Synopsis

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

Vitamin E (including mixed tocopherols and tocotrienols) has been investigated for its potential role in the treatment of hepatitis, particularly non-alcoholic steatohepatitis (NASH), a form of non-alcoholic fatty liver disease (NAFLD). Several studies and clinical trials have examined the effects of vitamin E supplementation in patients with NASH. The proposed mechanism involves vitamin E's antioxidant properties, which may help counteract oxidative stress implicated in liver inflammation and injury.

The most notable scientific support comes from the PIVENS trial (published in NEJM, 2010), which showed that vitamin E (800 IU/day) improved liver histology in non-diabetic adults with NASH compared to placebo. However, benefits were primarily observed in non-diabetic patients, and vitamin E did not consistently improve fibrosis. Other meta-analyses and guidelines, such as the 2018 AASLD guidance, cautiously recommend vitamin E for non-diabetic adults with biopsy-proven NASH, but not for viral hepatitis (hepatitis B or C) or alcoholic hepatitis.

For viral hepatitis, evidence is limited and inconsistent. Some small trials have explored vitamin E as adjunctive therapy for chronic hepatitis B or C, with minimal or no significant benefit. Thus, while there is moderate scientific evidence for vitamin E in non-viral hepatitis (NASH), its use in viral hepatitis is not well-supported.

In summary, vitamin E has some scientific backing for use in specific forms of hepatitis (notably NASH), but not broadly for all types of hepatitis.

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