Best Supplements for Reduced Alanine Aminotransferase Level
Ranked by research evidence. Compare 31 supplements across 47 papers from the biomedical literature, with effect direction, evidence strength, and dose range for each.
Top picks by evidence
- Moderate evidence6 studies
Across 6 studies, 4 reported beneficial effects of thistle (silymarin/silibinin) on reducing alanine aminotransferase (ALT) levels, with effect sizes ranging from small to large, and 2 found neutral results. The two highest-quality meta-analyses (evidence scores of 7) both showed statistically significant beneficial effects — one in NAFLD patients (moderate effect, SMD -0.47 to -0.88) and one in patients on anti-TB drugs (small effect, SMD -0.15). The median study duration across the 2 studies that reported it was 104 days (approximately 15 weeks), indicating effects are typically observed after several weeks of supplementation.
Dose: 140 mg three times daily (reported in one RCT; other studies did not specify dose) - Moderate evidence4 studies
Across 4 studies, all reported beneficial effects of vitamin E supplementation on reducing alanine aminotransferase (ALT) levels in patients with non-alcoholic fatty liver disease (NAFLD), with 3 reaching statistical significance. The predominant effect sizes were mixed (small to moderate), and effects were typically observed at 8–12 weeks (median study duration 72 days). The most commonly studied dose range was 400–1000 IU per day.
Dose: 400–1000 IU/day - Low evidence3 studies
Across 3 studies, 2 reported beneficial effects (small to moderate magnitude) on reducing ALT levels, with statistically significant findings. The most-studied population was patients with non-alcoholic fatty liver disease (NAFLD). Effects were typically observed at 60 days (median study duration). The only reported effective dose was 520 mg/day of grape seed extract.
- ModerateThistleAcross 6 studies, 4 reported beneficial effects of thistle (silymarin/silibinin) on reducing alanine aminotransferase (ALT) levels, with effect sizes ranging from small to large, and 2 found neutral results. The two highest-quality meta-analyses (evidence scores of 7) both showed statistically significant beneficial effects — one in NAFLD patients (moderate effect, SMD -0.47 to -0.88) and one in patients on anti-TB drugs (small effect, SMD -0.15). The median study duration across the 2 studies that reported it was 104 days (approximately 15 weeks), indicating effects are typically observed after several weeks of supplementation. · Dose: 140 mg three times daily (reported in one RCT; other studies did not specify dose)4 beneficial2 neutral6 studies
- ModerateVitamin EAcross 4 studies, all reported beneficial effects of vitamin E supplementation on reducing alanine aminotransferase (ALT) levels in patients with non-alcoholic fatty liver disease (NAFLD), with 3 reaching statistical significance. The predominant effect sizes were mixed (small to moderate), and effects were typically observed at 8–12 weeks (median study duration 72 days). The most commonly studied dose range was 400–1000 IU per day. · Dose: 400–1000 IU/day4 beneficial4 studies
- LowRed GrapeAcross 3 studies, 2 reported beneficial effects (small to moderate magnitude) on reducing ALT levels, with statistically significant findings. The most-studied population was patients with non-alcoholic fatty liver disease (NAFLD). Effects were typically observed at 60 days (median study duration). The only reported effective dose was 520 mg/day of grape seed extract.2 beneficial1 neutral3 studies
- LowBlack CuminAcross 3 studies, 1 large meta-analysis (n=5026) reported a beneficial small effect of black cumin supplementation on reducing alanine aminotransferase (ALT) levels, while 2 other meta-analyses/RCTs (including type 2 diabetes and knee osteoarthritis populations) found neutral effects. The median study duration was 19 days, shorter than typical for liver enzyme outcomes, and the most-studied dose range could not be reliably determined due to variability. The predominant effect direction is mixed (1 beneficial, 2 neutral), with the sole beneficial study showing a small effect size.1 beneficial2 neutral3 studies