Vitamin E

Does vitamin E help fatty liver disease?

Updated 10 Nov 2026

Short answer

In trials, vitamin E lowered liver enzymes in people with fatty liver disease, and in two trials it improved liver biopsies.[1][2] A 2024 Cochrane review of 16 trials found that it likely lowers the enzyme ALT slightly, by about 9 U/L. Whether this changes the course of the disease is unknown.[3] The trials gave 298 to 1,000 IU a day.[3]

What the reviews found

Non-alcoholic fatty liver disease (NAFLD) is a build-up of fat in the liver that alcohol does not cause. Its new name is metabolic dysfunction-associated steatotic liver disease (MASLD). It affects about 3 in 10 people.[3]

A 2024 Cochrane review included 16 trials with 1,066 children and adults with fatty liver disease. Most trials gave vitamin E alone, at 298 to 1,000 IU a day, for 2 to 24 months. In most trials, both groups also got advice on diet and lifestyle.[3] Vitamin E likely lowered ALT by 9.3 U/L and AST by 4.9 U/L (moderate certainty).[3] These enzymes are blood markers of liver inflammation.[4] The effects on death, serious side effects and quality of life were very uncertain, and no trial reported liver-related illness or death.[3]

A 2024 review of 7 trials in adults looked at liver biopsies. Vitamin E reduced fat, inflammation and the swelling of liver cells (ballooning). The inflamed form of the disease, steatohepatitis (MASH), went away about 1.9 times as often as in the control groups. Vitamin E did not reduce fibrosis, the scarring of the liver.[4]

The largest trials

  • PIVENS, USA (protocol): 247 adults with non-alcoholic steatohepatitis and without diabetes. 800 IU of vitamin E a day for 96 weeks improved the liver biopsy in 43% of people, against 19% with placebo. Fat and inflammation fell, but fibrosis did not improve.[1]
  • VENS, China: 124 adults with MASH and without diabetes. 300 mg of vitamin E a day improved the liver biopsy in 29.3% of people, against 14.1% with placebo. Fat, inflammation and fibrosis improved.[2]

Why it may work

Oxidative stress plays a major part in how fatty liver disease develops.[3] Vitamin E is an antioxidant that stops the production of reactive oxygen species when fats oxidize.[5]

What is still unknown

The 16 trials had 1,066 people in total and lasted up to 2 years.[3] No trial in the Cochrane review measured liver-related illness or death, so the effect on cirrhosis or liver failure is not known.[3] PIVENS and VENS included only people without diabetes.[1][2] Diet and lifestyle changes for weight loss remain the basic treatment.[3]

Who should be careful

These doses are far above the daily need of 15 mg.[5] 800 IU is 360 to 536 mg, depending on the form, which is above the EU upper limit of 300 mg a day.[5][6] High doses can raise the risk of bleeding with blood thinners.[5] People who take blood thinners or other medicines every day should ask a doctor or pharmacist first.[5]

Sources (6)

  1. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. Sanyal AJ, Chalasani N, Kowdley KV, McCullough A, Diehl AM, Bass NM, et al. N Engl J Med, 2010. PMID 20427778
  2. Vitamin E (300 mg) in the treatment of MASH: A multi-center, randomized, double-blind, placebo-controlled study. Song Y, Ni W, Zheng M, Sheng H, Wang J, Xie S, et al. Cell Rep Med, 2025. PMID 39970876
  3. Vitamin E for people with non-alcoholic fatty liver disease. Wen H, Deng H, Yang L, Li L, Lin J, Zheng P, et al. Cochrane Database Syst Rev, 2024. PMID 39412049
  4. Vitamin E improves serum markers and histology in adults with metabolic dysfunction-associated steatotic liver disease: Systematic review and meta-analysis. Chee NM, Sinnanaidu RP, Chan WK J Gastroenterol Hepatol, 2024. PMID 39150005
  5. Vitamin E: Fact Sheet for Health Professionals. NIH Office of Dietary Supplements. ods.od.nih.gov
  6. Scientific opinion on the tolerable upper intake level for vitamin E. European Food Safety Authority (EFSA), 2024. efsa.onlinelibrary.wiley.com

More about vitamin e

What is vitamin E?Which foods contain vitamin E?What is vitamin E used for?Who is at risk of vitamin E deficiency?Is vitamin E safe?Does vitamin E prevent heart disease?

For education; not medical advice. Talk to a doctor before you start, stop or change a supplement.