Micronutrient Cocktail & Liver Health

The journal Medicina recently reported the results of a double-blind and placebo-controlled pilot clinical trial evaluating the use of a micronutrient cocktail on parameters associated with liver fibrosis and steatosis among people with obesity and metabolic syndrome. One hundred ninety-six adults (median age 58) with obesity (BMI of 30 kg/m2 or higher, and an elevated abdominal circumference (AC)) and dyslipidemia were recruited, and randomized to receive either placebo or a daily dose of micronutrients, specifically 800 mcg 5-MTHF (5-methyltetrahydrofolate), 2g betaine, 1g ALA (alpha-linolenic acid), 700 mg EPA (eicosapentaenoic acid), 500 mg choline bitartrate, 280 mg DHA (docosahexaenoic acid), and 1000 mcg vitamin B12.

One hundred fifty-five participants completed the 3-month trial which monitored changes in 6 outcomes, including BMI, AC, cholesterol and triglyceride levels, controlled attenuation parameter (CAP), and transient elastography (TE), the latter 2 outcomes assessed by FibroScan technology, providing a measure of liver fat content (steatosis) and liver stiffness (fibrosis), respectively. One significant limitation of this study was the low rate of FibroScan evaluation; while offered at baseline and at 3 months, only 39 participants received both scans.

Despite the low rate of FibroScan completion, those participants receiving micronutrient supplementation had a significant reduction in CAP compared to placebo, a decrease of 4% compared to an increase of 5.4%. A similar improvement in the percent change in TE was also observed, a significant drop of 7.8% with micronutrient supplementation vs. an 8.6% increase with placebo. No other significant changes were observed. While limited by size and completion rate, this study suggests that providing omega-3 fatty acids, methyl donors, and vitamin b12 may improve objective signs of metabolic dysfunction-associated steatotic liver disease (MASLD) in adults with obesity and metabolic syndrome.