Vitamin E Update

The old adage “any press is good press” does not apply to supplements. It might be time to review the benefits of several vitamins and set the record straight.

Vitamin E was discovered at U.C. Berkeley in 1922. Vitamin E has a family of four compounds called tocopherols (alpha, beta, gamma and delta) and four ‘cousins’ called tocotrienols also called (alpha, beta, gamma and delta). Alpha a is the largest form of vitamin E. Alpha a vitamin E levels are 10 times greater than other forms actively maintained in the human body. Therefore it’s the form of vitamin E found in the largest quantities in the blood and tissue. For this reason it is typically the primary topic of discussions concerning vitamin E. This does not negate the actions of the other tocopherols and tocotrienols, for example gamma tocopherols are the most common type found in the American diet.

The primary function of vitamin E family is free radical management and antioxidant action. Free radicals are formed in the body by normal metabolism. Additionally free radicals are created by environmental exposures such as pollution. Fats found in cell membranes are susceptible to oxidative (free radical) damage. Vitamin E is suitable for intercepting oxidative reaction and preventing a cascade of cell damage. While neutralizing free radicals, vitamin E’s ability to be an antioxidant is lost, while vitamin C can rejuvenate its abilities. Vitamin E also protects the fats in low-density lipoproteins (LDL’s) from oxidative damage. Oxidized LDLs have been implicated in the development of cardiovascular diseases. Vitamin E has also been shown to inhibit the activity of the protein kinase C, an important cell-signaling molecule. Vitamin E can affect the activity of immune and inflammatory cells. Finally a tocopherols have been shown to inhibit platelet aggregation and to enhance vasodilatation. Deficiency of vitamin E is observed with malnutrition, genetic effects of the alpha-tocopherols transfer protein, and fat mal--absorption syndromes (cystic fibrosis)

Why the bad press on vitamin E in the last years? Starting in 2004 with the release of an epidemiological study that suggested vitamin E increased the rate of all case mortality including cancer and heart disease. The study was an epidemiological study, meaning it combined a multitude of studies to get a result. In 2011 another study indicated a 4% increase in disease (cancer, heart disease) in long term use. Some experts suggest vitamin E should be limited to 200 IU or less a day, if taken at all. In 2008, the Physicians’ Health Study II produced negative results as well (later to show no negative effects). Many experts still suggest consulting a physician if one is using blood thinners before taking vitamin E.

In a recent double blind study conducted by the American Journal of Clinical Nutrition concluded that individuals who took 400 IU. of vitamin E and 500mg. vitamin C daily resulted in no increased incidences of cancer. There were more than 14,000 participants. The study started in 1997 was completed in 2007 and followed up in 2011. Additionally a recent study by the Journal of American Medical Association found that individuals with mild to moderate Alzheimer’s disease who took high dosages of vitamin E (2000iu) showed a 19% reduction in functional decline. This was a double blind placebo controlled study, not an epidemiological study. The study compared the use of memantine (a FDA approved drug for Alzheimer’s), vitamin E and memantine, and finally just vitamin E by itself. The results concluded that only vitamin E showed positive results. Finally a Harvard study suggested that vitamin C and E are not a causative agent for cancers.

The Linus Pauling Institute of Medicine suggest in a new study on fish showing DHA molecules (OMEGA 3 FATTY ACID), essential for brain function, are not able to cross over to the brain if there is insufficient vitamin E. This results in increased neurological damage to the brain.

The author Jane Hidgen, former researcher at the Linus Pauling Institute of Medicine, suggests that toxicity levels of 2000 mg of vitamin E have not been adequately studied. In her book she suggests the Linus Pauling Institute of Medicine recommends 200 mg a day (about 400 IU) for prevention of disease. Drug interactions do exist and if you are taking medications it is advised to consult a physician.

Good or bad, what’s the verdict? We should remember that research on vitamin E has had mixed results in the last 70 years, some positive and some negative. Valued research seems to come from individual studies not epidemiological studies. Remember what is the result of research? More research. Additionally it is noted that over 90% of individuals in the United States do not get the RDA for vitamin E and levels continue to fall. Have cancer and heart diseases declined as well?

By Starkie Sowers CN


  2. SHOWS HIGH-DOSE VITAMIN E SUPPLEMENTS MAY INCREASE RISK OF DYINGJohns Hopkins Medicine Office of Corporate Communications MEDIA CONTACT: David March 410-955-1534/410-598-7056 cellular November 10, 2004
  5. Pioglitazone, Vitamin E, or Placebo for Nonalcoholic SteatohepatitisArun J. Sanyal, M.D., Naga Chalasani, M.B., B.S., Kris V. Kowdley, M.D., Arthur McCullough, M.D., Anna Mae Diehl, M.D., Nathan M. Bass, M.D., Ph.D., Brent A. Neuschwander-Tetri, M.D., Joel E. Lavine, M.D., Ph.D., James Tonascia, Ph.D., Aynur Unalp, M.D., Ph.D., Mark Van Natta, M.H.S., Jeanne Clark, M.D., M.P.H., Elizabeth M. Brunt, M.D., David E. Kleiner, M.D., Ph.D., Jay H. Hoofnagle, M.D., and Patricia R. Robuck, Ph.D., M.P.H. for the NASH CRNN Engl J Med 2010; 362:1675-1685May 6, 2010DOI: 10.1056/NEJMoa0907929
  6. ‘Reassuring’: Harvard’s large-scale randomized trial in men supports safety of vitamin C and E supplementsBy Stephen Daniells+, 21-Jul-2014
  8. © 2014 American Society for NutritionVitamin E and C supplementation and risk of cancer in men: posttrial follow-up in the Physicians’ Health Study II randomized trial1,2,3,4Lu Wang, Howard D Sesso, Robert JGlynn, William G Christen, Vadim Bubes,JoAnn E Manson, Julie E Buring, and J Michael Gaziano
  13. Original Investigation | January 1, 2014 Effect of Vitamin E and Memantine on Functional Decline in Alzheimer DiseaseThe TEAM-AD VA Cooperative Randomized Trial FREE. Maurice W. Dysken, MD1; Mary Sano, PhD2; Sanjay Asthana, MD3; Julia E. Vertrees, PharmD, BCPP4; Muralidhar Pallaki, MD5,6; Maria Llorente, MD7; Susan Love, MA1; Gerard D. Schellenberg, PhD8; J. Riley McCarten, MD1; Julie Malphurs, PhD9; Susana Prieto, MD9; Peijun Chen, MD, MPH, PhD5,6; David J. Loreck, MD10,11; George Trapp, MD, JD12; Rajbir S. Bakshi, MD12; Jacobo E. Mintzer, MD13,14,15; Judith L. Heidebrink, MD16; Ana Vidal-Cardona, MD17; Lillian M. Arroyo, MD17; Angel R. Cruz, MD18; Sally Zachariah, MD18; Neil W. Kowall, MD19; Mohit P. Chopra, MD19; Suzanne Craft, PhD20,21; Stephen Thielke, MD20,21; Carolyn L. Turvey, PhD22,23; Catherine Woodman, MD22,23; Kimberly A. Monnell, MD24; Kimberly Gordon, MSN, RN, FNP-BC24; Julie Tomaska, PhD1; Yoav Segal, MD, PhD1; Peter N. Peduzzi, PhD25,26; Peter D. Guarino, MPH, PhD25,26 [+] Author Affiliations
  14. JAMA. 2014;311(1):33-44. doi:10.1001/jama.2013.282834 .
  15. outlined by which inadequate vitamin E can cause brain damage04/13/2015
  17. Hidgons PhD, An Evidence-Based Approach to Vitamin & Minerals , Theime New York, NY. 20003, pg 82-89