Vitamin E: benefits, dosage, contraindications
Other name(s)
Alpha Tocopherol Acetate, Tocopherol Acetate
Scientific name(s)
Alpha tocotrienol, Alpha-tocopherol
Family or group:
Vitamins
Indications
Rating methodology
EFSA approval.
Vitamin E deficiency ✪✪✪✪✪
Vitamin E deficiency is rare and most often results from genetic abnormalities that prevent the maintenance of normal blood concentrations of vitamin E or conditions that prevent absorption. Vitamin E deficiency does not cause a specific disease in adults. Neurological and eye signs dominate the clinical picture of vitamin E deficiency. Symptom onset typically manifests with decreased reflexes, proprioceptive and vibratory sensitivity disorders, decreased distal muscle strength, and sometimes night blindness. An ataxia and nystagmus may also be present. In later stages, eye symptoms evolve into ophthalmoplegia and blindness, with the appearance of cognitive disorders indicating the depth and oldness of the deficiency. In the case of vitamin E deficiency, an oral dose of 50 to 2,000 IU/day is used.
Posologie
Orally
800 - 1200 mg
alpha Tocopherol
Ataxia ✪✪✪✪✪
Ataxia with vitamin E deficiency is a very rare and severe hereditary genetic condition leading to gait and balance disorders. The responsible gene is located on the long arm of chromosome 8. In the absence of replacement therapy, neurological signs worsen, leading to loss of autonomy. The recommended dose is 800 to 1500 mg/day of RRR alpha Tocopherol for adult patients, and 40mg/kg in children. This is lifelong treatment, and any temporary discontinuation results in a drop in vitamin E concentration within 2 to 3 days.
Posologie
Orally
800 - 1500 mg
Children, Adults
alpha Tocopherol
Immune enhancement ✪✪✪✪✪
It is known that age is associated with a reduction in immune reactivity, particularly regarding T lymphocyte functions, which include delayed responses to mitogens, antibody responses to antigen immunization and reductions in delayed hypersensitivity and IL2 production. Tests performed on healthy elderly individuals with 50 mg and 100 mg of α-tocopherol for six months showed an increase in immune reactivity. Other studies noted the same benefit with 200 mg of α-tocopherol in otherwise healthy elderly individuals. Limited studies evaluating T cell function in non-elderly adults (20-50 years old) receiving vitamin E supplements found no significant influence.
Posologie
Orally
50 - 200 mg
6 - months
alpha Tocopherol
Age influence on the immune system.
Humoral immunity in aging.
Vitamin E supplementation and in vivo immune response in healthy elderly subjects. A randomized controlled trial.
Signal transduction changes in granulocytes and lymphocytes with ageing.
Effect of 50- and 100-mg vitamin E supplements on cellular immune function in noninstitutionalized elderly persons.
Oxidative stress ✪✪✪✪✪
Vitamin E supplementation appears to reduce oxidation in the plasma at doses greater than 500 mg of α-tocopherol in states where there is an abnormal elevation of oxidative markers. Vitamin E has no effect at lower doses or in individuals without abnormal oxidation levels.
Posologie
Orally
500 mg
alpha Tocopherol
Dose Dependent Elevation Of Plasma Tocotrienol Levels And Its Effect On Arterial Compliance, Plasma Total Antioxidant Status, And Lipid Profile In Healthy Humans Supplemented With Tocotrienol Rich Vitamin E.
Effect Of Alpha-tocopherol Supplementation On Plasma Homocysteine And Oxidative Stress In Highly Trained Athletes Before And After Exhaustive Exercise
Dose Dependent Elevation Of Plasma Tocotrienol Levels And Its Effect On Arterial Compliance, Plasma Total Antioxidant Status, And Lipid Profile In Healthy Humans Supplemented With Tocotrienol Rich Vitamin E
The Relationship Between Dose Of Vitamin E And Suppression Of Oxidative Stress In Humans
The Relationship Between Dose Of Vitamin E And Suppression Of Oxidative Stress In Humans
Alzheimer's Disease ✪✪✪✪✪
Several clinical studies show that taking vitamin E can slow the progression of Alzheimer's disease. Some clinical research indicates that taking 2000 IU of synthetic vitamin E per day is similar to selegiline, and superior to placebo, in slowing cognitive decline in patients with moderately severe AD. However, there does not seem to be an additive effect when vitamin E is used in combination with selegiline. Other clinical research indicates that taking 2000 IU of synthetic vitamin E per day reduces the annual rate of decline in daily living activities in patients with mild to moderate Alzheimer's disease by 19% compared to placebo. This translates to a delay of 6.2 months in the progression of the disease.
Posologie
Orally
1333.33 mg
Synthetic alpha-tocopherol.
RISK REDUCTION OF COGNITIVE DECLINE AND DEMENTIA
A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study.
Combination therapy of donepezil and vitamin E in Alzheimer disease.
Male fertility issues ✪✪✪✪✪
In one study, men suffering from asthenozoospermia or oligoasthenozoospermia receiving oral vitamin E supplementation achieved a fertilization rate of 21% compared to 0% in similar patients receiving a placebo. In another study, men enrolled in an in vitro fertilization program with previously low fertilization rates were treated with oral vitamin E for three months. The fertilization rate increased from 19% initially to 29% after one month of treatment. Moreover, in a cross-over trial, men whose sperm contained high reactive oxygen species, which may be associated with infertility, were treated with oral vitamin E. After treatment, in vitro sperm binding to the zona pellucida (an extracellular matrix surrounding the egg) significantly increased. More recent studies combine vitamin E (400 IU/day) with selenium (and/or vitamin C) and have been correlated with increased fertility. Vitamin E has been used at doses ranging from 200 IU to 800 IU per day.
Posologie
Orally
133.33 - 533.33 mg
Synergies
Selenium-vitamin E supplementation in infertile men. Effects on semen parameters and micronutrient levels and distribution.
A double-blind randomized placebo cross-over controlled trial using the antioxidant vitamin E to treat reactive oxygen species associated male infertility.
Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebo-controlled, double-blind study.
The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program.
Hepatic steatosis ✪✪✪✪✪
In adults with non-alcoholic steatohepatitis, some clinical research shows that taking 800 IU of vitamin E daily for 24 months improves liver enzyme levels, liver fibrosis, steatosis, and lobular inflammation. In children with non-alcoholic steatohepatitis, taking vitamin E in doses of 400-1200 IU seems to also improve liver enzyme levels after 4 to 10 months of treatment.
Posologie
Orally
533.33 mg
24 - months
Adults
Vitamins E and C for the treatment of NASH: duplication of results but lack of demonstration of efficacy.
Vitamin E treatment of nonalcoholic steatohepatitis in children: a pilot study.
Vitamin E has a beneficial effect on nonalcoholic fatty liver disease: a meta-analysis of randomized controlled trials.
The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association.
Dysmenorrhea ✪✪✪✪✪
Clinical research conducted on young women with primary dysmenorrhea shows that taking 400 to 500 IU of vitamin E per day, starting 2 days before menstruation and continuing during the first 3 days of bleeding, decreases the intensity and duration of pain and reduces blood loss compared to placebo.
Posologie
Orally
266.7 - 333.33 mg
Premenstrual syndrome ✪✪✪✪✪
Taking vitamin E orally seems to reduce anxiety and depression symptoms in patients with premenstrual syndrome. Vitamin E 400 to 500 IU per day has been used from 2 days before the menstrual period and during the first 3 days of bleeding.
Posologie
Orally
266.7 - 333.33 mg
Rheumatoid arthritis ✪✪✪✪✪
Taking vitamin E orally in combination with standard treatment reduces the pain associated with rheumatoid arthritis more than standard treatment alone. However, vitamin E does not seem to improve inflammation. A dose of 600 IU twice a day has been used to relieve pain related to rheumatoid arthritis.
Posologie
Orally
800 mg
Synergies
Hypertension ✪✪✪✪✪
According to clinical research, vitamin E supplementation can reduce blood pressure and LDL oxidation and improve endothelial dysfunction associated with hypertension. Indeed, a clinical study showed that long-term intake of vitamin E (200 IU/d) decreases systolic blood pressure by 24% in hypertensive patients, compared to 1.6% with a placebo.
Posologie
Orally
133.33 mg
Properties
Essential
The primary function of vitamin E is likely that of an antioxidant that prevents the formation of free radicals. The therapeutic benefits of vitamin E have mainly been attributed to its antioxidant effects. Alpha-tocopherol is the most active form in humans.
Usages associés
Antioxidant
Vitamin E is a chain-breaking, free radical scavenging antioxidant.
Usages associés
Immune-modulator
Vitamin E may play a role in allergic reactions. Lower serum vitamin E levels have also been associated with higher IgE levels. Furthermore, most research suggests that vitamin E supplementation in healthy older adults improves delayed-type hypersensitivity skin test response, an indicator of immune function, and antibody response to hepatitis B, tetanus, and diphtheria and pneumococcal vaccines. However, it is unknown if vitamin E supplementation improves the overall health of older adults.
Usages associés
Cognitive Function
Vitamin E has been studied for its ability to slow the progression of Alzheimer's disease, possibly due to interaction with free radicals and decreased cellular damage. Preliminary data suggest that vitamin E may improve cognitive function by lessening the damage caused by beta-amyloid.
Usages associés
Fertility Effect
Vitamins C and E are antioxidants with the particularity of protecting DNA from free radicals, which have a highly detrimental impact on sperm. They also help increase sperm volume.
Usages associés
Cardiovascular
Tocotrienols may reduce total cholesterol and LDL cholesterol, possibly by decreasing the activity of HMG CoA reductase, but in a manner different from "statins" (lipid-lowering medications). Tocotrienols might also be able to reduce the size of carotid artery plaques in some people, possibly by decreasing platelet aggregation. In animals, gamma-tocopherol appears to prolong prothrombin time and cause bleeding. Large amounts of vitamin E interfere with the production of vitamin K-dependent coagulation factors, particularly in people with a vitamin K deficiency or those taking oral anticoagulants. Mixed tocopherols seem to have a greater effect on platelet aggregation than alpha-tocopherol alone, which could explain the difference between the effects of dietary vitamin E intake and those of a vitamin E supplement (alpha-tocopherol) in cardiovascular diseases.
Usages associés
Analgesic
Vitamin E is believed to reduce pain by decreasing prostaglandin production through the prevention of phospholipid peroxidation and arachidonic acid release.
Usages associés
Safety dosage
Adult from 10 years: 12 mg - 300 mg
Child from 1 to 2 years: 6 mg - 100 mg
Breastfeeding female from 18 years: 11 mg - 300 mg
Child from 3 to 3 years: 9 mg - 100 mg
Child from 4 to 6 years: 9 mg - 120 mg
Child from 7 to 9 years: 9 mg - 160 mg
Child from 10 to 10 years: 11 mg - 160 mg
Child from 11 to 14 years: 11 mg - 220 mg
Child from 15 to 17 years: 11 mg - 260 mg
Interactions
Médicaments
Antiplatelet agents/Anticoagulant: moderate interaction
The concurrent use of vitamin E and anticoagulants or antiplatelet drugs may increase the risk of bleeding. Vitamin E appears to inhibit platelet aggregation and interfere with vitamin K-dependent coagulation factors. Using more than 400 IU of vitamin E per day with warfarin could prolong prothrombin time and increase INR (International Normalized Ratio: derived from prothrombin rate, used to adjust doses of vitamin K antagonists) due to interference with the production of vitamin K-dependent coagulation factors. INR should be closely monitored in patients taking warfarin and who are taking vitamin E at doses of 400 IU or more. Anticoagulant and antiplatelet drugs that may interact with vitamin E include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
Cyclosporine: moderate interaction
There is some evidence that a specific formulation of vitamin E (D-alpha-tocopheryl polyethylene glycol-1000 succinate, TPGS, tocophersolane, Liqui-E) can increase the absorption of cyclosporine by 40% to 72%. This interaction is unlikely to occur with regular forms of vitamin E.
Statins: moderate interaction
Clinical research shows that the combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium), simvastatin (Zocor), and niacin may decrease HDL cholesterol levels, particularly HDL-2 fractions and apolipoprotein A1. However, vitamin E alone associated with a statin does not seem to decrease HDL cholesterol levels. Statins include lovastatin (Mevacor), pravastatin (Pravachol), fluvastatin (Lescol), and atorvastatin (Lipitor).
Precautions
Pregnant woman from 18 years: use with caution
Vitamin E is safe to use orally and appropriately in amounts not exceeding the recommended dietary allowance. However, some studies suggest that vitamin E supplementation in early pregnancy may be harmful. Until more is known, pregnant women are advised to avoid taking vitamin E supplements early in pregnancy unless it is necessary for a proper medical indication.
Angioplasty: avoid
Using antioxidant vitamins, including vitamin E, after angioplasty may be harmful to patients. Studies have shown that using vitamin E is associated with a significant increase in the risk of mortality and heart failure in people with a history of serious cardiovascular disease, such as a stroke or myocardial infarction.
Coagulation disorder: use with caution
Vitamin E administered at 1,000 IU per day may lower vitamin K-dependent coagulation factors, thus worsening coagulation disorders.
Surgical intervention: avoid
Vitamin E has antiplatelet effects, which can cause excessive bleeding if used perioperatively. Vitamin E should be stopped at least 2 weeks before scheduled surgery.
