Vitamin e how much

Easy does it with vitamin E

Published: March, 2014

Swallowing an amber-colored vitamin E capsule has long been a daily ritual for millions of American women. It may be time to stop.

Today vitamin E is one of the most widely used supplements, taken regularly by nearly a quarter of adults ages 55 and over. Its popularity derives from studies over the years suggesting that vitamin E’s antioxidant properties could help stave off common age-related ills, such as heart disease, cancer, and cataracts. Many health care professionals were personally on board, taking the supplement as well as recommending it. Although there was no proof of its effectiveness, the consensus was, “It might help, and it couldn’t hurt.”

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I understand your concern. Here’s the story: results of a new analysis from Johns Hopkins University suggest that taking daily doses of vitamin E that exceed 400 international units (IU) can increase the risk of death. The researchers arrived at their conclusion after analyzing death rates in 19 unrelated clinical trials that studied vitamin E supplementation for various health conditions. The trials took place from 1993 to 2004 and all together included more than 136,000 patients in North America, Europe and China. The vitamin E doses used in the different trials ranged from 15 to 2000 IU per day; the average daily intake was about 400 IU.

The technique used to arrive at the Hopkins’ results – called meta-analysis – can only raise questions, not answer them. Vitamin E has no known toxicity, except for an anticoagulant effect that is usually desirable.

The analysis found that taking a daily dose of 200 IU per day presented no increased risk of death and suggested that it might benefit health. However, the researchers found an increased risk of death at daily doses exceeding 200 IU; for those taking daily doses of 400 IU or more the risk of death was about 10 percent higher than among those taking placebos.

But the analysis also revealed some seemingly contradictory data. For example, one of the studies showed that among people who had had a heart attack, taking vitamin E was correlated with a lower risk of a second heart attack. Despite this encouraging finding, the patients taking the vitamin E were more likely to die than those taking the placebo.

It is important to know that most of the patients in all of the trials analyzed were over 60 and had pre-existing health problems such as heart or kidney disease. The Hopkins researchers conceded that because of the age and compromised health of the study participants, their findings might not apply to younger, healthier people. The study results were presented on Nov. 10, 2004, at the American Heart Association’s Scientific Sessions in New Orleans. They were simultaneously released on the Web site of the Annals of Internal Medicine.

My feeling is that the health status of the study participants could be the problem here – perhaps the vitamin E had some unpredictable bad effect on their pre-existing conditions or didn’t mix well with certain medications. The researchers also may have overlooked controlling for the form of vitamin E used in the various studies. Natural vitamin E in the form of mixed tocopherols can possibly provide different benefits than synthetic versions limited to alpha tocopherol. We’ve seen in the past that under certain circumstances supplements can have unexpected, negative effects. For example, two major studies have shown that straight beta carotene supplements led to more, not less, lung cancer among smokers.

Based on what we know now, my advice is still to take supplemental vitamin E in doses up to 400 IU a day but not exceeding that. Avoid dl-alpha-tocopherol and look for products that include all four tocopherols, not just the d-alpha form. Better yet, try to get the whole vitamin E complex: four tocopherols plus four tocotrienols. But, as always, be sure to discuss with your physician any supplements and medications you take – over the counter or otherwise.

Andrew Weil, MD

Vitamin E is a vital nutrient for good health, and it’s found in a wide variety of foods and supplements. The best way to consume this vitamin is through a healthy diet. Deficiency is rare, and overdosing by using supplements is a concern. Those who have certain health conditions or take certain medicines should be cautious with supplements.

Sources of vitamin E

Vitamin E is a family of fat-soluble compounds. “It occurs naturally in eight different forms, including four tocopherols (alpha, beta, gamma and delta) and four tocotrienols. Alpha tocopherol is the most common and most potent form of the vitamin,” said Elizabeth Somer, registered dietitian and author of “The Essential Guide to Vitamins and Minerals” (HarperTorch, 1993).

Good dietary sources of vitamin E include nuts, such as almonds, peanuts and hazelnuts, and vegetable oils, such as sunflower, wheat germ, safflower, corn and soybean oils, according to the U.S. National Library of Medicine (NLM). Sunflower seeds and green, leafy vegetables such as spinach and broccoli also contain vitamin E.

How much vitamin E do you need?

The recommended dietary allowance (RDA) for vitamin E is 15 milligrams (or 22.4 International Units, or IU) for people over age 14, according to the National Institutes of Health (NIH). Women who are breastfeeding may need a little more vitamin E, so the RDA for lactating women is 19 mg (28.4 IU). Doses below 1,000 mg (1,500 IU) seem to be safe for most adults.

Most people are able to get enough vitamin E from a healthy diet and do not need supplements. Always consult with a doctor before taking any supplement, especially if you are taking medications. More than 250 medications are known to interact with vitamin E, according to Drugs.com.

Vitamin E deficiency

A vitamin E deficiency is very rare, though some people are more prone to a vitamin E deficiency than others, according to NIH. Infants, people with fat malabsorption and abetalipoproteinemia (a condition that prevents the body from completely absorbing certain dietary fats) are more likely to have vitamin E deficiency. Anemia, skeletal myopathy, ataxia, peripheral neuropathy, retinopathy, impairment of the immune response and nerve damage are signs that there may be a deficiency.

Benefits

Including sources of vitamin E in your diet brings many benefits.

As a fat-soluble nutrient, vitamin E functions mainly as an antioxidant, which means it helps protect cells from damage caused by unstable molecules called free radicals.

“It protects cells from damage, and it might aid in lowering a variety of health problems, from heart disease to cancer, and possibly even dementia,” Somer told Live Science.

In addition to providing cell protection, vitamin E is vital to a functioning immune system. As a powerful antioxidant, it helps cells fight off infection.

This vitamin also helps protect eyesight. A 2015 study by the Department of Epidemiology and Health Statistics of the Qingdao University Medical College found that vitamin E intake and high serum-tocopherol levels were linked to a decreased risk of age-related cataracts.

Vitamin E plays an important role in the production of hormone-like substances called prostaglandins, which are responsible for regulating a variety of body processes, such as blood pressure and muscle contraction. Also, a 2015 study published by the U.S. National Library of Medicine found that vitamin E aids in muscle repair after exercise, said Somer.

People with Crohn’s disease, cystic fibrosis or an inability to secrete bile from the liver into the digestive tract may need to take water-soluble, supplementalforms of vitamin E to avoid digestive problems, according to the NIH.

Risks

Some people may be sensitive to vitamin E supplements, according to the Mayo Clinic. Consuming vitamin E in a supplement can cause diarrhea, nausea, stomach cramps, weakness, tiredness, headaches, rashes and other problems.

As a fat-soluble vitamin, vitamin E is stored in the body, and excess is not washed out through the urinary tract, as does happen with water-soluble vitamins, according to Georgia Highlands College. This trait means that vitamin E can accumulate to toxic levels over time, so it’s possible to overdose on this vitamin.

Too much supplemental vitamin E can cause excessive bleeding and many other symptoms, including fatigue, nausea, blurred vision and gonadal dysfunction, according to the Mayo Clinic. The vitamin is also a mild blood thinner, so high doses are discouraged prior to surgery, advised Somer.

Furthermore, a 2005 study by a team of researchers at The Johns Hopkins Medical Institutions attempted to demonstrate that vitamin E supplements could help treat cardiovascular disease and cancer. Instead, the team found that taking high doses of vitamin E increased the mortality rate during the study period for cardiovascular disease and cancer patients. The researchers concluded that large doses of vitamin E should be avoided. They published their results in the journal Annals of Internal Medicine.

Similarly, a study by researchers found that people who took antioxidant supplements, including vitamin E, had a slightly increased risk of mortality during the study period. The results from that study were published in 2007 in the Journal of the American Medical Association and were focused on 68 randomized controlled trials that followed 232,606 participants for an average of 3.3 years.

Additional resources

  • NLM: Multiple Vitamin Overdose
  • Mayo Clinic: Vitamin E
  • Merck Manuals Professional Edition: Vitamin E – Nutritional Disorders

Vitamin E (Tocopherol) Test

What is a vitamin E (tocopherol) test?

A vitamin E test measures the amount of vitamin E in your blood. Vitamin E (also known as tocopherol or alpha-tocopherol) is a nutrient that is important for many body processes. It helps your nerves and muscles work well, prevents blood clots, and boosts the immune system. Vitamin E is a type of antioxidant, a substance that protects cells from damage.

Most people get the right amount of vitamin E from their diet. Vitamin E is found naturally in many foods, including green, leafy vegetables, nuts, seeds, and vegetable oils. If you have too little or too much vitamin E in your body, it can cause serious health problems.

Other names: tocopherol test, alpha-tocopherol test, vitamin E, serum

What is it used for?

A vitamin E test may be used to:

  • Find out if you are getting enough vitamin E in your diet
  • Find out if you are absorbing enough vitamin E. Certain disorders cause problems with the way the body digests and uses nutrients, such as vitamin E.
  • Check the vitamin E status of premature babies. Premature babies are at a higher risk of vitamin E deficiency, which can cause serious complications.
  • Find out if you are getting too much vitamin E

Why do I need a vitamin E test?

You may need a vitamin E test if you have symptoms of vitamin E deficiency (not getting or absorbing enough vitamin E) or of vitamin E excess (getting too much vitamin E).

Symptoms of a vitamin E deficiency include:

  • Muscle weakness
  • Slow reflexes
  • Difficulty or unsteady walking
  • Vision problems

Vitamin E deficiency is very rare in healthy people. Most of the time, vitamin E deficiency is caused by a condition where nutrients are not properly digested or absorbed. These include Crohn’s disease, liver disease, cystic fibrosis, and some rare genetic disorders. Vtamin E deficiency may also be caused by a very low-fat diet.

Symptoms of vitamin E excess include:

  • Diarrhea
  • Nausea
  • Fatigue

Vitamin E excess is also rare. It’s usually caused by taking too many vitamins. If not treated, excess vitamin E can lead to serious health problems, including an increased risk of stroke.

What happens during a vitamin E test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You will probably need to fast (not eat or drink) for 12–14 hours before the test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

A low amount of vitamin E means you are not getting or absorbing enough vitamin E. Your health care provider will probably order more tests to find out the cause. Vitamin E deficiency can be treated with vitamin supplements.

High vitamin E levels means you are getting too much vitamin E. If you are using vitamin E supplements, you will need to stop taking them. Your health care provider may also prescribe other medicines to treat you.

Is there anything else I need to know about a vitamin E test?

Many people believe vitamin E supplements can help prevent certain disorders. But there is no solid evidence that vitamin E has any effect on heart disease, cancer, eye disease, or mental function. To learn more about vitamin supplements or any dietary supplements, talk to your health care provider.

Ten benefits of vitamin E oil

Vitamin E oil’s potential benefits derive from two key features: its antioxidant properties, which could fight inflammation and slow the effects of free radicals, and its moisturizing properties.

Some purported benefits of vitamin E oil include:

Moisturizing skin

Vitamin E is found in many moisturizers, and the oil may be used as a moisturizer to prevent or treat dry, flaking skin.

Wound healing

Some research suggests that vitamin E supplements may promote wound healing. It is possible that topical vitamin E oil might offer similar benefits, but there is little research on the subject.

Skin cancer prevention

A 2013 study found that mice given supplements containing vitamin E were less likely to develop skin cancer, even when exposed to large quantities of ultraviolet light. These results prompted some supporters of vitamin E oil and supplements to claim that it can prevent skin cancer.

However, studies on humans have not found any skin cancer prevention benefits associated with vitamin E.

Reducing skin itching

Share on PinterestVitamin E may help to reduce itchy skin and ease eczema.

Vitamin E cannot treat allergic reactions, infections, and other issues that cause skin itching.

Because it moisturizes the skin, however, it may offer temporary relief from itching caused by dry skin.

Keeping skin well moisturised may help to prevent dry skin, and prevent symptoms such as itchiness. Any kind of oil safe for skin may offer these benefits.

Eczema

Vitamin E may alleviate the dryness, itching, and flaking associated with eczema, or atopic dermatitis.

One study found that oral vitamin E supplements could produce significant improvements in eczema symptoms. Though vitamin E oil has not been well-studied in the treatment of eczema, it may increase the effectiveness of topical moisturizers.

Psoriasis

At least one study has linked topical vitamin E to a reduction in psoriasis symptoms. Even better, the study showed that there were no serious side effects.

However, the effects of vitamin E on psoriasis were not as good as most readily available treatments. Vitamin E oil might be a good option for people who want to avoid prescription remedies and who have mild psoriasis.

Preventing or minimizing the appearance of scars

Folk wisdom has long suggested that vitamin E, applied to the skin, taken as a supplement, or both, might treat scars, or prevent them from forming in the first place. But research does not support this claim and has found no association between vitamin E use and scar prevention.

In one older study from 1999, almost one-third of participants had an allergic reaction to topical vitamin E, suggesting the oil is more likely to make scarring worse rather than prevent it.

A more recent literature review found that evidence about whether vitamin E improved or worsened scarring was inconclusive.

Research does suggest that well-moisturized skin is less likely to scar. So for people who do not have an allergic reaction to vitamin E, using it as a moisturizer while the wound heals may offer some benefits.

Preventing or treating fine lines and wrinkles

Dry skin tends to look more wrinkled than well-moisturized skin. The moisturizing benefits of vitamin E oil may help the skin look more youthful and less wrinkled.

Claims that vitamin E prevents or treats wrinkles, however, are unsupported by scientific evidence. The best strategy for preventing wrinkles is to avoid direct sunlight and to wear a quality sunscreen.

Sunburn prevention

Share on PinterestVitamin E may help to reduce the risk of sunburn.

Limited research suggests that vitamin E can prevent or reduce the formation of sunburns.

Because vitamin E oil can moisturize and soothe dry, flaky skin, it may help to relieve the burning and itching that result from a sunburn.

However, wearing sunscreen and avoiding direct sun exposure remain the best strategies for protecting the skin.

Promoting nail health

Research suggests that vitamin E supplementation can prevent yellow nail syndrome, which causes peeling, cracked, and yellowing nails.

Vitamin E oil’s moisturizing benefits may also support nail health by preventing cracked cuticles and dry skin around the nail bed.

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Photo: Thomas Hassel via Flickr

How much can vitamin D supplementation boost memory, learning and decision-making in older adults – and how much can be too much?

That’s what Rutgers University-led research team set to find out in a recent study published in The Journals of Gerontology: Series A.

They examined the effects of three different doses of vitamin D on the cognition of older women. Overweight and obese participants who took more than three times the recommended daily dose of vitamin D showed improvements in memory and learning – but also had slower reaction times. The slower reaction times may increase the risk of falling among this group.

For this study, researchers evaluated three groups of 50- to 70-year-old women, in a double-blind, randomized controlled trial. One group took the recommended daily dose of 600 international units (IU), of vitamin D each day for a year. Another group took 2,000 IU per day and the third took 4,000. All women participated in lifestyle counseling and were encouraged to lose a modest amount of weight.

Memory and learning improved in the group that took 2,000 IU per day, but not in the group that took the higher dosage. Meanwhile, the women’s reaction time trended slower at 2,000 IU daily and was significantly slower at the higher dosage.

“The slower reaction time may have other negative outcomes such as potentially increasing the risk of falling and fractures,” said lead author Sue Shapses, Ph.D., a registered dietician and professor in the Department of Nutritional Sciences at Rutgers.

Other researchers have found that vitamin D supplementation at 2,000 IU or more daily increased risk of falls, but did not understand the cause, she said in a statement. The new study, which indicates slower reaction time, may be one answer.

“Many people think that more vitamin D supplementation is better, but this study shows that is not always the case,” Shapses said. A higher daily dose may not be a problem for younger people, but her team hypothesized that it might compromise walking or balance in older adults.

Vitamin D – known for its importance for bone health – is obtained through sun exposure, supplementation and some foods. Researchers also have found that vitamin D has a major impact on how the body, including the brain, functions. As this Scientific American article reports, other research has documented vitamin D’s role in cognitive function.

People who are overweight or obese have lower levels of vitamin D in their systems compared to non-obese people, according to prior research. Once women reach menopause, their vitamin D levels significantly decrease, leading to osteoporosis and a greater risk of fractures. The Endocrine Society recommends that most post-menopausal women supplement their diets with vitamin D and calcium.

According to the CDC, more than one in four adults age 65 and older fall each year. The annual U.S. tally includes 29 million falls, 3 million emergency department visits, 800,000 hospitalizations and 28,000 deaths. Falling also leads to more than $31 billion in annual Medicare costs, which are expected surge unless the problem is recognized and prevention stressed.

More research is needed to determine whether reaction time difference is related to rates of falls and injuries for at-risk populations, Shapses said. Examining different doses of vitamin D supplementation and from dietary sources in both men and women of different ages, and people of different races over a longer period also needs to be studied.

“Three Doses of Vitamin D and Cognitive Outcomes in Older Women: A Double-Blind Randomized Controlled Trial”appeared in the February issue of the Journal of Gerontology, Series A.

Resources & story angles

  • This AHCJ tip sheet has more information for journalists about falls in older adults.
  • Journalists may want to highlight various community-based fall prevention programs or what physicians are doing to promote programs such as the Centers for Disease Control initiative Stopping Elderly Accidents, Deaths & Injuries (STEDI).
  • Check with local emergency departments to see whether falls in adults over 60 are on the rise, holding steady, or decreasing, and possible reasons why.
  • Find out what is being done in your community to educate older people — especially women — about the need for bone density screening and potential dietary supplementation.

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