Vitamin E, including the gamma-tocopherol form, has been investigated for its potential role in supporting or treating hepatitis, particularly nonalcoholic steatohepatitis (NASH), a form of fatty liver disease. The rationale for its use is based on its antioxidant properties, which may help counteract the oxidative stress implicated in liver inflammation and cell damage in hepatitis. Several clinical trials and meta-analyses have evaluated Vitamin E (usually as alpha-tocopherol, but sometimes unspecified mixtures) in NASH and chronic hepatitis C, with mixed results. Some studies have demonstrated improvements in liver enzyme levels and histological features (such as steatosis and inflammation) in NASH patients, especially in non-diabetic adults. However, benefits in viral hepatitis (e.g., hepatitis B or C) are less clear, and Vitamin E is not considered a standard therapy.

Major guidelines, such as from the American Association for the Study of Liver Diseases (AASLD), recommend considering Vitamin E (800 IU/day) as a treatment option for non-diabetic adults with biopsy-proven NASH, but not for other forms of hepatitis. The evidence supporting Vitamin E’s efficacy is moderate for NASH but weak or absent for other hepatitis types. The majority of clinical research uses alpha-tocopherol; data specific to gamma-tocopherol are limited. Overall, the scientific evidence justifies Vitamin E's use in selected cases of NASH, but not broadly in hepatitis, and the strength of evidence is moderate (rated 2/5).