Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Vitamin E has been investigated as a supportive therapy for hepatitis, particularly non-alcoholic steatohepatitis (NASH), a form of non-alcoholic fatty liver disease. The rationale stems from Vitamin E's antioxidant properties, which may help reduce oxidative stress and inflammation implicated in the progression of liver disease. Several randomized controlled trials, most notably the PIVENS trial (Sanyal et al., 2010, NEJM), have evaluated Vitamin E supplementation (typically 800 IU/day of alpha-tocopherol) in non-diabetic adults with NASH. The PIVENS trial found that Vitamin E led to significant improvements in liver histology compared to placebo, including reductions in steatosis, inflammation, and hepatocellular ballooning. However, evidence for Vitamin E use in other types of hepatitis (such as hepatitis B or C) is much weaker or lacking. Additionally, concerns exist about long-term safety, as some meta-analyses have suggested a possible increased risk of all-cause mortality with high-dose Vitamin E supplementation. Current clinical guidelines (e.g., AASLD) suggest Vitamin E may be considered for non-diabetic adults with biopsy-proven NASH, but not for other forms of hepatitis or for patients with diabetes due to potential risks. In summary, scientific evidence supports the use of Vitamin E as a therapeutic option in a subset of hepatitis—specifically, non-diabetic adults with NASH—but not for other forms of hepatitis, and its use should be carefully weighed against potential risks.

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