Vitamin E

Introduction

Although it was discovered and isolated in the 1930s, vitamin E’s function in the body has come to light relatively recently. Vitamin E is an extremely important fat-soluble antioxidant. It insures the stability and integrity of cellular tissues and membranes throughout the body by preventing free radical damage.

Because vitamin E is destroyed by heat and oxidation during cooking or food processing, eating processed foods and/or fast foods can contribute to a vitamin E deficiency. Meanwhile, good sources of vitamin E include vegetable oils, wheat germ oil, seeds, nuts and soybeans. Other adequate sources are leafy greens, Brussels sprouts, whole wheat products, whole grain breads and cereals, avocados, spinach and asparagus.

Dosage Info

Dosage Range

Dosages that have been used in clinical studies generally range from 30 to 1,000IU daily. Doses as high as 3,000IU have been used in certain health conditions such as Huntington’s disease. (1)

Most Common Dosage

200 IU daily.

100 IU = 67 mg of natural vitamin E (RRR-alpha-tocopherol or d-alpha-tocopherol) = 100 mg of synthetic vitamin E (all rac-alpha-tocopherol or d,l-alpha-tocopherol)

Dosage Forms

Capsules, gel capsules, and emulsified liquid drops, and mycelized liquid drops.

Interactions and Depletions

Interactions

• mineral oil
• Anticoagulant medications
• Bile acid sequestrants
• orlistat
• chitosan

Depletions

• fenofibrate
• gemfibrozil
• haloperidol
• Polyunsaturated fatty acids (PUFAs)

Reported Uses

In addition to its antioxidant activity, vitamin E may support overall cardiovascular and circulatory health. It may also support the immune system and vision. During heavy exercise, vitamin E may also reduce the amount of exercise-induced free radical damage to the blood and tissues while helping the body reduce the incidence of exercise-induced muscle injury.

Vitamin E has a number of targeted clinical applications. First, it may slow the progression of Alzheimer’s disease. (2) In support of other conditions associated with aging, it may reduce the pain of rheumatoid arthritis and osteoarthritis. (3) , (4) Vitamin E may also lower the risk or delay the development of cataracts. (5) , (6) Older adults taking vitamin E saw significant decreases in oxidative stress and blood pressure. (7)

Vitamin E may increase HDL cholesterol levels while lowering LDL levels. (8) Studies suggest that vitamin E may treat many of the symptoms of atherosclerosis. (9) Some patients who have experienced heart attacks may have a lower risk of a second heart attack when supplementing with vitamin E. (10) However, a study involving 153 people with coronary artery disease and low HDL (good) cholesterol questioned these benefits. The antioxidants vitamin C, vitamin E, beta-carotene and selenium were added to cholesterol treatment of simvastatin and niacin and continued to show improvement over placebo, but decreased the benefits seen on HDL cholesterol measurements from simvastatin and niacin without the antioxidants. (11)

Numerous studies have indentified lower levels of vitamin E in patients with Crohn’s disease and other inflammatory bowel disorders compared to healthy individuals. What is still in question is how important these findings are to the severity of the disease. (12) , (13) , (14)

Also, vitamin E may protect against the effects of carcinogens, suppress tumor growth and reduce the toxicity of several anticancer therapies. (15) , (16) High levels of alph-tocopherol were found to reduce risk of certain stomach cancers and yet researchers also found an increased risk of another cancer when there were high levels of alpha-tocopherol. (17) It may also enhance insulin therapy for diabetics while reducing the risk of developing one form of the disease. (18) , (19) Vitamin E may help protect against medical complications that often develop in individuals with type 2 diabetes. (20) , (21)

For women, vitamin E may have some benefit for the symptoms of PMS. (22) Alpha tocopherol may also reduce risk of rectal cancer in women. (23) Vitamin E deficiency has also been linked to cervical dysplasia. (24)

Research has also found that vitamin E may reduce the occurance of the common cold in the elderly.

Toxicities & Precautions

Introduction

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General

This dietary supplement is considered safe when used in accordance with proper dosing guidelines.

Both a natural and synthetic form of vitamin E exist. Natural vitamin E is thought to be absorbed into the body to a greater extent than synthetic vitamin E. (25) A recent meta-analysis found that large doses of vitamin e was associated with an increase of over-all mortality. The dosage associated was greater than 400 IU daily. (26)

Side Effects

Occasional side effects reported with large doses of this dietary supplement include headache, fatigue, nausea, double vision, muscular weakness, and gastrointestinal distress. It may be necessary to reduce the dose of this dietary supplement. Tell your doctor if these side effects become severe or do not go away.

Pregnancy / Breast Feeding

To date, the medical literature has not reported any adverse effects related to fetal development during pregnancy or to infants who are breast-fed. Proper nutrition is essential during pregnancy for the healthy development of the fetus. Numerous vitamins and minerals are a vital part of proper nutrition. If you are pregnant, think you might be pregnant, trying to get pregnant, or breast-feeding an infant, talk to your healthcare professional about supplementing your diet with appropriate vitamins and minerals.

Age Limitations

To date, the medical literature has not reported any adverse effects specifically related to the use of this dietary supplement in children. Vitamins and minerals are an essential part of proper growth and development. Talk to your healthcare professional about the appropriate use of vitamins and minerals in children. Do not use any vitamin or mineral in children under 2 years of age unless first discussed with your healthcare professional.

References

1. View Abstract: Peyser CE, Folstein M, Chase GA, Starkstein S, Brandt J, Cockrell JR, et al. Trial of d-alpha-tocopherol in Huntington’s disease. Am J Psychiatry. 1995;152:1771-1775.
2. View Abstract: Lores Arnaiz S, et al. Chemiluminescence and Antioxidant Levels During Peroxisome Proliferation by Fenofibrate. Biochim Biophys Acta. May1997;1360(3):222-28.
3. View Abstract: Edmonds SE, et al. Putative Analgesic Activity of Repeated Oral Doses of Vitamin E in the Treatment of Rheumatoid Arthritis. Results of a Prospective Placebo Controlled Double-blind Trial. Ann Rheum Dis. Nov1997;56(11):649-55.
4. View Abstract: Scherak O, et al. High Dosage Vitamin E Therapy in Patients with Activated Arthrosis. Z Rheumatol. Dec1990;49(6):369-73.
5. View Abstract: Robertson JM, et al. Vitamin E Intake and Risk of Cataracts in Humans. Ann NY Acad Sci. 1989;570: 372-82.
6. View Abstract: Chylack LT Jr, Brown NP, Bron A, Hurst M, Kopcke W, Thien U, Schalch W. The Roche European American Cataract Trial (REACT): a randomized clinical trial to investigate the efficacy of an oral antioxidant micronutrient mixture to slow progression of age-related cataract. Ophthalmic Epidemiol. Feb2002;9(1):49-80.
7. View Abstract: Jessup JV, Horne C, Yarandi H, Quindry J. The effects of endurance exercise and vitamin E on oxidative stress in the elderly. Biol Res Nurs. Jul2003;5(1):47-55.
8. View Abstract: Rezaian GR, Taheri M, Mozaffari BE, Mosleh AA, Ghalambor MA. The salutary effects of antioxidant vitamins on the plasma lipids of healthy middle aged-to-elderly individuals: a randomized, double-blind, placebo-controlled study. J Med Liban. Jan2002;50(1-2):10-3.
9. View Abstract: Chan AC. Vitamin E and Atherosclerosis. J Nutr. Oct1998;128(10):1593-96.
10. View Abstract: Stephens NG, et al. Randomised Controlled Trial of Vitamin E in Patients with Coronary Disease: Cambridge Heart Antioxidant Study. Lancet. Mar1996;347(9004):781-86.
11. View Abstract: Cheung MC, Zhao XQ, Chait A, Albers JJ, Brown BG. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol. Aug2001;21(8):1320-6.
12. View Abstract: Geerling BJ, et al. Comprehensive nutritional status in patients with long-standing Crohn disease currently in remission. Am J Clin Nutr. May1998;67(5):919-26.
13. View Abstract: D’Odorico A, Bortolan S, Cardin R, D’Inca’ R, Martines D, Ferronato A, et al. Reduced plasma antioxidant concentrations and increased oxidative DNA damage in inflammatory bowel disease. Scand J Gastroenterol. Dec 2001;36(12):1289-94.
14. View Abstract: Kuroki F, Iida M, Tominaga M, Matsumoto T, Kanamoto K, Fujishima M. Is vitamin E depleted in Crohn’s disease at initial diagnosis? Dig Dis. Jul 1994;12(4):248-54.
15. View Abstract: Das S. Vitamin E in the Genesis and Prevention of Cancer. A Review. Acta Oncol. 1994;33(6):615-19.
16. View Abstract: Kennedy DD, Tucker KL, Ladas ED, Rheingold SR, Blumberg J, Kelly KM. Low antioxidant vitamin intakes are associated with increases in adverse effects of chemotherapy in children with acute lymphoblastic leukemia. Am J Clin Nutr. Jun2004;79(6):1029-36.
17. View Abstract: Taylor PR, Qiao YL, Abnet CC, et al. Prospective study of serum vitamin E levels and esophageal and gastric cancers. J Natl Cancer Inst. Sep2003;95(18):1414-6.
18. View Abstract: Salonen JT, et al. Increased Risk of Non-insulin Dependent Diabetes Mellitus at Low Plasma Vitamin E Concentrations: A Four-year Follow-up Study in Men. BMJ. Oct1995;311(7013):1124-27.
19. View Abstract: Paolisso G, et al. Pharmacologic Doses of Vitamin E Improve Insulin Action in Healthy Subjects and Non-insulin-dependent Diabetic Patients. Am J Clin Nutr. May1993;57(5):650-56.
20. View Abstract: Manzella D, Barbieri M, Ragno E, Paolisso G. Chronic administration of pharmacologic doses of vitamin E improves the cardiac autonomic nervous system in patients with type 2 diabetes. Am J Clin Nutr. Jun2001;73(6):1052-7.
21. View Abstract: Jialal I, Devaraj S, Venugopal SK. Oxidative stress, inflammation, and diabetic vasculopathies: the role of alpha tocopherol therapy. Free Radic Res. Dec2002;36(12):1331-6.
22. View Abstract: London RS, et al. Efficacy of Alpha-tocopherol in the Treatment of the Premenstrual Syndrome. J Reprod Med. Jun1987;32(6):400-04.
23. View Abstract: Murtaugh MA. Antioxidants, carotenoids, and risk of rectal cancer. Am J Epidemiol. 2004 Jan 1;159(1):32-41.
24. View Abstract: Palan PR, et al. Plasma Levels of Antioxidant Beta-carotene and Alpha-tocopherol in Uterine Cervix Dysplasias and Cancer. Nutr Cancer. 1991;15(1):13-20.
25. View Abstract: Hoppe PP, et al. Bioavailability and potency of natural-source and all-racemic alpha-tocopherol in the human: a dispute. Eur J Nutr. Oct2000;39(5):183-93.
26. View Abstract: Miller ER 3rd, et al. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality.Ann Intern Med. 2005 Jan 4;142(1):37-46.