What Is the Best Form of Vitamin E to Take?

Vitamin E is a fatty-soluble vitamin with several forms, but alpha-tocopherol is the only ane used by the human body. Its main role is to act equally an antioxidant, scavenging loose electrons—and so-called "complimentary radicals"—that can damage cells. [1] It also enhances immune part and prevents clots from forming in middle arteries. Antioxidant vitamins, including vitamin E, came to public attention in the 1980s when scientists began to empathise that gratis radical damage was involved in the early stages of artery-bottleneck atherosclerosis, and might also contribute to cancer, vision loss, and a host of other chronic atmospheric condition. Vitamin E has the ability to protect cells from free radical impairment as well equally reduce the production of free radicals in certain situations. However, alien study results have dimmed some of the hope of using high dose vitamin E to preclude chronic diseases.

Recommended Amounts

The Recommended Dietary Allowance (RDA) for vitamin Eastward for males and females ages fourteen years and older is xv mg daily (or 22 international units, IU), including women who are pregnant. Lactating women need slightly more than at 19 mg (28 IU) daily.

Vitamin E and Wellness

Heart disease

For a time, vitamin E supplements looked similar an easy way to forestall cardiovascular illness. Large observational studies have shown a benefit from vitamin Due east supplements, whereas controlled clinical trials have produced mixed results.

Do good Found

• Observational studies: The Nurses' Health Study [2] and Health Professionals Follow-Up Written report [3] suggested 20-40% reductions in heart disease risk among individuals who took vitamin Eastward supplements (normally containing 400 IU or more) for at least two years. [iv]
• Randomized controlled trials: In the Women's Health Written report, which followed almost twoscore,000 salubrious women for 10 years, vitamin E supplements of 600 IU taken every other twenty-four hour period did not significantly reduce the risk of then-called "major cardiac events" (middle attack, stroke, or cardiovascular expiry). Merely there was some encouraging news in the findings: When these major cardiac events were analyzed separately, vitamin E supplementation was linked to a 24% lower take chances of cardiovascular death. [5] And among women ages 65 and older, vitamin E supplementation reduced the gamble of major cardiac events by 26%. A subsequently analysis plant that women who took the vitamin E supplements besides had a lower risk of developing serious blood clots in the legs and lungs, with women at the highest risk of such claret clots receiving the greatest benefit. [vi]

No Benefit Found

• Randomized controlled trials in people who were at high chance for or who had heart disease at baseline. In the GISSI Prevention Trial, the results were mixed only mostly showed no preventive effects later on more than than three years of treatment with vitamin E among 11,000 heart attack survivors. [7] Results from the Heart Outcomes Prevention Evaluation (HOPE) trial too showed no benefit of four years' worth of vitamin E supplementation in more than 9,500 men and women already diagnosed with centre disease or at high risk for it. [8] In fact, when the HOPE trial was extended for another four years, researchers found that study volunteers who took vitamin E had a higher chance of heart failure. [9]

Based on such studies, the American Centre Clan concluded that "the scientific data do not justify the apply of antioxidant vitamin supplements (such as vitamin E) for CVD risk reduction." [x] It is possible that in people who already take eye affliction or are at high take chances of heart disease, the use of drugs such equally aspirin, beta blockers, and ACE inhibitors mask a modest effect of vitamin E, and that vitamin East may have benefits among healthier people.

• Randomized controlled trials in people without heart illness at baseline. The SU.VI.MAX randomized controlled trial found that vii years of low-dose vitamin Eastward supplementation (every bit function of a daily antioxidant pill) reduced the hazard of cancer and the risk of dying from any cause in men, just did not evidence these benign furnishings in women; the supplements did non offer any protection against heart disease in men or women. [11] Discouraging results take also come up from the Physicians' Health Study II, an viii-yr randomized controlled trial that involved about 15,000 center-anile men, most of whom were free of heart disease at the start of the study. Researchers found that taking vitamin E supplements of 400 IU every other twenty-four hours, alone or with vitamin C, failed to offering any protection confronting heart attacks, strokes, or cardiovascular deaths. [12]

More recent show introduces a theory that vitamin Due east supplements may have potential benefits just in certain subgroups of the full general population. A trial of high-dose vitamin Eastward in Israel, for example, showed a marked reduction in heart affliction amid people with type 2 diabetes who had a mutual genetic predisposition for greater oxidative stress. [13]

Cancer

The story on vitamin E and cancer prevention has been a bit less encouraging than the story on vitamin Due east and heart disease. Taken as a whole, observational studies take not constitute that vitamin E in food or supplements offers much protection against cancer in general, or against specific cancers. [14–23] Some observational studies and clinical trials, however, suggested that vitamin E supplements might lower the risk of advanced prostate cancer in smokers. [16,24–26]

Prostate cancer

Investigators had hoped that the Selenium and Vitamin E Cancer Prevention Trial (SELECT) would requite more definitive answers on vitamin E and prostate cancer. SELECT's 18,000 men were assigned to follow one of four pill regimens—vitamin E plus selenium, vitamin E plus a selenium placebo, selenium plus a vitamin E placebo, or a double placebo—and to be tracked for 7 to 12 years. Only investigators halted the study halfway through in 2008 when early analyses showed that vitamin Due east offered no cancer or prostate cancer prevention do good. [27] Though the trial concluded, researchers continued to follow the men who had participated. In 2011, they reported a 17% higher risk of prostate cancer among men assigned to take vitamin E; there was no meaning increased run a risk of prostate cancer amongst men who took vitamin Eastward and selenium. [28]

Though these results may sound worrisome, two other major trials of vitamin E and prostate cancer had quite dissimilar results: The Alpha-Tocopherol Beta Carotene randomized trial, for instance, followed near 30,000 Finnish male smokers for an average of 6 years. [24] It found that men assigned to have daily vitamin Eastward supplements had a 32% lower risk of developing prostate cancer—and a 41% lower gamble of dying from prostate cancer—than men given a placebo. Vitamin E's protective consequence was strongest for men whose cancers were far plenty forth that they could be detected by a clinical examination. The large and long-term Physicians' Health Report II trial, meanwhile, establish that vitamin E supplements did not increase or subtract the adventure of prostate cancer or any other cancer. [29]

Why were the SELECT findings on vitamin East and prostate cancer so different from those of earlier studies? Previous studies of vitamin Due east supplements and prostate cancer found the greatest do good in men who were smokers and who had more advanced cancers. [xvi,24–26] In the SELECT trial, nevertheless, fewer than 10% of the men were smokers and most had early-stage cancer detected through prostate specific antigen (PSA) blood tests. [27,28] Many early on-stage, low-course prostate cancers identified by PSA test would not go avant-garde cancers. At that place is as well show that different processes may exist at work in early on versus late-stage prostate cancers. A large trial of a drug to foreclose prostate cancer establish opposite effects when used in early versus advanced prostate cancers. [30]

Bear in mind that most prostate cancer develops slowly, and any study looking at prostate cancer prevention needs to rails men for a long time. Past stopping the SELECT trial early, in that location is no way to tell if vitamin Due east could have helped protect confronting prostate cancer in some men if they had continued the trial over a longer period of time. Very few cases in the SELECT trial were of advanced prostate cancer, farther limiting the estimation of the findings.

Age-related vision diseases

A six-twelvemonth trial found that vitamin E, in combination with vitamin C, beta carotene, and zinc, offered some protection against the development of advanced age-related macular degeneration (AMD), but not cataracts, in people who were at high risk of the affliction. [31,32] On its own, nevertheless, vitamin E does not seem to offer much benefit against either AMD or cataracts. [33,34]

Cognitive role and neurodegenerative diseases

Scientists seeking to untangle the causes of Alzheimer'due south, Parkinson's, and other diseases of the brain and nervous organisation have focused on the part that free radical harm plays in these diseases' development. [35] But to appointment, there is little evidence as to whether vitamin E can aid protect against these diseases or that it offers any benefit to people who already have these diseases.

• Dementia: Some prospective studies suggest that vitamin Due east supplements, specially in combination with vitamin C, may exist associated with small improvements in cerebral part or lowered take a chance of Alzheimer's affliction and other forms of dementia, while other studies have failed to find any such do good. [36–39] A three-year randomized controlled trial in people with balmy cerebral impairment—often a precursor to Alzheimer's disease—found that taking 2,000 IU of vitamin Eastward daily failed to ho-hum the progression to Alzheimer'due south affliction. [forty] Go along in heed, notwithstanding, that the progression from mild cerebral impairment to Alzheimer's illness can have many years, and this study was fairly short, and so it is probably non the last discussion on vitamin East and dementia.
• Parkinson'due south Disease: Some, but not all, prospective studies propose that getting higher intakes of vitamin East from diet—not from high-dose supplements—is associated with a reduced risk of Parkinson's affliction. [41–43] In people who already have Parkinson's, high-dose vitamin Eastward supplements do not deadening the disease'southward progression. [44] Why the divergence between vitamin E from foods versus that from supplements? It is possible that foods rich in vitamin E, such equally nuts or legumes, incorporate other nutrients that protect against Parkinson'southward disease. More than research is needed.
• Amyotrophic Lateral Sclerosis (ALS): One large prospective study that followed nigh one million people for up to sixteen years found that people who regularly took vitamin E supplements had a lower take a chance of dying from ALS than people who never took vitamin E supplements. [45] More recently, a combined analysis of multiple studies with more than 1 million participants constitute that the longer people used vitamin E supplements, the lower their chance of ALS. [46] Clinical trials of vitamin E supplements in people who already have ALS take generally failed to testify any benefit, however. [47] This may be a situation where vitamin E is beneficial for prevention, rather than treatment, but more research is needed.

Food Sources

Vitamin Eastward is found in plant-based oils, nuts, seeds, fruits, and vegetables.

• Wheat germ oil
• Sunflower, safflower, and soybean oil
• Sunflower seeds
• Almonds
• Peanuts, peanut butter
• Beet greens, collard greens, spinach
• Pumpkin
• Red bell pepper
• Asparagus
• Mango
• Avocado

Signs of Deficiency

Because vitamin East is found in a variety of foods and supplements, a deficiency in the U.South. is rare. People who have digestive disorders or do not absorb fatty properly (e.g., pancreatitis, cystic fibrosis, celiac affliction) can develop a vitamin E deficiency. The following are common signs of a deficiency:

• Retinopathy (harm to the retina of the eyes that tin can impair vision)
• Peripheral neuropathy (damage to the peripheral nerves, unremarkably in the easily or feet, causing weakness or pain)
• Ataxia (loss of control of body movements)
• Decreased allowed role

Toxicity

At that place is no testify of toxic effects from vitamin E constitute naturally in foods. Virtually adults who obtain more the RDA of 22 IU daily are using multivitamins or divide vitamin Due east supplements that incorporate anywhere from 400-grand IU daily. At that place take not been reports of harmful side effects of supplement use in salubrious people. Yet, there is a chance of excess bleeding, peculiarly with doses greater than 1000 mg daily or if an individual is as well using a claret thinning medication such as warfarin. For this reason, an upper limit for vitamin Due east has been set up for adults 19 years and older of k mg daily (1465 IU) of any course of tocopherol supplement. [1]

Did You Know?

Due to occasional reports of negative wellness effects of vitamin Due east supplements, scientists have debated whether these supplements could be harmful and even increase the risk of expiry.

Researchers have tried to reply this question past combining the results of multiple studies. In one such analysis, the authors gathered and re-analyzed information from 19 clinical trials of vitamin East, including the GISSI and HOPE studies [48]; they establish a college rate of death in trials where patients took more than 400 IU of supplements a twenty-four hours. While this meta-analysis drew headlines when it was released, at that place are limitations to the conclusions that can exist fatigued from information technology. Some of the findings were based on very pocket-sized studies. In some of these trials, vitamin E was combined with high doses of beta-carotene, which itself has been related to excess mortality.  Furthermore, many of the high-dose vitamin E trials included in the assay included people who had advanced heart disease or Alzheimer's affliction. Other meta-analyses have come to different conclusions. And then it is not clear that these findings would apply to healthy people. The Physicians' Health Study II, for example, did not find any divergence in death rates betwixt the study participants who took vitamin E and those who took a placebo. [12]

Related

Vitamins and Minerals

References

1. Constitute of Medicine. Dietary reference intakes for vitamin C, vitamin Due east, selenium, and carotenoids. Washington, D.C.: National Academies Press; 2000.
2. Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B, Willett WC. Vitamin E consumption and the take chances of coronary disease in women. Northward Engl J Med. 1993;328:1444-9.
3. Rimm EB, Stampfer MJ, Ascherio A, Giovannucci Due east, Colditz GA, Willett WC. Vitamin Due east consumption and the hazard of coronary centre disease in men. N Engl J Med. 1993;328:1450-6.
4. Rimm EB, Stampfer MJ. Antioxidants for vascular disease. Med Clin Northward Am. 2000;84:239-49.
5. Lee IM, Cook NR, Gaziano JM, et al. Vitamin E in the primary prevention of cardiovascular disease and cancer: the Women's Health Report: a randomized controlled trial. JAMA. 2005;294:56-65.
6. Glynn RJ, Ridker PM, Goldhaber SZ, Zee RY, Buring JE. Furnishings of random allocation to vitamin E supplementation on the occurrence of venous thromboembolism: written report from the Women'southward Wellness Study. Apportionment. 2007;116:1497-503.
7. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin Due east subsequently myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet. 1999;354:447-55.
8. Yusuf Due south, Dagenais K, Pogue J, Bosch J, Sleight P. Vitamin E supplementation and cardiovascular events in loftier-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000;342:154-60.
9. Lonn Due east, Bosch J, Yusuf S, et al. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA. 2005;293:1338-47.
10. Kris-Etherton PM, Lichtenstein AH, Howard BV, Steinberg D, Witztum JL. Antioxidant vitamin supplements and cardiovascular illness. Circulation. 2004;110:637-41.
11. Hercberg Southward, Galan P, Preziosi P, et al. The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Curvation Intern Med. 2004;164:2335-42.
12. Sesso HD, Buring JE, Christen WG, et al. Vitamins E and C in the prevention of cardiovascular affliction in men: the Physicians' Health Study Ii randomized controlled trial. JAMA. 2008;300:2123-33.
13. Milman U, Blum S, Shapira C, et al. Vitamin E supplementation reduces cardiovascular events in a subgroup of middle-aged individuals with both type 2 diabetes mellitus and the haptoglobin two-two genotype: a prospective double-blinded clinical trial. Arterioscler Thromb Vasc Biol. 2008;28:341-7.
14. Hunter DJ, Manson JE, Colditz GA, et al. A prospective written report of the intake of vitamins C, E, and A and the run a risk of breast cancer. N Engl J Med. 1993;329:234-40.
15. Willett WC, Polk BF, Underwood BA, et al. Relation of serum vitamins A and E and carotenoids to the risk of cancer. Northward Engl J Med. 1984;310:430-iv.
16. Chan JM, Stampfer MJ, Ma J, Rimm EB, Willett WC, Giovannucci EL. Supplemental vitamin E intake and prostate cancer hazard in a big cohort of men in the United States. Cancer Epidemiol Biomarkers Prev. 1999;8:893-9.
17. van Dam RM, Huang Z, Giovannucci E, et al. Diet and basal cell carcinoma of the skin in a prospective cohort of men. Am J Clin Nutr. 2000;71:135-41.
18. Wu K, Willett WC, Chan JM, et al. A prospective study on supplemental vitamin east intake and risk of colon cancer in women and men. Cancer Epidemiol Biomarkers Prev. 2002;11:1298-304.
19. Fung TT, Spiegelman D, Egan KM, Giovannucci E, Hunter DJ, Willett WC. Vitamin and carotenoid intake and risk of squamous jail cell carcinoma of the skin. Int J Cancer. 2003;103:110-5.
20. Feskanich D, Willett WC, Hunter DJ, Colditz GA. Dietary intakes of vitamins A, C, and E and risk of melanoma in 2 cohorts of women. Br J Cancer. 2003;88:1381-vii.
21. Cho E, Spiegelman D, Hunter DJ, et al. Premenopausal intakes of vitamins A, C, and E, folate, and carotenoids, and chance of breast cancer. Cancer Epidemiol Biomarkers Prev. 2003;12:713-xx.
22. Cho E, Hunter DJ, Spiegelman D, et al. Intakes of vitamins A, C and East and folate and multivitamins and lung cancer: a pooled assay of 8 prospective studies. Int J Cancer. 2006;118:970-8.
23. Lee JE, Giovannucci Due east, Smith-Warner SA, Spiegelman D, Willett WC, Curhan GC. Intakes of fruits, vegetables, vitamins A, C, and E, and carotenoids and take a chance of renal cell cancer. Cancer Epidemiol Biomarkers Prev. 2006;15:2445-52.
24. Heinonen OP, Albanes D, Virtamo J, et al. Prostate cancer and supplementation with blastoff-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst. 1998;xc:440-6.
25. Kirsh VA, Hayes RB, Mayne ST, et al. Supplemental and dietary vitamin E, beta-carotene, and vitamin C intakes and prostate cancer hazard. J Natl Cancer Inst. 2006;98:245-54.
26. Peters U, Littman AJ, Kristal AR, Patterson RE, Potter JD, White Due east. Vitamin Due east and selenium supplementation and run a risk of prostate cancer in the Vitamins and Lifestyle (VITAL) report cohort. Cancer Causes Command. 2008;xix:75-87.
27. Lippman SM, Klein EA, Goodman PJ, et al. Event of selenium and vitamin Due east on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2009;301:39-51.
28. Klein EA, Thompson IM, Jr., Tangen CM, et al. Vitamin Eastward and the gamble of prostate cancer: the Selenium and Vitamin Due east Cancer Prevention Trial (SELECT). JAMA. 2011;306:1549-56.
29. Gaziano JM, Glynn RJ, Christen WG, et al. Vitamins E and C in the prevention of prostate and full cancer in men: the Physicians' Health Study Ii randomized controlled trial. JAMA. 2009;301:52-62.
30. Thompson IM, Goodman PJ, Tangen CM, et al. The influence of finasteride on the development of prostate cancer. North Engl J Med. 2003;349:215-24.
31. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS written report no. 8. Curvation Ophthalmol. 2001;119:1417-36.
32. Age Related Eye Disease Study ii (AREDS2). National Eye Constitute, 2007. Accessed 8 November 2007,
33. Chong EW, Wong TY, Kreis AJ, Simpson JA, Guymer RH. Dietary antioxidants and chief prevention of historic period related macular degeneration: systematic review and meta-analysis. BMJ. 2007;335:755.
34. Christen WG, Glynn RJ, Chew EY, Buring JE. Vitamin E and age-related macular degeneration in a randomized trial of women. Ophthalmology. 2010;117:1163-viii.
35. Kamat CD, Gadal S, Mhatre Yard, Williamson KS, Pye QN, Hensley Grand. Antioxidants in key nervous system diseases: preclinical promise and translational challenges. J Alzheimers Dis. 2008;15:473-93.
36. Grodstein F, Chen J, Willett WC. Loftier-dose antioxidant supplements and cognitive office in community-dwelling elderly women. Am J Clin Nutr. 2003;77:975-84.
37. Zandi PP, Anthony JC, Khachaturian AS, et al. Reduced hazard of Alzheimer affliction in users of antioxidant vitamin supplements: the Cache County Study. Curvation Neurol. 2004;61:82-8.
38. Laurin D, Masaki KH, Foley DJ, White LR, Launer LJ. Midlife dietary intake of antioxidants and risk of late-life incident dementia: the Honolulu-Asia Aging Written report. Am J Epidemiol. 2004;159:959-67.
39. Grayness SL, Anderson ML, Crane PK, et al. Antioxidant vitamin supplement use and risk of dementia or Alzheimer'southward disease in older adults. J Am Geriatr Soc. 2008;56:291-v.
40. Petersen RC, Thomas RG, Grundman K, et al. Vitamin Eastward and donepezil for the treatment of mild cerebral harm. N Engl J Med. 2005;352:2379-88.
41. Zhang SM, Hernan MA, Chen H, Spiegelman D, Willett WC, Ascherio A. Intakes of vitamins E and C, carotenoids, vitamin supplements, and PD take a chance. Neurology. 2002;59:1161-nine.
42. Etminan M, Gill SS, Samii A. Intake of vitamin E, vitamin C, and carotenoids and the risk of Parkinson'southward disease: a meta-analysis. Lancet Neurol. 2005;four:362-5.
43. Morens DM, Grandinetti A, Waslien CI, Park CB, Ross GW, White LR. Case-command study of idiopathic Parkinson's disease and dietary vitamin E intake. Neurology. 1996;46:1270-4.
44. Effects of tocopherol and deprenyl on the progression of inability in early on Parkinson's disease. The Parkinson Study Group. N Engl J Med. 1993;328:176-83.
45. Ascherio A, Weisskopf MG, O'Reilly E J, et al. Vitamin Due east intake and risk of amyotrophic lateral sclerosis. Ann Neurol. 2005;57:104-x.
46. Wang H, O'Reilly EJ, Weisskopf MG, et al. Vitamin E intake and risk of amyotrophic lateral sclerosis: a pooled analysis of data from five prospective accomplice studies. Am J Epidemiol. 2011;173:595-602.
47. Orrell RW, Lane RJ, Ross M. Antioxidant handling for amyotrophic lateral sclerosis / motor neuron disease. Cochrane Database Syst Rev. 2007:CD002829.
48. Miller ER, 3rd, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-analysis: loftier-dosage vitamin E supplementation may increase all-cause bloodshed. Ann Intern Med. 2005;142:37-46.

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