CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-07-23). The draft was written by AI, the existence of all 4 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.6.
Verdict No. 1217 · Search date 2026-07-23 · Methodology v0.6

Black seed oil,
does it really help with Improvement of ALT, AST, and ultrasound steatosis in MASLD or nonalcoholic fatty liver disease?

30-Second Summary
C
Evidence Grade C · 53 · Safety unknown
Liver enzymes and ultrasound grade may improve over the short term, but histology, fibrosis, and long-term outcomes remain unproven
What the
research shows
Black seed oil is rated C for MASLD or nonalcoholic fatty liver disease. A 2021 meta-analysis of five trials and 358 participants reported improvements in ALT, AST, and ultrasound fatty-liver grade with Nigella sativa, and a double-blind 120-person trial of standardized seed oil at 5 mL/day for three months improved all three measures. The evidence, however, is confined to small single-region studies, mixed oil and powder preparations, short interventions of 8 to 24 weeks, and heterogeneous surrogate outcomes. There is no evidence of histologic MASH resolution, fibrosis improvement, or clinical liver outcomes, producing C with 53 points.
What the
ads claim
Marketing turns the antioxidant constituent thymoquinone and lower enzymes into treatment of fatty liver or liver regeneration. The actual evidence concerns blood tests and ultrasound grades after two to six months of Nigella sativa preparations added to lifestyle management, not treatment of advanced MASH or fibrosis and not replacement of medicine.
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Useful facts when choosing a product

  • Black seed oil is obtained from Nigella sativa seeds. Thymoquinone content and fatty-acid composition can vary substantially with extraction, storage, and product standardization.
  • A representative positive NAFLD trial used seed oil at 2.5 mL twice daily for three months, but the meta-analysis combined oil with seed-powder and capsule trials.
  • Short trials generally found good tolerability, but abdominal discomfort, bloating, diarrhea, headache, altered taste, and rare rash or hypersensitivity can occur.
  • Black seed may lower glucose, so hypoglycemia should be monitored with diabetes medicines. Potential bleeding and drug-metabolism interactions should be reviewed before use with anticoagulants, antiplatelet drugs, or planned surgery.
Gap Measurement · Verdict 1217 · C 53
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Tang and colleagues synthesized five randomized trials and 358 participants through June 2020 and concluded that Nigella sativa improved ALT, AST, and fatty-liver grade, while explicitly calling for larger high-quality trials. Khonche and colleagues randomized 120 patients with NAFLD to standardized seed oil at 5 mL/day or placebo for three months and reported significant improvements in ultrasound steatosis grade, ALT, and AST. Rashidmayvan and colleagues randomized 44 patients to seed oil or paraffin oil for eight weeks and reported improvements in ALT, AST, and inflammatory markers, but did not assess imaging-based liver fat. A later review found improvement in steatosis grade and enzymes in three of four trials, but studies were concentrated in small Iranian and Pakistani cohorts and included no biopsy or long-term liver event.

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Why this is classified as C (53)

A five-trial, 358-person meta-analysis and randomized oil trials of 120 and 44 participants support positive signals for ALT, AST, and ultrasound grade. Mixed preparations, regional and sample limitations, short follow-up, very high heterogeneity, and no histology, fibrosis, or clinical events limit the evidence to surrogate-only C with 53 points. Safety and interactions are assessed separately from efficacy.

Counterpoint. Weight loss, diet, activity, and management of diabetes and lipids remain central to MASLD care. Anyone using the supplement should still monitor enzymes and imaging with a clinician and should not stop established treatment.

Rejudgment record. New verdict — Applied C because a five-trial meta-analysis and standardized seed-oil trials support positive ALT, AST, and ultrasound signals, while mixed oil and powder preparations, small regional studies, high heterogeneity, short follow-up, and absence of histology, fibrosis, and clinical outcomes limit the evidence to surrogates

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Improvement of ALT and AST in MASLD or nonalcoholic fatty liver diseaseCMeta-analysis and small seed-oil trials were positive, but heterogeneity is high and the outcomes are surrogate measures.
Improvement of ultrasound fatty-liver gradeCA 120-person oil trial and synthesis were positive, but follow-up was short and imaging was limited to semiquantitative ultrasound.
Improvement of MASH histology, liver fibrosis, or long-term liver events?No human intervention trial directly evaluating these clinical benefits was identified.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Systematic review and meta-analysis of randomized controlled trials358Chinese academic investigators; no industry funding reported in the abstractALT, AST, metabolic markers, and fatty-liver gradeNigella sativa improved ALT, AST, and fatty-liver grade versus placebo, while several metabolic markers were null.Key synthesis limited by small trials and mixed preparations
Study 2Randomized double-blind placebo-controlled clinical trial120Iranian academic investigators; detailed funding not stated in the public abstractUltrasound steatosis grade, ALT, AST, and lipidsStandardized seed oil at 2.5 mL twice daily for three months improved ultrasound grade and ALT and AST versus placebo.Largest direct seed-oil trial, limited to surrogate outcomes
Study 3Randomized double-blind placebo-controlled clinical trial44Investigators at Ahvaz Jundishapur University of Medical Sciences; detailed funding not stated in the public abstractALT, AST, GGT, inflammation, lipids, and glucoseEight weeks of seed oil reduced ALT, AST, and several metabolic and inflammatory markers versus placebo, but did not assess imaging-based liver fat.Small direct seed-oil surrogate-outcome trial
Study 4Systematic review and meta-analysis of randomized controlled trials224Institutional core grant from NIPER under the Indian Department of PharmaceuticalsALT, AST, BMI, and lipidsALT and AST reductions were significant, but heterogeneity was very high at I² 96% and 95%, respectively.Synthesis showing both positive direction and very high heterogeneity
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Receipt — 4 References

All 4 cited sources were verified for existence at the original page (as of 2026-07-23).

Tang G, Zhang L, Tao J, Wei Z. Effect of Nigella sativa in the treatment of nonalcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials. Phytother Res. 2021;35(8):4183-4193. PMID: 33728708. DOI: 10.1002/ptr.7080.
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Tiwari A, Surendra G, Meka S, Varghese B, Vishwakarma G, Adela R. The effect of Nigella sativa on non-alcoholic fatty liver disease: A systematic review and meta-analysis. Hum Nutr Metab. 2022;28:200146. PMID: none. DOI: 10.1016/j.hnm.2022.200146.
checked
Khonche A, Huseini HF, Gholamian M, Mohtashami R, Nabati F, Kianbakht S. Standardized Nigella sativa seed oil ameliorates hepatic steatosis, aminotransferase and lipid levels in non-alcoholic fatty liver disease: A randomized, double-blind and placebo-controlled clinical trial. J Ethnopharmacol. 2019;234:106-111. PMID: 30639231. DOI: 10.1016/j.jep.2019.01.009.
checked
Rashidmayvan M, Mohammadshahi M, Seyedian SS, Haghighizadeh MH. The effect of Nigella sativa oil on serum levels of inflammatory markers, liver enzymes, lipid profile, insulin and fasting blood sugar in patients with non-alcoholic fatty liver. J Diabetes Metab Disord. 2019;18(2):453-459. PMID: 31890671. PMCID: PMC6915184. DOI: 10.1007/s40200-019-00439-6.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-07-23 · Corrections: none

Cite this verdict

Black seed oil x improved liver enzymes and ultrasound steatosis in MASLD Evidence Grade C card
[Chamgap] Black seed oil x improved liver enzymes and ultrasound steatosis in MASLD — Evidence Grade C·53. 4 cited sources checked. Source: https://chamgap.com/en/verdicts/liver/black-seed-oil-masld-liver-enzymes-ultrasound-steatosis/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.