Evidence supporting the use of: Vitamin E (mixed tocotrienols/tocopherols)
For the health condition: Hepatitis

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Synopsis

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

Vitamin E (in the forms of mixed tocotrienols and tocopherols) is sometimes used as an adjunct therapy for certain types of hepatitis, particularly nonalcoholic steatohepatitis (NASH), a severe form of nonalcoholic fatty liver disease (NAFLD). The rationale is based on Vitamin E’s antioxidant properties, which may help counteract oxidative stress implicated in liver cell injury in NASH. Several randomized controlled trials have investigated Vitamin E supplementation for NASH. The PIVENS trial (2010) is the most notable, showing that 800 IU/day of Vitamin E for 96 weeks improved liver histology in non-diabetic adults with NASH compared to placebo. However, the benefit was not observed in patients with hepatitis C virus (HCV)-related liver disease, and evidence for other forms of hepatitis (such as hepatitis B or C) is weak or lacking.

Meta-analyses suggest Vitamin E may improve biochemical and histological markers in NASH, but concerns remain regarding long-term safety and lack of consistent benefit for fibrosis. Major liver society guidelines (e.g., AASLD, EASL) cautiously recommend Vitamin E for non-diabetic adults with biopsy-proven NASH but not for viral hepatitis. Overall, evidence is modest (rated 2/5) and primarily limited to NASH; its use in viral hepatitis is not supported by strong clinical data.

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