Matthew Messer

Matthew Messer

Editor-in-chief

Vitamin E is one of the fat-soluble vitamins the body needs in order to function properly. When it was discovered nearly 100 years ago it was observed that it improved animals’ fertility: that’s where vitamin E’s other name, tocopherol comes from, in Greek it means birth and pregnancy. (1) It was later discovered that vitamin E works as a fat-soluble antioxidant thus protecting vulnerable fatty acids from oxidization, a.k.a souring. Extreme oxidative stress and free radical production can be linked to a large number of diseases and vitamin E is cardinal in averting these processes. (2

Forms of vitamin E

Vitamin E has many forms: alpha-, beta-, gamma-, and delta- tocopherols and tocotrienols. Natural foods contain their various combinations. Since it’s alpha-tocopherol that the liver can best recycle it has the highest concentration in tissue and blood. (9) This is why it’s a widely popular misconception that the human body can only use alpha-tocopherol. 

Mistaken conclusion 

As a result of the above, in studies observing the effects of vitamin E participants only received a synthetic form of alpha-tocopherol, and what’s more, in a much higher dose than it’s possible to consume from any source in a natural way. 

Several studies have proved that large dose antioxidant supplementation may be harmful as above a certain amount they don’t act as antioxidants but quite the contrary: they can increase the oxidative load. (1012, 13) In the case of vitamin E the overly large dose and the lack of other tocopherols provided the explanation: large dose alpha-tocopherol lowers the other tocopherols’ level in the blood. (11

Proper form and amount are important 

It’s particularly important with vitamin E to keep realistic dosing in view because supplementing it as alpha-tocopherol in an overly large, 400 IU or more dose has had a slightly negative effect in several studies while adequate, 150 IU or lower vitamin E supplementation was beneficial. (13, 14, 15)

If we pay attention to the appropriate form and amount, vitamin E supplementation is actually very profitable: several observational studies found that those who consume more vitamin E or have a higher vitamin E level tend to be more immune to various chronic illnesses and they also live longer. (16, 17)  

Other forms 

Gamma-tocopherol has similar antioxidant qualities to alpha-tocopherol but due to its molecule structure its anti-inflammatory effect is much more significant. (17) On top of that, potent anti cancer qualities of gamma- and delta-tocopherols have been discovered in various animal models so hopefully, in the future there will be more human studies where mixed tocopherols are supplemented in appropriate dosage. 

Choose well 

Unfortunately, most food supplements sold as vitamin E contain only alpha-tocopherol and in too large a dose. No matter how beneficial alpha-tocopherol is for the body if in a large dose and consumed on its own it diminishes the other tocopherols’ levels. 

If you decide to supplement vitamin E choose a product that definitely contains mixed tocopherols in a similar ratio and amount to how they are found in natural food. 

  1. Niki E, Traber MG. A history of vitamin E. Ann Nutr Metab. 2012;61(3):207-12. doi: 10.1159/000343106. Epub 2012 Nov 26. PMID: 23183290. 

  2. Pham-Huy LA, He H, Pham-Huy C. Free radicals, antioxidants in disease and health. Int J Biomed Sci. 2008;4(2):89-96. 

  3. Lee GY, Han SN. The Role of Vitamin E in Immunity. Nutrients. 2018;10(11):1614. Published 2018 Nov 1. doi:10.3390/nu10111614 

  4. La Fata G, Weber P, Mohajeri MH. Effects of vitamin E on cognitive performance during ageing and in Alzheimer's disease. Nutrients. 2014;6(12):5453-5472. Published 2014 Nov 28. doi:10.3390/nu6125453 

  5. Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med. 1993 May 20;328(20):1450-6. doi: 10.1056/NEJM199305203282004. PMID: 8479464. 

  6. Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B, Willett WC. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med. 1993 May 20;328(20):1444-9. doi: 10.1056/NEJM199305203282003. PMID: 8479463. 

  7. Sanyal AJ, Chalasani N, Kowdley KV, McCullough A, Diehl AM, Bass NM, Neuschwander-Tetri BA, Lavine JE, Tonascia J, Unalp A, Van Natta M, Clark J, Brunt EM, Kleiner DE, Hoofnagle JH, Robuck PR; NASH CRN. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. N Engl J Med. 2010 May 6;362(18):1675-85. doi: 10.1056/NEJMoa0907929. Epub 2010 Apr 28. PMID: 20427778; PMCID: PMC2928471. 

  8. Valk EE, Hornstra G. Relationship between vitamin E requirement and polyunsaturated fatty acid intake in man: a review. Int J Vitam Nutr Res. 2000 Mar;70(2):31-42. doi: 10.1024/0300-9831.70.2.31. PMID: 10804454. 

  9. Kayden HJ, Traber MG. Absorption, lipoprotein transport, and regulation of plasma concentrations of vitamin E in humans. J Lipid Res. 1993 Mar;34(3):343-58. PMID: 8468520. 

  10. Sotler R, Poljšak B, Dahmane R, et al. PROOXIDANT ACTIVITIES OF ANTIOXIDANTS AND THEIR IMPACT ON HEALTH. Acta Clin Croat. 2019;58(4):726-736. doi:10.20471/acc.2019.58.04.20 

  11. Huang HY, Appel LJ. Supplementation of diets with alpha-tocopherol reduces serum concentrations of gamma- and delta-tocopherol in humans. J Nutr. 2003 Oct;133(10):3137-40. doi: 10.1093/jn/133.10.3137. PMID: 14519797. 

  12. Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 1994 Apr 14;330(15):1029-35. doi: 10.1056/NEJM199404143301501. PMID: 8127329. 

  13. Klein EA, Thompson IM Jr, Tangen CM, Crowley JJ, Lucia MS, Goodman PJ, Minasian LM, Ford LG, Parnes HL, Gaziano JM, Karp DD, Lieber MM, Walther PJ, Klotz L, Parsons JK, Chin JL, Darke AK, Lippman SM, Goodman GE, Meyskens FL Jr, Baker LH. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2011 Oct 12;306(14):1549-56. doi: 10.1001/jama.2011.1437. PMID: 21990298; PMCID: PMC4169010. 

  14. Miller ER 3rd, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med. 2005 Jan 4;142(1):37-46. doi: 10.7326/0003-4819-142-1-200501040-00110. Epub 2004 Nov 10. PMID: 15537682. 

  15. Virtamo J, Taylor PR, Kontto J, et al. Effects of α-tocopherol and β-carotene supplementation on cancer incidence and mortality: 18-year postintervention follow-up of the Alpha-tocopherol, Beta-carotene Cancer Prevention Study. Int J Cancer. 2014;135(1):178-185. doi:10.1002/ijc.28641 

  16. Huang J, Weinstein SJ, Yu K, Männistö S, Albanes D. Relationship Between Serum Alpha-Tocopherol and Overall and Cause-Specific Mortality. Circ Res. 2019 Jun 21;125(1):29-40. doi: 10.1161/CIRCRESAHA.119.314944. Epub 2019 May 6. PMID: 31219752. 

  17. Yang CS, Suh N, Kong AN. Does vitamin E prevent or promote cancer? Cancer Prev Res (Phila). 2012 May;5(5):701-5. doi: 10.1158/1940-6207.CAPR-12-0045. Epub 2012 Apr 3. PMID: 22490437; PMCID: PMC3502042. 

  18. Abner EL, Schmitt FA, Mendiondo MS, Marcum JL, Kryscio RJ. Vitamin E and all-cause mortality: a meta-analysis. Curr Aging Sci. 2011;4(2):158-170. doi:10.2174/1874609811104020158 

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