Best Supplements for Reduced Alanine Aminotransferase Level
Ranked by research evidence. Compare 38 supplements across 55 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 on reducing alanine aminotransferase (ALT) levels in patients with non-alcoholic fatty liver disease (NAFLD), with 3 reaching statistical significance. Effect sizes were mixed (small to moderate) across studies. The most studied dose range was 400–1000 IU/day, and effects were typically observed at 8–12 weeks (median study duration 72 days).
Dose: 400–1000 IU/day - Moderate evidence3 studies
Across 3 studies, 2 reported beneficial effects (one moderate, one small) of red grape or its constituents (flavonoids, grape seed extract) on reducing ALT levels, primarily in individuals with NAFLD. The median study duration was 60 days (reported in one study). Evidence is preliminary, with effect sizes ranging from small to moderate.
- 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 on reducing alanine aminotransferase (ALT) levels in patients with non-alcoholic fatty liver disease (NAFLD), with 3 reaching statistical significance. Effect sizes were mixed (small to moderate) across studies. The most studied dose range was 400–1000 IU/day, and effects were typically observed at 8–12 weeks (median study duration 72 days). · Dose: 400–1000 IU/day4 beneficial4 studies
- ModerateRed GrapeAcross 3 studies, 2 reported beneficial effects (one moderate, one small) of red grape or its constituents (flavonoids, grape seed extract) on reducing ALT levels, primarily in individuals with NAFLD. The median study duration was 60 days (reported in one study). Evidence is preliminary, with effect sizes ranging from small to moderate.2 beneficial1 neutral3 studies
- LowBlack CuminAcross 3 studies (2 meta-analyses, 1 RCT), only 1 large meta-analysis reported a small beneficial effect of black cumin supplementation on reducing alanine aminotransferase (ALT) levels, while 2 studies found no significant effect. The overall effect direction is neutral, with small effect sizes across all studies.1 beneficial2 neutral3 studies