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Vitamin E is a fat-soluble vitamin and is a powerful biological antioxidant. Antioxidants such as vitamin E act to protect your cells against the effects of free radicals, which are potentially damaging by-products of the body's metabolism. Free radicals can cause cell damage that may contribute to the development of cardiovascular disease and cancer. Studies are underway to determine whether vitamin E might help prevent or delay the development of those chronic diseases.
Vitamin E is important in the prevention of cancer and cardiovascular disease. It improves circulation, is necessary for tissue repair, and is useful in treating premenstrual syndrome and fibrocystic disease of the breast. It promotes normal blood clotting and healing, reduces scarring from some wounds, reduces blood pressure, aids in preventing cataracts, improves athletic performance, and relaxes leg cramps. It also maintains healthy nerves and muscles while strengthening capillary wall. In addition, it promotes healthy skin and hair, and helps to prevent anemia and retrolental fibroplasia, an eye disorder that can affect premature infants.
As an antioxidant, vitamin E prevents cell damage by inhibiting the oxidation of lipids (fats) and the formation of free radicals. It protects other fat-soluble vitamins from destruction by oxygen, and aids in the utilization of vitamin A and protects it from destruction by oxygen. It retards aging and may prevent age spots as well.
Vitamin E deficiency may result in damage to red blood cells and destruction of nerves. Signs of deficiency can include infertility (in both men and women), menstrual problems, neuromuscular impairment, shortened red blood cell life span, spontaneous abortion (miscarriage), and uterine degeneration. Low levels of vitamin E in the body have been linked to both bowel cancer and breast cancer. Epidemiological links have been identified between the increase in the incidence of heart disease and the increasing lack of vitamin E in the diet due to our reliance on over-processed foods.
Vitamin E is actually a family of eight different but related molecules that fall into two major groups: the tocopherols and the tocotrienols. Within each group, there are alpha, beta, gamma, and delta forms. Each form has its own biological activity, the measure of potency or functional use in the body. Of all eight of these molecules, it is the alpha-tocopherol form that is the most potent and active form of vitamin E in humans.
SOURCES
Vegetable oils, nuts, and green leafy vegetables are the main dietary sources of vitamin E. Fortified cereals are also an important source of vitamin E in the United States. The table of selected food sources of vitamin E suggests foods that contain vitamin E.
Vitamin E is found in the following food sources: cold-pressed vegetable oils, dark green leafy vegetables, legumes, nuts, seeds, and whole grains. Significant quantities of this vitamin are also found in brown rice, cornmeal, dulse, eggs, kelp, desiccated liver, milk, oatmeal, organ meats, soybeans, sweet potatoes, watercress, wheat, and wheat germ. Herbs that contain vitamin E include alfalfa, bladderwrack, dandelion, dong quai, flaxseed, nettle, oat straw, raspberry leaf, and rose hips.
RECOMMENDED DIETARY ALLOWANCE (RDA)
The Recommended Dietary Allowance (RDA) is the average daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all (97-98 percent) healthy individuals in each life-stage and gender group.
The 2000 RDAs for vitamin E (5) for adults, in milligrams (mg) and International Units (IUs) are:
Life-Stage Men & Women Pregnancy Lactation Ages 19+ 15 mg* or 22 IU All ages 15 mg* or 22 IU 19 mg* or 28 IU *1 mg alpha-tocopherol equivalents = 1.5 IU
The RDA for vitamin E is based on the alpha-tocopherol form because it is the most active, or usable, form. Unlike other vitamins, the form of alpha-tocopherol made in the laboratory and found in supplements is not identical to the natural form, and is not quite as active as the natural form.
Results of two national surveys, the National Health and Nutrition Examination Survey (NHANES III 1988-91) and the Continuing Survey of Food Intakes of Individuals (1994 CSFII) indicated that the dietary intake of most Americans does not provide the recommended intake for vitamin E. However, a 2000 Institute of Medicine (IOM) report on vitamin E states that intake estimates of vitamin E may be low because energy and fat intake is often under reported in national surveys and because the kind and amount of fat added during cooking is often not known. The IOM states that most North American adults get enough vitamin E from their normal diets to meet current recommendations. However, they do caution individuals who consume low fat diets because vegetable oils are such a good dietary source of vitamin E. "Low-fat diets can substantially decrease vitamin E intakes if food choices are not carefully made to enhance alpha-tocopherol intakes".
TABLE OF SELECTED FOOD SOURCES OF VITAMIN E
As the 2000 Dietary Guidelines for Americans state, "Different foods contain different nutrients. No single food can supply all the nutrients in the amounts you need". The following table lists selected sources of vitamin E. As the tables indicate, vegetables oils, nuts, and green leafy vegetables are good dietary sources of vitamin E. Including these foods in your diet will help you meet your daily need for vitamin E, but it is still important to moderate total fat intake as recommended by the Dietary Guidelines for Americans.
Food manufacturers fortify many foods with vitamins and minerals. It is important to read the nutrition facts panel of the food label to determine whether a food provides vitamin E. If you want more information about building a healthful diet, refer to the Dietary Guidelines for Americans and the Food Guide Pyramid.
%DV* Wheat germ oil, 1 Tbsp 26.2 90 Almonds, dry roasted, 1 oz 7.5 25 Safflower oil, 1 Tbsp 4.7 15 Corn oil, 1 Tbsp 2.9 10 Soybean oil, 1 Tbsp 2.5 8 Turnip greens, frozen, boiled, 1 cup 2.4 8 Mango, raw, without refuse, 1 fruit 2.3 8 Peanuts, dry roasted, 1 oz 2.1 8 Mixed nuts w/ peanuts, oil roasted, 1 oz 1.7 6 Mayonnaise, made w/ soybean oil, 1 Tbsp 1.6 6 Broccoli, frozen, chopped, boiled, 1/2 cup 1.5 6 Dandelion greens, boiled, 1/2 cup 1.3 4 Pistachio nuts, dry roasted, 1 oz 1.2 4 Spinach, frozen, boiled, 1/2 cup 0.85 2 Kiwi, 1 medium fruit 0.85 2
REFERENCES
National Institutes of Health (NIH), Bethesda, MD, in conjunction with the Office of Dietary Supplements (ODS) in the Office of the Director of NIH.
VITAMIN E DEFICIENCY
Vitamin E deficiency is rare in humans. There are three specific situations when a vitamin E deficiency is likely to occur. It is seen in persons who cannot absorb dietary fat, has been found in premature, very low birth weight infants (birth weights less than 1500 grams, or 3 1/2 pounds), and is seen in individuals with rare disorders of fat metabolism. A vitamin E deficiency is usually characterized by neurological problems due to poor nerve conduction.
PREVENTING VITAMIN E DEFICIENCY
Individuals who cannot absorb fat may require a vitamin E supplement because some dietary fat is needed for the absorption of vitamin E from the gastrointestinal tract. Anyone diagnosed with cystic fibrosis, individuals who have had part or all of their stomach removed, and individuals with malabsorptive problems such as Crohn's disease may not absorb fat and should discuss the need for supplemental vitamin E with their health care provider. People who cannot absorb fat often pass greasy stools or have chronic diarrhea.
Very low birth weight infants may be deficient in vitamin E. These infants are usually under the care of a neonatologist, a pediatrician specializing in the care of newborns, who evaluates and treats the exact nutritional needs of premature infants.
Abetalipoproteinemia is a rare inherited disorder of fat metabolism that results in poor absorption of dietary fat and vitamin E. The vitamin E deficiency associated with this disease causes problems such as poor transmission of nerve impulses, muscle weakness, and degeneration of the retina that can cause blindness. Individuals with abetalipoproteinemia may be prescribed special vitamin E supplements by a health care provider to treat this disorder.
VITAMIN E & HEART DISEASE
Preliminary research has led to a widely held belief that vitamin E may help prevent or delay coronary heart disease. Researchers are fairly certain that oxidative modification of LDL-cholesterol (sometimes called "bad" cholesterol) promotes blockages in coronary arteries that may lead to atherosclerosis and heart attacks. Vitamin E may help prevent or delay coronary heart disease by limiting the oxidation of LDL-cholesterol. Vitamin E also may help prevent the formation of blood clots, which could lead to a heart attack. Observational studies have associated lower rates of heart disease with higher vitamin E intake. A study of approximately 90,000 nurses suggested that the incidence of heart disease was 30 to 40 percent lower among nurses with the highest intake of vitamin E from diet and supplements. The range of intakes from both diet and supplements in this group was 21.6 to 1,000 IU (32 to 1,500 mg), with the median intake being 208 IU (139 mg). A 1994 review of 5,133 Finnish men and women aged 30-69 years suggested that increased dietary intake of vitamin E was associated with decreased mortality (death) from heart disease. But even though these observations are promising, randomized clinical trials raise questions about the role of vitamin E supplements in heart disease. The Heart Outcomes Prevention Evaluation (HOPE) Study followed almost 10,000 patients for 4.5 years who were at high risk for heart attack or stroke. In this intervention study the subjects who received 265 mg (400) IU of vitamin E daily did not experience significantly fewer cardiovascular events or hospitalizations for heart failure or chest pain when compared to those who received a sugar pill. The researchers suggested that it is unlikely that the vitamin E supplement provided any protection against cardiovascular disease in the HOPE study. This study is continuing, to determine whether a longer duration of intervention with vitamin E supplements will provide any protection against cardiovascular disease.
At appropriate doses, vitamin E has been shown to have virtually the same pharmacological properties as Coumadin (crystalline warfarin sodium - a prescription anticoagulant). This means that appropriately high doses of Vitamin E may be substituted for Coumadin. Vitamin E may be considered safer than warfarin, the generic name of Coumadin. Increase the dose of Vitamin E over a period of weeks. Most people start with 200 IU daily, and eventually get to between 1,200 and 2,400 IU daily. Do it gradually, and here is a way to tell how it is working - Go in to see your health care provider regularly, as you always do, and continue to have him or her check your protime, as s/he always does. If you get the protime numbers s/he wants, s/he will not care how you got them. The more Vitamin E you take, the stronger the Coumadin's effect. You will probably get to the point where your protime is too long, and your health care provider have to cut back on the dosage of Coumadin."
VITAMIN E & CANCER
Antioxidants such as vitamin E help protect against the damaging effects of free radicals, which may contribute to the development of chronic diseases such as cancer. Vitamin E also may block the formation of nitrosamines, which are carcinogens formed in the stomach from nitrites consumed in the diet. It also may protect against the development of cancers by enhancing immune function. Unfortunately, human trials and surveys that tried to associate vitamin E with incidence of cancer have been generally inconclusive.
Some evidence associates higher intake of vitamin E with a decreased incidence of prostate cancer and breast cancer. There is evidence that vitamin E may reduce the size of cysts in women with fibrocystic breast disease, which is a risk factor for breast cancer. However, an examination of the effect of dietary factors, including vitamin E, on incidence of postmenopausal breast cancer in over 18,000 women from New York State did not associate a greater vitamin E intake with a reduced risk of developing breast cancer.
A study of women in Iowa provided evidence that an increased dietary intake of vitamin E may decrease the risk of colon cancer, especially in women under 65 years of age. On the other hand, vitamin E intake was not statistically associated with risk of colon cancer in almost 2,000 adults with cancer who were compared to controls without cancer. At this time there is limited evidence to recommend vitamin E supplements for the prevention of cancer.
VITAMIN E & CATARACTS
Cataracts are growths on the lens of the eye that cloud vision. They increase the risk of disability and blindness in aging adults. Antioxidants are being studied to determine whether they can help prevent or delay cataract growth. Observational studies have found that lens clarity, which is to diagnose cataracts, was better in regular users of vitamin E supplements and in persons with higher blood levels of vitamin E. A study of middle aged male smokers, however, did not demonstrate any effect from vitamin E supplements on the incidence of cataract formation. The effects of smoking, a major risk factor for developing cataracts, may have overridden any potential benefit from the vitamin E, but the conflicting results also indicate a need for further studies before researchers can confidently recommend extra vitamin E for the prevention of cataracts.
HEALTH RISK OF TOO MUCH VITAMIN E
The health risk of too much vitamin E is low. A recent review of the safety of vitamin E in the elderly indicated that taking vitamin E supplements for up to four months at doses of 530 mg or 800 IU (35 times the current RDA) had no significant effect on general health, body weight, levels of body proteins, lipid levels, liver or kidney function, thyroid hormones, amount or kinds of blood cells, and bleeding time. Even though this study provides evidence that taking a vitamin E supplement containing 530 mg or 800 IU for four months is safe, the long term safety of vitamin E supplementation has not been tested. The Institute of Medicine has set an upper tolerable intake level for vitamin E at 1,000 mg (1,500 IU) for any form of supplementary alpha-tocopherol per day because the nutrient can act as an anticoagulant and increase the risk of bleeding problems. Upper tolerable intake levels "represent the maximum intake of a nutrient that is likely to pose no risk of adverse health effects in almost all individuals in the general population".
COMMENTS
The body needs zinc in order to maintain the proper level of vitamin E in the blood.
If you take both vitamin E and iron supplements, take them at different times of the day. Inorganic forms of iron (such as ferrous sulfate) destroy vitamin E. Organic iron (ferrous gluconate or ferrous fumarate) leaves vitamin E intact.
CAUTIONS
If you are taking an anticoagulant medication (blood thinner), do not take more than 1,200 IU of vitamin E daily. If you suffer from diabetes, rheumatic heart disease, or an overactive thyroid, do not take more than the recommended dose. If you have high blood pressure, start with a small amount, such as 200 IU daily, and increase slowly to the desired amount.
VITAMIN E SUPPLEMENTS & PRODUCTS
Vitamin E 400, 100% Vegetarian, Nature's Way, 400 IU, 100 Liquid VCaps
Nature's Way Vitamin C is a 100% Vegetarian dietary supplement. Natural Vitamin E as d-alpha tocopherol is a powerful antioxidant that combats damaging free radicals. It also prevents oxidation of LDL cholesterol.
Vitamin E - 1000, D-Alpha-Tocopherols, NOW Foods, 100 Softgels
Vitamin E is a major antioxidant and the primary defense against lipid peroxidation. It is particularly important in protecting the body's cells from free radical/oxidative damage. These protective benefits are achievable with supplemental intakes higher than what is normally consumed in the average diet.
Vitamin E Succinate (Derived From Soy), Allergy Research Group / Nutricology, 100 Caps
Vitamin E Succinate takes vitamin E's antioxidant action one step further, and may help bring vitamin E into and across cell membranes. Succinate feeds directly into the Krebs cycle, our major metabolic pathway for generating energy.
Vitamin E (Hypoallergenic), Allergy Research Group / Nutricology, 120 Softgels
DL-alpha-Tocopheryl Acetate is a pure and stable form of Vitamin E, hypoallergenic and suitable for hypersensitive individuals. Soy-free, pure and synthetic.
Vitamin E, 100% Natural, NOW Foods, 400 IU, 100 Gelcaps
Vitamin E is a major antioxidant and the primary defense against lipid peroxidation. Selenium is an essential trace mineral that has been added as a synergist to complement Vitamin E.
Vitamin E Oil, 80% Mixed Tocopherols, Vegetarian, NOW Foods, 4 fl. oz.
NOW Foods Vitamin E Oil is often used topically on the skin as a skin softener and rejuvenator.
Vitamin E Oil, D-Alpha, Vegetarian, 100% Natural, NOW Foods, 32,000 IU, 1 oz.
This vitamin E oil may be used as a dietary supplement or applied to the skin for cosmetic or other purposes.
Vitamin E, Mixed Tocopherols, Unesterified, NOW Foods, 400 IU, 250 Softgels
Vitamin E is a major antioxidant and the primary defense against lipid peroxidation. Vitamin E is particularly important in protecting the body's cells from free radical/oxidative damage.
Vitamin E, D-Alpha Tocopheryl Acetate, 100% Natural, NOW Foods, 400 IU, 250 Softgels
Vitamin E is a major antioxidant and the primary defense against lipid peroxidation. It is particularly important in protecting the body's cells from free radical/oxidative damage.
Vitamin E Tocopherols, 100% Natural, 400 IU / 67 mg, 250 Softgels
Vitamin E Tocopherols contain all four tocopherol isomers from a natural source, providing synergistic antioxidant benefits against damaging free radicals.
Vitamin E Cream, NOW Foods, 28,000 IU, 4 oz.
NOW 100% Natural Vitamin E Cream delivers 28,000 IU to help nourish the skin and reduce the appearance of minor imperfections. NOW 28,000 IU potency is the highest natural concentration available in a cream.
Vitamin E Body & Bath Oil, Burt's Bees, 4 fl. oz.
An enriched, sheer Vitamin E body oil to moisturize and nourish your skin. The fresh, clean scent of lemon oil is invigorating and refreshing.
Vitamin E, Natural D-Alpha Tocopherol, Nature's Way, 400 IU, 100 Softgels
Vitamin E has potent antioxidant activity, supplies oxygen to the blood, aids in strengthening capillary walls, and plays a beneficial role in cancer and cardiovascular disease prevention, anti-aging benefits, circulation, wound-healing, immune function, nervous system function, PMS, hot flushes, diabetes, vascular disease, eye health, tissue repair, athletic performance, leg cramps, skin and hair health, and alleviating fatigue.
Heart Formula With Hawthorn CoQ10 & Vitamin E, Nature's Way, 60 Caps
Heart Formula with Hawthorn CoQ10 & Vitamin E represents the powerful synergy of current scientific research and traditional herbal medicine. Key ingredients include Hawthorn Extract, CoQ10, and Natural Vitamin E.
EPA 30 (Eiscosapentanoic Acid) High Potency Fish Oil With Vitamin E, Nature's Way, 1000 mg / 10 IU, 90 Softgels
Nature's Way EFAGold is the highest quality cold water Fish Oil - guaranteed to contain 30% EPA and 20% DHA.
Cayenne & Hawthorn Supplement With Vitamin E & Lecithin, Nature's Way, 480 mg, 100 Caps
Nature's Way has formulated its Cayenne and Hawthorn supplement with Vitamin E and Lecithin with the greatest concern for its purity, safety and effectiveness.
Pycnogenol With Vitamin E, Nature's Way, 100% Natural, 50 mg, 30 Tabs
Pycnogenol is an extract made from the bark of the European coastal pine. Pycnogenol is a concentrated source of proanthocyanidins, organic acids and other biologically active components.
Herbal Remedies: Vitamin E / Alpha Tocopherol Information
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