Evidence supporting the use of: Vitamin E (alpha-tocopheryl succinate)
For the health condition: Hepatitis

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Synopsis

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

Vitamin E (including alpha-tocopheryl succinate) has some scientific evidence supporting its use as an adjunctive treatment in hepatitis, specifically in non-alcoholic steatohepatitis (NASH) and, to a lesser extent, in chronic viral hepatitis. Vitamin E is an antioxidant, and oxidative stress is a key factor in the pathogenesis of liver inflammation and injury. Clinical trials, such as the PIVENS trial (NEJM, 2010), demonstrated that high-dose vitamin E supplementation (800 IU/day) improved histological features in non-diabetic adults with NASH. Some meta-analyses and small studies have also suggested potential benefits in reducing liver enzyme levels and improving steatosis in nonalcoholic fatty liver disease (NAFLD). For chronic viral hepatitis (hepatitis B or C), evidence is weaker. Some small studies have explored vitamin E supplementation as an adjunct therapy, but results are inconsistent and generally not robust enough to recommend routine use. There is insufficient evidence for vitamin E as a primary treatment for viral hepatitis, and it is not considered standard of care. Safety concerns exist for long-term high-dose supplementation, including possible increased all-cause mortality at very high doses. In conclusion, vitamin E’s use in hepatitis is supported by moderate scientific evidence mainly for NASH, with much weaker evidence for viral or other forms of hepatitis. Its use should be guided by clinical judgment and current guidelines.

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