The body needs vitamin E to function, making it an essential vitamin. It is fat-soluble, meaning that it requires fat from the diet to be properly absorbed. Vitamin E is mainly stored in the liver before being released into the blood stream for use.
Liver Health
Vitamin E Bioavailability Considerations for Maximized Health Benefits
Research has shown vitamin E’s health benefits to the brain, heart, bones; but, brands need to take notice of the form, as natural vitamin E imparts more health benefits.
Effects of Delta-tocotrienol Supplementation on Liver Enzymes, Inflammation, Oxidative stress and Hepatic Steatosis in Patients with Nonalcoholic Fatty Liver Disease
Pervez MA, Khan DA, Ijaz A, Khan S.
Turk J Gastroenterol. 2018 Mar;29(2):170-176. doi: 10.5152/tjg.2018.17297.
Abstract
BACKGROUND/AIMS:
Non-alcoholic fatty liver disease (NAFLD) is a growing public health problem worldwide and is associated with increased morbidity and mortality. Currently, there is no definitive treatment for this disease. δ-Tocotrienol has potent anti-inflammatory and antioxidant properties and may reduce liver injury in NAFLD. The present study aims to evaluate the efficacy and safety of δ-tocotrienol in the treatment of NAFLD.
MATERIALS AND METHODS:
The present study was a randomized, double-blind, placebo-controlled pilot study conducted in patients aged > 20 years, belonging to both sexes, having ultrasound-proven fatty liver disease, having a fatty liver index (FLI) of ≥ 60, and persistent elevation of alanine transaminase. A total of 71 patients were assigned to receive either oral δ-tocotrienol (n=35, 300 mg twice daily) or placebo (n=36) for 12 weeks. At the baseline and at the end of the study, clinical and biochemical parameters, including lipid profile, liver function tests, high-sensitivity C-reactive protein (hs-CRP), and malondialdehyde (MDA) were measured. Body mass index and FLI were calculated, and ultrasound grading of hepatic steatosis was performed.
RESULTS:
Out of 71 enrolled patients, 64 patients, 31 in the δ-tocotrienol group and 33 in the placebo group, completed the study. After 12 weeks of supplementation, δ-tocotrienol showed greater efficacy than placebo by decreasing serum aminotransferases, hs-CRP, MDA, and FLI score (p<0.001). However, it did not improve hepatic steatosis on ultrasound examination. No adverse effects were reported.
CONCLUSION:
δ-Tocotrienol was safe, and it effectively improved aminotransferase levels and inflammatory and oxidative stress markers in patients with NAFLD. Large-scale randomized clinical trials are warranted to further support these findings.
The Difference Between Tocopherol and Tocotrienol
Tocopherol is one of the 2 members of the vitamin E family. The other member is known as tocotrienol. Vitamin E incorporates 8 different compounds. These include 4 tocopherols (alpha, beta, gamma and delta) and 4 tocotrienols (alpha, beta, gamma and delta). Both of them require fat in the diet in order to be absorbed and distributed within the body. Although it may seem like the two members are similar, various differences exist between them as outlined below.
An E-xcellent local oil – The Star
They are a source of energy and nutrients for our bodies, as well as antioxidants that protect our cells against the effects of free radicals and help to reduce inflammation. These are the good oils that should form a small but essential part of our daily diet. While there are many types of oils out there, an excellent one in our very own backyard is palm oil, which contains a high level of vitamin E.
Benefits of Palm Tocotrienols in Health and Disease Management
During the recently concluded Palm International Nutra-Cosmeceutical Conference (PINC 2017), speakers highlighted recent breakthroughs in palm tocotrienols research and the current clinical practices of using palm tocotrienols for disease management. Some of the highlights are:
Health Benefits of Vitamin E
Vitamin E, a fat-soluble antioxidant, can only be obtained as a food supplement, but has widely-known health benefits for the skin, heart and brain. Deficiency of vitamin E is rarely naturally-occurring, but when it does appear, it is typically caused by fat malabsorption disorders or genetic abnormalities. Vitamin E is well-known in the cosmetic world for its skin benefits, but also protects against toxins that can deteriorate the eyes and brain.
Vitamin E Research: Current Science and Future Directions
In the almost 100 years since its discovery, vitamin E has been recognized as an antioxidant. However, recent findings suggest that the compound and its metabolites have roles that go beyond metabolism, gene regulation, immunomodulation, and neuroprotection. Free Radical Biology and Medicine has published a review of emerging aspects and future directions of vitamin E research in its November 2016 issue. This information, they believe, can help guide nutritional recommendations and trials on age-related and chronic disease prevention.
Study: Red Palm Oil Supplementation in Chronic Liver Disease Patients
A randomized, controlled study revealed that red palm oil (RPO, enriched with high levels of tocotrienols, tocopherols and carotenoids) supplementation decreased lipid peroxidation and endotoxemia (the presence of heat stable toxin derived from certain gram negative bacteria in the blood), production of inflammatory cytokines, and monocyte tissue factor (TF) in chronic liver disease patients.
The study, “Beneficial effect of refined red palm oil on lipid peroxidation and monocyte tissue factor in HCV-related liver disease: a randomized controlled study,” was published in Hepatobiliary & Pancreatic Diseases International. Sixty patients with mean age of 62 years old with Child A/B genotype 1 HCV-related cirrhosis with no history of alcoholic beverages consumption were recruited. The patients were randomly assigned to receive either 300 mg vitamin E (alpha-tocopherol acetate) or 15 g RPO supplementation for 8 weeks. Blood parameters such as circulating endotoxin, plasma endotoxin-inhibiting capacity, macrophage-colony stimulating factor (M-CSF), urinary isoprostane-F2α-III, and monocyte TF activity, erythrocyte malondialdehyde (MDA) were examined after the 2nd, 4th and 8th weeks. Liver ultrasound imaging was carried out to examine liver steatosis.
Tocotrienols for normalisation of hepatic echogenic response in nonalcoholic fatty liver: a randomised placebo-controlled clinical trial.
Magosso E, Ansari MA, Gopalan Y, Shuaib IL, Wong JW, Khan NA, Abu Bakar MR, Ng BH, Yuen KH.
Nutr J . 2013 Dec 27;12(1):166. doi: 10.1186/1475-2891-12-166.
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is one of the commonest liver disorders. Obesity, insulin resistance, lipid peroxidation and oxidative stress have been identified amongst the possible hits leading to the onset and progression of this disease. Nutritional evaluation of NAFLD patients showed a lower-than-recommended intake of vitamin E. Vitamin E is a family of 8 isoforms, 4 tocopherols and 4 tocotrienols. Alpha-tocopherol has been widely investigated in liver diseases, whereas no previous clinical trial has investigated tocotrienols for NAFLD. Aim of the study was to determine the effects of mixed tocotrienols, in normalising the hepatic echogenic response in hypercholesterolaemic patients with ultrasound-proven NAFLD.
Methods: Eighty-seven untreated hypercholesterolaemic adults with ultrasound-proven NAFLD were enrolled and randomised into control group (n = 44) and tocotrienols group (n = 43). The treatment, either mixed tocotrienols 200 mg twice daily or placebo, had a 1-year duration.Normalisation of hepatic echogenic response, being the trial primary aim, was used in sample size calculations. The data were assessed according to intention to treat principle as primary outcome. Per protocol analysis was also carried out as secondary outcome measurement.
Results: Thirty and 34 participants concluded the study in the tocotrienols and placebo group respectively. Alpha-tocopherol levels were within the normal range for all subjects. As primary outcome, the normalisation of hepatic echogenic response was significantly higher for the tocotrienols treated group compared to the placebo group in the intention to treat analysis (P = 0.039; 95% CI = 0.896-6.488). As secondary objective, the per protocol assessment also showed significant rate of remission (P = 0.014; 95% CI = 1.117-9.456). Worsening of NAFLD grade was recorded in two patients in the placebo group, but none in the group treated with tocotrienols. No adverse events were reported for both groups.
Conclusion: This is the first clinical trial that showed the hepatoprotective effects of mixed palm tocotrienols in hypercholesterolemic adults with NAFLD.
Trial registration: ClinicalTrials.gov NCT00753532.