Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Vitamin E, particularly in the form of alpha-tocopherol, has been studied for its potential benefit in nonalcoholic fatty liver disease (NAFLD), especially nonalcoholic steatohepatitis (NASH). Several randomized controlled trials, most notably the PIVENS trial, have shown that high-dose Vitamin E (800 IU/day) can improve liver histology in nondiabetic adults with NASH, specifically reducing steatosis, inflammation, and hepatocellular ballooning. These studies suggest Vitamin E's antioxidant properties may help reduce oxidative stress implicated in NAFLD/NASH progression. However, the majority of research has focused on alpha-tocopherol, with much less direct evidence for mixed tocopherols or tocotrienols. Clinical guidelines, such as those from the American Association for the Study of Liver Diseases (AASLD), cautiously recommend Vitamin E for nondiabetic adults with biopsy-proven NASH, but not for diabetic patients or those with simple steatosis due to limited evidence and concerns about long-term safety (e.g., all-cause mortality, prostate cancer risk with high doses). There is little to no robust evidence supporting the use of Vitamin E specifically for alcoholic fatty liver disease or in children. Overall, Vitamin E has some scientific backing for NASH treatment in select populations, but evidence for mixed tocopherols and tocotrienols, and for general “fatty liver disease,” is less clear and warrants further study.

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