Non-alcoholic fatty liver disease (NAFLD) has become an increasing epidemic. It is the most common cause of elevated liver enzymes and is associated with diabetes and obesity with advanced liver disease.

There are few guidelines for diagnostic and follow up methods and limited proven treatment options. Previous research of pharmacological agents to treat nonalcoholic fatty liver disease were performed with poor results.

Annatto tocotrienols are tocopherol free isomers of vitamin E that have been previously shown to reduce inflammation and oxidative stress in chronic disease.

According to a study just published in Complementary Therapies in Medicine, researchers investigated the effects of delta-tocotrienol supplementation on biomarkers of hepatocellular injury and steatosis in patients with nonalcoholic fatty liver disease (NAFLD).

This study was a randomized, double-blinded, placebo-controlled trial including 71 patients between the ages of 20 and 70 years of age with ultrasound proven fatty liver disease, a fatty liver index (FLI) greater than 60 with mild to moderate elevation in liver enzymes. The patients were randomized to receive either 300 mg twice daily of delta-tocotrienol supplementation or placebo for 24 weeks. Assessments included body weight, body mass index (BMI), waist circumference, blood pressure, FLI, homeostasis model of insulin resistance (HOMA-IR), and grading of hepatic steatosis on ultrasound. Laboratory assessment included glucose, urea, creatinine, uric acid, complete blood count (CBC), total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, tumor necrosis factor-α, (TNF-α), interleukin-6 (IL-6), leptin, adiponectin, high sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), alanine transaminase (ALT), and aspartate transaminase (AST).

As a result, there was a significant improvement in FLI, HOMA-IR, hs-CRP, MDA, ALT, AST, TNF-α, IL-6, total cholesterol, and triglycerides compared to placebo. In addition, hepatic steatosis was significantly reduced, and an average decrease in BMI of 8% and weight loss of 15 lbs.

These individuals are in a chronic disease state and have increased demands then what could be obtained from the diet alone and therefore, dietary supplements should be considered to help prevent the progression as well as improve liver function. Other nutrients to consider include phosphatidylcholine, fiber or resistant starch, n-acetylcysteine, fish oil, and probiotics.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Perez MA, Khan DA, et al. Delta-tocotrienol supplementation improves biochemical markers of hepatocellular injury and steatosis in patients with nonalcoholic fatty liver disease: A randomized, placebo-controlled trial. Complementary Therapies in Medicine. August 2020, Volume 52, 102494.

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