Vitamin D And Steatohepatitis

Vitamin D is a fat-soluble vitamin important for calcium absorption in the intestines. Vitamin D is obtained from dietary sources, and it synthesized under exposure to direct sunlight. The liver is involved in the activation of vitamin D, but in steatohepatits -- or irritation of the liver -- vitamin D levels are reduced. According to a "Falk Symposium" article published in 2001, the decreased levels of vitamin D in steatohepatitis do not correlate with decreased bone density.

Vitamin D Activation

The skin, liver and kidney play major roles in the activation of vitamin D. In the skin, inactive vitamin D is synthesized from cholesterol under UV light. After synthesis, vitamin D undergoes the first step of activation in the liver. From the liver, the processed vitamin D becomes fully activated in the kidneys. Adequate production of active vitamin D by the liver and kidneys is important in the maintainance of calcium balance in the body.

Causes of Steatohepatitis

There are two main types of steatohepatitis: alcoholic steatohepatitis, or ASH, and nonalcoholic steatohepatitis, or NASH. Alcohol is processed and inactivated by the liver. When consumed in excess, alcohol can cause damage to the liver. With prolonged damage, liver cirrhosis -- which is extensive scarring of the liver -- can result. Steatohepatitis is a stage in the process of liver inflammation or irritation. The condition is reversible, if the offending substance is withheld or avoided. According to the "Falk Symposium" article, nutritional deficiencies may play a role in causing steatohepatitis and helping it progress. This is based on the fact that most people with steatohepatitis are malnourished.

Evaluating Liver Function in Malnourished People

There are various reasons to evaluate the function of the liver, besides malnutrition. For example, the use of certain drugs that are processed by the liver warrants monitoring the liver function. The liver function test, or LFT, is a very useful tool in evaluating the functionality of the liver, as it can help identify various causes of liver dysfunction, such as obstructive causes, toxins, drugs and infective organisms. A malnourished person with liver dysfunction may have increased fluid accumulation in the abdomen. Palpation of the abdomen -- a physical examination that involves touching with applied pressure -- can help identify fluid in the abdomen and an enlarged liver.

Vitamin D Supplementation in Steatohepatitis

There are several forms of vitamin D available for supplementation, such as vitamin D2 and D3. When ingested, these forms of vitamin D are partially activated by the liver before complete activation in the kidneys. In steatohepatitis, there may be reduced partial activation of vitamin D due to the dysfunction of the liver, but sufficient supplementation of vitamin D can help compensate for reduced liver function. According to a 2007 article in "The American Journal of Clinical Nutrition," vitamin D supplementation should not exceed 100,000 IU per day, as higher doses are associated with increased adverse effects.Vitamin D supplementation is safe and effective at doses of 800 to 1000 IU per day. Vitamin D supplementation is likely more effective when used in conjunction with calcium. According to an article on postmenopausal women published in "The New England Journal of Medicine" in 2006, vitamin D supplementation with calcium was effective in increasing bone density.