Betaine for nonalcoholic fatty liver disease: results of a randomized placebo-controlled trial

Abdelmalek MF, Sanderson SO, Angulo P, Soldevila-Pico C, Liu C, Peter J, Keach J, Cave M, Chen T, McClain CJ, Lindor KD · Hepatology

The largest and hardest test of betaine on a clinical endpoint, and it was negative: 20 g/day for a year did not improve the NAFLD activity score or fibrosis stage versus placebo, and it failed to lower S-adenosylhomocysteine, insulin, glucose or the pro-inflammatory cytokines the mechanism predicted it would.

Population

Adults with biopsy-proven nonalcoholic steatohepatitis, 12 months, with paired liver biopsies in 34

Intervention

Oral betaine 20 g/day

Comparator

Placebo

Limitations

Only 35 of 55 randomised participants completed; 20 g/day is roughly ten times a typical supplement dose; the authors note the difficulty of carrying animal steatosis results into humans.