DHM Supplement 12 Months, Liver Enzyme Normalization 7x Placebo
Plenty of people get a liver enzyme flag on their annual checkup and move on without acting on it. A fatty liver diagnosis becomes a background fact, set aside with a vague intention to lose weight eventually. After 12 months, the rate of liver enzyme normalization was 35% in the DHM supplement group and 5% in the placebo group. A 7-fold difference.
That number comes from a randomized, double-blind, placebo-controlled trial published in the January-February 2026 issue of the Annals of Gastroenterology. Researchers enrolled 55 patients with MASLD and followed them for 12 months, tracking liver enzymes, glucose and lipid markers, and liver stiffness by elastography.
MASLD, the Condition That Changed Its Name
MASLD stands for Metabolic Dysfunction-Associated Steatotic Liver Disease. It replaced the older term NAFLD (Non-Alcoholic Fatty Liver Disease) in 2023 following international consensus. The name change was deliberate: the old framing defined the disease by what it wasn’t (alcohol-related), while the new name points to what actually drives it — metabolic dysfunction in the form of insulin resistance, blood sugar dysregulation, elevated lipids, and excess visceral fat.
Roughly 25 to 30 percent of adults worldwide are estimated to have MASLD. Most have no symptoms in the early stages. That’s why a lab result showing elevated ALT (a marker of liver cell damage) or GGT (indicating liver inflammation or bile duct involvement) often gets attributed to stress or fatigue and left unaddressed. Left untreated, the condition can progress from fat accumulation to liver inflammation, fibrosis, and in rarer cases, cirrhosis.
Treatment options remain limited. Lifestyle modification is the first-line approach, but adherence over time is difficult. The first FDA-approved drug for MASLD only arrived in 2024, and a universally adopted standard of care has not yet been established.
Where DHM Comes From
DHM, dihydromyricetin, is a polyphenol compound extracted from the Hovenia dulcis tree, commonly known as the Japanese raisin tree or oriental raisin tree. Hovenia dulcis has been used across East Asia for centuries. It appears in Korea’s Dongui Bogam, a foundational text of traditional Korean medicine, as a remedy for alcohol-related toxicity. In Japan, it has been used as a natural sweetening agent and appears in products from traditional herbal companies.
DHM is found in particularly high concentrations in the tree’s seeds, fruit, and branches. Western researchers began studying it seriously in the early 2010s, with initial interest focused on alcohol metabolism. A 2020 study from the University of Southern California found that DHM simultaneously increased the expression and efficiency of ADH (alcohol dehydrogenase) and ALDH (aldehyde dehydrogenase), two enzymes central to how the body processes alcohol. A separate randomized controlled trial reported a 70% reduction in hangover severity compared to placebo.
Hovenia tea is now widely available across Asian markets and has gained a reputation as a liver-friendly drink. But the clinical data on DHM operates at a concentration level that bears little resemblance to what’s in a standard commercial tea bag.
What 12 Months of Data Shows
DHM supplement group participants (28 people) took Hepatrat®, a formulated product from a Greek pharmaceutical company, twice daily. Each tablet contained dihydromyricetin, vitamin C, vitamin E, and choline, adding up to a daily dose of 600mg DHM, 160mg vitamin C, 24mg vitamin E, and 165mg choline. The placebo group (27 people) received visually identical capsules. Neither participants nor physicians knew which was which. Forty-six people completed the full 12 months.
The key secondary endpoint — combined normalization of both ALT and GGT — was reached by 35% of the DHM group and 5% of the placebo group (p=0.028). Intention-to-treat analysis produced 32.1% versus 3.7% (p=0.012). In multivariate logistic regression, the only statistically significant predictor of achieving combined liver enzyme normalization was DHM use, with an odds ratio of 11.8 (95% CI 1.5-120.4).
Metabolic markers moved as well, and only in the DHM group. Fasting glucose and HbA1c (a measure of average blood glucose over roughly three months) were both significantly lower at 12 months. Total cholesterol and LDL cholesterol also declined significantly by the 12-month mark.
Liver stiffness, measured by transient elastography, dropped in the DHM group from a median of 6.3 kPa at baseline to 5.3 kPa at 12 months (p=0.001). The placebo group showed no meaningful change.
Mechanisms: Oxidative Stress and Enzyme Activity
This trial was not designed to measure mechanisms directly. But prior research has outlined several pathways through which DHM may act on the liver.
The most consistently studied pathway involves antioxidant activity. DHM activates the Nrf2 pathway, a cellular signaling route that prompts cells to produce their own antioxidant enzymes. In a liver burdened by excess fat, oxidative stress accelerates cell damage and inflammation. Interrupting that cascade is one of the most plausible explanations for the enzyme improvements observed in this trial.
On the anti-inflammatory side, DHM has been shown to inhibit NF-κB, a protein complex that functions like an inflammation switch inside cells, and to reduce levels of IL-1β and TNF-α, two key inflammatory signaling molecules. For fibrosis, DHM appears to suppress the activation of hepatic stellate cells, which are the cells responsible for producing fibrous scar tissue in the liver.
Glucose and lipid improvements in the trial are consistent with research showing DHM can reduce insulin resistance. ADH and ALDH enzyme enhancement is primarily relevant in alcohol metabolism contexts; since MASLD is a non-alcohol-related condition, those mechanisms are less central to explaining the trial’s results.
Hovenia Tea vs. a Standardized DHM Supplement
The DHM content of a commercial hovenia tea product is typically not disclosed, and when it is, it varies enormously. Labels often list “hovenia dulcis extract” or “hovenia fruit concentrate” without specifying DHM milligrams. Different parts of the tree (seeds, fruit, branches) and different extraction methods yield substantially different DHM concentrations.
Getting to the 600mg daily dose used in this trial through tea alone would require consuming volumes far beyond what any commercial product recommends. Bioavailability — how much DHM actually reaches circulation after digestion — may also differ between a brewed beverage and a standardized capsule formulation.
For anyone evaluating a DHM supplement, the practical checklist is short: does the label state a specific milligram amount of DHM? Is the extract standardized? “Hovenia dulcis extract Xmg” without a stated DHM percentage tells you very little about what you’re actually getting.
Who This Research Is For
The most direct relevance is for adults who already have a MASLD diagnosis and elevated ALT or GGT. That is the population this trial enrolled. If a recent blood test has flagged liver enzyme levels above the normal range — or if a checkup has noted a fatty liver — the data here represents a meaningful clinical signal.
For people in a weight loss plateau whose liver enzymes remain elevated despite dietary changes, the metabolic parameter improvements in the DHM group are worth noting. The trial included participants who achieved liver enzyme normalization without large weight reductions; the median weight loss among responders was 5kg, but the relationship between weight loss and normalization was not statistically significant by itself.
DHM’s odds ratio of 11.8 in the regression model is striking. It suggests the supplement effect was not explained away by other factors. But OR values with wide confidence intervals (1.5 to 120.4) in small studies require replication in larger trials before they can be treated as reliable.
Limits and Context
This was a 55-person trial, with 46 completing the full protocol. The supplement used was a multi-component formulation, so isolating DHM’s individual contribution is not possible from this data. No liver biopsies were performed, which limits conclusions about structural tissue changes. Most participants had baseline liver stiffness values in the F0-F1 range (minimal fibrosis), meaning the observed improvements began from a relatively low starting point.
The trial’s primary endpoint — ALT improvement alone (normalization or more than 50% reduction) — was not statistically significant: 46% DHM versus 30% placebo, p=0.315. The headline result of 35% versus 5% is a secondary endpoint. That distinction matters for how confidently the finding can be interpreted.
DHM is not a pharmaceutical. It carries no approved indication for liver disease, and it cannot replace prescribed treatments. For anyone with existing liver pathology, starting a supplement without medical guidance carries risks that include potential interactions with medications and the rare but documented hepatotoxicity associated with certain herbal and supplement products.
Both groups in this trial reported no adverse events over 12 months. Tolerability was excellent. Short-term safety data is reassuring, but long-term data beyond 12 months has not been established.
Q. Can I get the same effect from hovenia tea as from a DHM supplement?
Hovenia tea contains some DHM, but reaching the 600mg daily dose used in this trial through tea alone would require drinking unrealistic quantities every day. Most commercial hovenia tea products don’t disclose their DHM content. If your liver enzymes are already elevated, a supplement with clearly stated DHM milligrams and a conversation with your physician is the more reliable path.
Q. Should someone with normal liver enzymes take DHM as prevention?
This study specifically enrolled MASLD patients with elevated liver enzymes. There is currently no clinical evidence that DHM prevents liver disease in people with normal baseline values. If a health checkup has flagged elevated liver enzymes or a fatty liver diagnosis, that’s the population this research speaks to — and even then, a physician’s guidance matters.
Q. Does DHM help people who drink alcohol regularly?
The trial participants had MASLD, a metabolic condition distinct from alcohol-related liver disease. Separate research suggests DHM can enhance the activity of ADH and ALDH enzymes that break down alcohol, and one RCT reported a 70% reduction in hangover severity. But those findings apply to alcohol metabolism, not to the liver repair mechanisms studied here. Pairing DHM with continued heavy drinking without reducing intake would leave the root cause unaddressed.