effectively delayed or reversed, 20% of the patients may develop cirrhosis or carcinoma of the liver or both. Despite the high prevalence and severity associated with NAFLD, there is a lack of efficient diagnosis and treatment. OBJECTIVE: This study aimed to perform a thorough and systematic assessment of NAFLD and its status quo, ongoing and published research studies on different traditional medicinal systems in India, viz. Unani, Ayurveda, and Siddha for NAFLD management, and to explore the potentials and possible avenues for managing NAFLD. METHOD: This review systematically searched databases, viz. PubMed, Scopus, Web of Science, Google Scholar, AYUSH portals, Clinical trial registry-India, and a few classical Unani texts to identify evidence on NAFLD and its herbal management in Unani, Ayurveda, and Siddha. After screening, 58 key studies and 12 clinical trials were synthesized, comparing traditional concepts with modern diagnostics and highlighting therapeutic insights. RESULTS: There are several herbal drugs and Indian traditional formulations that can be used to prevent and reverse NAFLD. Herbal extracts and natural products are currently the subject of an increasing number of research studies, many of which have been found effective with appreciable benefits against NAFLD. CONCLUSION: Herbal remedies comprise a promising class of prospective medications for the treatment of NAFLD. KEYWORDS: non-alcoholic fatty liver disease, quantitative ultrasonography, herbal medicine, Unani medicine, narrative review.