Picrorhiza kurroa, also known as Kutki, is a herb traditionally used in Ayurvedic medicine for various liver disorders, including cirrhosis. Its active constituents—mainly kutkin (a mixture of picroside I and kutkoside)—have been the subject of several preclinical and limited clinical studies investigating hepatoprotective effects. Scientific validation for its use in cirrhosis primarily comes from animal studies that demonstrate its ability to reduce liver fibrosis, lower liver enzyme levels (ALT, AST), and protect against carbon tetrachloride- or thioacetamide-induced hepatic injury. The proposed mechanisms include antioxidant activity, inhibition of lipid peroxidation, and modulation of inflammatory cytokines.

Small-scale human clinical trials and case studies have reported improved liver function parameters (e.g., reduced bilirubin, improved albumin levels) in patients with chronic liver disease, including cirrhosis, after supplementation with Picrorhiza kurroa extracts. However, these studies often suffer from methodological limitations such as small sample sizes, short duration, and lack of rigorous controls. No large, high-quality randomized controlled trials specifically in cirrhosis patients have been published as of 2024.

In summary, while Picrorhiza kurroa shows promise for supporting liver health and possibly attenuating the progression of cirrhosis, current scientific evidence is preliminary and not robust. Its use for cirrhosis is supported more by animal and in vitro data than by strong clinical evidence, warranting a cautious approach until further studies are conducted.