Written by Slawomir (“Swavak”) Gromadzki, MPH
POSSIBLE HEALTH BENEFITS
Vitamin E provides protection against free radicals, helps your body use vitamin K, promotes hormonal balance, supports immune system, helps prevent and treat heart disease, stroke, cancer, diabetes, dementia, age-related macular degeneration and many other conditions and health problems.
Reducing harmful effect and activity of oxygen and nitrogen radical species is the most important benefit and role of all vitamin E forms. Since it readily interacts with fats, vitamin E prevents oxidation of fat molecules. It does this job even better when combined with vitamin C. Deficiency of these two vitamin antioxidants are associated with higher fat oxidation and its harmful effects. Since fats are key building blocks for all cell membranes, lack of vitamin E leads to serious health issues including severe disruption of movement and coordination in children.
There are many studies available which suggest that vitamin E may be beneficial in the following health problems: Weak immunity, excessive blood clotting, deep venous thrombosis (DVT), pulmonary embolism, heart disease, restless legs syndrome, stroke, various forms of cancer (including breast and prostate cancer), fibrocystic breast disease, Alzheimer’s, vascular dementia, cataract, diabetes & diabetic neuropathy, kidney damage in diabetes, epilepsy, male infertility, prevention of preterm birth, macular degeneration, menopausal symptoms, menstrual pain, premenstrual syndrome (PMS), rheumatoid arthritis, poor physical endurance, HIV support, osteoarthritis, Parkinson’s disease, etc.
Vitamin E have powerful antioxidant abilities that reduce free radical damage, fight inflammation, help slow aging and heart disease, and significantly boost immunity. Research gives evidence that for immune system enhancement and antioxidant benefit, vitamin E isomers alpha- and gamma-tocotrienols seem to be most effective.
Studies have shown that vitamin E serves as a protective antioxidant that fights cholesterol oxidation. Tocotrienol isomers of vitamin E have three double bonds that positively impact cardiovascular health due to their ability to reduce activity of an enzyme that controls cholesterol synthesis. Tocotrienol isomers can also prevent cell adhesion and slow down progression of hardening of the arteries. However, synthetic vitamin E doesn’t have the same benefits as natural forms. As a matter of fact, too much alpha-tocopherol can even interfere with the cholesterol-lowering benefit of delta and gamma-tocotrienols.
Vitamin E benefits skin by strengthening the capillary walls, improving moisture and elasticity, figthing skin inflammation, and acting as a natural anti-aging factor. Taking vitamin E with vitamin C can be useful in decreasing signs of sunburn, acne and eczema. It also speeds up skin cell regeneration and can be used to treat scars and wrinkles, making skin look younger.
Since vitamin E is a powerful antioxidant, it helps decrease radical and environmental hair damage. Used internally and externally, vitamin E oil can also promote circulation to the scalp, prevents scalp from becoming dry and flakey.
HORMONES & PMS
Vitamin E can play a crucial role in balancing hormones. Taking vitamin E supplements few days before and after a menstrual period helps reduce uterine cramping, menstrual pains, mood changes, anxiety and other PMS symptoms >.
PREGNANCY AND DEVELOPMENT OF THE EMBRYO
Vitamin E helps the newly fertilized egg to attach, influences the nerve development and also protects the developing babies from damage. It is critical during pregnancy and is required for proper development of embrio as well as neurological development of infants and children due to its ability to protect critical fatty acids and prevent inflammation. The greatest demand for this vitamin is believed to be during the months before and after conception, as it impacts early stages of neurologic and brain development. It is therefore recommended that women who plan conception, pregnant women, nursing mothers and children up until the age of 2 increase consumption of rich in vitamin E foods such as sunflower seeds and almonds and even 1 tablespoon of take organic wheat germ oil with a meal or good quality supplement containing mixed natural tocopherols.
Alpha-tocopherol is critically important for the development of the placenta. It was shown that supplemental natural form of vitamin E was beneficial in the treatment of infertility in both men and women (>, >,>, >).
When diet of mice was deprived of cabbage leaves (source of vitamin E) it resulted in spontaneous abortions in pregnant mothers (>).
There are reasons to believe that during pregnancy the demand for vitamin E is much higher due to the fact that the concentration of vitamin E – binding protein, afamin in the blood is increased twofold (>). Also protein called TTPA which plays very important roles in pregnancy and development seems to be dependent on alpha-tocopherol form of vitamin E.
In one study, women with ovarian failure that could not be treated with hormonal therapy were given a combination of 1000 IU vitamin E and pentoxifylline every day for at least 9 months. The treatment resulted in a twofold increase in thickness of the wall of the uterus and increase in viable pregnancies (>).
Vitamin E can help improve sperm quality of men diagnosed with infertility (>). The therapy also resulted in 45% more pregnancies in their women.
According to another experiment, supplementation with the daily dose of 200 μg selenium and 400 IU vitamin E in men with fertility problems made their sperm 52 % more mobile and improved other parameters, increase pregnancy rates (>).
Vitamin E helps reduce the risk of age-related macular degeneration, a common cause of blindness. However, in order for vitamin E to be effective for eye problems, it should be taken with vitamin C, carotenoids, vitamin A, and zinc.
Anti-inflammatory properties of vitamin E in the form of tocotrienols was shown to slow down the memory loss in people with Alzheimer’s disease and other neurodegenerative brain disorders (>). It seems to work even better when taken with other antioxidants such as vitamin C.
Vitamin E can be used to reduce the harmful effects of cancer treatments including radiation and chemo. There is some evidence that used orally tocotrienols can suppress tumour growth (especially in breast, prostate, liver and skin cancer) by inducing cancer cell death, turning off genes tied to cancer and inhibiting angiogenesis (abnormal growth of blood vessels inside a tumour).
PHYSICAL ENDURANCE AND MUSCLE STRENGTH
Vitamin E helps improve muscle strength and physical endurance, increases energy and reduces the level of oxidative stress in muscles after exercise (>).
ASTHMA & ALLERGIES
vitamin E may lower risk of asthma and allergies (>).
VITAMIN E DEFICIENCY
In developed countries, dietary deficiency of vitamin E is relatively common. An estimated six billion people worldwide and 75 to 90 % of Americans are according to some sources deficient in vitamin E. The lack of this potent antioxidant vitamin places them at increased risk for various health problems including immune dysfunction and cancer, cognitive deterioration (including Alzheimer’s), or cardiovascular disease.
FORMS OF VITAMIN E IN NATURE
There are many forms of vitamin E found in nature, mostly in plants. The term “vitamin E” refers to a group of eight different compounds, including alpha, beta, delta and gamma tocopherol, as well as alpha, beta, delta and gamma tocotrienol.
The most studied forms that are also used in dietary supplements are alpha- and gamma-tocopherol. Alpha-tocopherol is the primary form of vitamin E that is preferentially used by the human body to meet appropriate dietary requirements. Alpha tocopherol has the highest biological activity and highest concentrations in human body.
Tocotrienols which are found in palm oil, coconut and raw coconut oil, barley, and rice bran oil are also frequently studied. Alpha- and beta-tocotrienols have been found to be the least active forms overall, while delta- and gamma-tocotrienols are the most active.
The best food source of natural vitamin E is wheat germ. Other excellent sources are seeds and nuts. However, in order to get a therapeutic dosages, you need to take a supplement.
Alpha-tocopherol is predominantly found in sunflower seeds, peanuts, and almonds.
Sunflower seeds, walnuts, pecans, pistachios, and sesame seeds are good sources of gamma-tocopherol.
Delta tocopherol is found especially in tomato seeds, rice germ oil and soybean oil.
Tocotrienols are found in palm oil and barley.
Tocopherol and its subgroups are found in seeds, nuts and green leafy vegetables. Sources of tocotrienols include palm oil, rice bran and barley oils.
KEY DIATERY SOURCES (IN MG)
Wheat germ oil, 1 tablespoon: 20 mg
Sunflower seeds, 1 ounce (2 tablesppons): 10 mg
Almonds (1 ounce or 30g): 7 mg
Sunflower oil 1 tablespoon 5
Hazelnuts 1 ounce 4
Peanut butter 2 tablespoons 3
Avocado (half) 2
Peanuts 1 ounce 2
Olive oil 1 tablespoon 2
Spinach ½ cup 2
Broccoli ½ cup 1
Soybean oil ½ cup 1
Kiwifruit 1 medium 1
Mango ½ cup 1
Tomato, raw 1 medium 0.7
Please notice that although on paper some oils (especially refined and high in polyunsaturaded fatty acids such as corn oil, soya oil or sunflower oil) are listed as sources of vitamin E yet in practice they significantly increase the demand for this vitamin due to the fact that they also a good sources of damaging free radicals the same vitamin E is used in our body to fight with. For this reasons the whole and unroasted seeds and nuts or cooked organic soya beans are much better vitamin E sources than oils.
Many do not know that the term “vitamin E” actually refers to a group of at least eight fat-soluble antioxidant compounds, divided into two families of molecules: tocopherols and tocotrienols. Each of the tocopherol and tocotrienol subfamilies contains four different forms: Alpha-, Beta-, Gamma-, and Delta-. And each one of these subgroups has its own unique biological effects. Therefore, vitamin E should be consumed in the form of mixed natural tocopherols and tocotrienols, (also known as the full-spectrum vitamin E) to get the maximum health benefits.
In supplements and fortified foods, natural vitamin E has a “d” or “RRR” before the compound name, such as “d-alpha tocopherol” or “d-alpha tocopheryl acetate“.
Synthetic forms have “dl” or “all-rac” in front of the name, like “dl-alpha tocopherol“.
Other supplemental forms may include tocopheryl succinate, tocopheryl acetate, mixed tocopherols, alpha tocopherol, d-tocopherol, dl-tocopherol, d-delta-tocopherol, d-beta-tocopherol, and d-gamma-tocopherol.
Tocopheryl acetate is the ester form of tocopherol, which means it has an alcohol in the structure. Alpha tocopheryl acetate has equivalent bioavailability to alpha tocopherol.
Unfortunately, the vast majority of vitamin E found in supplements contains only one, either synthetic (worse) or natural, form of tocopherol which is deprived of other vitamin E isomers and therfore much less efective in preventing disease and improving health. That’s why the best way to get vitamin E benefits is by consuming natural vitamin E foods or finding good quality supplements that consist of all isomers or at list mixed natural (not sinthetic) tocopherols.
It is important to know that vitamin E is composed of two structurally similar compounds (isomers), tocopherols and tocotrienols. Each of these vitamin E isomers has unique properties and health benefits. When supplemental vitamin E consists of only one natural (d-alpha tocopherolor) or synthetic (dl-alpha tocopherol) form it is actually deprived of numerous health benefits of other tocopherols and tocotrienols. Recent findings seem to suggest that when alpha-tocopherol is separated from other vitamin E isomers and used as a supplement it may even interfere with absorption of other tocopherols as well as tocotrienols needed for immunity, neurons, heart or cognitive health (>).
It’s therefore reasonable to get a variety of vitamin E isomers from listed here plant food sources as they will give all vitamin E benefits.
Unfortunately, unlike tocopherols, commonly found in seeds, nuts and other foods, sources of tocotrienols (such as coconut, barley, palm oil and rice bran oil) are not as widely available or popular in most people’s diets.
NATURAL SUPPLEMENTAL FORMS
It was shown that the natural form of vitamin E (d-alpha tocopherol) can be three times more bioavailable and efficient than synthetic vitamin E (dl-alpha tocopherol). Natural vitamin E is also excreted slower than the synthetic form, so it has more time to get into the tissues where it is needed.
Natural vitamin E is generally labelled d-alpha tocopherol, d-alpha tocopheryl acetate, or d-alpha tocopheryl succinate. When vitamin E is stabilized by adding either succinic or acetic acid, the chemical name changes from tocopherol to tocopheryl (as in d-alpha-tocopheryl succinate, for example). Used in some supplements, vitamin E succinate (or d-alpha tocopheryl succinate) is a natural form of vitamin E obtained from vacuum steam distillation of edible vegetable oils. It is one of the most potent antioxidant tocopherols and often used as a source of vitamin E in dietary supplements.
It can sometimes appear as mixed tocopherols (the most form as it contains not only d-alpha tocopherol but also natural mixtures of beta, gamma, and delta tocopherols).
Gamma-tocopherol form of vitamin E may be the most important (or, perhaps, the only) form which is effective in preventing prostate cancer. This is one of the reasons why it has been suggested that the best form vitamin E supplementation would be the mixed tocopherols.
Natural E comes from plant oils instead of petroleum. Due to its molecular structure, natural vitamin E is much better absorbed in the body. Specific transport proteins in the liver tend to bind better to natural vitamin E, allowing it to be transported to other tissues in the body to be used for important functions, including as an antioxidant.
TESTIMONIAL: “I agree synthetic vitamin E is toxic, but natural vitamin E and especially the non-oily form d-alpha tocopheryl succinate is a wonderful supplement. It has been shown to have no toxicity up to 180 gram/day! It boosts immunity, improves quality of sleep, reverses skin cancer and powerfully protects the liver against the toxicity of drugs. I have used this form of vitamin E for years at high dose with only benefits and not a single side-effect and I’m somebody extremely sensitive to side-effects. And I disagree with Dr Mercola on the point of reductive stress. The problem is ALWAYS oxidative stress and not the opposite. If synthetic vitamin E increases cancer risk this is due to its toxicity. Synthetic vitamin E will not cause reductive stress but strong oxidative stress because of its in vivo toxicity despite its in vitro antioxidant property…” (SOURCE >)
SYNTHETIC SUPPLEMENTAL FORMS
Synthetic vitamin E does not come from natural food sources and is generally derived from petroleum products.
Synthetic vitamin E (dl-alpha-tocopherol or any variation starting with dl-) is found in most vitamin E supplements, whereas most multivitamins contain a semi-synthetic vitamin E extracted from plant oils.
Synthetic vitamin E, due to its chemical structure, is only about 12% as potent as natural vitamin E. It is also not as bioavailable (easily used by the body) as natural.
Studies have shown that we may need three times more synthetic vitamin E to equal the biological activity of natural one. Synthetic vitamin E is also excreted faster than natural, and therefore it doesn’t have as much time to get into the tissues.
IS SUPPLEMENTAL VITAMIN E DANGEROUS?
Most of the studies on supplemental vitamin E provide eveidence about its beneficial effects. However, there are also some that seem to suggest also possible harmful effect. One of them even claim that taking vitamin E in the form of a supplement can increase risk of death!
Here is a very interesting response to this shocking conclussion written by Dr Andrew Weil: “Results of the analysis from Johns Hopkins University suggest that taking daily doses of vitamin E that exceed 400 international units (IU) can increase the risk of death. The researchers arrived at their conclusion after analyzing death rates in 19 unrelated clinical trials that studied vitamin E supplementation for various health conditions. The trials took place from 1993 to 2004 and all together included more than 136,000 patients in North America, Europe and China. The vitamin E doses used in the different trials ranged from 15 to 2000 IU per day; the average daily intake was about 400 IU. The technique used to arrive at the Hopkins’ results – called meta-analysis – can only raise questions, not answer them. Vitamin E has no known toxicity, except for an anticoagulant effect that is usually desirable. The analysis found that taking a daily dose of 200 IU per day presented no increased risk of death and suggested that it might benefit health. However, the researchers found an increased risk of death at daily doses exceeding 200 IU; for those taking daily doses of 400 IU or more the risk of death was about 10 percent higher than among those taking placebos. But the same analysis also revealed some seemingly contradictory data. For example, one of the studies showed that among people who had had a heart attack, taking vitamin E was correlated with a lower risk of a second heart attack. It is important to know that most of the patients in all of the trials analyzed were over 60 and had pre-existing health problems such as heart or kidney disease. The Hopkins researchers conceded that because of the age and compromised health of the study participants, their findings might not apply to younger, healthier people. My feeling is that the health status of the study participants could be the problem here – perhaps the vitamin E had some unpredictable bad effect on their pre-existing conditions or didn’t mix well with certain medications. The researchers also may have overlooked controlling for the form of vitamin E used in the various studies. Natural vitamin E in the form of mixed tocopherols can possibly provide different benefits than synthetic versions limited to alpha tocopherol. Based on what we know now, my advice is still to take supplemental vitamin E in doses up to 400 IU a day but not exceeding that. Avoid dl-alpha-tocopherol and look for products that include all four tocopherols, not just the d-alpha form. Better yet, try to get the whole vitamin E complex: four tocopherols plus four tocotrienols.” (source >)
RECOMMENDED DAILY INTAKE
Infants 0-6 months: 4 mg; 7-12 months: 5 mg
Children 1-3 years old: 6 mg
Children 4-8 years: 7 mg
Children 9-13 years: 11 mg
Adults (14 years and older): 15 milligrams (22 international units) of vitamin E per day
Pregnant women: 16 mg a day
Nursing women: 19 mg
Some experts suggest that the recommanded daily intake for this vitamin is too low and that in order to achieve a healthy level of 30 μmol/L, adults and children over 14 need a daily intake of at least 50 IUs (33 mg) of vitamin E.
VITAMIN E SHOULD BE INGESTED WITH HEALTHY FAT
Vitamin E is fat-soluble, and for proper absorbtion needs to be taken with healthy fats such as especially raw coconut oil. In fact, studies have shown human body can only absorb about 10 percent of the vitamin E from a supplement taken it without fat.
Most studies have used between 50 IU and 800 IU or higher daily dosages. This would be equivalent to approximately 25 to 400 mg of natural vitamin E (d-alpha- or mixed tocopherols), or 50 to 800 mg of synthetic vitamin E (dl-alpha-tocopherol).
Please, keep in mind that that some manufacturers use the term “mixed tocopherols” to refer to the synthetic dl-alpha-tocopherol, while natural mix tocopherols consist of d-alpha-, d-gamma-, d-delta-, and d-beta-tocopherol.
One IU of natural vitamin E equals 0.67 mg alpha-tocopherol;
One IU of synthetic vitamin E equals 0.45 mg alpha-tocopherol.
In order to meet the daily dietary recommendations of 15 mg vitamin E, we need to get either 22 IU of natural vitamin E (22 IU x 0.67 = 15 mg) or 33 IU of synthetic vitamin E (33 IU x 0.45 = 15 mg).
SAFE UPPER INTAKE
The safe (tolerable) upper intake levels for vitamin E are based on its ability to cause bleeding and for adult men and women, are set at 1,000 milligrams (or 1,500 international units) per day of the natural form or 1,100 international units per day of the synthetic form (for technical reasons, the conversion factor here is different than in the daily intake).
For pregnant women under 19, the safe upper limit is 800 mg.
TOXICITY & SAFETY
Try to use only natural vitamin E in supplements and avoid large doses of vitamin E for a longer period of time, as some studies suggest possible adverse effects of overdosing this vitamin in supplemental form.
There seems to be an evidence that suplemental Vitamin E (especially synthetic dl- form) may be unsafe when taken in high doses, especially for smokers and people who have conditions such as heart disease, diabetes and are on warfarin. Taking 400–800 IU each day might increase the chance of a hemorrhagic stroke by 22 percent due to increased risk of bleeding, especially in the brain. A study of 77,000 people found consuming 400 milligrams of vitamin E per day may increase lung cancer risk by 28 percent especially in smokers. If you suffer from these health issues, do not take doses of 400 IU/day or more.
Vitamin E should not be given to certain brain injured children, such as those with some types of autism because accumulation of long chain fats requires oxidation to remove them, which process is impaired by vitamin E, and may make the symptoms worse.
If your multivitamin or vitamin E supplement contains about 20-50 IU and contains the natural forms of the vitamin, you can use it safely for a long time. Higher doses of about 200IU (not more than 400IU) it is probably better to use for a shorter time such as a month and then reduce to not more than 50 IU per day.
With or without vitamin supplementation, try to increase your intake of soaked over night in clean water unsalted and unroasted sunflower seeds and/or raw nuts (also soaked in water to release natural enzymes), especially almonds, and raw coconut oil (to get also some tocotrienols).
INTERACTIONS WITH NUTRIENTS
– Vitamin E enhances vitamin A intestinal absorption at medium to high concentrations, up to 40 percent.
– Vitamin E can prevent selenium toxicity.
– Medium and high levels of vitamin E significantly reduce vitamin D uptake.
– Vitamin C helps regenerate vitamin E. Witamin E can work in tandem with vitamin C, as they have similar properties. In a 2001 study in it was shown that vitamin E disappears from the blood of smokers approximately 20 days faster compared with nonsmokers (>). Later it was also discovered that supplementation with 500mg vitamin C twice daily for two weeks helped to slow down the disappearance of vitamin E in smokers by 45% (>).
– CoQ10 regenerates vitamin E.
– High levels of beta-carotene may decrease serum levels of vitamin E.
– Overdosing vitamin E can block the action of vitamin K increasing the risk of bleeding.
– Vitamin E was better taken up by white and red blood cells of healthy people who took the supplement with a high-fat meal (>).
INTERACTIONS WITH MEDICATIONS
Vitamin E shouldn’t be taken with aspirin or blood thinners such as warfarin as it may increase the blood thinning effect and risk of bleeding. Although the results of a study on vitamin E and Coumadin (warfarin) found no evidence of interaction, yet for safety reasons it is stille better to not combine them together except under a physician’s supervision.
It may also interact with calcium channel blockers, beta-blockers, antipsychotic medications and chemotherapy drugs. If you are taking any prescription medication, consult your doctor before taking vitamin E.
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