Vitamin E and Reduced Alanine Aminotransferase Level

Research synthesisLow evidenceSmall effect3 studies · 3 beneficial · 0 neutral · 0 harmful

Across 3 studies, all reported beneficial effects of vitamin E on reducing alanine aminotransferase (ALT) levels, with effect sizes ranging from small to moderate. Two of three studies found statistically significant reductions. The evidence primarily comes from clinical populations with non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatohepatitis (MASH), with a median study duration of 72 days (approximately 10 weeks). The most-studied dose range is 298–1000 IU/day.

Effective dose range: 298–1000 IU/day
Studied populations: people with non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatohepatitis (MASH)

Caveats: Evidence base is small (only 3 studies) — conclusions should be considered preliminary. 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). The highest-quality evidence (moderate certainty meta-analysis) reported a small beneficial effect that was not statistically significant when analyzed independently, suggesting the true effect may be small.

Generated May 15, 2026

Doses used in studies

IU/day: 298–1,000 (median 649, IQR 298–1,000) — 1 study
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 3 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.

3 of 3 papers

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

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.