NAFLD and Vitamin D - many studies

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NAFLD ==> decreased semi-activation of vitamin D: should use a form that does not need the liver

Topical Vitamin D
Alternately: use larger doses of Vitamin D

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Might NAFLD be treated by Vitamin D? asked Perplexity AI Dec 2024

Vitamin D supplementation shows promising potential as a treatment for non-alcoholic fatty liver disease (NAFLD). Several studies have demonstrated beneficial effects of vitamin D on various aspects of NAFLD:
Insulin Resistance Improvement
Vitamin D supplementation has been shown to improve insulin resistance in NAFLD patients, as indicated by a reduction in the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) 1
 This improvement in insulin sensitivity is crucial, as insulin resistance plays a significant role in the pathogenesis of NAFLD.
Liver Enzyme Reduction
Additional vitamin D treatment has been associated with a decrease in alanine aminotransferase (ALT) levels in NAFLD patients 1 8
 This reduction in liver enzymes suggests a potential improvement in liver function and a decrease in liver inflammation.
Anti-inflammatory and Anti-fibrotic Effects
Vitamin D has demonstrated anti-inflammatory, anti-fibrotic, and anti-proliferative effects in preclinical models of NAFLD and non-alcoholic steatohepatitis (NASH) 6
 These properties may help mitigate the progression of liver damage in NAFLD patients.
Improvement in Fatty Liver Grade
A combination of aerobic training and vitamin D supplementation has been shown to significantly reduce fatty liver grade in elderly women with vitamin D deficiency 10
 This suggests that vitamin D, especially when combined with exercise, may help reverse the accumulation of fat in the liver.
Metabolic Parameter Improvements
Vitamin D supplementation has been associated with improvements in various metabolic parameters, including:

• Increased HDL cholesterol levels
• Reduced body weight and BMI
• Decreased waist circumference
• Lowered fasting blood sugar levels
• Improved HOMA-IR scores 9

These metabolic improvements can contribute to overall better management of NAFLD.
Potential Mechanisms
The beneficial effects of vitamin D on NAFLD may be attributed to several mechanisms:

1. Modulation of hepatic lipid metabolism
2. Reduction of chronic inflammation
3. Improvement of insulin sensitivity
4. Maintenance of intestinal integrity 6

While these findings are promising, it's important to note that some studies have shown conflicting results, and more research is needed to fully establish the efficacy of vitamin D as a treatment for NAFLD. Additionally, the optimal dosage and duration of vitamin D supplementation for NAFLD treatment remain to be determined.

In conclusion, vitamin D supplementation shows potential as a complementary treatment for NAFLD, particularly when combined with lifestyle modifications such as exercise and dietary changes. However, further large-scale clinical trials are necessary to confirm its effectiveness and establish standardized treatment protocols

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NAFLD treatment could be helped by Omega-3 - meta-analysis Aug 2024

Effectiveness of Omega-3 Polyunsaturated Fatty Acids in Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
Cureus. 2024 Aug 28;16(8):e68002. doi: 10.7759/cureus.68002
Tarique Aziz 1, Mukesh K Niraj 1, Shishir Kumar 1, Rajendra Kumar 2,✉, Hina Parveen 3

Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver disorder characterized by excessive hepatic fat accumulation without alcohol intake. It can progress to non-alcoholic steatohepatitis, increasing the risk of cirrhosis and liver failure. This study aims to evaluate the efficacy of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in treating NAFLD. A systematic review and meta-analysis was conducted including studies published from January 2018 to June 2023. Databases searched included PubMed, Embase, Cochrane Library, and ClinicalTrials.gov. Inclusion criteria comprised randomized controlled trials and cohort studies involving human subjects or animal models with NAFLD. Data were extracted and analyzed to assess the impact of omega-3 PUFAs on liver fat, hepatic enzymes, and serum lipid profiles using RevMan 5.4. A total of 15 studies met the inclusion criteria. Omega-3 supplementation significantly decreased alanine aminotransferase (ALT) (mean difference = -2.12, 95% confidence interval (CI) = -3.36, -0.87) and aspartate aminotransferase (AST) (mean difference = -1.50, 95% CI = -2.59, -0.42). Gamma-glutamyl transferase levels showed a trend toward reduction (mean difference = -0.82, 95% CI = -1.66, 0.02). Serum lipid profiles improved significantly with reductions in triglycerides, low-density lipoprotein, and total cholesterol along with significant reductions in AST, ALT, and alkaline phosphatase in animal models. Omega-3 PUFAs appear to offer beneficial effects on liver enzymes, serum lipid profiles, and anthropometric indices in NAFLD patients. While their impact on liver fat content remains uncertain, omega-3 supplementation could serve as a valuable adjunct treatment for enhancing metabolic profiles and liver function in NAFLD patients.
 Download the PDF from VitaminDWiki

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NAFLD increased 12X in recent years in those under 18 - Oct 2023

NAFLD Has Become a Health Emergency Among Children - Mercola

1 hour YouTube video

• NAFLD also affects up to 9.6% of American children aged 2 to 19, making it as common as asthma. In 15- to 19-year-olds, prevalence is as high as 17.3%. Prevalence among children 0 to 17 has risen 168.3% since 2017, with a particularly precipitous rise starting in 2020"
• "The dramatic rise in NAFLD in early 2020 may in part be due to the COVID lockdowns, which had the effect of raising childhood obesity rates by 8.3% to 13.4%, depending on the age group"

 Download the Mercola PDF from VitaminDWiki
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Incidence of Nonalcoholic Fatty Liver Disease Rises Quickly in U.S. Military - 2019

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NAFLD is treated by Vitamin D, Omega-3, etc. Aug 2023

NAFLD and nutraceuticals: a review of completed phase III and IV clinical trials
Front Med (Lausanne) . 2023 Aug 1;10:1227046. doi: 10.3389/fmed.2023.1227046
Omar E Hegazi 1 2, Samer O Alalalmeh 1 2, Ghala Rashid Humaid Alnuaimi 1 2, Moyad Shahwan 1 2, Ammar Abdulrahman Jairoun 3 4, Nasser M Alorfi 5, Shaker A Majrashi 6, Mustfa Faisal Alkhanani 7, Abdullah Alkhattabi 8, Mansour M Alourfi 8 9, Faris A Alsolami 10, Saeed Alsharif 11, Hatim Alshahrani 12

Background: Nonalcoholic Fatty Liver Disease (NAFLD) has become a significant public health concern, affecting approximately one-fourth of the population. Despite its prevalence, no FDA-approved drug treatments specifically target NAFLD.

Aim: To provide a review of clinical trials investigating the use of herbal remedies and dietary supplements in NAFLD management, utilizing the ClinicalTrials.gov database.

Methods: This review evaluates the current evidence by examining completed phase III and IV clinical trials registered on ClinicalTrials.gov. An exhaustive search was performed on April 17, 2023, using the terms "Nonalcoholic Fatty Liver Disease" and "NAFLD." Two independent reviewers appraised eligible trials based on pre-defined inclusion and exclusion criteria.

Results: An initial search yielded 1,226 clinical trials, with 12 meeting the inclusion criteria after filtration.
The majority of trials focused on

• Omega-3 fatty acids (20.0%) and
• vitamin D (26.7%),

followed by caffeine, chlorogenic acid, ginger, phosphatidylcholine, Trigonella Foenum-graecum seed extract, vitamin C, and vitamin E (each 6.7%). Most studies were Phase 3 (75.0%) and used a parallel assignment model (91.7%). Quadruple masking was the most prevalent technique (58.3%), and Iran was the leading country in terms of trial locations (25.0%). These interventions constitute two herbal interventions and nine supplement interventions.

Conclusion: This reveals a diverse range of nutraceuticals, with Omega-3 fatty acids and vitamin D being predominant in the management of NAFLD. The global distribution of trials highlights the widespread interest in these therapeutics. However, more rigorous, large-scale trials are needed to establish safety, efficacy, and optimal dosages.
 Download the PDF from VitaminDWiki

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Bibliometric Analysis of Vitamin D and Non-Alcoholic Fatty Liver Disease – June 2023

Journal of Innovations in Medical Research JUN. 2023 VOL.2, NO.6 doi:10.56397/JIMR/2023.06.07
Rui Wang1 & Zhanjie Chang1-2
The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang 712000, China
The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
Correspondence: Zhanjie Chang, The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang 712000, China; The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China.

Decrease publications due to COVID?

Background: The relationship between vitamin D and non-alcoholic fatty liver disease (NAFLD) has been a subject of significant interest. This study aimed to assess the current research status of vitamin D and NAFLD through a systematic analysis using bibliometric methods.

Methods: A search of the Web of Science Core Collection database was conducted to identify relevant literature meeting the study criteria. Key information such as the number of publications, authors, countries, and keywords was extracted.

Results: A total of 416 articles were included for analysis. The findings revealed an increasing trend in research on vitamin D and NAFLD in recent years. The dominant forces in the field were concentrated in China and the United States. A few institutions contributed to the majority of the research output, and the research topics primarily covered the association between vitamin D and NAFLD in terms of disease risk, severity, and treatment efficacy.

Conclusion: The bibliometric analysis of the literature in this study provided insights into the current status and trends of research on vitamin D and NAFLD. These findings are of significant importance in guiding future research directions and collaborations, offering new perspectives and strategies for the prevention and treatment of NAFLD. Further research should delve into the mechanisms underlying the association between vitamin D and NAFLD, and more clinical trials should be conducted to evaluate the potential role of vitamin D in the treatment of NAFLD.
 Download the PDF from VitaminDWiki

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Omega-3 should be considered for NAFLD treatment - umbrella meta-analysis Jan 2023

Omega-3 polyunsaturated fatty acids in the treatment of non-alcoholic fatty liver disease: An umbrella systematic review and meta-analysis
Clinical and Experimental Pharmacology and Physiology January 2023 https://doi.org/10.1111/1440-1681.13750 PDF can be rented for $12
Vali Musazadeh, Arash Karimi, Mahsa Malekahmadi, Sana Sedgh Ahrabi, Parvin Dehghan

There has been conflicting evidence from meta-analyses on the effect of polyunsaturated fatty acids (PUFA) on non-alcoholic fatty liver disease (NAFLD). Therefore, in this umbrella meta-analysis, we are evaluating whether omega-3 PUFA supplementation has any benefit in treating NAFLD. Electronic databases such as PubMed, Web of Science, Scopus, Embase and Google Scholar were assessed to October 2022. This meta-analysis included all meta-analyses that examined the effect of PUFAs on liver fat and liver function tests [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT)]. Meta-analysis was conducted using a random effects model. Subgroup analyses and sensitivity analyses were also performed.
In total, eight articles involving 6,561 participants met the eligibility criteria. Advantageous impacts PUFA supplementation were observed on ALT (ESWMD = −6.72 IU/L; 95% CI: −8.61, −4.84; p < 0.001, and ESSMD = −0.52 IU/L; 95% CI: −0.84, −0.20, p < 0.001), AST (ESWMD = −3.73 IU/L, 95% CI: −5.93, −1.53, p < 0.001, and ESSMD = −0.65 IU/L; 95% CI: −1.08, −0.22, p = 0.003), GGT levels (ESWMD = −4.20 IU/L, 95% CI: −6.85, −1.55, p = 0.002), and liver fat (ESWMD = −5.16; 95% CI: −8.49, −1.82, p < 0.001). Intervention with omega-3 PUFAs improves ALT, AST, GGT, and liver fat in patients with NAFLD.
Thus, omega-3 PUFAs could be considered as a therapeutic option in the treatment of NAFLD.

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NAFLD helped a bit by a single 300,000 IU Vitamin D dose (needed larger maintenance doses) – RCT March 2023

The effect of high oral loading dose of cholecalciferol in non-alcoholic fatty liver disease patients. A randomized placebo controlled trial
Front Pharmacol . 2023 Mar 14;14:1149967. doi: 10.3389/fphar.2023.1149967. eCollection 2023.
Amal Ahmed Mohamed 1, Ahmed Abdel Halim 2, Sahar Mohamed 2, Seham Mohamed Mahmoud 3, Eman Mohamed Bahgat Eldemiry 4, Rasha Sobh Mohamed 5, Mahmoud Maamoun Shaheen 5, Gina G Naguib 6, Nashwa M Muharram 7, Mona G Khalil 8, Salma Saed 9, Randa Ibrahim 10, Ahmed Salah Seif 11, Noha Kamal 12, Karima Nasraldin 13, Ali Elsaid Abdelrahman 14, Radwa El Borolossy 15

Background and Aim: Non-alcoholic fatty liver (NAFLD) is one of the most common progressive metabolic disorders worldwide. There are increasing scientific interests nowadays for the association between vitamin D status and Non-alcoholic fatty liver. Earlier studies have revealed that vitamin D deficiency is highly prevalent in Non-alcoholic fatty liver patients that contributes to poor outcomes. Hence, the present study aimed to assess the efficacy and safety of oral cholecalciferol on Non-alcoholic fatty liver patients.

Subjects and Methods: This study was conducted on 140 patients that were randomized either to group 1 that received the standard conventional therapy in addition to placebo or group 2 that received the standard conventional therapy in addition to cholecalciferol during the 4 months study period.

Results: At the end of the study group 2 revealed significant decrease (p < 0.05) in the mean serum level of TG, LDL-C, TC, hsCRP as compared to their baseline results and group 1 results. Additionally, a significant improvement in the serum levels of ALT (p = 0.001) was seen in group 2 at the end of the study when compared to group 1. Whereas group 1 did not show any change in these parameters when compared to group 2 and their baseline results.

Conclusion: Cholecalciferol was shown to have beneficial effects on serum ALT levels, hsCRP levels and lipid profile of NAFLD patients. Clinical Trial Registration: https://prsinfo.clinicaltrials.gov/prs-users-guide.html, identifier NCT05613192.

 Download the PDF from VitaminDWiki

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This RCT used 300,000 then 800 IU daily for 3 months

Actual total = 300,000 + 90 X 800 = 372,000 IU

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Only raised D level by 6 ng: should have used a much larger maintenance dose, perhaps 50K weekly

Wide range of response to Vitamin D: 50K Vitamin D weekly: rough chart

Translates to Before, After, Weekly
Proposed total: 300,000 + 12 X 50,000 = 900,000 IU

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NAFLD might be fought by D if the Vitamin D receptor is activated - Sept 2023

Insights into the role of vitamin D in targeting the culprits of non-alcoholic fatty liver disease
Life Sci. 2023 Sep 22;122124. doi: 10.1016/j.lfs.2023.122124 PDF is behind a paywall
Basma A Abdelrahman 1, Aiman S El-Khatib 2, Yasmeen M Attia 1

Vitamin D (VD) is a secosteroid hormone that is renowned for its crucial role in phospho-calcium homeostasis upon binding to the nuclear vitamin D receptor (VDR). Over and above, the pleiotropic immunomodulatory, anti-inflammatory, and metabolic roles VD plays in different disease settings started to surface in the past few decades. On the other hand, a growing body of evidence suggests a correlation between non-alcoholic fatty liver disease (NAFLD) and its progressive inflammatory form non-alcoholic steatohepatitis (NASH) with vitamin D deficiency (VDD) owing to the former's ingrained link with obesity and metabolic syndrome. Accordingly, a better understanding of the contribution of VDR signalling to NAFLD incidence and progression would provide further insights into its diagnosis, treatment modalities, and prognosis, especially since hitherto, no drug for NAFLD has been approved. This review, therefore, sought to set forth the likely contribution of VDR signalling in NAFLD and how it might influence its multiple drivers.

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27+ VitaminDWiki pages with NON-ALCOHOLIC or NAFLD in title

This list is automatically updated

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VitaminDWiki - 12 Intervention studies and Liver

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VitaminDWiki - 5 studies of Vitamin D Receptor and Liver

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VitaminDWiki – Overview Liver and vitamin D contains

• Fact: A properly functioning liver is needed for the efficient activation of vitamin D in the body
• Fact: Liver diseases often result in lower levels of vitamin D
• Fact: Various pain relievers damage the liver function
• Fact: Lower levels of vitamin D result in osteoporosis and many other diseases
• Options with a poorly functioning liver appear to be:

1. Increased vitamin D (example: 2X more vitamin D if Liver is 1/2 as efficient)
2. Increase the response you get from vitamin D
3. Increase sunshine / UVB,
4. Get the response you get from the sun/UVB
5. Consider supplementing with Iron - a patented Iron supplement appears to work very well
6. Get prescription for active form of vitamin D (Calcitriol) which does not need the liver or kidney to get the benefits of vitamin D in the body
7. Get Calcidiol which does not need the liver
8. Use Topical Vitamin D - activation by the skin etc does not require the liver

Click on image for ways of getting vitamin D even if Liver is not functioning well

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