Study Confirms Benefits of Vitamin E in Nonalcoholic Steatohepatitis
Megan Brooks
May 4, 2010 — Supplementation with the natural form of vitamin E (800 IU/day) has beneficial effects in patients with nonalcoholic steatohepatitis (NASH), but pioglitazone's benefits are less clear, according to the latest findings from the Pioglitazone vs Vitamin E vs Placebo for the Treatment of Nondiabetic Patients with Nonalcoholic Steatohepatitis (PIVENS) trial, reported online April 28 in the New England
To test the effectiveness of pioglitazone and vitamin E, Sanyal and colleagues at 11 other medical facilities identified 247 people who had severe fatty liver disease. None of the volunteers drank alcohol excessively or was diabetic, but all were overweight or obese. Their average age was in the mid-40s.
The researchers randomly assigned participants to one of three treatments — vitamin E, pioglitazone or a placebo capsule — taken daily for nearly two years.
Nowadays doctors are stopping to use metformin kindly read and do some r&d. Initially even i was on Metformin for PCOD and my doctor suggested to stop it.
Nonalcoholic steatohepatitis (NASH) is a hepatic disorder associated with the metabolic syndrome and insulin resistance. It is a very common problem for which no therapy, short of diet/weight loss and exercise, has shown benefit. Extreme measures of weight loss include bariatric surgery, which has not been well studied, but may be beneficial.[1] Accordingly, there is considerable interest in developing pharmacologic therapies directed toward addressing the presence of insulin resistance.
Thank You very much for your reply,
As I mentioned above, she was given new medicined once she experienced high blood sugar level few weeks back. She was given Metformin (850 mg) and Pioglitazone (30Mg per day). Once she started experiencing low blood sugar level, the doctor stopped giving Pioglitazone and asked to continue Metformin with few other medicines and the my mother was told that she experiencing such low levels of sugar due to Pioglitazone.
I am on hydrochlorothiazide (water pill) and Zocor for high cholestoral. Also take Humalog and Lantas insulin (4 shots per day). Take Prilosec for GERD and a potasium pill. Also on Peri-Colace for stomach problems. Spoke with the Dr. and discontinued all pills for a few days to see if it had any effect and it did not. Still swelling. Right now about 5 pounds of water, by tonight it will be 10 pounds.
The data regarding insulin resistance and its subsequent effect on HCV treatment is fairly new, and I don’t think there’s a firm consensus or body of knowledge available yet… only select studies showing a better response for patients that manage IR.
If insulin resistance is found, it can be addressed with a combination of diet, exercise, weight management and drugs such as metformin, pioglitazone etc.
Studies of these medications—including metformin, rosiglitazone, and pioglitazone—are being sponsored by the National Institutes of Health and should answer the question of whether these medications are beneficial in NASH.
For women who are unresponsive to clomiphene,the oral hypoglycemic agents like metformin could be of little help, or pioglitazone, may bring resumption of regular cycles and ovulation. These agents reduce the hyperinsulinemia and hyperandrogenemia in PCOS.
These are actually medically prescribed medicines for PCOS.As this syndrome is very common in women the case is often individualised and treatment option will be processed and prescribed.Fell free to talk to your Doc.
Unfortunately, initial trials of insulin-sensitizing agents such as metformin and pioglitazone have not shown significant improvements in HCV treatment outcome in patients receiving peginterferon/ribavirin.[Romero-Gómez 2009; Harrison 2012] Weight loss can improve insulin sensitivity and therefore should be encouraged in overweight patients before starting therapy.
Here is a link to an excellent presentation by Dr. Jean-Michel Pawlotsky.
among the two drugs Pioglitazone (Actos) has less sides and also active against HCC but i didn t find a study on its activity against hbsag and hbvdna
http://www.ncbi.nlm.nih.
Bitter melon (Momordica charantia) is an alternative therapy that has primarily been used for lowering blood glucose levels in patients with diabetes mellitus. Components of bitter melon extract appear to have structural similarities to animal insulin. Antiviral and antineoplastic activities have also been reported in vitro. Four clinical trials found bitter melon juice, fruit, and dried powder to have a moderate hypoglycemic effect.
Also important is treatment with diabetes drugs, such as metformin and pioglitazone, to improve insulin sensitivity and reduce fat accumulation in the liver. This might reverse disease progression, the researchers note.
Other approaches to enhance patients' response to combination drug therapy may include longer duration of treatment and higher doses to counteract the decreased response to the drugs.
Folks with diabetes often test before meals (in order to adjust our insulin to correct for the current blood sugar level and also to cover any carbos we intend to eat).
We also test 1 hour or 2 hours after a meal to see if we counted the carbos correctly or not, and to begin to learn our patterns.
Some endos suggest that elevated BGs after a meal often arise before any fasting anomalies.
Obesity is associated with insulin resistance....and insulin resistance causes a compensatory hyperinsulinemia.....and high insulin levels affect the response to Peginterferon in the first 24 hours. It lowers RVR and SVR.
Since the response to interferon is affected within the first 24 hours, that means you have to get rid of the insulin resistance BEFORE starting treatment.
Co
J Viral Hepat. 2009 Oct 21.
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