Vitamin E

Vitamin E (Tocopherol) and health

• Heart disease prevention – in the past few years, studies have shown that people who take vitamin E supplements have less heart disease. One study looked at 40,000 men who already had heart disease and found that vitamin E kept their heart disease from getting worse. The men who took vitamin E supplements cut their chances of having a non-fatal heart attack by 77%! Another study looked at over 87,000 female nurses and found that those who took vitamin E cut their overall risk of heart disease by about 66%. Finally, a long-term study of over 34,000 post-menopausal women showed that those who ate the most foods high in vitamin E, but did not take any Vitamin E supplements, had 60% less heart disease
• General heart health – two recent studies show that Vitamin E helps advanced heart disease. The studies looked at patients who needed heart surgery for blocked arteries. When these people took daily vitamin E supplements after their surgery, their arteries were a lot less likely to clog up again
• Atherosclerosis – vitamin E helps prevent atherosclerosis (hardening of the arteries) caused by atheromas or plaque on the walls of the arteries that lead to the heart. Vitamin E does this through its antioxidant action to keep cholesterol in the blood from oxidising into those artery clogging deposits in the first place – and helps keep the deposits already present from getting worse
• Cholesterol lowering effects – vitamin E keeps LDL (bad) cholesterol from being oxidised. Less oxidised cholesterol means less plaque, which means less heart disease
• Cancer prevention – the evidence that vitamin E helps prevent cancer isn’t as dramatic as for heart disease, but it is still pretty strong. Researchers have known for many years that people with cancer have low vitamin E levels. It is now known that people with low vitamin E levels are more likely to get cancer – in other words, low vitamin E could be a cause not an effect. There are several studies, which show that taking vitamin E supplements cuts risk of certain cancers
• Immune system assistance – the immune system naturally slows down as people age. There’s recently been some excellent news from a study which showed that taking vitamin E can give the immune system a real boost. Healthy volunteers, all over 65 years old, took vitamin E supplements for 33 weeks. Tests at the end showed their immune systems were much more active
• Alzheimer’s disease – studies show that vitamin E in large doses (2,000IU) seems to slow down but not stop or prevent Alzheimer’s disease. In fact, the vitamin E supplements work just as well as the more expensive prescription drugs. This is a promising area of research.
• Male infertility – some men seem to be infertile because of free radical damage. Cell membranes of sperm are very fatty, so they’re especially vulnerable to attack by free radicals. Taking vitamin E supplements can help mop up enough free radicals to prevent damage. In one study, five out of 15 infertile men became fathers after just one month of Vitamin E supplementation
• Benign breast disease – this disease simply makes breasts “lumpy”. The breasts may also swell and become tender prior to menstruation. Although annoying and uncomfortable, benign breast disease is usually not dangerous or a sign of cancer. Taking vitamin E each day seems to relieve the symptoms for a lot of women

Talk to a medical professional about vitamin E supplements before taking them.

Future directions

• Diabetes – vitamin E supplements are being researched to determine if they can help diabetics better control their blood sugar
• Eye health – the delicate eye vessels in the eyes are easily damaged by free radicals. Vitamin E helps prevent damage by mopping up the free radicals before they do any harm. Likewise, vitamin E helps protect the lens of the eye from free radical damage. People with low levels of vitamin E are more likely to develop cataracts (clouding of the lens) as they get older. Studies show that people who take vitamin E each day could cut their risk of cataracts in half
• Intermittent claudation and leg cramps – this is an annoying circulation problem caused by hardening of the arteries in the legs. It makes calf muscles ache and cramp up when you walk even a short distance. Vitamin E seems to help some people. Vitamin E also helps night-time leg cramps. Supplementation should be taken with the evening meal
• Parkinson’s disease – a long term study is looking at whether vitamin E, along with the drug Selegiline (Deprenyl), slows down the progression of this devastating brain disease. The evidence is not in yet, so people who have Parkinson’s disease should talk to a medical professional about their options for supplementation

Talk to a medical professional about vitamin E supplements before taking them.

Groups at risk of vitamin E (tocopherol) deficiency

There are a few conditions (medical and other) that can create a deficiency in vitamin E:

• People with cystic fibrosis – cannot digest fats well, so not enough vitamin E is absorbed
• People with gastrointestinal disorders – people who have digestive disorders such as Crohn’s disease and ulcerative colitis cannot absorb vitamin E very well through their intestines
• People with liver disease – these people cannot use vitamin E properly because their liver is not functioning properly
• People on a very low fat, low calorie diet – may not be getting enough vitamin E from the food eaten because some fat in the diet is required to absorb Vitamin E
• People on cholesterol-lowering drugs – while these drugs help to lower blood levels of cholesterol, they also block absorption of vitamin E and the other fat-soluble vitamins

Talk to a medical professional about Vitamin E supplements before taking them.

Symptoms of vitamin E (tocopherol) deficiency

The damage is from vitamin E deficiency is rare, hard to spot and takes a long time to show up. Vitamin E deficiency doesn’t have any dramatic effects, although if the recommended daily intake is not ingested for a long time (ie for several months or even years), eventually nerve damage will occur, especially to the nerves in the spinal cord and to the retina of the eye.

General vitamin E deficiencies at minor levels

• Burning in the mouth and throat
• Cramps
• Diarrhoea
• Insomnia
• Nervousness

Severe deficiency of vitamin E

• Skeletal abnormalities
• Softening of the bones and teeth

Vitamin E (tocopherol) in food

Vitamin E (Tocopherol) recommended daily intake (RDI)

The tolerable upper limits should only be taken for short periods and only under medical supervision.

* The tolerable upper limit for vitamin E for infants aged 0-12 months has not yet been determined due to a lack of data about the adverse effects in this age group. The only source of vitamin E intake should be from food (breast milk and/or baby formula).

Overdosage, toxicity and cautions for vitamin E (tocopherol)

Toxicity of Vitamin E is not easily reached. Very large doses of vitamin E (thousands of IU) can block usage of vitamin A. High intakes may induce diarrhea, nausea or abdominal wind.

Precautions

• People on blood-thinning drugs (anti-coagulants) or daily aspirin should consult their doctor before using Vitamin E
• Due to the risk of abnormal bleeding, Vitamin E should not be taken at least one week before and after surgery

References

• Diaz MN, Frei B, Vita JA, Keaney JF. Antioxidants and atherosclerotic heart disease. N Engl J Med. 1997;337(16):408-416
• Esterbauer H, Dieber-Rotheneder M, Striegl G, Waeg G. Role of vitamin E in preventing the oxidation of low-density lipoprotein. American Journal of Clinical Nutrition 1991, Vol 53, 314S-321S
• Meagher EA, et al. Effects of Vitamin E on Lipid Peroxidation in Healthy Persons.
• Rimm EB, etl. Vitamin E Consumption and the Risk of Coronary Heart Disease in Men. NEJM, 1993. Volume 328 (20):1450-1456
• Office of Dietary Supplements USA – has the official USA RDI for all vitamins (these are also adopted by Australia), accessed 9 August 2005
• Osiecki, Henry, The Nutrient Bible 2002, BioConcepts Publishing
• Brigelius-Flohé R, Kelly FJ, Salonen JT, Neuzil J, Zingg J-M, Azzi A. The European perspective on vitamin E: current knowledge and future research. American Journal of Clinical Nutrition, Vol. 76, No. 4, 703-716, October 2002
• Yusuf S, Dagenais G, Pogue J, Sleight P. Vitamin E supplementation and cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000 Jan 20;342(3):154-60
• Zhang D, et al. Vitamin E Inhibits Apoptosis, DNA Modification, and Cancer Incidence Induced by Iron-mediated Peroxidation in Wistar Rat Kidney. Cancer Research 57, 2410-2414, June 15, 1997

Last reviewed and updated: 9 May 2024