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New Study Demonstrates Delta-Tocotrienol Supplementation Improves Biomarkers in Patients with NAFLD

NAFLD annatto

Nonalcoholic 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 NAFLD were performed with poor results. 

Annatto Tocotrienols 

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 NAFLD. 


This study was a randomized, double-blinded, placebo-controlled trial including 71 patients between the ages of 20 and 70 with ultrasound-proven NAFLD, a fatty liver index (FLI) >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 a 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, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, tumour 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). 

Study Results 

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 a 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 than what could be obtained from diet alone. Therefore, dietary supplements should be considered to help prevent the progression as well as improve liver function. Other nutrients to consider including are phosphatidylcholine, fibre or resistant starch, n-acetylcysteine, fish oil and probiotics.

 By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Perez MA, Khan DA, Slehria, 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. 2020;52:102494.