Vitamin E, or alpha-tocopherol, is a fat-soluble vitamin that acts as a powerful antioxidant to protect cells from free radical damage and is involved in immune function. It’s an essential vitamin and must be found in your diet. Though vitamin E deficiency is rare, meeting daily vitamin E requirements is important to maintain health and prevent and treat disease.
Fat-soluble vitamins including vitamin E must be consumed with dietary fat in order for them to be efficiently transported and used throughout the body. Mother Nature has made it easy for this to happen as vitamin E is naturally found in many foods that also contain fat like vegetable oils, eggs, meat, poultry, and nuts. Vitamin E is also found in broccoli, spinach, kiwifruit, mango, and tomato.
After vitamin E is absorbed in the small intestine, it’s taken up by the liver where it’s stored until it’s needed for use. At that point, the liver only resecretes alpha-tocopherol, the form that is recognized by the body.
There are a few situations where vitamin E deficiency is possible: in premature babies with low birth weight or people with a fat-malabsorption disorder, like Crohn’s disease and cystic fibrosis, where the body has a hard time or does not properly absorb dietary fat. Both require supplementation to reduce the risk of complications.
Health Benefits
Vitamin E is important for the health of your brain, eyes, immune system, and heart. It is possible that the nutrient may prevent heart disease and eye disorders, improve cognitive function, and even protect against some cancers. However, the research supporting these claims is varied.
May Prevent Coronary Heart Disease
Whether vitamin E prevents coronary heart disease (CVD) for the general population has yet to be determined. Much of the existing research is contradictory with findings suggesting vitamin E supplementation in high-risk patients is beneficial, while other research indicates that vitamin E does not improve cardiovascular risk factors at all.
According to a review published in the Journal of Lipid Research, administering vitamin E supplementation may be cardioprotective for those with high levels of oxidative stress, including people with type 2 diabetes and individuals undergoing hemodialysis.
Interestingly, a 2019 study determined quite the opposite, that supplementing with vitamin E had negative effects on coronary artery disease (CAD). Scientists found that higher vitamin E levels may actually increase the risk of CAD.
At this time more research is needed to determine the effects of vitamin E on cardiovascular risk factors. Talk with your cardiologist before taking vitamin E to improve heart health.
Finally, the American Heart Association does not promote the usage of vitamin E supplementation to prevent cardiovascular disease as it may be associated with an increase in total mortality, heart failure, and hemorrhagic stroke. They do however suggest eating foods rich in vitamin E and other antioxidant nutrients to promote heart health.
Could Reduce Risk of Developing Certain Cancers
Another controversial benefit of vitamin E is its effect on cancer. Vitamin E acts as a powerful antioxidant that prevents and fights free radical oxidation and damage to cells which may play a role in the development of cancer and other health conditions.
Research on whether or not vitamin E prevents or promotes cancer is still emerging and is specific to the form of vitamin E and its bioavailability. There is some evidence suggesting that lower vitamin E intake is associated with increased cancer risk.
Other reviews have examined the type of vitamin E (tocopherols and tocotrienols) on cancer risk and have found that a gamma-tocopherol-rich mixture of vitamin E tocopherols is a promising anti-cancer agent and should be studied further.
On the other hand, some evidence does not support the supplementation of vitamin E for cancer prevention. One study examined the effect of vitamin E supplementation on risk of prostate cancer and showed that vitamin E is not a good prevention method for cancer. This study also determined that vitamin E may in fact increase the risk of prostate cancer.
More research is needed to determine whether vitamin E can help prevent cancer.
May Prevent or Treat Eye Disorders
Macular degeneration (AMD) and cataracts are the most common age-related eye diseases and are associated with oxidative stress and free radical damage. Vitamin E’s antioxidant activity makes it an ideal candidate for the prevention and treatment of both AMD and cataracts.
One review investigated the benefits of antioxidant micronutrients on eye health and macular degeneration. It found that vitamin E helps reduce the cellular oxidative stress of the retina or macular region of the eye. Additional studies have found a correlation between increased dietary vitamin E and the slower rate of progression of AMD.
In addition, vitamin E aids in the self-repair of the retina, cornea, and uvea (the pigmented portion of the eye). A 2015 review of studies published in Public Health Nutrition concluded that vitamin E supplementation was associated with a reduced risk of aging-related cataracts.
Though the evidence is promising for vitamin E and the prevention of age-related eye disorders, more research is needed.
May Prevent or Delay Cognitive Decline
Cognitive health refers to how well you think, learn, and remember things. A balanced, nutritious diet is at the forefront of maintaining good cognitive health and preventing age-related cognitive deterioration including dementia and Alzheimer’s.
It’s been postulated that foods rich in antioxidant vitamins would slow the onset of Alzheimer’s disease. However, the research is not clear on whether supplementing with antioxidant vitamins including vitamin E is only beneficial for those with antioxidant vitamin deficiencies.
However, one study did see a slight decline in the incidence of Alzheimer’s disease when supplementing with vitamin E.
Another study hypothesized that supplementation with vitamin E in patients with Alzheimer’s disease could protect against oxidative damage, reduce neuronal damage, and slow the progression of Alzheimer’s disease. After two years of supplementing with 2000 IUs per day of vitamin E, researchers found that they were able to slow the progression of the disease.
A similar study over three years found that vitamin E had no benefit in patients with mild cognitive impairment. And the rate of progression of Alzheimer’s disease did not change.
More research is needed to determine whether supplementing with vitamin E will slow the onset or progression of age-related cognitive decline. However, those with a deficiency would benefit from supplementing with alpha-tocopherol vitamin E.
Skin Disorders
Vitamin E has been used for decades in dermatology as a shield to protect the skin from free radical damage. When taken orally vitamin E helps reduce the time it takes for wounds to heal.
Topically vitamin E is known for its anti-inflammatory properties and is used to promote collagen production. Unfortunately, existing research is varied and inconclusive.
While it sounds great, expecting vitamin E to clear up skin conditions beyond reducing healing time could possibly be a waste of money. A quality skincare routine and a discussion with a dermatologist is the best way to combat skin disorders.
Possible Side Effects
Large Doses of Vitamin E
Vitamin E supplements rarely cause any harm if taken at the recommended daily dose. And research has not found any negative effects from vitamin E found in food.
However, if you take vitamin E in doses greater than the RDA of 300 IUs per day, you put yourself at a greater risk of hemorrhagic stroke. One study cautions against the use of vitamin E supplementation as it found vitamin E increased the risk of hemorrhagic stroke by 22%.
Even doses lower than this can trigger side effects like nausea, vomiting, stomach pain, and diarrhea.
Interactions with Medications
Vitamin E prevents platelet aggregation, meaning it slows blood clotting. Talk to a healthcare professional before taking vitamin E if you take blood thinners, including Coumadin (warfarin) or Plavix (clopidogrel), especially if you have low vitamin K intake.
Additionally, avoid taking vitamin E at least two weeks before surgery to prevent excessive bleeding.
Vitamin E may also interact with certain medications, including the immune-suppressive drug Sandimmune (cyclosporine), certain chemotherapy drugs, statin drugs like Lipitor (atorvastatin), and tamoxifen.
Pregnant or Breastfeeding
Vitamin E is generally found to be safe for people who are pregnant or breastfeeding. Always speak with a health care provider before taking any new supplements or medications.
Dosage and Preparation
The recommended dietary allowance (RDA) for vitamin E is 15 mg. Most vitamin E supplements provide around 67 mg of the nutrient, which is much greater than the RDA. Those requiring a vitamin E supplement likely have a diagnosed vitamin E deficiency, which is much more appropriate for the 60 to 75 mg per day dosage provided in a supplement. Large dosage vitamin E supplements should be approached with caution and discussed with your doctor in advance.
Vitamin E supplements are available in two forms: synthetic and natural. The natural form of vitamin E is alpha-tocopherol while the synthetic form is DI-alpha-tocopherol. Both work well, however, a larger dose of the synthetic form is required to achieve similar results. You can also find vitamin E supplements containing both forms of alpha-tocopherol, called mixed tocopherols.
It can be confusing to figure out if a product contains the dosing you need in a vitamin E supplement. Use these simple formulas to ensure you remain within the RDA of vitamin E:
Vitamin E Dosing Formulas
- To calculate the milligram dose of D-alpha-tocopherol, multiply the IUs by 0.67. Based on this formula, 25 IUs equal 16.75 mg.
- To calculate the milligram dose of Dl-alpha-tocopherol, multiply the IUs by 0.43. Based on this formula, 50 IUs equal 21.5 mg.
What to Look For
Supplement manufacturers are not required to put their products through vigorous testing and research. Because of this, there’s no way to be sure the label represents what is actually in the bottle.
To find products you can trust, opt for brands that voluntarily put their products through independent third-party testing by a certifying body like the U.S. Pharmacopeia (USP), ConsumerLab, or NSF International.
Vitamin E is sensitive to heat and can quickly degrade if exposed to extreme heat or direct sunlight. Always store vitamin E in a cool, dry room, in the original container. Remember to discard any gel caps that have reached their use-by or expiration date, are discolored, or have evidence of leakage.
Topical vitamin E oil is available in drugstores and health food markets. It’s intended for external use only.
Other Questions
Which foods are highest in vitamin E?
Vitamin E is found naturally in a variety of foods. The best food sources of vitamin E include nuts, seeds, vegetable oils, leafy green vegetables, and fortified cereals.
Vitamin E-Rich Foods
- Wheat germ oil: 21.8 mg per tablespoon (or 135% of your daily value)
- Sunflower seeds: 7.4 mg per one-ounce serving (or 49% of your daily value)
- Almonds: 7.4 mg per one-ounce serving (or 49% of your daily value)
- Avocados: 4.2 mg per avocado (or 28% of your daily value)
- Trout: 4 mg per average trout (or 26% of your daily value)
- Spinach: 3.7 mg per one-cup serving (or 25% of your daily value)
- Butternut squash: 2.6 mg per one-cup serving (or 18% of your daily value)
- Kiwi fruit: 2.6 mg per one-cup serving (or 18% of your daily value)
- Broccoli: 2.3 mg per one-cup serving (or 15% of your daily value)
- Olive oil: 1.9 mg per tablespoon (or 13% of your daily value)
- Shrimp: 1.9 mg per 3-ounce serving (or 13% of your daily value)