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September 2021

Growing Interest in Supplements for NAFLD

Nonalcoholic fatty liver disease (NAFLD) affects about 24% of adults in the US. It’s most common in people who are overweight or obese - up to 75% of people who are overweight have NAFLD. The growing prevalence of NAFLD has sparked interest in nutritional supplements that might help treat this condition. What should you tell patients?

There’s a lot of uncertainty in this area. Some small studies have found that taking fish oil by mouth seems to reduce liver fat and improve liver health in both adults and children with NAFLD. The average dose used is 2.7 grams by mouth daily. Current guidelines from the American Association for the Study of Liver Diseases (AASLD) advise that it only be considered to treat high triglyceride levels in people with NAFLD, not for NAFLD specifically. Larger-scale studies are needed before any strong recommendations can be made. 

There’s also a lot of interest in using vitamin E. Some evidence suggests that taking vitamin E improves liver function. It might help patients without diabetes who have confirmed advanced liver disease – nonalcoholic steatohepatitis (NASH). But until higher quality evidence is available, vitamin E isn’t recommended for people with NALFD who haven’t had a liver biopsy.

Turmeric and probiotics also show some promise. Clinical research shows that taking curcumin, the active chemical in turmeric, can reduce liver enzyme levels and might reduce NAFLD severity and fat deposition in the liver. It’s usually well-tolerated, but it’s not clear which form or dose of turmeric works best. Similarly, taking probiotics might improve liver enzyme levels and body mass index in people with NAFLD, but it’s not clear which species, if any, will help the most. The evidence is still too murky to make any strong recommendations.

Tell patients that the most effective treatment for NAFLD continues to be weight loss. Making healthy food choices and exercising regularly is crucial. Also remind patients that a lot of dietary supplements contain ingredients that can actually harm the liver. They shouldn’t try to self-medicate with any products, particularly weight loss products, without consulting a healthcare professional.

The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2021 Natural Medicines Inc. Commercial distribution or reproduction prohibited. Natural Medicines is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.