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
2% to 3%
Leads to advanced fibrosis in 5% to 15% of patients
Few therapies exist
Pioglitazone
A thiazolidinedione
Active in diabetic patients with NASH
Antiinflammatory, antifibrotic, insulin sensitizing
Current study sought to evaluate safety and efficacy of pioglitazone in nondiabetic patients with NASH
Schematic of Study Design
Eligibility
Main inclusion criteria
Biopsy-confirmed NASH
Fat in liver > 5% plus liver injury and liver inflammation with or withou
The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.
NASH affects 2 to 5 percent of Americans. An additional 10 to 20 percent of Americans have fat in their liver, but no inflammation or liver damage, a condition called “fatty liver.
The newer antidiabetic medications make the body more sensitive to insulin and may help reduce liver injury in patients with NASH. 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."
So NASH is a very serious medical condition which requires expert medical care for the best prognosis.
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.
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.
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.
Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.
NASH affects 2 to 5 percent of Americans. An additional 10 to 20 percent of Americans have fat in their liver, but no inflammation or liver damage, a condition called “fatty liver.” Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage.
http://www.digestive.niddk.nih.
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.
The posters here are partially correct. NASH definitely is a real condition. It is one where the liver is depositing fat within itself (the steato/steatosis, or the "S" of NASH) and there is inflammation (the hepatitis, or the "H" of NASH), and fairly commonly scarring as well. Liver biopsy has been considered the "gold standard" for confirming NASH (although imaging techniques are in the works). But, labs (bloodwork), and history is also important.
I'm 36,white, male and a former heavy weight lifter. I am currently being seen by a GI after I had mildly high liver enzymes after routine blood work (ALT 109) back in 2013. I was just taking many herbal supplements and test boosters. Three years later my alt ranges from 40-50 but never goes under 40. Ast is usually 28-32. All other liver values WNL.
I am 35, T2 diabetes and overweight. Was just dx with NASH. I am taking Vit E, Vit C and Milk thistle in addition to diet and exercise. Are there any other ways to prevent progression of disease? Is it possible to "reverse" or change to just NAFLD? What is life expectancy of someone with NASH? I also was hopeful before dx to have another child- would pregnancy affect NASH? Are there any good forum/support websites for someone with NASH or NAFLD?
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