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Participants had significant reductions in ALT and AST (liver enzymes that rise with liver stress or damage), as well as ultrasound-graded liver fat, compared to placebo.33 A 2023 systematic review pooling RCTs in NAFLD concluded that black seed supplementation lowered ALT, AST, and steatosis scores, but highlighted variability in protocols and quality.34 Taken together, these results point to a potential supportive role for black seed in fatty liver management, but the trials are small and short-term