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  Vitamin E  
 
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Vitamin E works alongside other antioxidant nutrients including selenium, vitamin C, B-carotene and others to quench free radicals, peroxides and other potentially harmful substances. Vitamin E has a sparing effect on other antioxidants and vice versa. Vitamin E (also known as the tocopherols) occurs naturally in foods such as nuts and seeds, whole grains, cold-pressed vegetable oils and dark-green leafy vegetables. There are 4 tocopherols occurring in foods - alpha, beta, gamma, delta (a, b, g and d). D-alpha tocopherol accounts for 80% of the activity of the vitamin; d,l -alpha tocopherol is the name given to synthetic derivatives which are composed of equal amounts of all the stereoisomers.

'Mixed tocopherols' on vitamin labels indicates that 80% of the natural d-alpha variety is present with the remaining 20% being a mixture of b, g and d. The tocotrienols, which are less distributed in nature than the tocopherols, have not been well studied. However, they have already been found to have a greater anti-tumor effect than the most biologically active tocopherol.

Vitamin E requires the presence of bile for absorption and only 20-30% of normal dietary vitamin E is absorbed (the percentage decreases with increasing dose). There is no correlation between serum levels and vitamin E stores.

Dietary fat must be sufficient in amount for adequate secretions of the lipases and bile. Like other fat-soluble vitamins (A, D, K), the absorption of tocopherols and tocotrienols will not be complete without the presence of dietary fat. Therefore their absorption in the bloodstream will be erratic, especially when taken in fasted condition. The consistency of bile and lipase secretions in between doses also plays a major role in determining the extent of absorption. New emulsified forms are becoming available which claim a 200%+ increase in absorption.

Getting vitamin E naturally from foods or using a mixed tocopherol supplement does have advantages over simple using the most commonly available alpha-tocopherol. For example, naturally occurring E was helpful in preventing Parkinson's Disease, while supplemental E was not. [Neurology 2002;59(8): pp.1161-9]

To obtain optimal health benefits from vitamin E, a mixture of tocopherols (alpha, beta, delta, and gamma) and tocotrienols (alpha, beta, delta, and gamma) are required. Some of the functions of these vitamin E fractions are similar while others are completely different. When taken together, these various forms of vitamin E work synergistically as a team to provide maximum benefits.

Caution: If you are taking anticoagulants, you should not take vitamin E supplements because vitamin E has its own anticoagulant properties.

November 2004 Taking too much vitamin E has been linked to an increased death risk, according to research presented at the American Heart Association's annual scientific sessions in New Orleans. Daily intake of vitamin E at doses exceeding 400 IU was linked to an increased death risk.

The researchers pointed out that the majority of patients in the trials analyzed were over 60, and many suffered from pre-existing medical conditions, including heart disease. With this in mind, the study's application to healthy, younger adults may be limited. Using a mixed tocopherol product, instead of only alpha-tocopherol, may eliminate this risk.
 

 
 

Vitamin E can help with the following:
 
 
Aging  Parkinson's Disease / Risk
 High dietary intake of vitamin E (from food only) was associated with a reduced risk of Parkinson disease in a study of over 124.000 men and women who were followed for at least 12 years. Vitamin E or vitamin C supplements were NOT associated with the risk of developing Parkinson's. [Neurology 2002;59(8): pp.1161-9]

Allergy

  Allergic Rhinitis / Hay Fever

Autoimmune

  Myasthenia Gravis
 Vitamin E is directly involved with the energy metabolism of muscles. A deficiency causes increased amounts of muscle protein to break down and be expelled with the urine as as is the case with MG. The importance of vitamin E in MG can be seen in cases where the initial use of other vitamins improved the condition somewhat, but only after the addition of vitamin E did all symptoms of the disease disappear [E. M. Josephson, Thymus, Manganese, and Myasthenia Gravis 1961]. Also, MG may resurface after a year or two and then vitamin E is no longer effective unless manganese is supplemented in addition.

The various vitamins suggested for this condition have been used successfully in megadose quantities [F.R. Klenner, J. Appl. Nutr. 1973; 25: 16.]. Although helpful, these vitamins alone are often not sufficient for a permanent cure.

  Multiple Sclerosis / Risk
 Please also see the article about the approach that Fred Klenner, MD used with MS.

  Crohn's Disease
 Dr. Antonio J. DeLiz treated an advanced case of Crohn's disease with remarkable results using 16,000IU of vitamin E daily. Dr. Wilfred Shute, too, was able to bring relief to several individuals with Crohn’s disease who telephoned or wrote him after a particular lecture in Australia.

  Ulcerative Colitis

Childhood

  Down's Syndrome
 Down's Syndrome is associated with an increased oxidation problem. Antioxidants such as vitamin E provide protection in such situations.

Circulation

  Phlebitis / Thrombophlebitis
 Milroy's disease is a rare, incurable disease due to poor development of the lymphatic system, with a consequent chronic pooling of lymph in the legs often with recurring attacks of thrombophlebitis. Every case Dr. Shute, MD treated with vitamin E resulted in a positive response, with some cases being fully cured. The dose of vitamin E used for thrombophlebitis is 600-1,600 IU daily.

  Intermittent Claudication
 400 to 2,000 I.U. per day of vitamin E for many months has lead to improvements.

  Hypercoagulation (Thickened Blood)
  Atherosclerosis
 A higher dietary intake of vitamin E but not vitamin A, vitamin C or carotenoids, was associated with less development of preclinical carotid atherosclerosis in a study of 310 women. [Am J Clin Nutr 2002;76(3): pp.582-587] The recommended dosage is at least 400IU per day.

In another study, supplementation with vitamin C (500mg per day) or vitamin E (alpha-tocopherol 400IU per day) did reduce lipid peroxidation in a study of non-smoking adults. Supplementation with a combination of vitamin C and vitamin E conferred no benefit beyond that of either vitamin alone. [Am J Clin Nutr 2002;76(3): pp.549-555]

  Vasculitis
 A membrane's lipid bilayers is high in polyunsaturated fatty acids which are subject to oxidation. Vitamin E's function in maintaining membrane integrity might be attributed to its prevention of the membrane damage. It has been hypothesized vitamin E protects the lysosomal membranes from rupturing and destroying the cells.

  Raynaud's Phenomenon
  Increased Risk of Stroke
 Vitamin E at 300 IU or above reduces platelet aggregation, as do the tocotrienols. It is interesting to note that some doctors report that starting to take large doses of vitamin E immediately after a stroke will encourage a higher level of recovery than without the use of vitamin E. For example, instead of having to use a walker, a patient may become mobile with just a cane. This was based on the work of Dr.s Wilfred and Evan Shute. They believed that vitamin E reduces ischemia commonly experienced in myocardial infarction, stroke and renal failure.

These doctors recommended doses from 400 IU to 8,000 IU daily. The usual dose range was 800 to 1600 IU but they reported that they had given 8,000 IU (about 8 grams) without seeing any toxicity.

Yet, a study reported in the June 15, 1999, issue of the "Annals of Internal Medicine" presented data derived from over 40,000 subjects -- male health professionals whose dietary intake, use of vitamin supplements and health status were followed starting in 1986.

The researchers found no difference in risk of stroke between the high vitamin E- and C-consuming subjects and those who consumed lower levels of the two nutrients. Similarly, the researchers found that a higher intake of most of the carotenoids did not decrease the risk in these men of either total stroke or ischemic stroke. Only with respect to lutein (a carotenoid found mainly in dark-green leafy vegetables) did the investigators find a weak trend of decreased risk of stroke with increased intake.

  Varicose Veins
  Aneurysm / Weakened Arteries
 In evaluating 83 patients, it was found that serum cholesterol and triglyceride levels were higher in patients with aortic occlusive and aneurysmal disease than in control organ donors. Vitamin E concentrations were highest in peripheral occlusive diseased tissue and as much as 3 times greater than in organ donors compared to patients with aortic occlusive disease and aneurysmal disease. Signs of lipid peroxidation were markedly elevated in all diseased arterial tissue compared to controls. These data supply evidence of altered vitamin E metabolism and free radical processes in the tissues of patients with various manifestations of atherosclerosis. [Atherosclerosis, 1996;126: pp.289-297]

Digestion

  IBS (Irritable Bowel Syndrome)
 See the link between IBS and Vitamin B12.

Emergency Care

Not recommended for:
  Upcoming Surgical Procedure
 Caution is advised regarding Vitamin E due to its blood thinning ability. A general recommendation would be to keep your dose below 800 IU per day and dropping it even further starting several days before surgery. Your doctor or presurgical nurse may have a specific recommendation regarding Vitamin E for you before your surgery.

Environment / Toxicity

  Cigarette Smoke Damage
 Smokers have been found to have a lower alpha tocopherol level than non-smokers. Furthermore, persons with low physical activity levels were found to have a lower level than those with high activity. [Journal of Internal Medicine, 1993;234: pp.53-60]

  Tendency to Sunburn Easily
 Vitamins C and E, anti-oxidants, help reduce the damage due to free radicals produced through exposure to UV light. If you happen to burn, apply vitamin E oil directly to your skin. It's been shown to reduce the redness and inflammation caused by the sun.

Hormones

  Histadelia (Histamine High)

Immunity

  Weakened Immune System
  Immune System Imbalance (TH2 Dominance)
 Vitamin E increases TH1 cytokines, which help balance a TH2 dominant immune system.

Lab Values

  Low Platelet Count
 Five patients with thrombocytopenic purpura received 200-400mg of alpha-tocopherol acetate daily. Within 7-14 days, platelet counts and capillary fragility returned to normal or near normal. [Science 163: 762, 1946)] Note, however, that vitamin E is known to increase bleeding tendency by reducing platelet aggregation, so higher doses may be contraindicated for some patients.

  Elevated LDL/HDL Ratio
 Vitamin E causes an increase in HDL levels. In a separate study, tocotrienol use did not improve lipid measures over a 28 day period. [Am J Clin Nutr 2002;76(6): pp.1237-43]

However, in other studies, tocotrienols have been shown to reduce the level of LDL and apolipoprotein B, both of which are important risk factors for atherosclerosis and cardiovascular disease.

Some studies have demonstrated a significant reduction of both total and LDL cholesterol with tocotrienols administered to patients with high serum lipids. In a double blind, crossover study on 25 patients with high cholesterol levels, the patients in the treatment group were given 4 capsules daily of 50 mg tocotrienols mixed with palm oil, while the control group received only corn oil. At the end of the 8-week trial period, total cholesterol and LDL cholesterol had decreased significantly (15% and 8%) in the 15 subjects given the palm tocotrienols. There was no change in the control group. [Am J Clin Nutr 1991 Apr;53(4 Suppl): pp.1021S-1026S]

Total cholesterol and LDL-cholesterol were reduced even more (17 % and 24 % respectively) when tocotrienols were added to a low fat, low cholesterol diet and alcohol-free regimen in another double-blind, longer-lasting trial (12 weeks). [Journal of Nutritional Biochemistry1997, 8/5 pp.290-298] Other important cardiovascular risk factors were reduced by tocotrienols. Apoli-poprotein B and lipoprotein(a), strong predictors of cardiovascular disease [N Engl J Med 1983 Aug 18;309(7): pp.385-9], as well as thromboxane B2 and platelet factor 4 were all significantly lowered in the tocotrienol-treated group (15%, 17%, 31% and 14% respectively).

Medications

Not recommended for:
  Anticoagulant Use

Mental

  Stress

Metabolic

  Cystic Fibrosis
 Cystic fibrosis is associated with defective absorption of vitamin E because of a lack of lipase and poor formation of chylomicrons (small fat clusters).

  Methylation, Excess

Not recommended for:
  Metabolic Diet Type

Musculo-Skeletal

  Osgood-Schlatter Disease
 400 I.U. bid of vitamin E along with selenium at 200mcg per day has proven beneficial against Osgood-Schlater disease. Vitamin E can be applied topically along with DMSO. This can also be used for growing pains in the legs, inside or around the shins. [Marz, p.186, 1997]

  Leg Cramps At Night
 Nocturnal leg cramping often responds to 400-800iu of vitamin E per day. In one of the largest studies, 103 of 125 people who had been experiencing leg and foot cramps at night reported relief after taking vitamin E. A daily dose of 300iu was effective for half of the participants, while the others required 400iu or more for relief.

Recommended Product:
Thompson's Nutritional Vitamin E 400 IU with Mixed Tocopherols 60Sg



  Muscle Pains (Myalgia)
 Three months of supplementation with vitamin E at 1000IU per day prevented muscle soreness after a 45-minute downhill run in young men (mean age 24 years), but not older men (mean age 71 years), in a placebo-controlled study of 32 men.
[Experimental Biology, April 20-24, 2002, New Orleans, LA, USA; abstract]

  Restless Leg Syndrome (RLS) / Periodic Limb Moveme
 400 to 800 IU per day of vitamin E has helped in cases of RLS. In one trial involving 9 patients, 7 had complete relief following supplementation, one had almost 75% relief and one had 50% relief. It may take up to three months for the full benefit to become apparent. [Calif Med 111: pp.87-91, 1969]

  Muscular Dystrophy
 Severe deficiency results in muscular dystrophy-like symptoms. Some cases have shown improvement.

  Osteoarthritis
 A clinical trial using 600 IU of vitamin E in patients with osteoarthritis demonstrated significant benefit. The benefit was thought to be due to vitamin E's antioxidant and membrane stabilizing actions. Later studies have shown that vitamin E has an ability to inhibit the enzymatic breakdown of cartilage as well as to stimulate cartilage synthesis.

However, two years of supplementation with vitamin E (500IU per day) had no effect on symptoms or cartilage loss in a randomized, double-blind, placebo-controlled study of 136 patients with knee osteoarthritis. [J Rheumatol 2002;29(12): pp.2585-91]

Nervous System

  Huntington's Disease
 Dr. Abram Hoffer has treated an advanced case of Huntington's Chorea and returned him to apparent normalcy with large amounts of vitamin E (4,800IU per day) along with niacin.

  Tardive Dyskinesia
 See the link between Tardive Dyskinesia and Melatonin.

Nutrients

  Antioxidant Need/Oxidative Stress w/o Supplements
  Vitamin E Requirement

Organ Health

  Fatty Liver
 Alpha-tocopherol is effective in improving the liver biochemistry and histological lesions of NASH because of its actions as an antioxidant agent and as an inhibitor of TGF-ß, a cytokine involved in liver fibrogenesis.

  Diabetes Type II
 In a study published in the July 11, 2000 issue of Circulation, Drs. Ishwarlal Jialal and Sridevi Devaraj found that increased inflammation caused by white blood cells - monocytes - was reduced when diabetics were given 1,200 IU per day of natural vitamin E (alpha-tocopherol) for three months.

Another study showed that vitamin E (680IU) along with vitamin C (1200mg) will reduce the albumin excretion rate in urine which reduces the risk of end stage renal disease associated with diabetes. [DiabetMe 2001;18: pp.756-760]

  Kidney Failure
 Vitamin E levels, independent of dietary intake, have been found to be lower in patients with chronic renal failure. This reflects increased oxidative activity and suggests the need for antioxidants such as vitamin E. [Dietary Intake and Plasma Levels of Antioxidant Vitamins in Health and Disease: A Hospital-Based, Case-Control Study, Singh, Ram, B., M.D., et al, Journal of Nutritional & Environmental Medicine, 1995;5: pp.235-242]

  Hepatitis
 Vitamin E levels have been shown to be low in people with hepatitis [1], as well as in those who go on to develop liver cancer from long-standing hepatitis.[2] Vitamin E levels in the liver may also be decreased in some people with hepatitis.[3]

In a study of individuals with hepatitis B, half received 600 IU of vitamin E per day for nine months, while the others received no vitamin E (control group). In five of the twelve people receiving vitamin E (compared with none of those in the control group), all signs of hepatitis disappeared.[4]

In a study of adults with hepatitis C, administering 1,200 IU per day of vitamin E for eight weeks appeared to reduce liver damage to some extent.[5] In a preliminary study of people with hepatitis C, 544 IU of vitamin E per day for 24 weeks improved the response to interferon/antioxidant therapy, although the results did not reach statistical significance.[6] However, in children with viral hepatitis, daily injections of vitamin E (300 IU) for seven days did not produce any benefit.[7]

[1] Von Herbay A, Stahl W, Niederau C, et al. Diminished plasma levels of vitamin E in patients with severe viral hepatitis. Free Radic Res 1996;25: pp.461-6
[2] Pan WH, Wang CY, Huang SM, et al. Vitamin A, vitamin E or beta-carotene status and hepatitis B-related hepatocellular carcinoma. Ann Epidemiol 1993;3: pp.217-24
[3] Mezes M, Par A, Nemeth P, Javor T. Studies of the blood lipid peroxide status and vitamin E levels in patients with chronic active hepatitis and alcoholic liver disease. Int J Clin Pharmacol Res 1986;6: pp.333-8
[4] Andreone P, Gramonzi A, Bernardi M. Vitamin E for chronic hepatitis B. Ann Intern Med 1998;128: pp.156-7
[5] Houglum K, Venkataramani A, Lyche K, Chojkier M. A pilot study of the effects of d-alpha-tocopherol on hepatic stellate cell activation in chronic hepatitis C. Gastroenterology 1997;113: pp.1069-73
[6] Look MP, Gerard A, Rao GS, et al. Interferon/antioxidant combination therapy for chronic hepatitis C - a controlled pilot trial. Antiviral Res 1999;43: pp.113-22
[7] Yurdakok M, Kanra G. Vitamin E therapy in viral hepatitis. Mikrobiyol Bul 1986;20: pp.91-4 [in Turkish]

  Pancreatectomy

Not recommended for:
  Rheumatic Heart Disease
 Do not start with high doses of vitamin E in chronic rheumatic heart disease.

Respiratory

  Asthma
 Vitamin E has multiple actions that makes it a useful supportive agent in asthma treatment.

Risks

  Increased Risk of Breast Cancer
 It appears that the most common form of vitamin E, alpha tocopherol, does not help prevent or treat breast cancer. It may also actually increase the dose of Tamoxifen required to inhibit growth of estrogen receptor negative cancer cell lines. However, gamma tocopherol has demonstrated some cancer prevention effects compared to alpha tocopherol.

Vitamin E succinate is a derivative of vitamin E and has been shown to inhibit tumor cell growth. In one study, vitamin E succinate inhibited growth and induced apoptic cell death in estrogen-receptor-negative human breast cancer cell lines. Vitamin E succinate may be of clinical use in the treatment of aggressive human breast cancers, particularly those that are resistant to anti-estrogen therapy. Those with estrogen-receptor-negative breast cancers should consider taking 1200 IU of vitamin E succinate each day.

However, the best vitamin E to take for both prevention and treatment is in the form of tocotrienols. Tocotrienols induce breast cancer cell death (apoptosis). Although apoptosis could be achieved, the dose of tocotrienol needed to induce 50% apoptosis was up to 4 times higher than the dose of tocotrienol required to induce 50% growth inhibition.

Tocotrienols inhibit human breast cancer cells irrespective of estrogen receptor status. Although delta tocotrienol was found to be the most effective tocotrienol in inducing apoptosis (cell death) in estrogen-responsive and estrogen-nonresponsive human breast cancer cells, alpha and gamma-tocotrienol have shown anticancer effects also. Gamma-tocotrienol may be more potent in inhibiting growth of human breast cancer cultured cells than Tamoxifen.

A daily dose of 30-50mg mixed tocotrienols may be adequate for reducing breast cancer risk, if elevated, and higher doses as part of a treatment plan for breast cancer. It is especially important to take the tocotrienols with some form of oil or fat-containing food. One study showed that when tocotrienols are taken on an empty stomach, absorption was reduced by an average of 64%.

  Increased Risk of Alzheimer's / Dementia
 Ensure sufficient antioxidant intake. A study of more than 5,000 men and women found that people who consumed very high amounts of dark green, yellow, and red vegetables appear to reduce their risk of dementia by about 25%. Several studies have shown that vitamin E, an anti-oxidant, can slow progression of Alzheimer's.

Dietary vitamin E is rich in the gamma tocopherol fraction of vitamin E, whereas vitamin E supplements consist primarily of alpha tocopherol. It is the gamma tocopherol fraction of vitamin E that has been shown to be the critical factor in suppressing free radicals. The brain is especially vulnerable to the toxic effects of free radicals because of its high-energy output. Notably, in this study, only those with a genetic predisposition for contracting Alzheimer’s disease (those whose genetic structure was without the APOE epsilon 4 allele) showed the remarkable protective benefit from dietary vitamin E. [ JAMA June 26, 2002]

There is a conflicting study of Japanese men living in Hawaii that did not show any protective benefit from supplemental vitamin C or E over a period of 5.2 years. [JAMA 2002;288(18): pp.2266-8]

  Increased Risk of Prostate Cancer
 Among the various forms of vitamin E, researchers discovered that one, gamma-tocopherol, may have value as an anti-cancer agent. Gamma-tocopherol occurs naturally in plant seeds such as walnuts, pecans and sesame seeds.

According to a study, gamma-tocopherol inhibited the production of lab-cultured human prostate cancer cells. And although the presence of gamma-tocopherol caused cell death by interrupting the synthesis of sphingolipids (certain fatty molecules, which are important components of cell membranes), it left healthy human prostate cells unaffected. As researchers increased the amount of gamma-tocopherol, cancer cells slowed in growth and healthy cells grew normally.

"This is the first time gamma-tocopherol has been shown to induce death in lab-grown human cancer cells while leaving healthy cells alone," said the head researcher of the study.

Since gamma-tocopherol does not appear in most manufactured nutritional supplements, researchers have suggested combining it with another form of vitamin E: Alpha-tocopherol.

Alpha-tocopherol is the major form of vitamin E found in the body and, in contrast to gamma-tocopherol, is found in most manufactured nutritional supplements. It has justifiably earned a good reputation as an antioxidant, which helps fight against damage caused by unwanted free radicals. Thus, it is better to supplement a diet with mixed forms of vitamin E, as together they will enhance the positive effects found in each. [Proceedings of the National Academy of Sciences December 21, 2004;101(51): pp.17825-17830]

High blood levels of alpha- and gamma-tocopherol appeared to reduce the risk of prostate cancer by about 50 percent each.
These results are based on a study involving 100 individuals with prostate cancer and 200 individuals without, participating in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, which included nearly 30,000 men in all. Not only did the study indicate that men with the highest levels of alpha-tocopherol in their blood at baseline were about 50% less likely to develop prostate cancer than those with the lowest level of the vitamin, but it also showed:

*Men with highest levels of gamma-tocopherol were 43 percent less likely to develop the cancer, compared with men with the lowest levels.
*The connection between high tocopherol levels and low cancer risk was stronger among individuals taking alpha-tocopherol supplements compared to those not taking them. [Journal of the National Cancer Institute March 2, 2005;97(5): pp.396-399]

  Increased Risk of Lung Cancer
 High levels of alpha-tocopherol (a form of vitamin E) in the blood appear to reduce the risk of developing lung cancer in smokers by about 20%. The researchers attribute the decrease in cancer to vitamin E's antioxidant properties and anticancer properties. The researchers report that the men most likely to experience a benefit from high serum levels of alpha-tocopherol included those younger than 60, men who had smoked for less than 40 years and men who took vitamin E supplements containing alpha-tocopherol during the study. [Journal of the National Cancer Institute October 20,1999;91: pp.1738-1743]

  Increased Risk of Coronary Disease / Heart Attack
 Vitamin E may protect the endothelial cells of the arteries from becoming oxidized. Free radical stress can be reduced with antioxidants such as vitamin E.

In a study published in Epidemiology in 2002, a substantial inverse association with myocardial infarctions (MI) was found for total dietary vitamin E (assessed by food-frequency questionnaire), in a case-control study of 475 survivors of a first MI and 479 controls in Costa Rica. Dietary gamma tocopherol intake was not associated with the risk of myocardial infarction. This study again indicates that alpha tocopherol may be the preferred form of vitamin E for protection from MI. [Epidemiology 2002; 13(2): pp.216-223]

However, vitamin supplementation (E-600mg, C-250mg and beta-carotene-20mg per day) over a 5 year period had no effect on mortality from, or incidence of, any type of vascular disease or cancer in a placebo-controlled study of over 20,000 adults in the UK with coronary disease, other occlusive arterial disease, or diabetes. [ Lancet 2002;360(9326): pp.23-33]

Also, the use of vitamin C, vitamin E, and multivitamin supplements was not associated the risk of death due to
cardiovascular disease (CVD) or coronary heart disease in a study of over 80,000 male doctors (initially without overt CV disease) in the United States who were followed for an average of 5.5 years. [Arch Intern Med 2002;162(13): pp.1472-1476]

However, 800 IU of vitamin E and 1gm of vitamin C was associated with a increased risk of death in a study of 423 postmenopausal women with at least one coronary stenosis at baseline. [Effects of hormone replacement therapy and antioxidant vitamin supplements on coronary atherosclerosis in postmenopausal women. JAMA 2002;288(19):2432-40.]

  Increased Risk of Lymphoma
 Observational Study: Serum vitamin E concentrations were significantly lower in leukemia and lymphoma patients than in normal controls.

  Increased Risk of Bladder Cancer
 Ten years of regular supplemental vitamin E intake, but not regular use of shorter duration was associated with a reduced risk of bladder cancer mortality in a study of 991,522 adults in the United States. [Am J Epidemiol 2002;156(11): pp.1002-10]

  Increased Risk of Colon Cancer
 Although useful in helping colon cancer cases about to be treated, supplementation with vitamin E was found not to be associated with the risk of colon cancer in a study of 87,998 women and 47,344 men. [Cancer Epidemiol Biomarkers Prev 2002;11(11): pp.1298-1304]

Skin-Hair-Nails

  Adult Acne
 Vitamin E regulates retinol levels in humans. Male acne patients have significantly decreased levels of erythrocyte glutathione peroxidase, which normalizes with vitamin E and selenium treatment. The acne of both men and women improves with these treatments, probably by reducing the development of lipid peroxides.

  Adolescent Acne
 Acne in both men and women can show improvement with vitamin E and selenium treatment.

  Eczema
 Supplementation with vitamin E for 8 months improved symptoms and reduced serum IgE levels in a placebo-controlled study of 96 patients with atopic dermatitis. [Int J Dermatol 2002;41(3): pp.146-150]

  Concern Over Wrinkled Skin
 The skin's natural defenses against the free radicals produced by UV light are vitamin C and vitamin E. These two antioxidants intercept free radicals before they can damage your skin. Vitamin C protects significantly better against UVA phototoxicity than vitamin E; vitamin E, on the other hand, is more efficient against UVB.

Tumors, Malignant

  Breast Cancer
 It appears that the most common form of vitamin E, alpha tocopherol, does not help prevent or treat breast cancer. It may also actually increase the dose of Tamoxifen required to inhibit growth of estrogen receptor negative cancer cell lines. Gamma tocopherol has demonstrated significant cancer prevention effects compared to alpha tocopherol.

Vitamin E succinate is a derivative of vitamin E and has been shown to inhibit tumor cell growth. In one study, vitamin E succinate inhibited growth and induced apoptic cell death in estrogen-receptor-negative human breast cancer cell lines. Vitamin E succinate may be of clinical use in the treatment of aggressive human breast cancers, particularly those that are resistant to anti-estrogen therapy. Those with estrogen-receptor-negative breast cancers should consider taking 1200 IU of vitamin E succinate each day.

However, the best form to take for both prevention and treatment is known as the tocotrienols. Tocotrienols induce breast cancer cell death (apoptosis). Although apoptosis could be achieved, the dose of tocotrienol needed to induce 50% apoptosis was up to 4 times higher than the dose of tocotrienol required to induce 50% growth inhibition.

Tocotrienols inhibit human breast cancer cells irrespective of estrogen receptor status. Although delta tocotrienol was found to be the most effective tocotrienol in inducing apoptosis (cell death) in estrogen-responsive and estrogen-nonresponsive human breast cancer cells, alpha and gamma-tocotrienol have shown anticancer effects also. Gamma-tocotrienol may be more potent in inhibiting growth of human breast cancer cultured cells than Tamoxifen.

A daily dose of 30-50mg mixed tocotrienols may be adequate for reducing breast cancer risk, if elevated, and higher doses should be considered as part of a treatment plan for breast cancer. It is especially important to take the tocotrienols with some form of oil or fat-containing food. One study showed that when tocotrienols are taken on an empty stomach, absorption was reduced by an average of 64%.

  Colon Cancer
 Supplementation with vitamin E at 750IU per day before chemotherapy or radiation increased CD4/CD8 ratio and production of T helper 1 cytokines in 12 patients with Dukes C and D colorectal cancer. [Clin Cancer Res 2002;8(6): pp.1772-1778]

Uro-Genital

  Possible Pregnancy-Related Issues
 Several studies imply that harmful free radicals called lipid peroxides contribute to pre-eclampsia [Khan KS, Chien Pl. Brit J of Obst & Gyn 1997;104(10): pp.1173­9], and that women with this condition are low in the antioxidants that combat them. [Ziari SA, et al. Am Jl of Perinat 1996;13(5): pp.287­91]

The U.S. RDA is 10mg.

  Menorrhagia (Heavy Periods)
 Free radicals may have a causative role in endometrial bleeding, particularly in the presence of an intrauterine device. One study showed that supplementation with 100 IU for 10 weeks resulted in improvement in all patients. [Int J Fertil 1983;28: pp.55-6] Caution must be exercised as higher doses have a blood thinning effect.

  Susceptibility To Miscarriages
  Fibrocystic Breasts
 Several studies report that 200–600 IU of vitamin E per day, taken for several months, reduces symptoms. Most double blind research has not found vitamin E to relieve fibrocystic breast disease symptoms, however. Nevertheless, many women take 400 IU of vitamin E for three months to see if it helps.

  Dysmenorrhea, Painful Menstruation
 Supplementation with vitamin E (500IU per day) from 2 days before menstrual onset through the third day of bleeding, for two consecutive menstrual cycles reduced pain in a placebo-controlled trial of 100 young women with primary dysmenorrhea. [BJOG 2001;108(11): pp.1181-1183]

Another study used vitamin E successfully at a dosage of 75 - 400IU tid. [Butler & McKnight. Lancet 1: pp.844-47, 1955]

  Premenstrual Syndrome / PMDD
 Although vitamin E research concerning PMS has focused primarily on mastalgia, significant reduction of other PMS symptomatology has been demonstrated in double-blind studies. Nervous tension, headache, fatigue, depression, and insomnia were all significantly reduced.

  Menopausal Status / Issues
 Vitamin E, at a dose of 800 IU per day, is modestly effective in reducing hot flashes, on average cutting the number by one per day. [The Lancet Oncology 2001;2: pp.199-204] A review of other studies did not support the use of vitamin E for this purpose. [Ann Intern Med 2002;137(10): pp.805-13]

Vitamin E may be worth trying because it is safe and inexpensive. Up to 3,000IU per day is considered more effective by some doctors, but will have somewhat of a blood thinning effect. Some researchers believe the unesterified forms may be more effective.
 
 


KEY
May do some good
Likely to help
Highly recommended
May have adverse consequences
Reasonably likely to cause problems
Avoid absolutely







GLOSSARY

Alpha Tocopherol:  A form of vitamin E.

Anticoagulant:  A substance that prevents or delays blood clots (coagulation).

Antioxidant:  A chemical compound that slows or prevents oxygen from reacting with other compounds. Some antioxidants have been shown to have cancer-protecting potential because they neutralize free radicals. Examples include vitamins C and E, alpha lipoic acid, beta carotene, the minerals selenium, zinc, and germanium, superoxide dismutase (SOD), coenzyme Q10, catalase, and some amino acids, like cystiene. Other nutrient sources include grape seed extract, curcumin, gingko, green tea, olive leaf, policosanol and pycnogenol.

Bile:  A bitter, yellow-green secretion of the liver. Bile is stored in the gallbladder and is released when fat enters the first part of the small intestine (duodenum) in order to aid digestion.

Free Radical:  A free radical is an atom or group of atoms that has at least one unpaired electron. Because another element can easily pick up this free electron and cause a chemical reaction, these free radicals can effect dramatic and destructive changes in the body. Free radicals are activated in heated and rancid oils and by radiation in the atmosphere, among other things.

IU:  International Units. One IU is 1/40th (0.025) of a microgram (mcg).

Lipase:  An enzyme secreted by the pancreas to assist in fat breakdown.

Parkinson's Disease:  A chronic, slowly-progressing disease of the nervous system characterized clinically by the combination of tremor, rigidity, extreme slowness of movement, and stooped posture. It is characterized pathologically by loss of dopamine in the substantia nigra.

Peroxides:  Free radicals that are by-products formed in our bodies when molecules of fat react with oxygen.

Selenium:  An essential element involved primarily in enzymes that are antioxidants. Three selenium- containing enzymes are antioxidant peroxidases and a fourth selenium-containing enzyme is involved in thyroid hormone production. The prostate contains a selenium-containing protein and semen contains relatively large amounts of selenium. Clinical studies show that selenium is important in lowering the risk of several types of cancers. In combination with Vitamin E, selenium aids the production of antibodies and helps maintain a healthy heart. It also aids in the function of the pancreas, provides elasticity to tissues and helps cells defend themselves against damage from oxidation.

Serum:  The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Tocopherol:  Any of several fat-soluble, oily, phenolic compounds with antioxidant vitamin E activity.

Vitamin C:  Also known as ascorbic acid, Vitamin C is a water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.

Vitamin E:  An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.