Ranked by evidence
Best supplements for fatty liver (MASLD/NAFLD)
Weight loss of 7–10% remains the only intervention with strong evidence in fatty liver disease, and MASLD needs a doctor to stage fibrosis and manage diabetes, lipids and alcohol. The supplements below mostly move liver enzymes rather than outcomes: a 2024 Cochrane review found vitamin E likely lowers ALT and AST slightly, while its effects on mortality and serious harms are very uncertain. Picks are ranked by the grade for fatty liver specifically, and several popular liver products are on the skip list because they can injure the liver.
Picks are ranked by the strength of published evidence for this goal in otherwise healthy adults. A persistent symptom needs a clinician's evaluation, and no supplement on this list replaces treatment.
Evidence last reviewed: October 2026
Solid options
| Option | Evidence | Best for | The honest note | |
|---|---|---|---|---|
| Dihydromyricetin (DHM) | Limited evidence | liver enzymes and insulin resistance | In a randomized trial in 60 adults with NAFLD, 300 mg twice daily for 3 months lowered ALT and AST and improved HOMA-IR and LDL cholesterol versus placebo. It is one small trial with blood-marker endpoints, not liver fat or fibrosis on biopsy. | View |
Situational
| Option | Evidence | Best for | The honest note | |
|---|---|---|---|---|
| Vitamin E | Limited evidence | non-diabetic NASH, under medical care | In PIVENS, 800 IU a day improved NASH histology in 43% versus 19% on placebo without improving fibrosis, and Cochrane rates its ALT and AST reduction as slight. Doses of 400 IU a day and above carry prostate cancer, hemorrhagic stroke and bleeding signals. | View |
| Choline | Moderate evidence | low-choline diets only | Controlled feeding studies show that too little choline causes fatty liver that resolves when intake is restored, but that is a deficiency effect, not a treatment. Most people fall short of the adequate intake of 425–550 mg a day, and egg yolks are an easy food source. | View |
Popular for this goal — but the evidence says skip
- Milk Thistle (Silymarin) Limited evidence
Two NASH trials of up to 48 weeks missed their primary endpoints; it lowers ALT and AST modestly, and a fibrosis signal from one trial still needs confirming.
- Liver Detox Formulas Limited evidence
Weight loss, not these blends, has strong evidence, and common ingredients such as green tea extract and garcinia have caused liver injury.
- Green Tea Extract (EGCG) Limited evidence
Concentrated extracts have caused acute hepatitis and liver failure, with raised liver enzymes at 800 mg a day of EGCG or more, a poor trade when your liver is already the problem.
- Citrus Bergamot Limited evidence
Its fatty liver data are a few small, mostly open-label pilot studies using ultrasound and enzymes.
- Artichoke Extract Moderate evidence
Its fatty liver trials are small, mostly single-country and rely on enzyme or imaging endpoints rather than histology.
- TUDCA (Tauroursodeoxycholic Acid) Limited evidence
Guidelines recommend the licensed drug UDCA, not TUDCA, and there are no outcome trials in liver disease.
Our verdict
No supplement reverses fatty liver; diet, weight loss and treating diabetes do the work. DHM has the best small trial for liver markers, and vitamin E at 800 IU a day belongs only under a doctor for non-diabetic NASH. Skip milk thistle, detox blends and green tea extract.