Health Benefits of Vitamin E, Side Effects, Dosage

Health Benefits of Vitamin E/Vitamin E is the major lipid-soluble antioxidant in the cell antioxidant system and is exclusively obtained from the diet. Vitamin E protects polyunsaturated fatty acids and other components of cell membranes and low-density lipoproteins from oxidation by free radicals. It is located primarily within the phospholipid bilayer of cell membranes. The most important form is α-tocopherol. Clinical signs of deficiency occur very rarely [rx].

Vitamin E is a group of eight compounds that include four tocopherols and four tocotrienols. All eight feature a chromane double ring, with a hydroxyl group that can donate a hydrogen atom to reduce free radicals, and a hydrophobic side chain which allows for penetration into biological membranes. Both the tocopherols and tocotrienols occur in α (alpha), β (beta), γ (gamma) and δ (delta) forms, as determined by the number and position of methyl groups on the chromanol ring. Of the many different forms of vitamin E, gamma-tocopherol (γ-tocopherol) is the most common form found in the North American diet. γ-Tocopherol is the major tocopherol in corn oil and soybean oil. Alpha-tocopherol (α-tocopherol), the most biologically active form of vitamin E, is the second-most common form of vitamin E in the diet. This variant can be found most abundantly in wheat germ oil, sunflower oil, and safflower oil. As fat-soluble antioxidants, tocopherols interrupt the propagation of reactive oxygen species that spread through biological membranes or through fat when its lipid content undergoes oxidation by reacting with lipid radicals.

Naturally occurring vitamin E exists in eight chemical forms (alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol) that have varying levels of biological activity. Alpha- (or α-) tocopherol is the only form that is recognized to meet human requirements.

Types of  Vitamin E

Vitamin E and other mixed tocopherols are isolated from vegetable oil distillate (VOD) and concentrated to contain d-alpha, d-beta, d-gamma, and d-delta tocopherols. Tocopherols are also found in vegetable oils as well as grains, seeds, and nuts. They naturally protect fats and oils from oxidation.

• Natural Vitamin E – Is what most people refer to as vitamin E; is the non-esterified form called d-alpha-tocopherol, alcohol that occurs in nature as a single stereoisomer. These come from vegetable oils (primarily soy) and sunflower oil.
• Semi-Synthetic, Esters Vitamin E – Manufacturers commonly convert the phenol form of the vitamin (with a free hydroxyl group) to esters, using acetic or succinic acid. An ester is a salt formed by a carboxylic acid and an alcohol (tocopherol is the alcohol). These tocopheryl esters (e.g., alpha-tocopheryl acetate, tocopheryl succinate, tocopheryl nicotinate, tocopheryl linoleate, alpha-tocopheryl phosphates, etc.) are more stable (esters are less susceptible to oxidation) during storage because they are not acting as an antioxidant in their esterified form.
• Synthetic Vitamin E – The synthetic form of vitamin E, dl-alpha-tocopherol is made by coupling trimethylhydroquinone (a reduced benzoquinone) with isophytol (acyclic terpenoid). Synthetic vitamin E is a racemic mixture containing all the eight isomers of alpha-tocopherol (all racemic) in approximately equal amounts, so it has approximately half of the biological activity of natural vitamin E.
• Fractionated Forms – The most-common fractionated forms are: natural mixed tocopherols and high d-gamma-tocopherol.

Tocopherols

• Alpha-tocopherol – Current literature suggests the primary role in the body of vitamin E is to function as a major lipid antioxidant for free radicals formed from normal cellular metabolism.1 Free radicals are destructive to the cell membrane and other body components. Vitamin E acts as an antioxidant (a molecule capable of inhibiting the oxidation of other molecules), which then makes the free radical unreactive, thus undamaging. The phenolic vitamin E compound donates a hydrogen (from the hydroxyl (-OH) group on the ring structure) and itself becomes a relatively unreactive free radical as well.
• Gamma-Tocopherol – Gamma-tocopherol is actually the major form of vitamin E ingested in the U.S. diet. It is not as well-known as alpha-tocopherol. The function of gamma-tocopherol is not entirely clear, but both forms (alpha and gamma) are potent antioxidants. It was previously assumed that gamma-tocopherol is not important, because the body had much lower concentrations as alpha-tocopherol. The serum blood levels of gamma-tocopherol are generally 10-times lower than those of alpha-tocopherol.
• Tocotrienols – There have been more studies on tocotrienols indicating they may have significant antioxidant and anti-cancer effects. Tocotrienols (in particular, gamma-tocotrienol) appear to act on a specific enzyme called 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA) involved in cholesterol production in the liver

Causes  of Vitamin E

In developed countries, it is unlikely that vitamin E deficiency occurs due to diet intake insufficiency and the more common causes are below.

• Premature, very low birth weight infants – birth weights less than 1500 grams (3.3 pounds).^[rx]
• Rare disorders of fat metabolism – There is a rare genetic condition termed isolated vitamin E deficiency or ‘ataxia with isolated with vitamin E deficiency’, caused by mutations in the gene for the tocopherol transfer protein.^[rx] These individuals have an extremely poor capacity to absorb vitamin E and develop neurological complications that are reversed by high doses of vitamin E.
• Fat malabsorption – 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 or who have had a gastric bypass, and individuals with malabsorptive problems such as Crohn’s disease, liver disease or exocrine pancreatic insufficiency may not absorb fat (people who cannot absorb fat often pass greasy stools or have chronic diarrhea and bloating). Abetalipoproteinemia is a rare inherited disorder of fat metabolism that results in poor absorption of dietary fat and vitamin E.^[rx]The vitamin E deficiency associated with this disease causes problems such as the poor transmission of nerve impulses and muscle weakness.
• Premature low birth weight infants with a weight less than 1500 grams (3.3 pounds)
• Mutations in the tocopherol transfer protein causing impaired fat metabolism
• Disrupted fat malabsorption as the small intestine requires fat to absorb vitamin E
• Patients with cystic fibrosis patients fail to secrete pancreatic enzymes to absorb vitamins A, D, E, and K
• Short-bowel syndrome patients may take years to develop symptoms. Surgical resection, mesenteric vascular thrombosis, and pseudo-obstruction are a few examples of this issue
• The chronic cholestatic hepatobiliary disease leads to a decrease in bile flow and micelle formation that is needed for vitamin E absorption
• Crohn’s disease, exocrine pancreatic insufficiency, and liver disease may all not absorb fat
• Abetalipoproteinemia an autosomal-recessive disease causes an error in lipoprotein production and transportation
• Isolated vitamin E deficiency syndrome an autosomal recessive disorder of chromosome arm 8q

In developing countries, the most common cause is the inadequate intake of vitamin E.

Symptoms of Vitamin E

Signs of vitamin E deficiency include the following

• Neuromuscular problems – such as spinocerebellar ataxia and myopathies.
• Neurological problems – may include dysarthria, absence of deep tendon reflexes, loss of the ability to sense vibration and detect where body parts are in three-dimensional space, and positive Babinski sign.
• Muscle weakness – Vitamin E is essential to the central nervous system. It is among the body’s main antioxidants, and a deficiency results in oxidative stress, which can lead to muscle weakness.
• Coordination and walking difficulties – A deficiency can cause certain neurons, called the Purkinje neurons, to break down, harming their ability to transmit signals.
• Hemolytic anemia – due to oxidative damage to red blood cells^[rx]
• Retinopathy^[rx][rx]
• Impairment of the immune response^[rx][rx][rx]
• Numbness and tingling –  Damage to nerve fibers can prevent the nerves from transmitting signals correctly, resulting in these sensations, which are also called peripheral neuropathy.
• Vision deterioration – A vitamin E deficiency can weaken light receptors in the retina and other cells in the eye. This can lead to loss of vision over time.
• Immune system problems – Some research suggests that a lack of vitamin E can inhibit the immune cells. Older adults may be particularly at risk.
• Hemolytic anemia – due to oxidative damage to red blood cells
• Retinopathy
• Impairment of the immune response

Recommended Intakes of Vitamin E

Intake recommendations for vitamin E and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of The National Academies (formerly National Academy of Sciences). DRI is the general term for a set of reference values used to plan and assess the nutrient intakes of healthy people. These values, which vary by age and gender, include:

• Recommended Dietary Allowance (RDA) – Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.
• Adequate Intake (AI) – Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
• Estimated Average Requirement (EAR) – Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals.
• Tolerable Upper Intake Level (UL) – Maximum daily intake unlikely to cause adverse health effects.

The FNB’s vitamin E recommendations are for alpha-tocopherol alone, the only form maintained in the plasma. The FNB based these recommendations primarily on serum levels of the nutrient that provide adequate protection in a test measuring the survival of erythrocytes when exposed to hydrogen peroxide, a free radical. Acknowledging “great uncertainties” in these data, the FNB has called for research to identify other biomarkers for assessing vitamin E requirements.

Conversion rules are as follows

Though normally presented in our diets, adults need 15mg of vitamin E per day. A supplement of 15 to 25 mg/kg once per day or mixed tocopherols 200 IU can both be used. If a patient has issues with the small intestine and/or oral ingestion intramuscular injection is necessary.[rx][rx][rx]The recommended daily allowance of alpha-tocopherol is as follows.

• Age 0 to 6 months: 3 mg
• Age 6 to 12 months: 4 mg
• Age 1 to 3 years: 6 mg
• Age 4 to 10 years: 7 mg
• Adults and elderly patients: 10 mg

To convert from mg to IU

• 1 mg of alpha-tocopherol is equivalent to 1.49 IU of the natural form or 2.22 IU of the synthetic form.

To convert from IU to mg

• 1 IU of the natural form is equivalent to 0.67 mg of alpha-tocopherol.
• 1 IU of the synthetic form is equivalent to 0.45 mg of alpha-tocopherol.

However, under FDA’s new labeling regulations for foods and dietary supplements that take effect by January 1, 2020 (for companies with annual sales of $10 million or more) or January 1, 2021 (for smaller companies), vitamin E will be listed only in mg and not IUs.

RDAs for alpha-tocopherol in both mg and IU of the natural form; for example, 15 mg x 1.49 IU/mg = 22.4 IU. The corresponding value for synthetic alpha-tocopherol would be 33.3 IU (15 mg x 2.22 IU/mg).

Uses / Health Benefit of Vitamin E

• Epidermolysis bullosa – Several case reports suggest the efficacy of vitamin E (300–600 IU/day) for the management of epidermolysis bullosa.[rx,rx] Vitamin E acts as an antioxidant, thus protecting the cell membranes and intracellular organelles from lipid peroxidation.[rx] It is possible that in case of epidermolysis bullosa, there is a genetic defect that affects the storage of Vitamin E in the tissues or in the ability of tissues to use it, which necessitates an additional supply.[rx]
• Acne vulgaris – In one of the studies conducted in a series of 98 patients, the emphasis was based on the correction of the defective keratinization of sebaceous follicles with a combination of vitamin E and vitamin C.[rx] This was seen to prevent the formation of comedones, thus depriving the Propionibacterium acnes of a culture medium. Vitamin E prevents lipid peroxidation of serum from bacterial-induced leakage through follicles and sebaceous glands, thus preventing inflammation due to peroxide irritation.
• Psoriasis  – A natural product, called “Mirak,” for the treatment of psoriasis has recently become available in many European countries. Mirak consists of natural spring water, volcanic earth, and vitamin E cream. It induces a modest therapeutic effect compared with placebo, without any significant side effects, but may not be able to compete with the already existing treatment options for psoriasis.[rx]
• Cutaneous ulcers – Vitamin E has been seen to be useful in the treatment of pressure sores in doses of 800 IU/L gradually increasing to 1600 IU/L in four patients.[rx]
• Skin cancer prevention – Mouse studies reported inhibition of UV-induced tumors in mice fed with α-tocopherol acetate.[rx] Multiple human studies have shown no effects of vitamin E on the prevention or development of skin cancers.[rx,rx]
• Wound healing – Vitamin E along with zinc and vitamin C, is included in oral therapies for pressure ulcers and burns.[rx] The antioxidant supplementation through vitamins E and C and the mineral zinc has been seen to apparently enhance the antioxidant protection against oxidative stress and allow less time for wound healing.[rx]
• Melasma – Vitamin E alone has shown minimal efficacy in the treatment of melasma.[rx] It has been shown to cause depigmentation by interference with lipid peroxidation of melanocyte membranes, increase in intracellular glutathione content, and inhibition of tyrosinase.[rx] Other dermatological indications for which there is little utility for the use of Vitamin E.
• Atopic dermatitis – A single-blind, placebo-controlled study was performed by Tsoureli-Nikita et al. in which 96 atopic dermatitis patients were treated with either placebo or oral vitamin E (400 IE/day) for 8 months. They found an improvement and near remission of atopic dermatitis and a 62% decrease in serum IgE levels in the vitamin E-treated group. Vitamin E decreases serum levels of IgE in atopic subjects.[rx] The correlation between vitamin E intake, IgE levels, and the clinical manifestations of atopy indicate that vitamin E could be a therapeutic tool for atopic dermatitis.
• Epidermolysis bullosa – Several case reports suggest the efficacy of vitamin E (300–600 IU/day) for the management of epidermolysis bullosa.[rx,rx] Vitamin E acts as an antioxidant, thus protecting the cell membranes and intracellular organelles from lipid peroxidation.[rx] It is possible that in case of epidermolysis bullosa, there is a genetic defect that effects the storage of Vitamin E in the tissues or in the ability of tissues to use it, which necessitates an additional supply.[rx]
• Psoriasis – A natural product, called “Mirak,” for the treatment of psoriasis has recently become available in many European countries. Mirak consists of natural spring water, valconic earth, and vitamin E cream. It induces a modest therapeutic effect compared with placebo, without any significant side effects, but may not be able to compete with the already existing treatment options for psoriasis.[rx]
• Cutaneous ulcers – Vitamin E has been seen to be useful in the treatment of pressure sores in doses of 800 IU/L gradually increasing to 1600 IU/L in four patients.[rx]
• Skin cancer prevention – Mouse studies reported inhibition of UV-induced tumors in mice fed with α-tocopherol acetate.[rx]Multiple human studies have shown no effects of vitamin E on the prevention or development of skin cancers.[rx,rx
• Wound healing – Vitamin E along with zinc and vitamin C, is included in oral therapies for pressure ulcers and burns.[rx] The antioxidant supplementation through vitamins E and C and the mineral zinc has been seen to apparently enhance the antioxidant protection against oxidative stress and allow less time for wound healing.[rx]
• 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.
• Vitamin E deficiency – Taking vitamin E by mouth is effective for preventing and treating vitamin E deficiency.
• Alzheimer’s disease – Vitamin E might slow down the worsening of memory loss in people with moderately severe Alzheimer’s disease. Vitamin E might also delay the loss of independence and the need for caregiver assistance in people with mild-to-moderate Alzheimer’s disease.
• Anemia –  Some research shows that taking vitamin E improves the response to the drug erythropoietin, which affects red blood cell production, in adults and children on hemodialysis.
• Blood disorder (beta-thalassemia) – Taking vitamin E by mouth seems to benefit children with blood disorder called beta-thalassemia and vitamin E deficiency.
• Bladder cancer – Taking 200 IU of vitamin E by mouth for more than 10 years seems to help prevent death from bladder cancer.
• 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.
• Chemotherapy-related nerve damage – Taking vitamin E (alpha-tocopherol) before and after treatment with cisplatin chemotherapy might reduce the risk of nerve damage.
• Dementia – Research suggests that men who consume vitamin E and vitamin C have a decreased risk of developing several forms of dementia. However, it does not appear to reduce the risk of Alzheimer’s dementia.
• Painful menstruation (dysmenorrhea) – Taking vitamin E for 2 days before and for 3 days after bleeding begins seems to decrease pain severity and duration, and reduce menstrual blood loss.
• Movement and coordination disorder called dyspraxia – Taking vitamin E by mouth together with evening primrose oil, thyme oil, and fish oils seems to improve movement disorders in children with dyspraxia.
• Kidney problems in children (glomerulosclerosis) – There is some evidence that taking vitamin E by mouth might improve kidney function in children with glomerulosclerosis.
• An inherited disorder called G6PD deficiency  –  Some research shows that taking vitamin E by mouth, alone or together with selenium, might benefit people with an inherited disorder called G6PD deficiency.
• Healing a type of skin sore called granuloma annulare – Applying vitamin E to the skin seems to clear up skin sores called granuloma annulare.
• Huntington’s disease – Natural vitamin E (RRR-alpha-tocopherol) can improve symptoms in people with early Huntington’s disease. However, it does not seem to help people with more advanced disease.
• Male infertility – Taking vitamin E by mouth improves pregnancy rates for men with fertility problems. Taking high doses of vitamin E together with vitamin C does not seem to provide the same benefits.
• Bleeding within the skull – Taking vitamin E by mouth seems to be effective for treating bleeding in the skull in premature infants.
• Bleeding within the ventricular system of the brain – Taking vitamin E by mouth seems to be effective for treating bleeding within the ventricular system of the brain in premature infants.
• Nitrate tolerance – There is some evidence that taking vitamin E daily can help prevent nitrate tolerance.
• The liver disease called nonalcoholic steatohepatitis –  Taking vitamin E daily seems to improve symptoms of NASH in adults and children.
• Parkinson’s disease – Early evidence suggests that vitamin E intake in the diet might be linked with a decreased risk of Parkinson’s disease. However, taking all-rac-alpha-tocopherol (synthetic vitamin E) does not seem to have any benefit for people with Parkinson’s disease.
• Laser eye surgery (photoreactive keratectomy) – Taking high doses of vitamin A along with vitamin E (alpha-tocopheryl nicotinate) daily seems to improve healing and vision in people undergoing laser eye surgery.
• Premenstrual syndrome (PMS) – Taking vitamin E by mouth seems to reduce anxiety, craving, and depression in some women with PMS.
• Physical performance – Research suggests that increasing vitamin E intake in the diet is linked with improved physical performance and muscle strength in older people.
• Fibrosis caused by radiation – Taking vitamin E by mouth with the drug pentoxifylline seems to treat fibrosis caused by radiation. However, taking vitamin E alone does not seem to be effective.
• An eye disease in newborns called retinopathy of prematurity –  Taking vitamin E by mouth seems to be effective for treating an eye disease cause retinopathy of prematurity in newborns.
• Rheumatoid arthritis (RA) – Vitamin E taken along with standard treatment is better than standard treatment alone for reducing pain in people with RA. However, this combination does not reduce swelling.
• Sunburn – Taking high doses of vitamin E (RRR-alpha-tocopherol) by mouth together with vitamin C protects against skin inflammation after exposure to UV radiation. However, 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.
• Movement disorder (tardive dyskinesia) – Taking vitamin E by mouth seems to 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.
• Swelling in the middle layer of the eye (uveitis) – Taking vitamin E with vitamin C by mouth seems to improve vision, but does not reduce swelling, in people with uveitis.

Possibly Ineffective for

• The majority of research suggests that taking vitamin E, alone or along with other antioxidants, is not effective for preventing or treating age-related vision loss.
• Research suggests that taking vitamin E (alpha-tocopherol) along with conventional medication does not affect the function or increase survival rates compared to conventional medication alone in people with Lou Gehrig’s disease.
• Taking vitamin E by mouth might have some effect on the functioning of blood vessels, but does not appear to reduce chest pain.
• Taking vitamin E (RRR-alpha-tocopherol) by mouth does not appear to prevent the progression of atherosclerosis. However, there is some early evidence that taking vitamin E and vitamin C might help prevent the progression of atherosclerosis in men.
• Research suggests that taking vitamin E, alone or along with selenium, does not improve symptoms of eczema.
• Taking vitamin E by mouth does not seem to reduce hot flashes in women who have had breast cancer.
• Research shows that taking vitamin E by mouth does not benefit newborn infants with a lung condition called bronchopulmonary dysplasia.
• Taking a combination of vitamin E, vitamin C, beta carotene, selenium, and zinc does not seem to lower overall cancer risk. However, it might reduce the risk of cancer in men, although evidence is conflicting.
• Most evidence suggests that taking vitamin E does not prevent the occurrence of colorectal cancer or the development of non-cancerous colorectal tumors, which are considered precursors to colon cancer.
• Taking vitamin E by mouth for 12 weeks does not seem to improve heart function in people with heart failure.
• Research shows that taking vitamin E with the drug penicillamine does not slow the progression of the muscle disease called Duchene muscular dystrophy.
• Taking vitamin E (all-rac-alpha-tocopherol) daily during radiation therapy and for 3 years after the end of therapy does not seem to reduce the risk of head and neck cancer recurrence. There is some concern that taking vitamin E might actually increase the risk of tumor recurrence. People with head and neck cancer should avoid daily vitamin E supplements in doses over 400 IU daily.
• Giving vitamin E to premature infants does not have a beneficial effect on the abnormal breakdown of red blood cells.
• Taking vitamin E by mouth does not seem to lower blood pressure in people already taking blood pressure medications.
• Taking vitamin E does not reduce the risk of death in people with liver disease.
• Taking vitamin E and selenium by mouth does not slow the progression of an inherited muscle disorder called myotonic dystrophy.
• Most research shows that taking vitamin E (all-rac-alpha-tocopherol) for up to 7 years does not reduce the risk of mouth sores in men who smoke.
•  Taking vitamin E does not seem to decrease pain or stiffness in people with osteoarthritis. Vitamin E also does not seem to prevent the condition from becoming worse.
• Taking vitamin E, alone or together with other antioxidants such as beta-carotene and vitamin C, does not seem to reduce the risk of developing pancreatic cancer.
• Research shows that people with diabetes who take vitamin E (RRR-alpha-tocopherol) by mouth do not have a reduced risk of developing mouth or pharyngeal cancer.
• Most evidence suggests that taking a combination of vitamins E and C does not reduce the risk of high blood pressure during pregnancy. However, some research suggests that taking a combination of vitamins E and C daily reduces the risk of high blood pressure in high-risk women when started in weeks 16 to 22 of pregnancy.
• Research on the effects of vitamin E on prostate cancer risk has been inconsistent. Overall, research suggests that taking vitamin E supplements does not reduce the risk of developing prostate cancer, and might actually increase the risk.
• Taking vitamin E by mouth, alone or as a multivitamin, does not appear to decrease the risk of respiratory tract infections or the severity of symptoms once an infection develops.
• Taking vitamin E (all-rac-alpha-tocopherol) by mouth does not appear to slow vision loss, and might actually increase vision loss, in people with a condition called retinitis pigmentosa.
• Some research shows that applying vitamin E to the skin does not reduce scarring after surgery.
• Taking vitamin E supplements does not seem to be effective for treating benign breast disease.
• Although having higher blood levels of vitamin E might be linked with a reduced risk of breast cancer, increasing vitamin E intake from the diet or supplements does not reduce the risk of developing breast cancer.
• Most research suggests that taking vitamin E supplements does not prevent heart disease. However, some evidence suggests that increasing vitamin E intake in the diet might be beneficial.
• Taking all-rac-alpha-tocopherol (synthetic vitamin E) for up to 8 years does not reduce the risk of developing lung cancer in men who smoke. Also, taking vitamin E (alpha-tocopherol) for up to 10 years does not prevent lung cancer or reduce the risk of death from lung cancer.
• Research suggests that taking vitamin E daily or every other day for up to 10 years does not reduce the risk of death from any cause. Furthermore, some research suggests that regularly taking high doses of vitamin E might increase the risk of death.

Insufficient Evidence for

• There is inconsistent evidence about the role of vitamin E in asthma. Some research suggests that consuming more vitamin E in the diet seems to prevent asthma. However, taking vitamin E supplements do not have the same benefit.
• Some evidence suggests that taking vitamin E, alone or together with other vitamins or antioxidants, does not prevent the development or progression of cataracts. However, other evidence suggests that vitamin E might help reduce the risk of developing cataracts.
• Research suggests that higher intake of vitamin E in the diet might reduce the risk of infection in children undergoing chemotherapy.
• Vitamin E might be beneficial for people with diabetes. Some research suggests that vitamin E improves blood sugar control. Other research suggests that higher vitamin E intake in the diet is linked to a reduced risk of diabetes.
• Taking vitamin E plus beta-carotene or vitamin C and beta-carotene does not seem to prevent stomach cancer. However, there is limited evidence that consuming more vitamin E from the diet might slow the progression of stomach cancer.
• Some early research suggests that taking vitamin E with vitamin C might benefit children with high cholesterol.
• Early research suggests that taking vitamin E can improve kidney function in children with a kidney disease called IgA nephropathy.
• Taking all-rac-alpha-tocopherol (synthetic vitamin E) alone or together with beta-carotene by mouth does not appear to improve poor blood flow in the legs. However, other research suggests that taking vitamin E daily for 18 months reduces symptoms of intermittent claudication.
• Taking vitamin E by mouth with vitamin C and conventional medication two days before bypass surgery and one day after surgery appears to reduce complications. However, vitamin E does not appear to be beneficial when taken alone.
• There is some evidence that all-rac-alpha-tocopherol (synthetic vitamin E) might help prevent stroke in male smokers who have high blood pressure and diabetes. However, other research suggests that it might not reduce the risk of stroke.
• Taking vitamin E (tocopheryl succinate polyethylene glycol) might reduce the dose of immunosuppressant needed after a liver transplant.
• Some evidence suggests that taking vitamin E (RR-alpha-tocopherol) daily does not reduce the risk of developing skin cancer.
• Early evidence suggests that vitamin E might reduce nighttime leg cramps. However, other evidence suggests otherwise.
• Early evidence suggests that taking vitamin E with aged garlic extract and vitamin C might be useful for sickle cell anemia.
• Chronic cutaneous lupus erythematosus[rx]
• Keratosis follicularis[rx]
• Postherpetic neuralgia[rx]
• Pseudoxanthoma elasticum[rx]
• Porphyria cutanea tarda.[rx]
• Allergies.
• Chronic fatigue syndrome (CFS).
• Epilepsy.
• Common cold.

The Recommended Dose of Vitamin E

In the case of vitamin E, the recommended intake (6–10 mg of α-tocopherol or the equivalent) is based solely on an estimate of how much tocopherol the average person consumes.[rx] In a healthy adult who had been on a normal diet, it would take an estimated 4 years to fully deplete body stores of vitamin E.[rx]

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