Chamomile tea is a popular herbal remedy often explored by people seeking natural approaches to health concerns, including fatty liver disease. Non-alcoholic fatty liver disease (NAFLD) affects approximately one in three UK adults and is closely linked to obesity, type 2 diabetes, and metabolic syndrome. Whilst chamomile contains antioxidant and anti-inflammatory compounds that show promise in laboratory studies, there is currently no robust clinical evidence that drinking chamomile tea improves fatty liver outcomes in humans. This article examines the available evidence, safety considerations, and the importance of evidence-based lifestyle modifications for managing fatty liver disease.

Understanding Fatty Liver Disease and Herbal Remedies

Fatty liver disease, medically termed hepatic steatosis, occurs when excess fat accumulates in liver cells. Steatosis is typically defined as more than 5% of hepatocytes (liver cells) containing fat, or an imaging fat fraction exceeding 5%. This condition exists in two main forms: non-alcoholic fatty liver disease (NAFLD), which affects people who drink little or no alcohol, and alcohol-related liver disease (ARLD), caused by excessive alcohol consumption. NAFLD has become increasingly common in the UK, affecting approximately one in three adults, often associated with obesity, type 2 diabetes, and metabolic syndrome.

The liver plays a crucial role in metabolising nutrients, filtering toxins, and producing essential proteins. When fat accumulation progresses beyond simple steatosis, it may lead to non-alcoholic steatohepatitis (NASH), characterised by inflammation and potential liver damage. Left unmanaged, this may advance to fibrosis, cirrhosis, or even liver failure.

Many patients explore complementary approaches alongside conventional management, with herbal remedies gaining particular interest. Chamomile tea (Matricaria chamomilla or Chamaemelum nobile) has been used traditionally for various digestive complaints and inflammatory conditions. The appeal of herbal interventions stems from their perceived natural origin and historical use, though it is essential to distinguish traditional practice from evidence-based medicine.

Whilst lifestyle modification remains the cornerstone of fatty liver management according to NICE guidance (NG49), understanding the potential role—and limitations—of herbal remedies like chamomile tea helps patients make informed decisions. Any complementary approach should complement, not replace, established medical advice including dietary changes, weight management, and treatment of underlying metabolic conditions.

Can Chamomile Tea Help with Fatty Liver?

The question of whether chamomile tea can benefit fatty liver disease requires careful examination of available evidence. Chamomile contains various bioactive compounds, including flavonoids (particularly apigenin), terpenoids, and antioxidants, which have demonstrated anti-inflammatory and hepatoprotective properties in laboratory studies. These compounds theoretically could influence liver health through multiple mechanisms.

In preclinical research, chamomile extracts have shown promise in animal models of liver injury. Studies have demonstrated potential benefits including reduced oxidative stress, decreased inflammatory markers, and improved liver enzyme profiles in rodents with experimentally induced liver damage. The proposed mechanisms include antioxidant activity, modulation of inflammatory pathways, and potential effects on lipid metabolism.

However, there is currently no robust human clinical evidence that chamomile tea improves NAFLD outcomes. The translation from laboratory findings to clinical benefit remains unproven. Most research has utilised concentrated chamomile extracts at doses far exceeding what typical tea consumption would provide. A standard cup of chamomile tea contains significantly lower concentrations of active compounds compared to experimental preparations, and the potency of brewed tea varies considerably between products.

Currently, no clinical trials have specifically evaluated chamomile tea as a treatment for NAFLD in humans. It is important to note that chamomile products are not licensed in the UK for treating liver disease. Whilst chamomile is generally recognised as safe for most people when consumed as a beverage, patients should not rely upon it as a primary intervention for fatty liver disease. The condition requires comprehensive management addressing underlying metabolic factors, and there is insufficient evidence to recommend chamomile tea as a therapeutic agent for hepatic steatosis.

Evidence for Chamomile Tea in Liver Health

The scientific evidence regarding chamomile and liver health exists primarily at the preclinical level. Laboratory studies have identified several potentially beneficial compounds within chamomile, particularly apigenin, a flavonoid with demonstrated antioxidant and anti-inflammatory properties. In cell culture studies, apigenin has shown ability to reduce oxidative stress and modulate inflammatory signalling pathways relevant to liver disease.

Animal studies have provided more detailed insights into potential mechanisms. Research in rodent models has demonstrated that chamomile extracts may reduce elevated liver enzymes (ALT and AST), decrease markers of oxidative stress such as malondialdehyde, and increase antioxidant enzyme activity. Some studies have reported reduced hepatic fat accumulation and improved liver histology in animals treated with chamomile preparations alongside high-fat diets.

Despite these promising preclinical findings, human clinical evidence remains extremely limited. A small number of studies have examined chamomile's effects on metabolic parameters in people with diabetes or metabolic syndrome, showing modest improvements in glycaemic control and lipid profiles—factors indirectly relevant to fatty liver disease. However, these studies did not specifically assess liver outcomes or include participants diagnosed with NAFLD, and liver-specific endpoints were not measured.

The quality and applicability of existing evidence present significant limitations. Most animal studies used concentrated extracts standardised to specific compound levels, making direct comparison to brewed chamomile tea problematic. The doses used in research often exceed what humans would consume through regular tea drinking by a considerable margin, and the potency of brewed tea cannot be extrapolated from standardised extract studies. Additionally, the pathophysiology of fatty liver disease in humans differs substantially from experimental animal models, limiting the generalisability of findings. Well-designed, adequately powered clinical trials in humans with diagnosed fatty liver disease are needed before any therapeutic claims can be substantiated. According to the EMA HMPC community herbal monograph, chamomile is recognised for traditional use in mild digestive complaints, but not for liver disease.

How to Use Chamomile Tea Safely

For individuals considering chamomile tea as part of their general wellness routine, understanding safe consumption practices is essential. Chamomile tea is generally well-tolerated by most adults when consumed in typical amounts (1–4 cups daily). To prepare chamomile tea, steep one tea bag or 1–2 teaspoons of dried chamomile flowers in freshly boiled water for 5–10 minutes, then strain if using loose flowers.

However, several important safety considerations apply. People with known allergies to plants in the Asteraceae/Compositae family—including ragweed, chrysanthemums, marigolds, or daisies—may experience allergic reactions to chamomile, ranging from mild skin reactions to, rarely, anaphylaxis. If you develop itching, rash, swelling, or breathing difficulties after consuming chamomile, discontinue use immediately and seek medical attention.

Drug interactions warrant particular attention. Chamomile may potentially enhance the effects of anticoagulant medications such as warfarin, increasing bleeding risk, though evidence is limited to case reports. If you take warfarin or other anticoagulants, consult your GP or pharmacist before using chamomile regularly, and consider closer INR monitoring if you do consume it. Chamomile may also interact with sedative medications, potentially enhancing their effects. Chamomile contains compounds that can be metabolised by cytochrome P450 enzymes, theoretically affecting medications processed by the same pathways. Always inform your GP or pharmacist about herbal products you are consuming, especially if you take regular medications.

Pregnant and breastfeeding women should exercise caution. The NHS advises limiting herbal teas during pregnancy and breastfeeding and discussing individual use with your midwife or GP. Chamomile has traditionally been used as an emmenagogue (promoting menstruation), raising theoretical concerns during pregnancy, and medicinal doses should be avoided. Patients with diagnosed fatty liver disease should not use chamomile tea as a substitute for evidence-based management. If you are considering chamomile or any herbal supplement for liver health, discuss this with your healthcare provider first. They can assess potential interactions with your medications and ensure it fits appropriately within your overall treatment plan.

Reporting side effects: If you experience a suspected side effect from chamomile or any herbal product, you can report it via the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or by searching for 'Yellow Card' in the Google Play or Apple App Store.

Other Lifestyle Changes for Fatty Liver Management

Evidence-based management of fatty liver disease centres on lifestyle modification, which remains the most effective intervention for most patients with NAFLD. According to NICE guidance (NG49), the primary therapeutic goal is achieving gradual, sustained weight loss in those who are overweight or obese. Research demonstrates that losing 7–10% of body weight can significantly reduce liver fat, improve inflammation, and potentially reverse fibrosis in some cases. Weight loss should be gradual, typically around 0.5–1 kg per week, as rapid weight loss can paradoxically worsen liver inflammation.

Dietary modifications form a cornerstone of management. The Mediterranean diet pattern—emphasising vegetables, fruits, whole grains, legumes, nuts, olive oil, and fish whilst limiting red meat, processed foods, and added sugars—has shown particular benefit for liver health. Reducing intake of refined carbohydrates and fructose (particularly from sugar-sweetened beverages) helps decrease hepatic fat accumulation. Patients should aim for a balanced, calorie-controlled diet rather than extreme restrictions.

Regular physical activity provides benefits independent of weight loss. The UK Chief Medical Officers' guidelines recommend at least 150 minutes of moderate-intensity aerobic exercise weekly, such as brisk walking, cycling, or swimming. Both aerobic exercise and resistance training have demonstrated efficacy in reducing liver fat content. Even without significant weight loss, increased physical activity improves insulin sensitivity and metabolic parameters relevant to fatty liver disease.

Managing associated conditions is equally crucial. This includes optimising control of type 2 diabetes, treating dyslipidaemia (statins are generally safe in NAFLD when indicated), and managing hypertension according to established guidelines. Patients should follow UK Chief Medical Officers' low-risk drinking guidance (no more than 14 units of alcohol per week, spread over three or more days). Those with advanced fibrosis or cirrhosis should abstain from alcohol completely, or as advised by their clinician. Smoking cessation is important, as smoking is associated with more severe liver fibrosis.

Monitoring and referral pathways: Your GP may use non-invasive scoring systems such as the FIB-4 score or NAFLD fibrosis score to assess your risk of advanced fibrosis. If these scores suggest higher risk, you may be offered an Enhanced Liver Fibrosis (ELF) blood test as recommended by NICE (DG34). An ELF score of 10.51 or above may prompt referral to specialist hepatology services. Regular monitoring typically includes periodic assessment of liver enzymes (ALT, AST, GGT), metabolic parameters, and potentially liver imaging.

When to contact your GP urgently: Seek medical advice promptly if you develop new symptoms such as:

• Jaundice (yellowing of skin or eyes)

• Dark urine or pale stools

• Persistent abdominal pain or swelling (ascites)

• Unexplained confusion or excessive drowsiness

• Vomiting blood or passing black, tarry stools (melaena)

• Fever with right upper abdominal pain

Remember that fatty liver disease management requires a comprehensive, evidence-based approach—herbal remedies should never replace established medical care. For further information, visit the NHS page on non-alcoholic fatty liver disease (NAFLD) or discuss your individual circumstances with your GP.

Frequently Asked Questions