Scientists identified vitamin E about 80 years ago, but only
in the past few decades has its power as an antioxidant been revealed
and fully appreciated. Initially, there was great interest and
excitement regarding what this vitamin could do for a number of
ailments, particularly heart disease. Well-designed studies completed
recently, however, have found that the effect may be a less beneficial
than once thought.
One point on which most sources agree is that vitamin E-rich
foods are the optimal way to ensure adequate levels of this nutrient
in the body. Wheat germ, almonds, peanuts, vegetable oils (safflower,
corn, soybeans), green leafy vegetables, and walnuts are just
a few prime sources. Given that many of these foods are also high
in fat and calories, however, it's also worth considering a vitamin
E supplement of 400 IU daily.
When summoned from the body's fatty tissue where it's stored,
vitamin E--and it's antioxidant powers--go into action, protecting
cells by deactivating or destroying the potentially damaging oxygen
molecules called free radicals. Vitamin E also helps in the formation
of red blood cells and facilitates the use of the trace mineral
selenium and vitamins A and K.
Vitamin E is actually an umbrella term for a group of compounds
called tocopherols and tocotrienols. Until recently, most vitamin
E products contained only tocopherols (alpha-, beta-, delta-,
and gamma-tocopherols), with alpha-tocopherol recognized as the
body's predominant and most potent form.
But this thinking is changing as researchers also are identifying
heart-healthy powers in the tocotrienols. Manufacturers now offer
combination products, although tocotrienols are still easiest
to find in single supplement form. To realize vitamin E's full
health benefits, however, you really need both tocopherols and
As a key antioxidant, vitamin E appears to play a modest but
notable role in protecting the body from many chronic disorders.
It may even slow the aging process and guard against damage from
secondhand smoke and other pollutants. According to test-tube
studies, the tocotrienols (alpha-tocotrienol, specifically) appear
to be the most powerful of the vitamin E antioxidants. Circulatory
disorders, skin and joint problems, diabetes-related nerve complications,
high cholesterol, endometriosis, immune-system function, and memory
are also believed to benefit from vitamin E. To date, however,
research has been more intriguing than definitive.
The healing powers of regular vitamin E supplements (that is,
those containing tocopherols only) are often merged with those
of vitamin C, a sister antioxidant that actually increases the
effectiveness of vitamin E. This combination holds some promise
for preventing and possibly easing complications of such disorders
as congestive heart failure, alcoholism, cancer, HIV infection,
lupus, multiple sclerosis and nail problems.
On the other hand, a number of disappointing or ambiguous clinical
trial results were published in the late 1990s and early 2000s.
A large study on Parkinson's disease, a neurologic condition,
for example, indicated that taking vitamin E neither helped nor
hurt its symptoms.
Specifically, vitamin E may help to:
- Prevent or delay heart disease and related complications.
Vitamin E's ability to protect against cardiovascular disease
has been intensively studied and was initially thought to be
very promising. The vitamin appears to prevent the oxidation
of LDL ("bad") cholesterol, the first step in the
development of atherosclerosis, a buildup of plaque in the arteries
that inhibits normal circulation.
Additionally, vitamin E is believed to help prevent the formation
of blood clots and to minimize the inflammatory process involved
in heart disease development. Still a matter of debate, however,
is whether an antioxidant such as vitamin E (including both
tocopherols and tocotrienols) can prevent strokes, which aren't
directly related to atherosclerosis.
Studies designed to answer the question as to whether vitamin
E can actually prevent heart disease in people who are currently
healthy (with no heart disease) are generating confusing and
conflicting results. In two large studies at the Harvard School
of Public Health, vitamin E supplements lowered the risk of
heart disease in both women and men by about 40%. Other positive
lifestyle factors may partially account for this apparent
benefit, however, leaving the true contribution of the supplements
In 2003, a major study published in the American Heart Association's
journal, Circulation, indicated that vitamin E showed no benefit
for preventing heart attacks. The researchers, again from
Harvard, followed the levels of major carotenoids (including
beta-carotene) and certain tocopherols from vitamin E in the
blood of otherwise healthy physicians over the course of 13
years. They found that levels of beta-carotene and tocopherols
in 531 physicians who went on to have a heart attack were
similar to levels in a group of 531 similar men who did not
have a heart attack.
Vitamin E supplements also appear to produce no actual therapeutic
(healing) effect in people who are already sick with heart
disease. Major, well-designed trials comparing vitamin E supplements
to other drugs such as statins or a placebo (a dummy pill)
proved disappointing, with vitamin E showing no benefit over
the placebo in most cases. One clearly positive effect of
statins is to raise HDL ("good") cholesterol; recent
studies, however, indicate that vitamin E and other antioxidant
supplements seem to actually reduce this beneficial effect.
Disappointing results were reported from the widely publicized
HOPE study (Heart Outcomes Prevention Evaluation Study), which
followed nearly 10,000 people at high risk for heart attack
or stroke for more than four years. The participants who took
400 IU of vitamin E daily experienced about the same number
of heart disease complications and hospitalizations for chest
pain or heart failure as did those participants on a placebo.
On the other hand, the drug tested (an ACE inhibitor called
ramipril) proved very effective.
An extension of the HOPE trial (called HOPE-TOO), published
in September, 2003, found that after seven years, there was
no apparent heart-health benefit from taking vitamin E: 21.4%
of patients given vitamin E experienced heart attack, stroke,
or death from heart disease compared with 20.6% of participants
on a placebo.
Still, the subject of vitamin E and heart benefits remains
muddled. Earlier investigations seemed to indicate that the
supplement can clearly inhibit the progression of atherosclerosis
in individuals with existing heart disease. In the Cambridge
Heart Antioxidant Study, published in the British medical
journal Lancet in 1996, people with coronary atherosclerosis
who took vitamin E had a 77% lower risk of subsequent (nonfatal)
heart attack than those who took a placebo. A separate study
investigating the cholesterol-lowering effects of tocotrienols
specifically--they appear to inhibit the liver's synthesis
of cholesterol--found that large doses could lower LDL cholesterol
- Protect against prostate and other cancers. As an antioxidant,
vitamin E helps to safeguard cell membranes from the damaging
effects of free radicals that can play a role in the development
of cancer. The vitamin may also help fight cancer by boosting
the immune system. It remains unclear, however, whether these
beneficial actions on reducing free-radical (DNA oxidation)
activity actually leads to a protective effect against cancer,
a complex disease.
Research findings so far are confusing at best. One Finnish
study reported a reduced incidence of prostate cancer (and
death from the disease) in male smokers who took vitamin E
(50 IU daily) for five to eight years; it remains speculative,
however, as to whether it was the vitamin E that made the
difference. Other trials indicate that increased dietary vitamin
E may reduce the risk of colon cancer, particularly in women
under age 65. To confuse matters further, a separate study
of nearly 2,000 adults who developed colon cancer found that
the amount of vitamin E they took was no different than dosages
taken by those without cancer.
Prevent or delay cataracts and macular degeneration. Animal
studies indicate that vitamin E protects against cataracts,
a clouding of the lens of the eye that is a leading cause
of blindness in older people. So far most studies have shown
only a minor protective effect, although one study of 764
people reported that taking vitamin E supplements cut the
incidence of cataracts in half. One recent study in humans
found that the risk of late-stage macular degeneration, a
potentially blinding eye disorder, was significantly lower
in older adults who had high levels of vitamin E in their
- Slow the progression of Alzheimer's disease and dementia.
No one knows exactly what causes this progressive loss of memory
and nerve function, but one theory is that over time, free radicals
gradually damage nerve fibers. Columbia University researchers
reported that very high doses of vitamin E (2,000 IU a day)
slowed the progression of Alzheimer's disease. In fact it proved
as effective at this as selegiline, a prescription drug commonly
used to treat Alzheimer's.
However, no research has shown that vitamin E can actually
prevent Alzheimer's disease from developing in the first place.
- Retard the aging process and boost immune function. With
age, the immune system becomes less efficient at fighting off
microbes and viruses. Part of this decline may be due to low
levels of vitamin E in the bloodstream. Some studies have shown
improved immune responses in older people who take vitamin E
supplements. Vitamin E may also slow the effects of aging by
protecting cells from free-radical damage.
- Promote healing of burns, eczema, and other skin problems.
When applied to the skin, vitamin E-containing creams or oils
are believed to promote healing, protecting cells from free-radical
damage and reducing itchiness. Many people use such products
to ensure optimal skin health.
Note: Vitamin E has also been found to be useful for a
number of other disorders. For information on these additional
ailments, see our Dosage Recommendations Chart for Vitamin E.
The current Recommended Intake (or RDA) for vitamin E is 15 mg,
equal to about 23 IU daily.
If You Get Too Little
A vitamin E deficiency can lead to neurological damage. This
is quite rare, however, occurring primarily in people suffering
from metabolic diseases that inhibit fat absorption (vitamin E
is a fat-soluble vitamin). The RDA is easy for most people to
obtain if they eat a well-balanced diet containing even a minimum
amount of polyunsaturated fat.
If You Get Too Much
Vitamin E appears to be safe when consumed in amounts up to 1,000
IU a day, although diarrhea and headaches have been reported in
some people. Doses of over 800 IU a day of vitamin E may interfere
with the body's ability to clot blood, posing a risk to people
taking blood thinners (anticoagulants). In addition, high doses
of vitamin E may inhibit the absorption of vitamin A.
General Dosage Information
Special tips: For most people, supplement dosages for
vitamin E should be relatively low (400 IU or less), as there
are apparent risks in taking very high doses. It turns out that
in some situations antioxidants such as vitamin E can actually
turn into potentially cancer-promoting pro-oxidants. The exact
amount of vitamin E needed for disease-protecting effects remains
to be determined. It most likely varies from person to person.
- Vitamin E is particularly effective when taken with vitamin
C, which increases its absorption by the body.
- For topical use, commercial creams containing vitamin E are
easy to find. Alternatively, you can break open a capsule or
prick at softgel and gently rub the oil directly into the affected
- Vitamin E is available in natural and synthetic forms. The
latest findings indicate natural vitamin E supplements seem
to be superior to the synthetic forms. Most studies showing
health benefits for vitamin E have used synthetic forms, which
are cheaper and more widely available than the natural ones.
(Natural forms will be designated with a "d," as in
d-alpha. Synthetic forms will be designated with a "dl,"
as in dl-alpha.)
- Products marked as "mixed tocopherols" (alpha, beta,
delta and gamma) are absorbed well and also make a good choice.
- In addition to the following vitamin E dosages for tocopherols
indicated below, take 100 mg tocotrienols daily.
* For general health: Take 200-400 IU daily.
* For heart disease prevention: Take up to 800 IU daily.
* For cancer prevention: Take up to 800 IU daily.
Be sure to check out our Dosage Recommendations Chart for Vitamin
E, which lists therapeutic dosages for specific ailments at a
Guidelines for Use
- Try to take vitamin E at the same time each day.
- To promote absorption and lower the risk of stomach irritation,
take this fat-soluble vitamin with food that contains some fat.
- Once vitamin E squelches free radicals, it becomes a weak
free radical itself. For this reason, make sure to get plenty
of vitamin C as well; it not only recycles vitamin E that has
used up its antioxidant fuel but also restores its free-radical-fighting
- Tocotrienols can't perform many of the important health functions
of tocopherols, so don't substitute tocotrienol supplements
for your regular vitamin E capsules. The two can safely be combined,
however. You can also get tocotrienols naturally by eating foods
that contain it, such as cereal brans (barley, oats, rice) and
* Vitamin E's mild blood-thinning effect could cause problems
if it is routinely taken with anticoagulant (blood-thinning) drugs
such as warfarin or blood-thinning dietary supplements such as
ginkgo. Aspirin could also present problems in this regard. Consult
your doctor before taking such a combination.
Note: For information on interactions with specific generic drugs,
see our WholeHealthMD Drug/Nutrient Interactions Chart.
- Because of vitamin E's effect on blood clotting, don't take
supplements for two days before or after any type of surgery
(including dental surgery). The minimum amount of vitamin E
it takes to alter blood clotting is about 30 IU a day.
- A number of chemotherapy and radiation treatments are designed
to actually create free radicals for the purpose of killing
cancer cells. If you are undergoing cancer treatment, don't
take antioxidants such as vitamin E supplements without consulting
your oncologist first. Otherwise, you may be working counter
to what the cancer treatment is designed to do.
- Consult your doctor before taking vitamin E if you have high
blood pressure that is poorly controlled; the increased risk
for bleeding with vitamin E could possibly lead to a greater
risk for the complications of high blood pressure, such as hemorrhagic
stroke (bleeding in the brain)
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