April 30, 2010 | 5:42 pm
Posted by Albert Fuchs, M.D.
My regular readers know my skepticism about vitamin supplements. I leap at the chance to bring you news that some vitamin has been tested for some disease and found useless. So for balance, I have to also report when a well-designed study finds that a vitamin actually helps something.
This week’s New England Journal of medicine published a study about the treatment of nonalcoholic steatohepatitis (NASH). NASH, also known informally as fatty liver, is a condition in which fat is deposited in the liver, causing liver inflammation. It is more common in overweight patients, and those with diabetes and elevated triglycerides. Fatty liver may eventually progress to liver failure.
Weight loss is the mainstay of treatment for fatty liver, and though some medications have been used for NASH, none have been proven to be effective.
The study randomized patients with fatty liver to placebo or 800 IU of vitamin E daily. (There was a third group randomized to Actos, a diabetes medication, but that’s for another post.) The patients were followed for about two years. Improvement in their fatty liver was assessed by liver biopsy at the beginning and end of the study.
The patients taking vitamin E did quite a bit better than the patients taking placebo, with significantly more of the vitamin E patients having improvement or resolution of their fatty liver. The authors of the study caution that the trial was too short to test the long-term safety of vitamin E, especially at this high dose. They cite a worrisome study from 2005 that suggests that vitamin E at high doses may actually be associated with higher mortality. (See second article, below.)
So if you have NASH talk to your doctor about starting vitamin E, and keep working on losing weight. If you don’t have NASH and are taking vitamin E, consider donating your vitamin E to someone with NASH and taking a daily dose of nothing.
New England Journal of Medicine article: Pioglitazone, Vitamin E, or Placebo for Nonalcoholic Steatohepatitis
Annals of Internal Medicine Articles: Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality
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