Vitamin E Confirmed as Effective Treatment for Fatty Liver Disease

James Meschino DC, MS, ROHP

Fatty Liver Disease is known medically as “steatohepatitis”, which involves inflammation and fat accumulation in the liver. It is often seen in alcoholics, but a form of the condition is also seen in non-alcoholic patients and labelled non-alcoholic steatohepatitis (NASH), which is also commonly seen in individuals with diabetes, obesity and metabolic syndrome (pre-diabetic state). Both forms of the condition can progress to cirrhosis.

Liver cirrhosis is a consequence of chronic liver disease whereby liver tissue is replaced by fibrosis, scar tissue and regenerative nodules, which together culminate into loss of liver function. Cirrhosis and chronic liver disease were the 10th leading cause of death for men and the 12th for women in the United States in 2001. Cirrhosis has a 10-year mortality of 34-66%, largely dependent on the cause of the cirrhosis.  Alcoholic cirrhosis has the worse prognosis.

As a point of nutritional interest, a 2006 study suggested that coffee may help reduce risk of liver cirrhosis (Klatsky AL, Morton C,Udaltsova N, Friedman GD. 2006. “Coffee, cirrhosis, and transaminase enzymes”. Archives of Internal Medicine166 (11): 1190–5). The studies by AL Klatsky et al, have shown that some yet unidentified constituent in coffee helps protect the liver from cirrhosis. This appears to be especially true in alcohol-induced cirrhosis injury. They also note that their studies suggest that coffee consumption is associated with a reduced risk of primary liver cancer known as hepatocellular carcinoma (not liver cancer from metastasis from other body sites).

How Does Vitamin E Fit into the Story?
The updated practice guideline from the American Association for the Study of Liver Diseases, the American College of Gastroenterology, and the American Gastroenterological Association, were released to medical doctors on August 3, 2012.

According to these latest guidelines patients with NASH are encouraged to reduce excess body fat and avoid alcohol. One of the surprising recommendations includes providing these patients with 800 IU of vitamin E per day. Studies have shown that vitamin reverses liver cell damage (histological features of liver cells) in cases of NASH. They state that, it should therefore be considered as a first-line pharmacotherapy for this patient population. This is a crucial finding, as very few agents have been shown to actually reverse liver damage in cases of non-alcoholic steatohepatitis. As such, vitamin E is one of the interventions that is likely to prevent progression to cirrhosis in these cases. Of note is the fact relating to recent findings that showed that vitamin E is also associated with reduced risk of liver cancer (hepatocellula carcinoma) in high-risk populations (http://jnci.oxfordjournals.org/content/early/2012/07/12/jnci.djs277).

Reference:
If you have a fatty liver problem you may wish to review the total medical management guidelines published in the journal Hepatology (2012). See the following link:

http://onlinelibrary.wiley.com/doi/10.1002/hep.25762/full