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
Scoring methodology
EFSA approval.
Vitamin E deficiency ✪✪✪✪✪
Vitamin E deficiency is rare and most often manifests through genetic abnormalities that prevent maintaining normal blood concentrations of vitamin E or through conditions that prevent absorption. nnVitamin E deficiency does not cause a specific disease in adults. Neurological and ocular signs dominate the clinical picture of vitamin E deficiency. Symptomatic early deficiency usually presents with decreased reflexes, impairment of proprioceptive and vibratory sensation, decreased distal muscle strength and sometimes night blindness. Ataxia and nystagmus may also be present. At a later stage, ocular signs progress to ophthalmoplegia and blindness with the onset of cognitive disturbances indicating the severity and chronicity of the deficiency.nnIn cases of vitamin E deficiency, an oral dose of 50 to 2,000 IU/day is used.nn
Posologie
Orally
800 - 1200 mg
alpha-Tocopherol
Ataxia ✪✪✪✪✪
Ataxia with constitutional vitamin E deficiency is a very rare and severe hereditary genetic disorder causing gait and balance disturbances. The responsible gene is located on the long arm of chromosome 8. In the absence of replacement therapy, the neurological signs worsen leading to loss of independence. nnThe recommended dose is 800 to 1500 mg/day of RRR alpha-Tocopherol for adult patients, and 40 mg/kg in children. It is a lifelong treatment and any interruption, even temporary, is accompanied by a drop in vitamin E concentration within 2 to 3 days.nn
Posologie
Orally
800 - 1500 mg
Children, Adults
alpha-Tocopherol
Immune support ✪✪✪✪✪
It is known that age is associated with a reduction in immune responsiveness, particularly with regard to T-lymphocyte functions, including delayed responses to mitogens, antibody responses to antigen immunization, and decreases in delayed-type hypersensitivity and IL-2 production. In tests conducted on healthy elderly individuals given 50 mg and 100 mg of α-tocopherol for six months, an increase in immune responsiveness was observed. Other studies have observed the same benefit with 200 mg of α-tocopherol in otherwise healthy elderly subjects. Limited studies evaluating T cell function in non-elderly adults (20-50 years) who received vitamin E supplements did not find a significant effect.
Posologie
Oral
50 - 200 mg
6 months
alpha-tocopherol
Influence of age 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 aging.
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 plasma oxidation at doses above 500 mg of alpha-tocopherol in conditions where there is an abnormal increase in oxidation. Vitamin E has no effect at lower doses or in people without abnormal oxidation levels.
Posologie
Oral
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 may slow the progression of Alzheimer's disease. Some clinical research shows that taking synthetic vitamin E at a dose of 2000 IU per day is similar to selegiline, and superior to placebo, in slowing the decline of cognitive function in patients with moderately severe Alzheimer's disease. However, there does not appear to be an additive effect when vitamin E is used in combination with selegiline. Other clinical research shows that taking synthetic vitamin E at a dose of 2000 IU per day reduces the annual rate of decline in activities of daily living in patients with mild to moderate Alzheimer's disease by 19% compared with placebo. This corresponds to a delay of 6.2 months in disease progression.
Posologie
Oral
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 problems ✪✪✪✪✪
In one study, men with asthenozoospermia or oligoasthenospermia who received oral vitamin E supplementation achieved a pregnancy rate of 21% versus 0% in similar patients receiving placebo. In another study, men enrolled in an in vitro fertilization program who had previously had low fertilization rates were treated with oral vitamin E for three months. The fertilization rate rose from 19% at baseline to 29% after one month of treatment. Additionally, in a cross-over trial, men whose semen contained high levels of 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 that surrounds the oocyte) increased significantly. 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 of 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 nonalcoholic steatohepatitis, some clinical research shows that daily intake of vitamin E at 800 IU for 24 months improves liver enzyme levels, hepatic fibrosis, steatosis, and lobular inflammation. The intake of vitamin E at 400-1200 IU in children with nonalcoholic steatohepatitis also appears to improve liver enzyme levels after 4 to 10 months of treatment.
Posologie
Oral administration
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 in young women with primary dysmenorrhea shows that taking vitamin E at 400 to 500 IU per day, starting 2 days before menstruation and continuing for the first 3 days of bleeding, reduces the intensity and duration of pain and decreases blood loss compared with placebo.
Posologie
Oral administration
266.7 - 333.33 mg
Premenstrual syndrome ✪✪✪✪✪
Oral vitamin E appears to reduce symptoms of anxiety and depression in women with premenstrual syndrome. Vitamin E 400 to 500 IU per day was used starting 2 days before menstruation and during the first 3 days of bleeding.
Posologie
Oral
266.7 - 333.33 mg
Rheumatoid arthritis ✪✪✪✪✪
Oral vitamin E in combination with standard treatment reduces rheumatoid arthritis-related pain more than standard treatment alone. However, vitamin E does not appear to improve inflammation. A dose of 600 IU twice daily was used to relieve pain related to rheumatoid arthritis.
Posologie
Oral
800 mg
Synergies
High blood pressure ✪✪✪✪✪
According to clinical research, vitamin E supplementation can reduce blood pressure and LDL oxidation and improve endothelial dysfunction related to hypertension. Indeed, a clinical trial showed that long-term vitamin E intake (200 IU/day) reduced systolic blood pressure by 24% in hypertensive patients, compared with 1.6% with placebo. nn
Posologie
Orally
133.33 mg
Properties
Essential
The main function of vitamin E is probably that of an antioxidant that prevents the formation of free radicals. The therapeutic benefits of vitamin E have been mainly attributed to its antioxidant effects. Alpha-tocopherol is the most active form in humans.
Usages associés
Antioxidant
Vitamin E is a chain reaction inhibitor and neutralizes free radicals.
Usages associés
Immunomodulator
Vitamin E may play a role in allergic reactions. Lower serum levels of vitamin E have also been associated with higher IgE levels. Furthermore, most research suggests that vitamin E supplementation in healthy older adults improves the response to the delayed-type hypersensitivity skin test, an indicator of immune function, and the antibody response to hepatitis B, tetanus and diphtheria, as well as to pneumococcal vaccines. But it is unknown whether vitamin E supplementation improves the 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 an interaction with free radicals and a reduction in cellular damage. Preliminary data suggest that vitamin E could improve cognitive function by reducing damage caused by beta-amyloid.
Usages associés
Effect on fertility
Vitamins C and E are antioxidants that protect DNA against free radicals, which have a very harmful impact on sperm. They also help increase sperm volume.
Usages associés
Cardiovascular
Tocotrienols may reduce total cholesterol and LDL cholesterol, possibly by decreasing HMG-CoA reductase activity, but in a different way than "statins" (lipid-lowering drugs). Tocotrienols may also be able to reduce the size of carotid artery plaques in some people, possibly by decreasing platelet aggregation.nnIn animals, gamma-tocopherol appears to prolong prothrombin time and cause bleeding.nnLarge amounts of vitamin E interfere with the production of vitamin K-dependent clotting factors, particularly in people who are vitamin K deficient or those taking oral anticoagulants. Mixed tocopherols appear to have a greater effect on platelet aggregation than alpha-tocopherol alone, which may explain the difference between the effects of dietary vitamin E intake and those of a vitamin E supplement (alpha-tocopherol) on cardiovascular disease.nn
Usages associés
Analgesic
Vitamin E is thought to reduce pain by decreasing prostaglandin production through prevention of phospholipid peroxidation and the release of arachidonic acid.nn
Usages associés
Safe dosage
Adults aged 10 years and older: 12 mg - 300 mg
Children aged 1 to 2 years: 6 mg - 100 mg
Breastfeeding women aged 18 years and older: 11 mg - 300 mg
Children aged 3 years: 9 mg - 100 mg
Children aged 4 to 6 years: 9 mg - 120 mg
Children aged 7 to 9 years: 9 mg - 160 mg
Children aged 10 years: 11 mg - 160 mg
Children aged 11 to 14 years: 11 mg - 220 mg
Children aged 15 to 17 years: 11 mg - 260 mg
Interactions
Médicaments
Antiplatelet agents/Anticoagulants: moderate interaction
Concurrent use of vitamin E and anticoagulants or antiplatelet agents may increase the risk of bleeding. Vitamin E appears to inhibit platelet aggregation and interfere with vitamin K-dependent clotting factors. The use of more than 400 IU of vitamin E per day with warfarin could prolong prothrombin time and increase the INR (International Normalized Ratio: derived from the prothrombin time, used to adjust doses of vitamin K antagonists) due to interference with the production of vitamin K-dependent clotting factors. The INR should be closely monitored in patients taking warfarin who are also taking vitamin E at doses of 400 IU or more. Anticoagulant and antiplatelet medications 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, tocophersolan, Liqui-E) may increase cyclosporine absorption by 40% to 72%. It is unlikely that this interaction occurs with the usual 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 the HDL-2 fractions and apolipoprotein A1. However, vitamin E alone in combination with a statin does not appear to decrease HDL cholesterol levels. Statins include lovastatin (Mevacor), pravastatin (Pravachol), fluvastatin (Lescol), and atorvastatin (Lipitor).
Precautions
Pregnant women aged 18 years and older: use with caution
Vitamin E is safe when used orally and appropriately at amounts not exceeding the recommended dietary allowance. However, some studies suggest that vitamin E supplementation early in pregnancy may be harmful.nnUntil more is known, pregnant women are advised to avoid taking a vitamin E supplement early in pregnancy unless it is necessary for an appropriate medical indication.nn
Angioplasty: avoid
The use of antioxidant vitamins, particularly vitamin E, after angioplasty can have harmful effects in patients. Studies have shown that the use of 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 stroke or myocardial infarction.
Coagulation disorder: use with caution
Vitamin E administered at 1,000 IU per day can decrease vitamin K-dependent clotting factors, thereby worsening the coagulation disorder.
Surgical procedure: avoid
Vitamin E has antiplatelet effects, so it can cause excessive bleeding if used perioperatively. Vitamin E should be stopped at least 2 weeks before a planned surgical procedure.
