diagnosed with fatty liver this fall. I am taking the capsules but I bet the powder is stronger (more concentrated). Sometimes I feel a little "spacey" or tired on these pills but I haven't noticed any strong die-off symptoms. I had already done between 15-20 Liver Flushes before I even knew I had fatty liver so I don't know whether that made any difference or not. The medical profession is about the same where I live. They have no idea what to do about fatty liver which is the reason I turned to Dr. Cabot's book and formula