Evidence supporting the use of: Vitamin E (tocopherol not specified)
For the health condition: Hepatitis

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Synopsis

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

Vitamin E has been investigated as a supportive therapy in certain types of hepatitis, particularly nonalcoholic steatohepatitis (NASH), a form of nonalcoholic fatty liver disease (NAFLD). The rationale for its use stems from its antioxidant properties, as oxidative stress is implicated in the pathogenesis of liver injury in hepatitis. Several randomized controlled trials, notably the PIVENS trial (Sanyal et al., 2010, NEJM), have shown that Vitamin E supplementation (typically 800 IU/day of alpha-tocopherol) can improve histological features of NASH in non-diabetic adults. Improvement was noted in steatosis, inflammation, and hepatocellular ballooning, but not in fibrosis. However, Vitamin E has not shown clear benefit in viral hepatitis (e.g., hepatitis B or C) or in alcoholic hepatitis. Major guidelines, such as those from the American Association for the Study of Liver Diseases (AASLD), conditionally recommend Vitamin E for non-diabetic adults with biopsy-proven NASH but not for broader hepatitis indications. Safety concerns, including potential increased risk of hemorrhagic stroke and prostate cancer with high-dose, long-term use, further limit its widespread adoption. In summary, while there is moderate scientific evidence supporting Vitamin E for NASH, its use in other forms of hepatitis is not supported by strong evidence, and it is not part of standard therapy for these conditions.

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