Vitamin E and Reduced Alanine Aminotransferase Level

Research synthesisModerate evidenceMixed effect size4 studies · 4 beneficial · 0 neutral · 0 harmful

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.

Effective dose range: 400–1000 IU/day
Studied populations: patients with non-alcoholic fatty liver disease (NAFLD)

Caveats: Available evidence is overwhelmingly positive — clinical literature in this area is subject to publication bias (null-result studies are less likely to be published or indexed). Evidence base is small (only 4 studies) — conclusions should be considered preliminary. Effect sizes varied from small to moderate across studies, and one meta-analysis (2024) found the effect did not reach statistical significance despite an overall beneficial trend.

Generated Jun 11, 2026

Doses used in studies

IU/day: 298–1,000 (median 524.5, IQR 323.5–850) — 2 studies
mg/day: 300–800 (median 550, IQR 300–800) — 1 study

Time to effect

Median: 10.3 weeks · IQR 9.4 weeks–11.1 weeks · Range 8.6 weeks–2.8 months — Reported in 2 of 4 studies

Safety in these studies

all-cause mortalityNo significant differenceSerious adverse eventRR 3.45, 95% CI 0.57 to 20.86
The effects of vitamin E versus placebo or no intervention on all-cause mortality (risk ratio (RR) 3.45, 95% confidence interval (CI) 0.57 to 20.86; 3 trials, 351 participants; very low certainty evidence) and serious adverse events (RR 1.91, 95% CI 0.30 to 12.01; 2 trials, 283 participants; very low certainty evidence) are very uncertain.
from: Vitamin E for people with non-alcoholic fatty liver disease.
serious adverse eventsNo significant differenceSerious adverse eventRR 1.91, 95% CI 0.30 to 12.01
The effects of vitamin E versus placebo or no intervention on all-cause mortality (risk ratio (RR) 3.45, 95% confidence interval (CI) 0.57 to 20.86; 3 trials, 351 participants; very low certainty evidence) and serious adverse events (RR 1.91, 95% CI 0.30 to 12.01; 2 trials, 283 participants; very low certainty evidence) are very uncertain.
from: Vitamin E for people with non-alcoholic fatty liver disease.
Overall tolerabilityReported
The effects of vitamin E versus placebo or no intervention on physical health-related quality of life ... and non-serious adverse events (RR 0.86, 95% CI 0.64 to 1.17; 2 trials, 283 participants; very low certainty evidence) are also very uncertain.
from: Vitamin E for people with non-alcoholic fatty liver disease.

4 of 4 papers

The Effect of Vitamin E Supplementation on Serum Aminotransferases in Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis.
- 2023-08-25
- Meta-Analysis · n = 794
- Nutrients 15(17)
- - Stamatina Vogli
  - Androniki Naska
  - Georgios Marinos
  - Maria-Iosifina Kasdagli
  - Philippos Orfanos
- PubMed: 37686767
- DOI: 10.3390/nu15173733
2 Insights on
- Reduced Alanine Aminotransferase Level
- High evidence
- Rigorous Journal
- Clinical
among studies testing vitamin E supplementation at 400 IU/day and above, the values of alanine aminotransferase (ALT) were reduced compared with placebo or no intervention [ALT Mean Difference (MD) = -6.99 IU/L, 95% CI (-9.63, -4.35), for studies conducted in Asian countries and MD = -9.57 IU/L, 95% CI (-12.20, -6.95) in non-Asian countries]
Effect
Beneficial
Effect size
Moderate
Significant
Yes
Dose
400 IU/day and above
Vitamin E for people with non-alcoholic fatty liver disease.
- 2024-10-16
- Meta-Analysis · n = 708
- The Cochrane database of systematic reviews 2024(10)
- - Hongzhu Wen
  - Hongyong Deng
  - Lili Yang
  - Lujin Li
  - Jiang Lin
  - Peiyong Zheng
  - Milica Bjelakovic
  - Guang Ji
- PubMed: 39412049
- DOI: 10.1002/14651858.cd015033.pub2
8 Insights on
- Reduced Alanine Aminotransferase Level
- High evidence
- Clinical
Vitamin E likely slightly reduces serum alanine transaminase (ALT) (MD -9.29, 95% CI -13.69 to -4.89; 11 trials, 708 participants; moderate certainty evidence)
Effect
Beneficial
Effect size
Small
Significant
No
Dose
298 to 1000 IU/day
The effects of co-administration of artichoke leaf extract supplementation with metformin and vitamin E in patients with nonalcoholic fatty liver disease: A randomized clinical trial.
- 2021-09-17
- RCT
- Phytotherapy research : PTR 35(11)
- - Mohammad Bagher Majnooni
  - Mari Ataee
  - Gholamreza Bahrami
  - Fatemeh Heydarpour
  - Ina Yosifova Aneva
  - Mohammad Hosein Farzaei
  - Touraj Ahmadi-Juoibari
- PubMed: 34533249
- DOI: 10.1002/ptr.7279
4 Insights on
- Reduced Alanine Aminotransferase Level
- High evidence
- Clinical
the rate of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was significantly reduced within all the study groups (p < .05)
Effect
Beneficial
Effect size
Small
Significant
Yes
Efficacy and Safety of Vitamin E in Adults With Metabolic Dysfunction-Associated Steatohepatitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
- 2025-07-29
- Review
- Cureus 17(7)
- - Helai Hussaini
  - Manpreet Kaur Dhanjal
  - Rahman Hameed Mohammed Abdul
  - Olaniyi Fadeyi
  - Najeeha A Bhatti
  - Mohammed Qasim Rauf
  - Calvin R Wei
  - Adil Amin
- PubMed: 40895855
- DOI: 10.7759/cureus.88949
4 Insights on
- Reduced Alanine Aminotransferase Level
- Low evidence
- Clinical
vitamin E significantly reduced serum alanine aminotransferase levels compared to placebo (mean difference (MD): -12.27, 95% confidence interval (CI): -16.66 to -7.89)
Effect
Beneficial
Effect size
Moderate
Significant
Yes
Dose
300 to 800 mg daily

Vitamin E and Reduced Alanine Aminotransferase Level

The Effect of Vitamin E Supplementation on Serum Aminotransferases in Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis.

Vitamin E for people with non-alcoholic fatty liver disease.

The effects of co-administration of artichoke leaf extract supplementation with metformin and vitamin E in patients with nonalcoholic fatty liver disease: A randomized clinical trial.

Efficacy and Safety of Vitamin E in Adults With Metabolic Dysfunction-Associated Steatohepatitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.