Recent research has found that probiotics may be effective at preventing and delaying the progression of nonalcoholic fatty liver disease (NAFLD).

Your gut microbiome — the bacteria, fungi, and other microbes in your intestines that aid digestion — may be a key player in the treatment of nonalcoholic fatty liver disease (NAFLD).

A healthy, balanced gut microbiome has been linked to numerous benefits, including improved immune, heart, and brain function. But according to research from 2015, an imbalanced microbiome has been linked to adverse conditions such as inflammatory bowel disease, diabetes, and liver disease.

Probiotics can help keep your gut microbiome in balance, and in doing so, may help prevent and delay the progression of NAFLD.

While research into exactly which probiotics are most effective for preventing and treating NAFLD (as well as how much, how often, and how long you should take them) is still underway, several studies have shown promising results.

Fast facts about nonalcoholic fatty liver disease

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Researchers have found a complex interplay between your gut microbiome and your health. A 2023 review of studies found that type 2 diabetes, lipid metabolism disorders, and obesity are all closely related to NAFLD. These conditions can all contribute to fat building up in the liver.

In addition, when intestinal flora (your gut bacteria) is imbalanced, it allows things to move from the intestines to the liver more freely. This can cause issues such as inflammation and disruptions to lipid metabolism that can also contribute to the buildup of fat in the liver.

Here’s where probiotics may help. According to a 2022 review of studies, probiotic therapy, which helps bring a balance of microorganisms to your gut microbiome, was found to affect the health of people with NAFLD by:

  • improving liver enzyme levels
  • reducing insulin resistance
  • helping to regulate lipid metabolism
  • reducing liver inflammation

In short, several studies have found that probiotic use is effective at delaying the progression of (and potentially preventing) NAFLD.

Can probiotics help with other liver disorders?

Researchers from a 2021 study believe it’s possible that probiotics could help with other liver diseases besides NAFLD, but currently there isn’t enough research to say one way or the other.

Experimental studies have shown some promise for the use of probiotics to treat alcohol-related liver disease, but so far there are very few clinical trials that support that idea.

When it comes to the use of probiotics for other liver diseases, such as hepatitis B and C, and Wilson’s disease, experts say they’re either poorly studied or not studied at all.

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While the science is making it increasingly clear that probiotic therapy has the potential to prevent and treat NAFLD, exactly what type of probiotic, how much, how often, and how long to continue the therapy is still up in the air. That said, there are some clues as to what might be most beneficial.

When it comes to types of probiotics that are best for treating NAFLD, a 2023 study notes that the probiotics that have shown to help with NAFLD management include Lactobacillus and Bifidobacterium species. In addition, the studies that were analyzed had participants take a probiotic once or twice a day.

When it comes to how long you’ll need to take probiotics, you may want to think of it as a long-term commitment. In the 2023 review of studies, researchers found that participants with NAFLD who took probiotics for longer than 12 weeks saw the most improvements.

Of course, it’s always best to talk with a doctor before starting a probiotic regimen. They’ll know what’s best for your specific situation and can provide recommendations in terms of type of probiotic, dosage, and duration.

While there are no medications or procedures approved for the treatment of NAFLD, certain lifestyle changes can help reduce the amount of fat in your liver, according to the NIDDK. These include:

  • getting regular exercise
  • eating nutrient-dense foods
  • avoiding alcohol
  • reducing the amount of time you’re sedentary during the day
  • losing weight if you have overweight or obesity (according to the NIDDK, losing around 3–5% of your body weight can help lower the amount of fat in your liver. Gradual weight loss is best, as malnutrition and rapid weight loss can make liver issues worse.)

Not everyone with NAFLD may want to lose weight. Increasing physical activity without weight loss is also beneficial, according to experts. And remember, it’s a good idea to talk with a doctor before starting a new exercise routine.

It’s worth noting that the effects of weight discrimination can also contribute to negative health effects.

How long does it take to heal from fatty liver disease?

If you’ve received a diagnosis of NAFLD, you most likely won’t develop any complications from it, although it’s possible you might experience pain from an enlarged liver. NAFLD doesn’t typically go away completely, but with lifestyle changes, and potentially with probiotics, it can be managed.

If you’ve received a diagnosis of NASH, the more serious type of NAFLD, you could experience inflammation that can lead to liver damage and scarring, called cirrhosis. There are medications and treatments that can help if it progresses to this point.

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NAFLD typically has no symptoms. Even if you develop scarring in the liver, you may not have symptoms.

If you feel particularly fatigued or experience pain in the upper right side of your abdomen, those could be symptoms of NAFLD, so you’ll want to consider checking in with a doctor.

More often, though, NAFLD is diagnosed after routine blood tests come back with levels of liver enzymes that are higher than normal.

Common risk factors for NAFLD

NAFLD is a common liver disease, but some people may be more likely to develop it. Here are risk factors to be aware of:

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While experts don’t yet have formal recommendations for taking probiotics for fatty liver disease, research shows that these tiny microorganisms can have a big effect on preventing and delaying disease progression for NAFLD.

If you’re curious on whether probiotics might be worth a try, consider bringing it up at your next doctor’s appointment. Taking probiotic won’t hurt, and you might even find that it helps with your digestion and other gastrointestinal issues.