Therapeutic Effects of Vitamin E Supplementation in Liver Diseases and Transplantation

Abstract

Oxidative stress is commonly associated with liver disease. It is thought to play a role in non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease and chronic hepatitis C. This review evaluates antioxidant therapy through vitamin E supplementation as an alternative or supplemental treatment in liver disease management. PubMed and CINAHL databases were searched for research studies on vitamin E supplementation in various states of chronic liver disease, including applications for pre and post liver transplantation. The findings from the clinical studies reviewed were mixed. Timing between vitamin E supplementation, diagnosis, and staging of liver disease varied between subjects compared against each other within studies. Research findings demonstrated the beneficial effects of tocotrienol supplementation over alpha-tocopherol supplementation through a greater reduction in Model for End-Stage Liver Disease scores. The risk of adverse outcome or no benefit from vitamin E supplementation was common in alcoholics and hepatitis C patients. Four post transplant patients consuming doses of vitamin E >1 g/day had elevations in aminotransferase levels. Although the evidence of oxidative stress in chronic liver disease is clear, limited data do not support vitamin E supplementation in all forms of chronic liver disease. Investigating the differences between the two vitamin E compounds, tocopherols and tocotrienols, is an important area for future research.