Synopsis

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

Vitamin E (alpha tocopherol) has been investigated for its potential role in liver diseases, including hepatitis, due to its antioxidant properties. Oxidative stress is a key factor in the pathogenesis of chronic liver diseases such as hepatitis B, hepatitis C, and nonalcoholic steatohepatitis (NASH). Vitamin E, as a lipid-soluble antioxidant, can help neutralize free radicals and may reduce liver cell injury.

Clinical evidence supporting Vitamin E for hepatitis is limited and mostly pertains to non-viral, nonalcoholic fatty liver disease (NAFLD) or NASH. Several randomized controlled trials have shown that Vitamin E supplementation can improve liver histology in NASH patients, particularly in those without diabetes. For example, the PIVENS trial (Sanyal et al., 2010, NEJM) demonstrated significant improvements in steatohepatitis with 800 IU/day of Vitamin E over placebo. However, for viral hepatitis (hepatitis B or C), randomized trials have not consistently demonstrated significant benefit in disease progression or viral clearance; some small studies have shown modest reductions in liver enzyme levels, but results are inconclusive.

Guidelines such as those from the American Association for the Study of Liver Diseases recommend Vitamin E only for certain patients with biopsy-proven NASH, not for viral hepatitis. In summary, while there is some scientific evidence for Vitamin E's use in non-viral hepatitis (NASH), its role in the treatment of viral hepatitis is not well-supported.

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