Vitamin E (Tocopherol)

Vitamin E is a vitamin that dissolves in fat. It is found in many foods including vegetable oils, cereals, meat, poultry, eggs, fruits, vegetables, and wheat germ oil. It is also available as a supplement.

Vitamin E is used for treating vitamin E deficiency, which is rare, but can occur in people with certain genetic disorders and in very low-weight premature infants.

Some people use vitamin E for treating and preventing diseases of the heart and blood vessels including hardening of the arteries, heart attack, chest pain, stroke, irregular heart beat (atrial fibrillation), heart failure, leg pain due to blocked arteries, and high blood pressure.

Vitamin E is also used for treating diabetes and its complications, liver disease, kidney disease, Peyronie's disease (painful erection in men), and enlarged prostate (BPH). It is used for preventing cancer, particularly lung and oral cancer in smokers; colorectal cancer and polyps; and gastric, skin, bladder, breast, head and neck, prostate, and pancreatic cancers. Vitamin E is also used decrease side effects of chemotherapy.

Some people use vitamin E for diseases of the brain and nervous system including Alzheimer's disease and other dementias, Parkinson's disease, night cramps, restless leg syndrome, and for epilepsy, along with other medications. Vitamin E is also used for Huntington's chorea, and other disorders involving nerves and muscles.

Women use vitamin E for preventing complications in late pregnancy due to high blood pressure (pre-eclampsia), for preventing preterm labor, premenstrual syndrome (PMS), benign breast disease, weak bones (osteoporosis), painful periods, menopausal syndrome, hot flashes associated with breast cancer, and breast cysts.

Sometimes vitamin E is used to lessen the harmful effects of medical treatments such as dialysis and radiation. It is also used to reduce unwanted side effects of drugs such as hair loss in people taking doxorubicin and lung damage in people taking amiodarone.

Vitamin E is sometimes used for improving physical endurance, increasing energy, reducing muscle damage after exercise, and improving muscle strength.

Vitamin E is also used for cataracts, age-related vision loss (age-related macular degeneration), asthma, respiratory infections, skin disorders, aging skin, sunburns, cystic fibrosis, infertility, impotence, chronic fatigue syndrome (CFS), neurodegenerative disease called Lou Gherig's disease (ALS), leg cramps, peptic ulcers, H pylori, swelling in the middle layer of the eye (uveitis), mouth sores (oral mucosal lesions), movement and coordination disorder called dyspraxia, kidney problems in children (glomerulosclerosis), movement disorder (ataxia) associated with vitamin E deficiency (AVED), rheumatoid arthritis, for certain inherited diseases and to prevent allergies. Finally, vitamin E is used for preventing death.

Some people apply vitamin E to their skin to keep it from aging, sunburn, scarring, lice, stretch marks, and to protect against the skin effects of chemicals used for cancer therapy (chemotherapy).

The American Heart Association recommends obtaining antioxidants, including vitamin E, by eating a well-balanced diet high in fruits, vegetables, and whole grains rather than from supplements until more is known about the risks and benefits of taking supplements.

How does it work?

Vitamin E is an important vitamin required for the proper function of many organs in the body. It is also an antioxidant. This means it helps to slow down processes that damage cells.

Movement disorder (ataxia) associated with vitamin E deficiency.
Alzheimer's disease.
Anemia.
Blood disorder (beta-thalassemia).
Leakage of chemotherapy drug into surrounding tissue.
Chemotherapy-related nerve damage.
Painful menstruation (dysmenorrhea).
Movement and coordination disorder called dyspraxia.
Kidney problems in children (glomerulosclerosis).
An inherited disorder called G6PD deficiency.
Healing a type of skin sore called granuloma annulare.
Huntington's disease.
Male infertility.
Bleeding within the skull.
Bleeding within the ventricular system of the brain.
Liver disease (nonalcoholic steatohepatitis, NASH).
Nitrate tolerance.
Parkinson's disease.
Laser eye surgery (photoreactive keratectomy).
Premenstrual syndrome (PMS).
Physical performance.
Fibrosis caused by radiation.
An eye disease in newborns called retinopathy of prematurity.
Rheumatoid arthritis (RA).
Sunburn. T
Movement disorder (tardive dyskinesia). Taking vitamin E by mouth seems to improve symptoms associated with the movement disorder called tardive dyskinesia. However, some other research suggests that it does not improve symptoms, but may prevent symptoms from worsening.
Swelling in the middle layer of the eye (uveitis). Taking vitamin E with vitamin C by mouth seems to improve vision, but does not reduce swelling, in people with uveitis.

By Mouth:

For vitamin E deficiency: a typical dose in adults is RRR-alpha tocopherol (natural vitamin E) 60-75 IU per day.

For a movement disorder (ataxia) associated with vitamin E deficiency.

For anemia: vitamin E 447-745 IU daily with erythropoietin 93-74 U/kg/week.

For the movement disorder called tardive dyskinesia: RRR-alpha-tocopherol (natural vitamin E) 1600 IU daily.

For the movement and coordination disorder called dyspraxia in children: vitamin E (dl-alpha tocopheryl acetate) in combination with fish oil, evening primrose oil, and thyme oil (Efalex, Efamol Ltd) daily.

For improving male fertility: vitamin E 298-894 IU daily.

For Alzheimer's disease: up to 2000 IU daily. Combination therapy of donepezil (Aricept) 5 mg and vitamin E 1000 IU per day has been used for slowing memory decline in people with Alzheimer's disease.

For liver disease called non-alcoholic steatohepatitis: 800 IU daily in adults has been used; 400-1200 IU daily has been used in children.

For early Huntington's chorea: RRR-alpha-tocopherol (natural vitamin E) 3000 IU.

For rheumatoid arthritis pain: vitamin E 600 IU twice daily.

For preventing nerve damage caused by cisplatin: vitamin E (alpha-tocopherol) 447 IU daily with each chemotherapy treatment and for up to 3 months after stopping cisplatin therapy.

For improving effectiveness of nitrates used for heart disease: vitamin E 298 IU three times daily.

To reduce protein in the urine of children with a kidney disease called focal segmental glomerulosclerosis: vitamin E 200 IU.

For G6PD deficiency: vitamin E 800 IU daily.

For premenstrual syndrome (PMS): RRR-alpha-tocopherol (natural vitamin E) 400 IU daily.

For painful menstrual periods: vitamin E 200 IU twice or 500 IU daily starting 2 days before the menstrual period and continuing through the first 3 days of bleeding.

For healing the eyes after a surgery called keratectomy: 343 IU vitamin E (alpha-tocopheryl nicotinate) and vitamin A (retinol palmitate) 25,000 units have been used 3 times daily for 30 days, followed by twice daily for 2 months.

For fibrosis caused by radiation: vitamin E 1000 IU daily in combination with pentoxifylline 800 mg.

For beta-thalassemia: vitamin E 750 IU daily.

For swelling in the middle layer of the eye (uveitis): vitamin E (unspecified forms) 149 IU in combination with vitamin C 500 mg twice daily.

For preventing sunburn: RRR-alpha-tocopherol (natural vitamin E) 1000 IU in combination with 2 grams of ascorbic acid.

Vitamin E is SAFE for most healthy people when taken by mouth or applied to the skin. Most people do not experience any side effects when taking the recommended daily dose, which is 22.4 IU.

Vitamin E is POSSIBLY UNSAFE if taken by mouth in high doses. If you have a condition such as heart disease or diabetes, do not take doses of 400 IU/day or more. Some research suggests that high doses might increase the chance of death and possibly cause other serious side effects. The higher the dose, the greater the risk of serious side effects.

There is some concern that vitamin E might increase the chance of having a serious stroke called hemorrhagic stroke, which is bleeding into the brain. Some research shows that taking vitamin E in doses of 300-800 IU each day might increase the chance of this kind of stroke by 22%. However, in contrast, vitamin E might decrease the chance of having a less severe stroke called an ischemic stroke.

There is contradictory information about the effect of vitamin E on the chance of developing prostate cancer. Some research suggests that taking large amounts of a multivitamin plus a separate vitamin E supplement might actually increase the chance of developing prostate cancer in some men.

High doses can also cause nausea, diarrhea, stomach cramps, fatigue, weakness, headache, blurred vision, rash, and bruising and bleeding.

Pregnancy: When used in the recommended daily amount, vitamin E is SAFE for pregnant women. There has been some concern that taking vitamin E supplements might be harmful to the fetus when taken in early pregnancy. However, it is too soon to know if this is an important concern. Until more is known, do not take vitamin E supplements during early pregnancy without talking with your healthcare provider.
Breast-feeding: Vitamin E is LIKELY SAFE when taken by mouth in recommended daily amounts during breast-feeding.

Infants and children: Vitamin E is SAFE when taken by mouth appropriately. The maximum amounts of vitamin E that are considered safe for children are based on age. Less than 298 IU daily is safe for children 1 to 3 years old. Less than 447 IU daily is safe for children 4 to 8 years old. Less than 894 IU daily is safe for children 9 to 13 years old. Less than 1192 IU daily is safe for children ages 14 to 18 years old. Vitamin E (alpha-tocopherol) is POSSIBLY UNSAFE when given intravenously (by IV) to premature infants in high doses.

Angioplasty, a heart procedure: Avoid taking supplements containing vitamin E or other antioxidant vitamins (beta-carotene, vitamin C) immediately before and following angioplasty without the supervision of a health care professional. These vitamins seem to interfere with proper healing.

Diabetes: Vitamin E might increase the risk for heart failure in people with diabetes. People with diabetes should avoid high doses of vitamin E.

Heart attack: Vitamin E might increase the risk for death in people with a history of heart attack. People with a history of heart attack should avoid high doses of vitamin E.

Low levels of vitamin K (vitamin K deficiency): Vitamin E might worsen clotting problems in people whose levels of vitamin K are too low.

An eye condition called retinitis pigmentosa: All-rac-alpha-tocopherol (synthetic vitamin E) 400 IU seems to speed vision loss in people with retinitis pigmentosa. However, much lower amounts (3 IU) do not seem to produce this effect. If you have this condition, it is best to avoid vitamin E.

Bleeding disorders: Vitamin E might make bleeding disorders worse. If you have a bleeding disorder, avoid taking vitamin E supplements.

Head and neck cancer: Do not take vitamin E supplements in doses of 400 IU/day or more. Vitamin E might increase the chance that cancer will return.

Prostate cancer: There is concern that taking vitamin E might increase the chance of developing prostate cancer. The effect of vitamin E in men who currently have prostate cancer is not clear. However, in theory, taking vitamin E supplements might worsen prostate cancer in men who already have it.

Stroke: Vitamin E might increase the risk for death in people with a history of stroke. People with a history of stroke should avoid high doses of vitamin E.

Surgery: Vitamin E might increase the risk of bleeding during and after surgery. Stop using vitamin E at least 2 weeks before a scheduled surgery.