Best Supplements for Fatty Liver Disease (9 min.)

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Non-alcoholic fatty liver disease (NAFLD), now called metabolic dysfunction-associated steatotic liver disease (MASLD), a condition in which excessive fat accumulates in the liver, is becoming increasingly common. You can develop this condition even if you don’t drink alcoholic beverages. NAFLD may not cause symptoms. If left unmanaged, it can lead to more serious liver issues, including hepatitis, cirrhosis, and liver failure. Obesity or Type 2 diabetes is a common cause of NAFLD. With increasing rates of both obesity and diabetes, it is estimated more than 30 percent of people worldwide have NAFLD. Non-alcoholic fatty liver disease may also increase your risk of developing cancer, cardiovascular disease and diabetes. While lifestyle changes like diet and exercise are key, you may wonder if there are supplements for fatty liver disease. Certain vitamins and supplements have shown promise for supporting liver health and potentially reducing NAFLD symptoms. Let’s explore these supplements that may help manage non-alcoholic fatty liver disease.

Vitamin E

Vitamin E is a fat-soluble vitamin, meaning your body absorbs and stores it. It is a powerful antioxidant that may provide some protection from heart disease, cancer, macular degeneration, and cognitive decline.  The FDA recommends 15 mg of vitamin E for adults each day. Those on blood thinners or cholesterol medications should avoid taking high-dose (1,000 IU or more) vitamin E supplements. Vitamin E is one of the most studied supplements for fatty liver disease. This antioxidant reduces oxidative stress in the liver, which can damage liver cells and promote fat accumulation.

Several randomized controlled trials have found that Vitamin E supplementation reduced liver inflammation and improved liver function in people with non-alcoholic steatohepatitis (NASH), a more severe form of fatty liver disease. However, the role of vitamin E in the long-term management of NAFLD is not clear, and more clinical trials are needed.

Food sources:  Sunflower seeds, almonds, hazelnuts, oils from wheat germ, sunflower or safflower.

Vitamin D

Vitamin D is also a fat-soluble vitamin stored in the liver and other fatty tissues. Most of the vitamin D we get is through exposure to sunlight rather than food. Around 35 percent of adults in the United States are thought to be deficient in vitamin D. This essential vitamin is known for its role in bone health but has many other benefits. Read about the benefits of vitamin D.

Low levels of Vitamin D are often associated with various liver conditions, including fatty liver disease. While Vitamin D itself doesn’t directly reduce liver fat, it is a key vitamin for liver health. It helps improve overall liver function and may have a role in controlling inflammation and fibrosis in the liver. More studies are needed to determine how much vitamin D supplementation is recommended.

Food sources: Vitamin D occurs naturally in very few foods. Fortified foods provide most of the vitamin D obtained through diet. Fatty fish, mushrooms, fortified milk and orange juice are good options. Cooper Clinic recommends a minimum daily intake of 25-50 mcg (1000-2000 IU) of vitamin D3. Vitamin D supplements are likely necessary to obtain this amount. Cooper Complete multivitamins contain 50 mcg (2000 IU) of vitamin D. Additionally, Cooper Complete offers stand-alone D3 supplements. Remember, vitamin D is a fat-soluble vitamin, so take it with food that contains some fat for best absorption.

Milk Thistle

Milk thistle is a plant with a purplish-pink thistle at the top. Often considered a weed, milk thistle, particularly its active compound silymarin from the seeds, has been used by herbalists for centuries as a supplement for liver health. Modern studies have confirmed its hepatoprotective properties, making it a popular supplement for those with liver conditions, including use as a supplement for fatty liver disease.

A small study found that silymarin significantly reduced liver enzymes in individuals with NAFLD, indicating improved liver function and reduced inflammation. However, silymarin is not standardized in formulas, and effective dosages are lacking. Well-designed, double-blind, placebo-controlled studies are needed.

Milk thistle can cause an allergic reaction. As with any supplement, speak with your doctor or health care provider before taking it, as it interacts with many medications, including diabetes medications, some antibiotics, and blood thinners.

N-Acetylcysteine (NAC)

N-Acetylcysteine (NAC) comes from the amino acid L-cysteine. NAC boosts glutathione, one of the body’s most powerful antioxidants. Glutathione plays a critical role in detoxifying the liver and reducing oxidative stress, both of which are important for managing fatty liver disease.

A small study found that NAC supplementation led to significant improvements in liver function tests in people with NAFLD. The study concluded that NAC could be an effective therapeutic option for patients with fatty liver. Another study in mice concluded NAC might be an effective drug to treat NAFLD; however, no optimal dose was determined, and it was only performed on male mice. Larger-scale clinical trials are needed with people (both women and men) to determine how much of this supplement should be taken for fatty liver disease.

Food sources: NAC is not directly found in food sources. However, it is derived from the amino acid L-cysteine, found in eggs, meat, milk, nuts, broccoli, and garlic. Eating these foods can help increase the body’s production of NAC.

Omega-3 Fatty Acids

Omega-3 fatty acids, commonly found in fish oil, are known for their anti-inflammatory properties. Studies suggest these fats can help reduce liver fat and improve liver function by decreasing inflammation. A meta-analysis of ten studies showed omega-3 fatty acids were beneficial for improving liver fat.

Another meta-analysis of 22 random controlled trials with 1366 participants found that omega-3 supplementation improved liver fat, as seen on ultrasonography. It may also improve total cholesterol, triglycerides, HDL (good cholesterol) and body mass index.

Nine clinical trials are currently evaluating omega-3 supplementation for fatty liver. Their results should provide additional insight into the benefits of omega-3 supplements for nonalcoholic fatty liver disease.

Cooper Complete offers both an omega 3 liquid and a softgel option.

Food Sources: Fatty fish such as salmon, tuna and sardines. Flaxseeds, chia seeds and walnuts. Find out more about omega-3 fatty acids from the National Institute of Health (NIH).

Curcumin

Curcumin, the active compound in turmeric, is known for its potent anti-inflammatory and antioxidant effects. It has been shown to fight free radicals and reduce the stress levels the body experiences, which, in turn, prevents the inflammation response.

A small study of 64 people with NAFL took either 2 grams of turmeric or a placebo daily for 8 weeks. Liver enzymes dropped significantly in the turmeric group. Serum levels of triglycerides and cholesterol also declined in the turmeric group, while the placebo group did not see these changes. The anti-inflammatory properties of curcumin seem to make it a good supplement for liver health and improving liver function.

Food Sources: Turmeric is a spice often added to foods such as curry; however, the amount of curcumin can vary depending. Your body also cannot absorb or use it well. Supplements are a good way to provide more accurate amounts of curcumin.

Read about the many other health benefits of turmeric.

Coenzyme Q10 (CoQ10)

Coenzyme Q10 (CoQ10), a powerful antioxidant, plays a key role in cellular energy production. A deficiency of CoQ10 affects cellular energy production, which can lead to increased fat accumulation in the liver. It has shown promise in protecting liver cells from damage caused by free radicals.

A 12-week study showed that taking 100 mg of CoQ10 daily decreased systemic inflammation and blood biomarkers associated with NAFLD.

Cooper Complete offers CoQ10 in 50 and 100 mg, and the Cooper Complete Original multivitamins contain 100mg of CoQ10.

Food Sources: CoQ10 is found in organ meat, fish and nuts. However, the amount found in food is insufficient to significantly increase CoQ10 levels in the body. CoQ10 supplements are the best option when considering taking Coq10 for non-alcoholic fatty liver disease.

Berberine

Berberine is a plant-derived compound known for its ability to regulate blood sugar and improve insulin sensitivity, both of which are important for people with fatty liver disease. Insulin resistance is often a contributing factor in developing NAFLD, and berberine’s ability to modulate blood sugar and lipid metabolism may help reduce liver fat. Berberine also can reduce oxidative stress and inflammation in the liver, making it a good supplement for liver health.

A 2015 study found that berberine supplementation improved insulin sensitivity and reduced liver fat content in patients with NAFLD. These findings suggest that berberine could be a valuable supplement for managing fatty liver disease.

Food Sources: Berberine is not found in any common foods and is bitter, making berberine supplements a better choice for nonalcoholic fatty liver disease. Cooper Complete offers a Berberine Complex containing vitamin C and alpha lipoic acid in addition to 1000mg of Berberine.

Berberine has many benefits beyond its use as a supplement for fatty liver disease. Read more about Berberine health benefits.

Probiotics

The gut microbiome plays a critical role in liver health, and imbalances in gut bacteria have been associated with fatty liver disease. Probiotics, beneficial bacteria that support gut health, may help reduce liver inflammation and fat accumulation by promoting a healthy gut microbiome.

Studies have found that probiotics improved liver function and reduced markers of liver inflammation in people with NAFLD. The most studied probiotics have been the strains Lactobacillus or Bifidobacterium, but next-generation probiotics Akkermansia muciniphila and Faecalibacterium prausnitzii are gaining attention as potential options. Further studies are needed to provide efficacy and find if these new probiotics are superior to traditional ones.  Cooper Complete Advanced Daily Probiotic contains Lactobacillus, Bifidobacterium longum and lactis.

Food Sources: Sauerkraut, kombucha, kefir, kimchi and yogurts that contain live, active bacteria.

Potassium

Potassium is an essential mineral that helps maintain proper electrolyte balance, which is crucial for normal cell function, including liver cells. Most people in the US don’t eat enough fruits and vegetables, which are the best sources of potassium. In fact, 98 percent of Americans are potassium deficient.  Low serum potassium is associated with NAFLD in middle-aged and elderly.

A study showed that potassium supplementation helped reduce liver inflammation in patients with liver disease, including NAFLD. The research suggests that potassium and vitamin C have an interactive effect in reducing NAFLD.

Food Sources: Bananas, dried fruit, potatoes, lentils and beans.

Supplements can be a valuable tool for those dealing with non-alcoholic fatty liver disease. However, they should not replace lifestyle changes like a healthy diet and regular exercise. As with any health-related issue, your healthcare provider understands your health profile best. Always consult with a healthcare professional before starting any new supplement regimen, particularly if you have a liver condition. With the right approach, vitamins and supplements can help manage the effects of fatty liver disease and support liver health.

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Cooper Complete February 15, 2025