Vitamin E
Natural Standard evidence-based flashcard. Copyright © 2008 (www.naturalstandard.com). Commercial distribution prohibited. This flashcard is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. 		Image
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Summary:
Vitamin E exists in eight different forms ("isomers"): alpha, beta, gamma, and delta tocopherol; and alpha, beta, gamma, and delta tocotrienol. Alpha-tocopherol is the most active form in humans.

Uses
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Grade*
Vitamin E deficiency A
Allergic rhinitis (nasal allergies) C
Altitude sickness C
Anemia (not enough red blood cells) C
Angina (chest pain) C
Antioxidant C
Atherosclerosis (clogging and hardening of arteries) C
Bladder cancer C
Breast cancer C
Breast cancer-related hot flashes C
Cancer treatment C
Heart disease in dialysis (cleaning waste from blood) patients C
Cataract prevention C
Chemotherapy neurotoxicity C
Colon cancer prevention C
Dementia/Alzheimer's disease C
Diabetes C
Dysmenorrhea (painful menstruation) C
G6PD deficiency C
Glomerulosclerosis (kidney disease) C
Healing after photorefractive keratectomy (laser eye surgery) C
Hepatitis (hepatitis C) C
High cholesterol C
Immune system function C
Intermittent claudication C
Macular degeneration (eye disease) C
Parkinson's disease C
Premenstrual syndrome (PMS) C
Prostate cancer prevention C
Respiratory infection prevention C
Seizure disorder C
Steatohepatitis (inflamed liver) C
Stomach cancer (prevention) C
Supplementation in preterm and very low birth weight infants C
Tardive dyskinesia (involuntary movements) C
Uveitis (inflammation of the eye) C
Venous thromboembolism (VTE) C
Asthma D
Cancer prevention (general) D
Heart disease prevention D
Osteoarthritis D
Peyronie's disease D
Retinitis pigmentosa (loss of peripheral vision) D
Scar prevention D
Stroke D
*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Safety:
Avoid if allergic or hypersensitive to vitamin E. Avoid with retinitis pigmentosa (loss of peripheral vision). Use cautiously with bleeding disorders or if taking blood thinners. Avoid above the recommended daily level in pregnant women and breastfeeding women.

Possible side effects:
Abdominal pain, blurred vision (particularly when used in high doses), contact dermatitis, diarrhea, diminished kidney function, dizziness, eczema, fatigue, flu-like symptoms, gonadal dysfunction, headache, increased rate of hemorrhagic (bleeding) stroke and gum bleeding, increased risk of bleeding, increased risk of death (from "all causes"), more rapid loss of visual acuity, nausea, necrotizing enterocolitis (infection of the intestine), weakness.

Possible interactions:
Anticoagulants such as warfarin (Coumadin®) or heparin, anticonvulsant drugs such as phenobarbital, phenytoin, or carbamazepine, antioxidants, anti-platelet drugs such as clopidogrel (Plavix®), blood-thinning drugs such as aspirin, chemotherapy agents (such as alkylating agents, anthracyclines, or platinums), cholesterol-lowering medications, cholestyramine (Questran ®), colestipol (Colestid®), orlistat (Xenical®), isoniazid (INH, Lanizid®, Nydrazid®), olestra (Olean® fat substitute), and sucralfate (Carafate®), cyclosporine, gemfibrozil (Lopid®), non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®), and herbs and supplements with similar effects.

Dosing

Adults (18 years and older):
U.S. Recommended Dietary Allowance (RDA) for adults: The RDA for males or females older than 14 years old is 15 milligrams; for pregnant women of any age is 15 milligrams; and for breastfeeding women of any age is 19 milligrams. For adults older than 18 years, the tolerable upper limit of dosing for supplementary alpha-tocopherol recommended by the U.S. Institute of Medicine is 1,000 milligrams daily. This limit recommendation is not altered during pregnancy or breastfeeding.
Other dosing recommendations vary based on the cause. Please check with a doctor and pharmacist.

Children (younger than 18 years):
U.S. Recommended Dietary Allowance (RDA) and Adequate Intake (AI) for infants/children: There is no RDA for infants, but there is a recommended Adequate Intake (AI) for healthy breastfeeding infants ages 0-6 months old of 4 milligrams daily, and for infants ages 7-12 months old of 5 milligrams daily. The RDA for children ages 1-3 years old is 6 milligrams daily; for ages 4-8 years old is 7 milligrams daily; for ages 9-13 years old is 11 milligrams per daily; for ages greater than 14 years old is 15 milligrams daily; for pregnant women of any age is 15 milligrams daily; and for breastfeeding women of any age is 19 milligrams daily.
Natural Standard Monograph (www.naturalstandard.com)
Copyright © 2008 Natural Standard Inc. Commercial distribution or reproduction prohibited.
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.