DHM Improves Liver Health in MASLD Patients: 2026 RCT Results

The supplement industry has a research problem. Most ingredients are backed by in-vitro studies (cells in a dish), animal models, or short-duration human trials with tiny sample sizes. Brands cite these studies as if they’re equivalent to the kind of rigorous clinical evidence that earns the trust of physicians.

DHM just cleared a bar that most supplement ingredients never reach: a 12-month, double-blind, placebo-controlled randomized controlled trial in humans with diagnosed liver disease.

Published in Annals of Gastroenterology in January 2026, this trial is the most rigorous human study of dihydromyricetin conducted to date. Here’s what it found and what it means for people who take DHM.

These statements have not been evaluated by the Food and Drug Administration or Health Canada. This article summarizes published research and does not constitute medical advice.

Study Background: What Is MASLD?

Before the results, some context on the patient population.

MASLD stands for Metabolic-Associated Steatotic Liver Disease — the new clinical term (as of 2023) for what was previously called NAFLD (Non-Alcoholic Fatty Liver Disease). The renaming reflects updated understanding: this is not simply a “non-alcoholic” condition but a metabolic disease strongly linked to insulin resistance, obesity, and metabolic syndrome.

MASLD is the most common liver disease in the world. Current estimates put prevalence at 25–30% of the global adult population. In North America, it affects approximately 1 in 4 adults. Most people have no idea they have it — MASLD is frequently asymptomatic in early stages.

The clinical progression looks like this:

Simple steatosis (fat accumulation in the liver, mostly benign)
MASLD with inflammation (formerly NASH — the dangerous form)
Liver fibrosis (scarring from chronic inflammation)
Cirrhosis (advanced scarring, irreversible)
Hepatocellular carcinoma (liver cancer)

Most people with MASLD never progress beyond stage 1 or 2. But for the significant minority who do progress — it’s a leading cause of liver transplantation, and the connection to cardiovascular disease and type 2 diabetes makes early intervention medically relevant.

As of early 2026, there are no FDA-approved pharmaceutical treatments specifically for MASLD. Management is primarily lifestyle-based (weight loss, diet, exercise), which is why the supplement research space is particularly active here.

The Study Design

Publication: Annals of Gastroenterology, January 2026 Study type: Double-blind, placebo-controlled randomized controlled trial (RCT) Duration: 12 months Participants: 55 patients with confirmed MASLD diagnosis Setting: Two hospitals (multicenter)

Intervention group: DHM 300mg/day combined with vitamins C and E plus choline Control group: Identical placebo capsules

Assessments: Liver enzymes (ALT, GGT, AST), liver stiffness via transient elastography (FibroScan), glucose and lipid profiles, body composition, adverse event monitoring

A few things worth noting about this design:

Double-blind means neither the participants nor the researchers knew who was receiving DHM versus placebo. This eliminates placebo effect and researcher bias from the results.

Randomized means participants were assigned to groups by chance, not by any characteristic that might affect outcomes.

Placebo-controlled means the comparison group received an identical-looking intervention, eliminating the effect of simply taking something.

12 months makes this the longest human DHM study ever published. Most supplement research struggles to get past 3 months of follow-up. A year of continuous intervention in a liver disease population is genuinely rigorous.

The Results

Liver Enzymes

After 12 months, the DHM group showed significant reductions in liver enzymes compared to placebo:

ALT (alanine aminotransferase): Significantly reduced in the DHM group (p-value indicates statistical significance)
GGT (gamma-glutamyl transferase): Significantly reduced in the DHM group

ALT and GGT are the primary biomarkers clinicians use to assess liver inflammation and injury. Elevated ALT and GGT are hallmarks of liver disease and metabolic liver stress. When these numbers come down, it indicates reduced hepatocellular damage.

For context: elevated liver enzymes are present in approximately 15–30% of the adult population in Western countries, with MASLD being the most common cause. These are not exotic clinical measurements — they’re part of routine bloodwork that millions of people get every year.

Liver Stiffness (FibroScan)

This is the most striking finding.

Liver stiffness measured by transient elastography (FibroScan) is the current clinical standard for non-invasive assessment of liver fibrosis. As the liver accumulates scar tissue (fibrosis), it becomes stiffer. A reading above 7–8 kPa typically indicates clinically significant fibrosis.

In the DHM group:

Baseline liver stiffness: 6.3 kPa
12-month liver stiffness: 5.3 kPa
Reduction: 1.0 kPa
Statistical significance: p=0.001

A p-value of 0.001 means there is a 0.1% probability this result occurred by chance. In clinical research terms, this is a very strong statistical result.

The reduction from 6.3 to 5.3 kPa represents a meaningful shift in the direction of healthier liver tissue stiffness — and this happened over 12 months in a population with diagnosed liver disease.

Glucose and Lipid Profiles

The DHM group also showed improved glucose and lipid profiles compared to placebo. This is consistent with DHM’s documented effects on metabolic parameters in earlier studies and reflects the metabolic nature of MASLD — it’s not purely a liver disease but part of a broader metabolic syndrome picture.

Safety: Zero Adverse Events

No adverse events were reported in the DHM group over 12 months of daily supplementation.

This is worth emphasizing: a full year of continuous DHM supplementation in a liver disease population — a population with already-compromised liver function — produced zero safety signals. This is strong evidence for DHM’s hepatoprotective profile, not just safety in healthy individuals.

Why This Study Matters

It’s the Standard That Other Supplement Research Isn’t

Most ingredient research that supplement brands cite is:

In-vitro (cells in a dish — not humans)
Animal studies (rodent models — not directly applicable to humans)
Short-duration (4–8 weeks — not 12 months)
Single-center (not multi-site, which adds validity)
Small sample sizes (under 20 participants — underpowered to detect real effects)

The 2026 MASLD RCT clears every one of these limitations. It’s human, double-blind, placebo-controlled, 12 months, multicenter, and large enough to generate statistically significant results.

The Annals of Gastroenterology is a peer-reviewed clinical journal. This is not a supplement company’s in-house research. It is independent clinical investigation.

MASLD Is Not a Niche Population

MASLD affects roughly 1 in 4 adults in North America. Most of them don’t know they have it. Most of them are not taking any targeted liver support.

DHM is not positioned as a pharmaceutical for MASLD treatment. It is a dietary supplement that demonstrates liver support activity in a population with the most common liver disease in the world. That’s a very large addressable market with essentially no competition from pharmaceutical options.

The Dose Context

The study used 300mg/day DHM — combined with vitamins C and E and choline. This is the lower end of the dose range used in premium supplement formulations like Hovenia (1,000mg+) and competitor products like Cheers and No Days Wasted (1,000–1,200mg).

The fact that 300mg showed statistically significant liver effects in a 12-month trial with diagnosed liver disease patients supports the expectation that 1,000mg formulations would produce at least equivalent effects on liver health markers. The 1,000mg dose is the target used in acute support applications (post-celebration use), where the alcohol metabolism pathway (ADH/ALDH upregulation) benefits from higher dosing.

What This Study Doesn’t Prove

Responsible interpretation requires acknowledging limitations.

It does not prove DHM reverses liver disease. The study shows statistically significant improvements in liver biomarkers over 12 months. It does not prove that these improvements constitute disease reversal or that they would persist if supplementation stopped. MASLD management is multifactorial; the study participants were presumably also making some lifestyle changes.

The combination formula is a confounder. The intervention used DHM with vitamins C, E, and choline. While the research design attributes the effects primarily to DHM (it’s the novel ingredient; vitamins C and E at the doses used are generally not expected to produce this magnitude of liver enzyme reduction), the study cannot definitively isolate DHM as the sole active component.

55 participants is a limited sample. Statistically significant, but clinical medicine typically wants to see effects replicated in larger trials before changing treatment guidelines. This is groundbreaking for a supplement ingredient; it’s early-phase for a pharmaceutical pathway.

Structure/function claim language still applies. In the US and Canada, this research supports DHM’s positioning as a liver support supplement — not as treatment for MASLD. The regulatory framework for supplements requires structure/function claim language regardless of what clinical research shows.

Where DHM Fits in a Liver Health Context

For healthy adults who drink socially, the MASLD study provides a strong scientific basis for DHM’s liver health positioning that goes beyond acute hangover support.

DHM’s liver activity operates through multiple pathways simultaneously:

Metabolic: upregulation of ADH/ALDH speeds alcohol processing
Antioxidant: reduces oxidative stress generated during alcohol metabolism
Anti-inflammatory: reduces hepatic inflammation (the mechanism connecting MASLD findings to daily supplement use)
Senolytic (2026 discovery): clears senescent cells via PRDX2 binding — an independent mechanism relevant to long-term liver health

The MASLD trial result is the first to show all of these mechanisms translating into measurable biomarker changes in a human liver disease population over a clinically meaningful time period.

→ DHM as a Senolytic Agent: The 2026 Nature Communications Study → What is DHM? Complete Guide to Dihydromyricetin → DHM for Liver Health: What the Research Shows

Bottom Line

The January 2026 Annals of Gastroenterology RCT is the most rigorous human study of DHM published to date. Key results after 12 months:

Significant reduction in liver enzymes (ALT, GGT) vs. placebo
Liver stiffness reduced from 6.3 → 5.3 kPa (p=0.001)
Improved glucose and lipid profiles
Zero adverse events

This is DHM graduating from a promising ingredient with preclinical support to an ingredient with gold-standard clinical evidence in a human population with real liver disease.

Let’s be direct: no other supplement ingredient in this category has a 12-month double-blind RCT in liver disease patients. Not milk thistle. Not NAC. Not prickly pear. DHM does. That’s not a marketing claim — it’s a citation. Annals of Gastroenterology, January 2026.

Hovenia contains 1,000mg DHM per serving — more than the 300mg/day used in the MASLD trial, and consistent with premium formulations targeting acute and chronic liver support. The full stack: DHM + L-Cysteine + milk thistle + prickly pear + B-complex + electrolytes. $1.50–2.00/serving.

Join the Waitlist → · See the full formula →