Picrorhiza kurroa is a traditional medicinal herb from the Himalayas, widely used in Ayurveda and Unani medicine for liver disorders. In recent years, its use for Fatty Liver Disease (including non-alcoholic fatty liver disease, NAFLD) has gained scientific interest. Several animal studies and a few small human clinical trials suggest that extracts of Picrorhiza kurroa exert hepatoprotective effects: they reduce liver fat accumulation, improve liver enzyme levels, and demonstrate antioxidant, anti-inflammatory, and antifibrotic properties. The active constituents, such as picroside I and II and kutkoside, are believed to modulate pathways involved in lipid metabolism and oxidative stress, which are central to fatty liver disease pathogenesis.

For example, a 2014 randomized controlled trial in humans found that supplementation with Picrorhiza kurroa extract led to significant improvements in liver function tests and reductions in liver fat content as assessed by ultrasound. Preclinical studies in rodents show decreased hepatic triglyceride levels and protection against chemically-induced fatty liver. However, while these findings are promising, high-quality, large-scale human trials are still lacking, and most available evidence is preliminary or based on animal models. Thus, while there is both traditional use and emerging scientific support for Picrorhiza kurroa in managing fatty liver disease, the overall quality and quantity of evidence is moderate (rated 3/5).