The array of supplements available for the liver is astonishing. The probability is that each claim made the relevant purveyor can be back up with some evidence but in my opinion it is all a matter of probability.
The PPC with the cholic acid evidence appears to be successful in 2.5 out of seven individuals with cholesterol Gallstones
that were radio opaque. These individuals were also on a strict diet which excluded fat but we don't know what else in included. If you fit the criteria of the trial this gives you a 35% chance of success of partial gallstone dissolution and 28% chance of dissolving all gallstones. There is no evidence about whether the Gallstones
return and there is no evidence that these supplements are suitable for pigment gallstones.
Malic acid has a synergy with pectin. The claim that malic acid dissolves stones is made without much supporting evidence and I have found it difficult to find the evidence. However, I have found some good scientific evidence that there is a relationship between malic acid and pectin both of which are found in apples. The malic acid dissolves the cholesterol in the bile while it is in digestive tract which allows the pectin to chemically bind to the cholesterol. This allows the "old" cholesterol to be evacuated from the body encouraging new cholesterol to be produced by the liver. This cholesterol cycle appears to be a very important mechanism in stopping the growth of gallstones. Pectin has been demonstrated to actually reduce the size of gallstones. It also reduces blood cholesterol levels by around 16% on average. I believe the synergy between malic acid and pectin has become confused over time and today too much emphasis is put on the benefit of malic acid whereas it is the combination of malic and pectin that is so important.
However, PPC with the cholic nor malic acid with pectin have supporting evidence that they dissolve pigment stones. Moreover, none of these supplements tackle the underlying problem that the cause of Gallstones
may be congestion or damage in the liver. In my view that a liver cleanse by flushing is inevitable at some time following even the best preparation and dedication to the use of supplements.