Normal liver function involves removing toxins and waste, producing bile and hormones, and synthesizing certain proteins. However, vitamin deficiency can affect your liver’s health and disrupt these important functions.
Deficiencies in several vitamins have been found to be associated with a number of chronic liver diseases, such as alcoholic and non-alcoholic liver disease (NAFLD), cirrhosis, and liver cancer.¹
Being deficient in certain vitamins may contribute to the development or worsening of some liver conditions. In others, the condition itself could cause vitamin deficiency. A vicious cycle occurs in some cases where the vitamin deficiency contributes to the condition, while the condition contributes to the vitamin deficiency, worsening the condition in turn.
This article looks at what science and research say about increasing your intake of certain vitamins to improve liver health. It will also uncover whether you can obtain these vitamins from food alone or whether you need to take supplements.
Please speak with your doctor before you start taking a new supplement formula or vitamin, especially if you have a known liver condition.
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The liver contributes to the functions of almost every system in the body. One of its main functions involves processing everything you consume. After your stomach and intestines digest food, drinks, or medications, the ingredients that have been broken down go through your bloodstream directly to your liver to be processed.
Some substances/nutrients will be stored, and others will be altered before they are sent back into the bloodstream for your body to use. Your liver will process and filter the waste or toxins, which are later sent to the bowels to be excreted.
Other liver functions include the following:
Producing bile, which helps break down fat to be used as energy
Aids the metabolism of carbohydrates, proteins, and fats
Assists in the storage of minerals, vitamins, and glycogen
Synthesizes plasma proteins like albumin and clotting factors
Helps in the excretion of drugs, hormones, cholesterol, and bilirubin
An estimated 1.5 billion people worldwide have chronic liver disease (this number includes all cases, regardless of severity). Non-alcoholic fatty liver disease is the most common liver disease worldwide and accounts for 59% of cases. 29% of cases are caused by the hepatitis B virus, 9% by the hepatitis C virus, and 2% by alcoholic liver disease.²
In the US, 4.5 million people have chronic liver disease and cirrhosis (liver scarring caused by long-term damage).³ The proportion of people with alcoholic liver disease is much higher in the US than globally, but it is still less prevalent than NAFLD.
Rising alcohol consumption in the US over the past ten years has caused the number of hospitalizations of people with alcoholic liver disease to double.
Reducing alcohol consumption can lower the risk of alcoholic liver disease. The Centers for Disease Control and Prevention (CDC) define moderate drinking as one drink or less per day for women and two drinks per day or less for men (on days when alcohol is consumed).⁴
So is it possible to improve your liver health with vitamins?
Vitamin E is a fat-soluble compound that helps protect cell membranes from oxidation and destruction.
Vitamin E deficiency is often reported in people with chronic liver disorders, particularly cholestatic liver diseases, alcoholic liver disease, and liver cancer.⁵
A systematic review published in 2020 summarized findings from eight randomized controlled trials.⁶ These trials evaluated the effects of vitamin E supplementation in people with NAFLD.
All eight trials evaluated changes in liver function tests after vitamin E treatment, with six reporting improvements. Six trials evaluated the effect on steatosis (a build-up of fat in the liver cells), with four noting improvements. Four trials examined the vitamin’s effect on inflammation, with three reporting improvements. Three trials evaluated the effects of vitamin E on hepatocyte ballooning (a type of liver cell degeneration), with two noting improvements.
Fibrosis/cirrhosis (scarring of the liver tissue) was the only marker that did not widely suggest improvements with vitamin E treatment. Of the five trials that examined this marker, only one reported improvements.
The authors of the analysis concluded that vitamin E has “significant potential” to improve some indicators of NAFLD. This may be the case, particularly when used together with lifestyle adjustments and certain medications.
Natural sources of vitamin E include the following:
Nuts and seeds
Wheat germ (found in cereals and cereal products)
However, evidence demonstrates that high dose vitamin E intake of ≥400 IU/day in those with chronic diseases may increase all-cause mortality.⁹ A study also linked the use of vitamin E supplements in smokers to an increased risk of hemorrhagic stroke.
On the other hand, vitamin E has reported potential protective effects against prostate cancer. More studies are required to confirm these results.
The best thing to do is talk to your doctor before increasing your intake of vitamin E. They can advise you on whether or not it’s safe for you and tell you about any risks.
Chronic liver diseases are often associated with vitamin D deficiency. Almost 93% of people with chronic liver disease have some level of vitamin D insufficiency.¹⁰
A 2018 literature review found that several studies had reported a significant correlation between insufficient vitamin D levels and the progression of liver disease in people with hepatitis B and hepatitis C.¹¹
In a recent systematic review of the available studies on vitamin D supplements in people with NAFLD, it was reported that the vitamin had a significant effect on some of the factors contributing to the development of this condition.¹²
The authors found that vitamin D supplements improved fasting blood sugar, body mass index (BMI), waist circumference, insulin resistance, serum calcium, and alanine transaminase (ALT). ALT is an enzyme that is released when liver cells are damaged and used to test liver function.
Another earlier study suggested that vitamin D may be involved in activating and regulating certain aspects of the immune system that affect liver health.¹³
Foods that contain vitamin D include the following:
Certain mushrooms, like morels and chanterelles
Fresh orange juice
Fortified products like some fat spreads and breakfast cereals
Cod liver oil is the most common vitamin D supplement.
Vitamin C — also called L-ascorbic acid — is a water-soluble vitamin involved in many processes in the body. It enables the biosynthesis of some neurotransmitters and collagen, plays a role in protein metabolism, and has antioxidant effects.¹⁴
Since oxidative stress plays a role in NAFLD, researchers have examined whether or not vitamin C can protect against the condition. Historically, conflicting results have come from studies on the impact of dietary vitamin C on NAFLD and other liver diseases.
In 2021, researchers published a randomized clinical trial that observed improved liver function and deceleration of NAFLD with vitamin C supplementation.¹⁵
Another study published in 2020 found improvements in some liver function parameters after one month of vitamin C supplementation in patients with hepatitis C.¹⁶
You can increase your vitamin C intake by consuming the following foods:
Citrus fruits like oranges and lemons
Low levels of several B vitamins have been seen in people with liver conditions.
Alcoholic fatty liver disease disrupts the absorption and metabolism of many vitamins, including B1, B3, B6, B9, and B12. Supplementing these vitamins is essential in these cases to prevent serious metabolic and neurological complications. However, it is not proven to improve the liver disease itself.
On the other hand, research published in 2022 found that supplementing vitamins B12 and B9 (folate) could delay or prevent the worsening of advanced NAFLD cases.¹⁷
Vitamin B6 deficiency has been seen in people with cirrhosis, which experts often link to increased oxidative stress and reduced antioxidant activity. Being deficient in vitamin B6 is thought to affect the liver’s antioxidant capabilities.
Foods and supplements containing B vitamins include the following:
Green leafy vegetables
Fruits like watermelons and bananas
Chicken and beef
Dairy products like milk and cheese
Yeast and nutritional yeast
Whole grains and cereals
Vitamin B12 is only found in animal products such as meat, fish, and eggs. Supplementation with vitamin B12 is essential if you primarily consume a plant-based diet.
The best way to fight and prevent liver problems is by eating a healthy and balanced diet, maintaining a healthy weight, keeping active, and avoiding excessive use of alcohol or medications.
You can also get vaccinated against the viruses hepatitis C and B. This is particularly important if you are in a high-risk group. Ask your doctor if these vaccinations are suitable for you and whether they advise you to have them.
You can take adequate care of the liver by making lifestyle changes. The following are some ways you can improve and maintain liver health:
Add colors to your diet — fruits and vegetables have many of the essential vitamins for liver support
Lead an active lifestyle that involves activities like swimming, brisk walking, or jogging
Maintain a healthy weight, as obesity and related problems such as type 2 diabetes and high cholesterol levels are leading causes of NAFLD¹⁸
Drink alcoholic beverages responsibly to avoid scarring or damaging your liver cells
Practice safe sex — unprotected sex with multiple partners increases your risk of hepatitis B and hepatitis C exposure
Each vitamin plays a different essential role in the body, and many vitamins can affect liver health.
Healthy people can acquire these vitamins from various dietary sources. However, people with marked deficiencies or conditions that may affect the absorption or use of nutrients (such as in some chronic liver conditions) will benefit from supplementation alongside a healthy, vitamin-rich diet.
Research into the effects of vitamin deficiencies on liver health is still unfolding. Remember to speak to your doctor about supplementing vitamins to ensure it is safe for you to do so.
Liver cells can be regenerated and repaired in many cases, but there are many variables involved.
In most people, early-stage NAFLD doesn’t cause significant health concerns. However, it can become serious if it progresses to the next stages of liver disease, causing liver inflammation, fibrosis, and eventually cirrhosis. Liver cirrhosis is considered an end-stage liver disease. It affects all liver functions and can lead to liver failure and even liver cancer.
Yes, liver disease can affect children.
NAFLD is the most common type of liver disease seen in children in the US and affects nearly 10% of this population group.¹⁹
Chronic liver disease and cirrhosis | Centers for Disease Control and Prevention (CDC)
Alcohol questions and answers | Centers for Disease Control and Prevention (CDC)
Vitamin C | NIH: National Institute of Health
B vitamins can potentially be used to treat advanced non-alcoholic fatty liver disease: Duke-NUS | Duke-NUS Medical School
Symptoms & causes of NAFLD & NASH | NIH: National Institute of Diabetes and Digestive and Kidney Diseases