Vitamin E, particularly in the form of mixed tocopherols (including alpha-tocopherol), has been investigated as a supportive therapy in certain types of hepatitis, especially nonalcoholic steatohepatitis (NASH), a severe form of nonalcoholic fatty liver disease (NAFLD). The interest in Vitamin E arises from its role as a fat-soluble antioxidant, which may help counteract the oxidative stress and inflammation believed to contribute to liver cell injury in these conditions.

Several randomized controlled trials have examined Vitamin E supplementation in patients with NASH. The most prominent is the PIVENS trial (published in the New England Journal of Medicine, 2010), which found that 800 IU/day of Vitamin E improved liver histology in adults with NASH who did not have diabetes. These improvements included decreased liver inflammation and steatosis, though effects on fibrosis were less clear. Based on such evidence, some clinical guidelines (such as those from the American Association for the Study of Liver Diseases) cautiously endorse Vitamin E therapy for non-diabetic adults with biopsy-proven NASH.

However, there is less evidence supporting Vitamin E for viral hepatitis (such as hepatitis B or C), alcoholic hepatitis, or other liver conditions. The use of Vitamin E in these cases is not standard practice, and more research is needed. Overall, scientific validation exists primarily for NASH, not for all types of hepatitis, and the strength of evidence is moderate.