July 11, 2010

Integrative Medicine: Weight loss and vitamin E two liver-disease fighters

Published: Sunday, Jul. 11, 2010 - 12:00 am

Liver disease is a huge problem worldwide, and one of the contributors is the epidemic of obesity. Persistent obesity often leads to fat deposits and inflammation in the liver, and unchecked inflammation ultimately produces scarring and even cirrhosis.

Perhaps you've thought of cirrhosis of the liver as a drinker's disease; in fact, obesity is now a common cause of cirrhosis. More than 20 percent of all liver disease in the United States is now attributed to non-alcoholic fatty liver disease, also known as NAFLD.

So how do we treat inflammation in the liver when it's caused by fat? The most obvious answer is to lose weight, but for many people this is difficult. Thus, scientists have looked for ways to reduce inflammation in the liver before scarring sets in.

A recently published study in the New England Journal of Medicine suggests that high-dose vitamin E might be one answer.

In this well-designed, two-year study, researchers randomized 247 non-diabetic adults with NAFLD to receive one of three treatments: pioglitazone (an expensive drug used to reduce insulin resistance); vitamin E, 800 units per day; or a placebo. Liver tissue was examined at the beginning and end of the study to look for changes in inflammation and scarring.

The scientists found that both vitamin E and pioglitazone reduced fatty changes and inflammation in the liver, but vitamin E seemed to work better than pioglitazone, and only vitamin E produced significant improvements in scarring. In fact, 43 percent of the patients getting the vitamin E showed benefit. In addition, those people taking the pioglitazone gained weight during this study.

There are no good treatments for NAFLD other than weight loss; based on this study, some researchers believe that everyone with NAFLD should be treated with vitamin E. Vitamin E in high doses like this is probably safe, though there have been some studies suggesting that it may increase the risk of bleeding.

If you have or are at risk of fatty liver disease, first and foremost, we strongly encourage you to do whatever it takes to eat a healthier diet and lose weight. Reducing your intake of animal food and processed food is a great way to start; the website NutritionMD.org is an excellent source of healthy nutrition information and recipes.

If you are overweight or obese, we encourage you to speak with your doctor about your risk of liver disease, and to see if vitamin E supplementation might be right for you.

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