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CF related Liver disease, Lycopene and Vitamin E

Question
Dear Expert,

I'm a father to a 7years old boy with CF. Recently, a CF related Liver disease was diagnosed (by ultrasound and elevated liver enzymes in the blood). It was also discovered that his Vitamin E level is higher than normal 33mg/L. Can the high level of Vitamin E affect the Liver disease (for good or for bad)?

In addition he has being received a daily dose of 15mg of lycopene. Can the lycopene affect the liver disease? After stopping the lycopene administration a moderate decrease in the liver enzymes in the blood was monitored.

Thank you in advance.
Answer
Dear Questioner
Thank you for your question. In cystic fibrosis it is commoner to see a low level of fat soluble vitamins (A,D,E and K). There has been a consensus recomendation that low vitamin levels should be corrected and improved nutrition as a goal for treatment and to prevent further liver disease progression (Recommendations for management of liver and biliary tract disease in cystic fibrosis. Cystic Fibrosis Foundation Hepatobiliary Disease Consensus Group. Sokol RJ, Durie PR. J Pediatr Gastroenterol Nutr. 1999;28 Suppl 1:S1.). To my knowledge and from reviewing the published literature, I cannot find any cases or research suggesting an elevated Vitamin E level is harmful, or has any effect on the progression of liver disease. I can therefore only comment on low levels of Vitamin E and these should be corrected to prevent further problems.
With regards to your second question, Lycopene (belonging to the carotinoid group with antioxidative effects) has not been specifically reported in cystic fibrosis or any other disease to affect the liver. It has been shown to interact with some other medications including cholesterol lowering agents (statins). While it is possible, it cannot be certain that Lycopene has had any affect on the liver enzymes in this instance.
I hope that this is helpful to you and best wishes,
Stephen

Dr Stephen Rowan
Prof Stuart Elborn
Queen's University Belfast and Belfast City Hospital
Belfast

30.10.2012