Vitamin E, specifically alpha-tocopheryl succinate, has been investigated for its role in supporting or treating hepatitis, particularly non-alcoholic steatohepatitis (NASH) and chronic hepatitis C. The rationale stems from Vitamin E's antioxidant properties, which may help counteract oxidative stress—a key driver of liver inflammation and damage in hepatitis. Several studies, including randomized controlled trials, have shown that Vitamin E supplementation can improve liver enzyme levels and histological features in patients with NASH. For example, the PIVENS trial (NEJM, 2010) demonstrated that 800 IU/day of vitamin E improved liver histology in non-diabetic adults with NASH compared to placebo. Similar, albeit less consistent, benefits have been observed in pediatric NASH populations.

For viral hepatitis (such as hepatitis B or C), the evidence is less robust. Some small studies suggest modest improvements in liver enzymes and oxidative stress markers, but these have not translated into clear clinical benefits or changes in disease progression. Current guidelines (such as those from AASLD and EASL) recommend Vitamin E only in non-diabetic adults with biopsy-proven NASH, and do not endorse its use for viral hepatitis. There are also safety concerns with high-dose, long-term use, such as increased risk of hemorrhagic stroke.

In summary, while there is some scientific evidence supporting Vitamin E for certain forms of hepatitis (mainly NASH), the evidence is moderate and not universal for all hepatitis types.