SUPPLEMENT - VITAMIN

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What is vitamin E and what does it do?


Vitamin E is a fat-soluble nutrient found in many foods. In the body, it acts as an antioxidant, helping to protect cells from the damage caused by free radicals. Free radicals are compounds formed when our bodies convert the food we eat into energy. People are also exposed to free radicals in the environment from cigarette smoke, air pollution, and ultraviolet light from the sun.

The body also needs vitamin E to boost its immune system so that it can fight off invading bacteria and viruses. It helps to widen blood vessels and keep blood from clotting within them. In addition, cells use vitamin E to interact with each other and to carry out many important functions.

Vitamin E is found naturally in some foods, added to others, and available as a dietary supplement. “Vitamin E” is the collective name for a group of fat-soluble compounds with distinctive antioxidant activities [1].

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 [1]. Alpha- (or α-) tocopherol is the only form that is recognized to meet human requirements.

Serum concentrations of vitamin E (alpha-tocopherol) depend on the liver, which takes up the nutrient after the various forms are absorbed from the small intestine. The liver preferentially resecretes only alpha-tocopherol via the hepatic alpha-tocopherol transfer protein [1]; the liver metabolizes and excretes the other vitamin E forms [2]. As a result, blood and cellular concentrations of other forms of vitamin E are lower than those of alpha-tocopherol and have been the subjects of less research [3,4].

Antioxidants protect cells from the damaging effects of free radicals, which are molecules that contain an unshared electron. Free radicals damage cells and might contribute to the development of cardiovascular disease and cancer [5]. Unshared electrons are highly energetic and react rapidly with oxygen to form reactive oxygen species (ROS). The body forms ROS endogenously when it converts food to energy, and antioxidants might protect cells from the damaging effects of ROS. The body is also exposed to free radicals from environmental exposures, such as cigarette smoke, air pollution, and ultraviolet radiation from the sun. ROS are part of signaling mechanisms among cells.

Vitamin E is a fat-soluble antioxidant that stops the production of ROS formed when fat undergoes oxidation. Scientists are investigating whether, by limiting free-radical production and possibly through other mechanisms, vitamin E might help prevent or delay the chronic diseases associated with free radicals.

In addition to its activities as an antioxidant, vitamin E is involved in immune function and, as shown primarily by in vitro studies of cells, cell signaling, regulation of gene expression, and other metabolic processes [1]. Alpha-tocopherol inhibits the activity of protein kinase C, an enzyme involved in cell proliferation and differentiation in smooth muscle cells, platelets, and monocytes [6]. Vitamin-E–replete endothelial cells lining the interior surface of blood vessels are better able to resist blood-cell components adhering to this surface. Vitamin E also increases the expression of two enzymes that suppress arachidonic acid metabolism, thereby increasing the release of prostacyclin from the endothelium, which, in turn, dilates blood vessels and inhibits platelet aggregation [6].


How much vitamin E do I need?


The amount of vitamin E you need each day depends on your age. Average daily recommended amounts are listed below in milligrams (mg).

  LifeStage

  RecommendedAmount

  Birth to 6 months

4 mg  

  Infants 7–12 months

5 mg  

  Children 1–3 years

6 mg  

  Children 4–8 years

7 mg  

  Children 9–13 years

11 mg  

  Teens 14–18 years

15 mg  

  Adults

15 mg  

  Pregnant teens and women

15 mg  

  Breastfeeding teens and women

19 mg  


What happens if I don’t get enough vitamin E?


Vitamin E deficiency is very rare in healthy people. It is almost always linked to certain diseases in which fat is not properly digested or absorbed. Examples include Crohn’s disease, cystic fibrosis, and certain rare genetic diseases such as abetalipoproteinemia and ataxia with vitamin E deficiency (AVED). Vitamin E needs some fat for the digestive system to absorb it.

Vitamin E deficiency can cause nerve and muscle damage that results in loss of feeling in the arms and legs, loss of body movement control, muscle weakness, and vision problems. Another sign of deficiency is a weakened immune system.


What are some effects of vitamin E on health?


Scientists are studying vitamin E to understand how it affects health. Here are several examples of what this research has shown.

Cancer

Most research indicates that vitamin E does not help prevent cancer and may be harmful in some cases. Large doses of vitamin E have not consistently reduced the risk of colon and breast cancer in studies, for example. A large study found that taking vitamin E supplements (180 mg/day [400 IU]) for several years increased the risk of developing prostate cancer in men. Two studies that followed middle-aged men and women for 7 or more years found that extra vitamin E (201−268 mg/day [300–400 IU], on average) did not protect them from any form of cancer. However, one study found a link between the use of vitamin E supplements for 10 years or more and a lower risk of death from bladder cancer.

Vitamin E dietary supplements and other antioxidants might interact with chemotherapy and radiation therapy. People undergoing these treatments should talk with their doctor or oncologist before taking vitamin E or other antioxidant supplements, especially in high doses.

Heart disease

Some studies link higher intakes of vitamin E from supplements to lower chances of developing coronary heart disease. But the best research finds no benefit. People in these studies are randomly assigned to take vitamin E or a placebo (dummy pill with no vitamin E or active ingredients) and they don’t know which they are taking. Vitamin E supplements do not seem to prevent heart disease, reduce its severity, or affect the risk of death from this disease. Scientists do not know whether high intakes of vitamin E might protect the heart in younger, healthier people who do not have a high risk of heart disease.

Eye disorders

Age-related macular degeneration (AMD), or the loss of central vision in older people, and cataracts are among the most common causes of vision loss in older people. The results of research on whether vitamin E can help prevent these conditions are inconsistent. Among people with AMD who were at high risk of developing advanced AMD, a supplement containing large doses of vitamin E combined with other antioxidants, zinc, and coppershowed promise for slowing down the rate of vision loss.

Mental function

Several studies have investigated whether vitamin E supplements might help older adults remain mentally alert and active as well as prevent or slow the decline of mental function and Alzheimer’s disease. So far, the research provides little evidence that taking vitamin E supplements can help healthy people or people with mild mental functioning problems to maintain brain health.


Can vitamin E be harmful?


Vitamin E that is naturally present in food and beverages is not harmful and does not need to be limited.

In supplement form, however, high doses of vitamin E might increase the risk of bleeding (by reducing the blood’s ability to form clots after a cut or injury) and of serious bleeding in the brain (known as hemorrhagic stroke). Because of this risk, the upper limit for adults is 1,000 mg/day for supplements of either natural or synthetic vitamin E. This is equal to 1,500 IU/day for natural vitamin E supplements and 1,100 IU/day for synthetic vitamin E supplements. The upper limits for children are lower than those for adults. Some research suggests that taking vitamin E supplements even below these upper limits might cause harm. In one study, for example, men who took 400 IU (180 mg) of synthetic vitamin E each day for several years had an increased risk of prostate cancer.


Where can I find out more about vitamin E?


• For general information on vitamin E:
o Office of Dietary Supplements Health Professional Fact Sheet on Vitamin E
o Vitamin E, MedlinePlus®
• For more information on food sources of vitamin E:
o U.S. Department of Agriculture’s (USDA’s) FoodData Central 
o Nutrient List for vitamin E (listed by food or by vitamin E content), USDA
• For more advice on choosing dietary supplements:
• For information about building a healthy dietary pattern:


References


1. Traber MG. Vitamin E. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins R, eds. Modern Nutrition in Health and Disease. 10th ed. Baltimore, MD: Lippincott Williams & Wilkins, 2006;396-411.

2. Traber MG. Vitamin E regulatory mechanisms. Annu Rev Nutr 2007;27:347-62. [PubMed abstract]

3. Sen CK, Khanna S, Roy S. Tocotrienols: vitamin E beyond tocopherols. Life Sci 2006;78:2088-98. [PubMed abstract]

4. Dietrich M, Traber MG, Jacques PF, Cross CE, Hu Y, Block G. Does γ-tocopherol play a role in the primary prevention of heart disease and cancer? A review. Am J Coll Nutr 2006;25:292-9. [PubMed abstract]

5. Verhagen H, Buijsse B, Jansen E, Bueno-de-Mesquita B. The state of antioxidant affairs. Nutr Today 2006;41:244-50.

6. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Vitamin C, Vitamin E, Selenium, and Carotenoids . Washington, DC: National Academy Press, 2000.

7. Health information data from U.S. National Institutes of Health

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