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In a multicenter randomized trial, NAC combined with metformin improved liver measures in non-alcoholic steatohepatitis over several months, supporting its role as an add-on to standard care rather than a replacement.[3]NAC in NASH Randomized Trial PubMed View source A more recent double-blind trial in metabolic-associated fatty liver disease also reported improvements in liver function and metabolic markers with NAC, adding to the promising but still-developing evidence base.[4]NAC on Liver Function in MASLD RCT PubMed View source Liver enzymes: modest ALT and AST reductions in trials
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