Antioxidants are substances that protect healthy cells from being damaged by toxins. In the case of vitamin E, the fats in the cell membranes are what are being protected by this unique fat-soluble antioxidant. Antioxidants also play a role in destroying diseased cells such as the ones that occur in cancer. Unfortunately, even the most experienced oncologists still discourage patients who supplement with antioxidants in the mistaken belief that antioxidants “protect cancer cells.” As is now very obvious from peer-reviewed scientific studies, this dogma is unproven and antioxidants like vitamin E are a must for any cancer victim, especially for those who are being treated with either radiation or chemotherapy (see the periodical Cancer Treatment Reviews, May, 2007).
Deficiency of vitamin E is seen in those suffering from severe malnutrition, genetic defects affecting the alpha-tocopherol transfer protein, and fat malabsorption syndromes (e.g. children with cystic fibrosis or cholestatic liver disease, who have an impaired capacity to absorb dietary fat and therefore fat-soluble vitamins).
Deficiency of vitamin E results mainly in neurological symptoms, including impaired balance and coordination (ataxia), injury to the sensory nerves (peripheral neuropathy), muscle weakness (myopathy), and damage to the retina of the eye (pigmented retinopathy aka retinitis pigmentosa).
Suboptimal intake of vitamin E is relatively common in the U.S. (27% of Caucasians, 41% of African Americans, 28% of Mexican Americans and 32% of the other groups were found to have insufficient blood levels of alpha-tocopherol).
Many drugs reduce the absorption of vitamin E and can create deficiency states: cholestyramine, colestipol, isoniazid, mineral oil, orlistat, sucralfate, and the fat substitute, olestra. Anticonvulsant drugs such as phenobarbitol, phenytoin, or carbamazepine may decrease plasma levels of vitamin E.
The RDA was revised in 2000. Unfortunately, the latest RDA for vitamin E continues to be based on the prevention of deficiency symptoms rather than on health promotion and the prevention of chronic disease.
The Recommended Dietary Allowance (RDA) for RRR-alpha-tocopherol (d-alpha-tocopherol)
Life Stage | Age | Males; mg/day (IU/day) | Females; mg/day (IU/day) |
---|---|---|---|
Infants | 0-6 months | 4 mg (6 IU) | 4 mg (6 IU) |
Infants | 7-12 months | 5 mg (7.5 IU) | 5 mg (7.5 IU) |
Children | 1-3 years | 6 mg (9 IU) | 6 mg (9 IU) |
Children | 4-8 years | 7 mg (10.5 IU) | 7 mg (10.5 IU) |
Children | 9-13 years | 11 mg (16.5 IU) | 11 mg (16.5 IU) |
Adolescents | 14-18 years | 15 mg (22.5 IU) | 15 mg (22.5 IU) |
Adults | 19 years and older | 15 mg (22.5 IU) | 15 mg (22.5 IU) |
Pregnancy | all ages | 15 mg (22.5 IU) | |
Breastfeeding | all ages | 19 mg (28.5 IU) |
From USDA food composition database (https://www.nal.usda.gov/fnic/foodcomp/search/)
Food | Serving | Alpha-tocopherol (mg) | Gamma-tocopherol (mg) |
---|---|---|---|
Olive oil | 1 tablespoon | 1.9 | 0.1 |
Soybean oil | 1 tablespoon | 1.2 | 10.8 |
Corn oil | 1 tablespoon | 1.9 | 8.2 |
Canola oil | 1 tablespoon | 2.4 | 4.2 |
Safflower oil | 1 tablespoon | 4.6 | 0.1 |
Sunflower oil | 1 tablespoon | 5.6 | 0.7 |
Almonds | 1 ounce | 7.3 | 0.3 |
Hazelnuts | 1 ounce | 4.3 | 0 |
Peanuts | 1 ounce | 2.4 | 2.4 |
Spinach | ½ cup, raw chopped | 1.8 | 0 |
Carrots | ½ cup, raw chopped | 0.4 | 0 |
Avocado (California) | 1 medium | 3.4 | 0.6 |
There are several supplement forms offered by a variety of different manufacturers:
The table below provides the tolerated upper limits of daily vitamin E supplementation by individuals at different ages. It is based on a combination of numerous published studies and clinical experience.
Tolerable Upper Intake Level (UL) for Alpha-Tocopherol
Age Group | mg/day (IU/day d-alpha-tocopherol) |
---|---|
Infants 0-12 months | Not Possible to Establish* |
Children 1-3 years | 200 mg (300 IU) |
Children 4-8 years | 300 mg (450 IU) |
Children 9-13 years | 600 mg (900 IU) |
Adolescents 14-18 years | 800 mg (1,200 IU) |
Adults 19 and older | 1,000 mg (1,500 IU) |
Although rare, adverse reactions to vitamin E are possible and include:
Vitamin E continues to be the most popular of all the nutritional supplements despite numerous attacks on its validity as a preventive and therapeutic nutrient. During the past three decades, medical journal warnings about vitamin E’s lack of effectiveness as well as its potential toxicity have failed to stop millions of people in both Canada and the USA from taking it as a regular habit. The main reason for this is that all the negative articles have been very poorly done or used synthetic vitamin E to draw their conclusions. Oncologists who continue to profess that vitamin E supplements will reduce the effectiveness of radiation and chemotherapy have simply not kept up with latest research that proves otherwise.
The most recent frivolous attack on the benefits of vitamin E and other antioxidants was a JAMA (Journal of the American Medical Association) article (Bjelakovic G, et. al., 2007 Feb 28; 297 (8): 842-57) that concludes, “Treatment with beta carotene, vitamin A and vitamin E may increase mortality.”
According to Dr. Jeffrey Blumberg, Director of the Antioxidants Research Laboratory at Tufts University in Boston, Massachusetts, “This is a flawed analysis, the totality of the evidence indicates that antioxidants from foods or supplements have many health benefits, including reduced risk for cardiovascular disease, some types of cancer, eye disease and neurodegenerative disease. They are a key to an enhanced immune system and resistance to infection.”
Like practically all negative studies on vitamin E, the conclusions of this JAMA study were based entirely on a selected statistical review of old data. There was no experimental design or actual study done. Further, it was published by the same scientists who denounced antioxidants in a Lancet article in 2004. Most credible scientists dismissed the latter as science fiction, but the authors are back again. They discount most of the well-established scientific support for antioxidants, and then go on to conclude that antioxidant vitamins increase death from all causes.
There is more than ample evidence supporting the supplementation of vitamin E for all adults on a regular basis. Depending on one’s state of health, optimum doses will vary from 400 to 1200 IU daily of the mixed tocopherols (vitamin E complex). For conditions where inflammation is an issue (e.g. arthritis), doses of over 2400 IU may be quite effective in reducing pain, redness and swelling. If one is on anti-coagulant drugs or has other serious health issues, it’s best to consult a natural health care practitioner for advice on optimum dosages.
Websites:
https://lpi.oregonstate.edu/infocenter/vitamins/vitaminE/
https://www.healthy.net/scr/Article.asp?Id=2136&xcntr=1
https://www.lef.org/magazine/mag2002/may2002_cover_vitamine_03.html
Journal Articles:
Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. JAMA. 2007 Feb 28;297(8):842-57
L. Iuliano; F. Micheletta; M. Maranghi; G. Frati; U. Diczfalusy; F. Violi (2001). “Bioavailability of Vitamin E as Function of Food Intake in Healthy Subjects”. Arteriosclerosis, Thrombosis, and Vascular Biology 21: e34–e37.
Jiang Q et al.Gamma tocopherol, the major form of vitamin E in the US diet, deserves more attention. Am J Clin Nutr 2001; 74: 714-22.
Walker M, New/Old Findings on Unique Vitamin E, Townsend Letter for Doctors and Patients, No. 111, 1992, p. 826
MacWilliam L,What Makes Gamma Tocopherol Superior to Alpha Tocopherol, LE Magazine, Report, April 2006
Traber MG and Packer L. Vitamin E: Beyond antioxidant function. Am J Clin Nutr 1995;62:1501S-9S.
Traber MG. Does vitamin E decrease heart attack risk? summary and implications with respect to dietary recommendations. J Nutr. 2001;131(2):395S-397S.
Cherubini A, Zuliani G, Costantini F, et al. High vitamin E plasma levels and low low-density lipoprotein oxidation are associated with the absence of atherosclerosis in octogenarians. J Am Geriatr Soc
Yusuf S, Dagenais G, Pogue J, Bosch J, Sleight P. Vitamin E supplementation and cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000;342(3):154-160.
Keith I. Blocka, Amanda C. Kocha, Mark N. Meada, Peter K. Tothya, Robert A. Newmanc, and Charlotte Gyllenhaala, Impact of antioxidant supplementation on chemotherapeutic efficacy: A systematic review of the evidence from randomized controlled trials; Cancer Treatment Reviews, May 2007.
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