Vitamin E

 

    Dietary Sources

    • Vegetable oils
    • Cereals
    • Meat
    • Poultry
    • Eggs
    • Fruits
    • Vegetables
    • Wheat germ oil

    Recommended Use

  • Vitamin E deficiency
  • Certain genetic disorders  
  • Very low-weight premature infants
  • Treating and preventing diseases of the heart and blood vessels including hardening of the arteries, heart attack, chest pain, leg pain due to blocked arteries, and high blood pressure.
  • Treating diabetes and its complications.
  • Preventing cancer, particularly lung and oral cancer in smokers; colorectal cancer and polyps; and gastric, prostate, and pancreatic cancer.
  • Diseases of the brain and nervous system including:
  • Alzheimer’s disease and other dementias
  • Parkinson’s disease
  • Night cramps
  • Restless leg syndrome
  • Epilepsy
  • Huntington’s chorea
  • Disorders involving nerves and muscles
  • Preventing complications in late pregnancy due to high blood pressure (pre-eclampsia)
  • Premenstrual syndrome (PMS)
  • Painful periods
  • Menopausal syndrome
  • Hot flashes associated with breast cancer and breast cysts
  • To lessen the harmful effects of medical treatments such as dialysis and radiation.
  • To reduce unwanted side effects of drugs such as hair loss in people taking doxorubicin and lung damage in people taking amiodarone
  • Improving physical endurance
  • Increasing energy
  • Reducing muscle damage after exercise
  • Improving muscle strength
  • Cataracts
  • Asthma
  • Respiratory infections
  • Skin disorders
  • Aging skin
  • Sunburns
  • Cystic fibrosis
  • Infertility
  • Impotence
  • Chronic fatigue syndrome (CFS)
  • Peptic ulcers
    • To prevent allergies.
    • Some people apply vitamin E to their skin to keep it from aging and to protect against the skin effects of chemicals used for cancer therapy (chemotherapy)

    Clinical Use

  • Movement disorder (ataxia) associated with vitamin E deficiency
  • The genetic movement disorder called ataxia causes severe vitamin E deficiency.
  • Vitamin E supplements are used as part of the treatment for ataxia.
    • 2- Vitamin E deficiency
    • Oral vitamin E is effective for preventing and treating vitamin E deficiency.
      • 3- Alzheimer’s disease
      • Vitamin E may slow down the worsening of memory loss in people with moderately severe Alzheimer’s disease.
      • Vitamin E may also delay the loss of independence and the need for caregiver assistance in people with mild-to-moderate Alzheimer’s disease.
      • Vitamin E does not seem to prevent moving from mild memory problems to full-blown Alzheimer’s disease.
      • 4- Anemia
      • Vitamin E may improve the response to the drug erythropoietin, which affects red blood cell production, in adults and children on hemodialysis.
      • 5- Beta-thalassemia
      • Oral vitamin E may benefit children with the blood disorder called beta-thalessemia and vitamin E deficiency.
  • 6- Bladder cancer
    • Oral vitamin E, 200 IU daily for more than 10 years may prevent death from bladder cancer.
    • 7- Leakage of chemotherapy drug into surrounding tissue
    • Applying vitamin E to the skin together with dimethylsulfoxide (DMSO) seems to be effective for treating leakage of chemotherapy into surrounding tissues.
    • 8- Chemotherapy-related nerve damage
    • Oral vitamin E (alpha-tocopherol) before and after treatment with cisplatin chemotherapy might reduce the risk of nerve damage.
    • 9- Dementia
    • Men who consume vitamin E and vitamin C may have a decreased risk of developing several forms dementia.
    • Vitamin E does not appear to reduce the risk for Alzheimer’s dementia.
    • 10- Painful menstruation (dysmenorrhea)
    • Oral vitamin E for 2 days before and for 3 days after bleeding begins may decrease pain severity and duration, and reduce menstrual blood loss.
    • 11- Movement and coordination disorder called dyspraxia
    • Oral vitamin E together with evening primrose oil, thyme oil, and fish oils may improve movement disorders in children with dyspraxia.
    • 12- Kidney problems in children (glomerulosclerosis)
    • Oral vitamin E may improve kidney function in children with glomerulosclerosis.
    • 13- An inherited disorder called G6PD deficiency
    • Oral vitamin E alone or together with selenium, may benefit people with an inherited disorder called G6PD deficiency.
    • 14- Healing a type of skin sore called granuloma annulare
    • Topical vitamin E may clear up skin sores called granuloma annulare.
    • 15- Huntington’s disease
    • Natural vitamin E (RRR-alpha-tocopherol) can improve symptoms in people with early Huntington’s disease.
    • Vitamin E may not help people with more advanced disease.
    • 16- Male infertility
    • Oral vitamin E may improve pregnancy rates for men with fertility problems.
    • High doses of vitamin E together with vitamin C may not provide the same benefits.
    • 17- Bleeding within the skull
    • Oral vitamin E may be effective for treating bleeding in the skull in premature infants.
    • 18- Bleeding within the ventricular system of the brain
    • Oral vitamin E may be effective for treating bleeding within the ventricular system of the brain in premature infants.
    • 19- Nitrate tolerance
    • Oral vitamin E on daily basis may prevent nitrate tolerance.
    • 20- Liver disease called nonalcoholic steatohepatitis
    • Oral vitamin E on daily basis may improve symptoms of NASH in adults and children.
    • 21- Parkinson’s disease
    • Dietary vitamin E may be associated with a decreased risk of Parkinson’s disease.
    • Taking all-rac-alpha-tocopherol (synthetic vitamin E) may not have any benefit for people with Parkinson’s disease.
    • 22- Laser eye surgery (photoreactive keratectomy)
    • High doses of vitamin A along with vitamin E (alpha-tocopheryl nicotinate) daily may improve healing and vision in people undergoing laser eye surgery.
    • 23- Premenstrual syndrome (PMS)
    • Oral vitamin E may reduce anxiety, craving, and depression in some women with PMS.
    • 24- Physical performance
    • Increasing vitamin E intake in the diet may improve physical performance and muscle strength in older people.
    • 25- Fibrosis caused by radiation
    • Oral vitamin E with the drug pentoxifylline may imptove fibrosis caused by radiation.
    • Oral vitamin E alone may not be effective.
    • 26- An eye disease in newborns called retrolental fibroplasia
    • Oral vitamin E may be effective for treating an eye disease called retrolental fibroplasia in newborns.
    • 27- Rheumatoid arthritis (RA)
    • Oral vitamin E along with standard treatment is better than standard treatment alone for reducing pain in people with RA. However, this combination does not reduce swelling.
    • 28- Sunburn
    • High doses of oral vitamin E (RRR-alpha-tocopherol) together with vitamin C protects against skin inflammation after exposure to UV radiation.
    • Oral vitamin E alone does not provide the same benefit.
    • Applying vitamin E to the skin, together with vitamin C and melatonin, provides some protection when used before UV exposure.
    • 29- Movement disorder (tardive dyskinesia)
    • Oral vitamin E may improve symptoms associated with the movement disorder called tardive dyskinesia. However, some other research suggests that it does not improve symptoms, but may prevent symptoms from worsening.

    • 30- Swelling in the middle layer of the eye (uveitis)
    • Oral vitamin E with oral vitamin C may improve vision, but does not reduce swelling, in people with uveitis.

    How does vitamin E work?

    • Vitamin E is an important vitamin required for the proper function of many organs in the body.
    • It is also an antioxidant which helps to slow down processes that damage cells.

    Safety

    • Vitamin E is may be for most healthy people when taken by mouth or applied to the skin.
    • Most people do not experience any side effects when taking the recommended daily dose, which is 15mg.
    • Vitamin E is may be unsafe if taken by mouth in high doses.
    • If you have a condition such as heart disease or diabetes, do not take doses of 400 IU/day or more.
    • Some research suggests that high doses might increase the chance of death and possibly cause other serious side effects.
    • The higher the dose, the greater the risk of serious side effects.
    • There is some concern that vitamin E might increase the chance of having a serious stroke called hemorrhagic stroke, which is bleeding into the brain.
    • Some research shows that taking vitamin E in doses of 300-800 IU each day might increase the chance of this kind of stroke by 22%.
    • However, in contrast, vitamin E might decrease the chance of having a less severe stroke called an ischemic stroke.
    • There is contradictory information about the effect of vitamin E on the chance of developing prostate cancer.
    • Some research suggests that taking large amounts of a multivitamin plus a separate vitamin E supplement might actually increase the chance of developing prostate cancer in some men.
    • High doses can also cause nausea, diarrhea, stomach cramps, fatigue, weakness, headache, blurred vision, rash, and bruising and bleeding

    Recommended Daily Dietary Allowances

    Table 1: Recommended Dietary Allowances (RDAs) for Vitamin E (Alpha-Tocopherol) [6]

    Age

    Males

    Females

    Pregnancy

    Lactation

    0–6 months*

    4 mg
    (6 IU)

    4 mg
    (6 IU)

     

     

    7–12 months*

    5 mg
    (7.5 IU)

    5 mg
    (7.5 IU)

     

     

    1–3 years

    6 mg
    (9 IU)

    6 mg
    (9 IU)

     

     

    4–8 years

    7 mg
    (10.4 IU)

    7 mg
    (10.4 IU)

     

     

    9–13 years

    11 mg
    (16.4 IU)

    11 mg
    (16.4 IU)

     

     

    14+ years

    15 mg
    (22.4 IU)

    15 mg
    (22.4 IU)

    15 mg
    (22.4 IU)

    19 mg
    (28.4 IU)

  • *Adequate Intake (AI)

  • Special precautions & warnings

    Pregnancy

    • When used in the recommended daily amount, vitamin E may be for pregnant women.
    • There has been some concern that taking vitamin E supplements might be harmful to the fetus when taken in early pregnancy.
    • However, it is too soon to know if this is an important concern. Until more is known, do not take vitamin E supplements during early pregnancy without talking with your healthcare provider. 

    Breast-feeding

    • Vitamin E may be when taken orally in recommended daily amounts during breast-feeding. 

    Infants and children

    • The maximum amounts of vitamin E that are considered safe for children are based on age.
    • Less than 200 mg daily is safe for children 1 to 3 years old.
    • Less than 300 mg daily is safe for children 4 to 8 years old.
    • Less than 600 mg daily is safe for children 9 to 13 years old.
    • Less than 800 mg daily is safe for children ages 14 to 18 years old.
    • Vitamin E (alpha-tocopherol) is may be unsafe when given intravenously (by IV) to premature infants in high doses.

    Angioplasty (a heart procedure)

    • Avoid taking supplements containing vitamin E or other antioxidant vitamins (beta-carotene, vitamin C) immediately before and following angioplasty without the supervision of a health care professional.
    • These vitamins seem to interfere with proper healing.

    Diabetes

    • Vitamin E might increase the risk for heart failure in people with diabetes.
    • People with diabetes should avoid high doses of vitamin E.

    Heart attack

    • Vitamin E might increase the risk for death in people with a history of heart attack.
    • People with a history of heart attack should avoid high doses of vitamin E.

    Low levels of vitamin K (vitamin K deficiency)

    • Vitamin E might worsen clotting problems in people whose levels of vitamin K are too low.

    Retinitis Pigmentosa (An eye condition)

    • All-rac-alpha-tocopherol (synthetic vitamin E) 400 IU seems to speed vision loss in people with retinitis pigmentosa.
    • However, much lower amounts (3 IU) do not seem to produce this effect.
    • If you have this condition, it is best to avoid vitamin E.

    Bleeding disorders

    • Vitamin E might make bleeding disorders worse.
    • If you have a bleeding disorder, avoid taking vitamin E supplements.

    Head and neck cancer

    • Do not take vitamin E supplements in doses of 400 IU/day or more.
    • Vitamin E might increase the chance that cancer will return.


    Prostate cancer

    • There is concern that taking vitamin E may increase the chance of developing prostate cancer.
    • The effect of vitamin E in men who currently have prostate cancer is not clear.
    • However, in theory, taking vitamin E supplements might worsen prostate cancer in men who already have it.

    Stroke

    • Vitamin E may increase the risk for death in people with a history of stroke.
    • People with a history of stroke should avoid high doses of vitamin E.

    Surgery

    • Vitamin E may increase the risk of bleeding during and after surgery.
    • Stop using vitamin E at least 2 weeks before a scheduled surgery.

    Interactions with medications

    Moderate Vitamin E – Drug Interactions

    Be cautious with this combination.

    1. Cyclosporine (Neoral, Sandimmune)
    • Taking large amounts of vitamin E along with cyclosporine (Neoral, Sandimmune) may increase how much cyclosporine (Neoral, Sandimmune) absorption.
    • By increasing cyclosporine absorbtion, vitamin E may increase the effects and side effects of cyclosporine (Neoral, Sandimmune).
    1. Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
    • Some medications are changed and broken down by the liver.
    • Vitamin E may increase liver break down of some medications.
    • Taking vitamin E along with some medications that are broken down by the liver may decrease the effectiveness of some medications.
    • Before taking vitamin E, talk to your healthcare health care provider if you are taking any medications that are changed by the liver.
    • Examples of medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.
    1. Medications for cancer (Chemotherapy)
    • Vitamin E is an antioxidant.
    • Antioxidants may decrease the effectiveness of some medications used for cancers.

    1. Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs; Blood Thinners)
    • Vitamin E may slow blood clotting.
    • Taking vitamin E along with blood thinners may increase the chances of bruising and bleeding.
    • Blood thinners include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, Aleeve, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

    1. Medications used for lowering cholesterol (Statins)
    • Taking vitamin E, beta-carotene, vitamin C, and selenium together may decrease the effectiveness of some medications used for lowering cholesterol.
    • It is not known if taking vitamin E alone decreases the effectiveness of some medications used for lowering cholesterol. 
    • Some medications used for lowering cholesterol include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol) and simvastatin (Zocor).

    1. Niacin
    • Taking vitamin E along with beta-carotene, vitamin C, and selenium may decrease some of the beneficial effects of niacin.
    • Niacin can increase the good cholesterol.
    • Taking vitamin E along with these other vitamins may decrease the good cholesterol.

    1. Warfarin (Coumadin)
    • Warfarin (Coumadin) is used to slow blood clotting.
    • Vitamin E can also slow blood clotting.
    • Taking vitamin E along with warfarin (Coumadin) may increase the chances of bruising and bleeding.
    • Be sure to have your blood checked regularly.
    • The dose of your warfarin (Coumadin) may need to be changed.

    Vitamin E interactions with herbs and supplements

    1. Beta-carotene
    • Vitamin E may reduce absorption of beta-carotene.
    • The body needs beta-carotene to make vitamin A. Taking vitamin E 800 units daily seems to reduce blood levels of beta-carotene by 20%.
    • Higher doses of vitamin E may reduce beta-carotene even more.

    1. Herbs and supplements that slow blood clotting
    • Vitamin E slows blood clotting.
    • Using vitamin E along with other herbs and supplements that slow blood clotting may increase the risk of bleeding in some people.
    • These herbs include angelica, asafoetida, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, horse chestnut, meadowsweet, poplar, quassia, red clover, willow, and others.

    1. Iron
    • Large doses of vitamin E (>10 units/kg/day) may slow the uptake of iron supplements in severely anemic infants.
    • Avoid high doses of vitamin E in infants.
    • It isn't known whether this interaction occurs in adults.

    1. Omega-6 fatty acids
    • Taking omega-6 fatty acids, especially in high doses, may increase the amount of vitamin E that the body needs.

    1. Vitamin A
    • Vitamin E may affect how vitamin A acts in the body.

    1. Vitamin K
    • Vitamin E at 800 IU/day or more may decrease the effects of vitamin K.
    • This may increase the risk of bleeding in people taking warfarin or other medicines that slow blood clotting.
    • People with low vitamin K levels may be at especially high risk.

    Vitamin E interactions with foods

    1. Fatty foods
    • The body needs fat to be able to use vitamin E.
    • However, it isn't necessary to increase dietary fat to make sure vitamin E can be used by the body.

    Recommended Oral Doses

    1. Vitamin E deficiency
    • Dose in adults is RRR-alpha tocopherol (natural vitamin E) 60-75 IU per day.
    • 2- Tardive dyskinesia (movement disorder)
    • RRR-alpha-tocopherol (natural vitamin E) 1600 IU daily.
    • 3- Male fertility improvement
    • Vitamin E 200-600 IU daily.
    • 4- Alzheimer’s disease
    • Vitamin E 2000 IU daily.
    • Combination therapy of donepezil (Aricept) 5 mg and vitamin E 1000 IU per day may slow memory decline in people with Alzheimer’s disease.
    • 5- Non-alcoholic steatohepatitis (liver disease)
    • Vitamin E 800 IU daily for adults
    • Vitamin E 400-1200 IU for children.
    • 6- Early Huntington’s chorea
    • RRR-alpha-tocopherol (natural vitamin E) 3000 IU.
    • 7- Rheumatoid arthritis pain
    • Vitamin E 600 IU twice daily.
    • 8- For preventing nerve damage caused by cisplatin
    • Vitamin E (alpha-tocopherol) 300 mg daily with each chemotherapy treatment and for up to 3 months after stopping cisplatin therapy.
    • 9- For improving effectiveness of nitrates used for heart disease
    • Vitamin E 200 mg three times daily.
    • 10- To reduce protein in the urine of children with a kidney disease called focal segmental glomerulosclerosis
    • Vitamin E 200 IU.
    • 11- G6PD deficiency
    • Vitamin E 800 IU daily.
    • 12- Premenstrual syndrome (PMS)
    • RRR-alpha-tocopherol (natural vitamin E) 400 IU daily.
    • 13- Painful menstrual periods
    • Vitamin E 200 IU twice or 500 IU daily starting 2 days before the menstrual period and continuing through the first 3 days of bleeding.
    • 14- Healing the eyes after a surgery called keratectomy
    • 230 mg vitamin E (alpha-tocopheryl nicotinate) and vitamin A (retinol palmitate) 25,000 units may be used 3 times daily for 30 days, followed by twice daily for 2 months.
    • 15- Fibrosis caused by radiation
    • Vitamin E 1000 IU daily in combination with pentoxifylline 800 mg.
    • 16- Beta-thalassemia
    • Vitamin E 750 IU daily.
    • 17- Preventing sunburn
    • RRR-alpha-tocopherol (natural vitamin E) 1000 IU in combination with 2 grams of ascorbic acid.
    • 18- Preventing high blood pressure during pregnancy (pre-eclampsia) in high risk women
    • Vitamin E 400 IU with vitamin C 1000 mg daily.

    Other Names of Vitamin E

     
    • Acétate d’Alpha Tocophérol
    • Acétate de D-Alpha-Tocophéryl
    • Acétate de DL-Alpha-Tocophéryl
    • Acétate de Tocophérol
    • D-Alpha-Tocopherol
    • D-Alpha-Tocopheryl Acetate
    • D-Alpha-Tocopheryl Acid Succinate
    • D-Alpha-Tocopheryl Succinate
    • D-Alpha-Tocopheryl
    • D-Alpha-Tocophéryl
    • D-Beta-Tocopherol
    • D-Delta-Tocopherol
    • Delta Tocotrienol
    • Tocotrienol Concentrate
    • Tocotrienols
    • Vitamin E Acetate
    • Alpha-Tocophérol
    • Acétate d’Alpha Tocophérol
    • Acétate de D-Alpha-Tocophéryl
    • Acétate de DL-Alpha-Tocophéryl
    • Acétate de Tocophérol
    • Acétate de Vitamine E
    • All Rac-Alpha-Tocopherol
    • Delta-tocopherol
    • D-Gamma Tocotrienol
    • D-Gamma-Tocopherol
    • DL-Alpha-Tocopherol
    • DL-Alpha-Tocopheryl Acetate
    • DL-Alpha-Tocopheryl
    • DL-Tocopherol
    • D-Tocopheryl Acetate
    • Fat-Soluble Vitamin
    • Tocopheryl Acid Succinate
    • Tocopheryl Succinate
    • Vitamin E Succinate
    • Vitamina E
    • Alpha Tocopherol Acetate
    • Alpha tocotrienol
    • Alpha-tocopherol
    • Beta tocotrienol
    • Bêta-tocotriénol
    • Concentré de Tocotriénol
    • D-Alpha Tocopherol
    • D-Alpha Tocopheryl Succinate
    • D-Alpha Tocopheryl Acetate
    • D-Alpha Tocotrienol
    • Tocophérols Mixtes
    • Tocotriénols de Palme
    • Tocotriénols de Riz
    • Tocotriénols Mixtes
    • Tocopheryl Acetate
    • Vitamine Liposoluble
    • Vitamine Soluble dans les Graisses
    • Gamma-tocotriénol
    • Gamma-tocophérol
    • Mixed Tocopherols
    • Mixed Tocotrienols
    • Palm Tocotrienols
    • Rice Tocotrienols
    • RRR-Alpha-Tocopherol
    • Succinate Acide de D-Alpha-Tocophéryl
    • Succinate Acide de Tocophéryl
    • Succinate de D-Alpha-Tocophéryl
    • Succinate de Tocophéryl
    • Succinate de Vitamine E
    • Tocopherol Acetate
    • Tocophérol
    • Tocopheryl Acid Succinate
    • Tocopheryl Succinate
    • Tocotrienol