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Vitamin E

Vitamin E is a group of eight different compounds which, collectively, help support antioxidation in the body. Benefits of high doses have uncertain safety, and lower doses seem effective in boosting immunity in the elderly.

Our evidence-based analysis on vitamin e features 486 unique references to scientific papers.

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Summary of Vitamin E

Primary information, health benefits, side effects, usage, and other important details

Vitamin E is a term used to refer to eight molecules, which are divided into two categories: tocopherols and tocotrienols. Each category is further divided up into alpha (α), beta (β), gamma (γ), and delta (δ) vitamers. The vitamer α-tocopherol is considered to be the ‘main’ vitamer, but the gammas (γ-tocopherol and γ-tocotrienol) are also popular research topics, due to their presence in the diet. Collectively, these compounds are called vitamin E. Vitamin E supplements almost always contain α-tocopherol.

The majority of vitamin E’s benefits come from avoiding a deficiency, but there are several instances where supplementation can offer additional benefits. Supplementing α-tocopherol is able to improve T-cell mediated immune function, which boosts the immune system.

Vitamin E also seems to be able to enhance the body’s antibody response to vaccinations. Vitamin E is particularly important for the elderly, since a deficiency is associated with a higher risk of bone fractures. Supplementing additional vitamin E, however, will not provide additional benefits to bone health. Vitamin E may also be able to protect against age-related cognitive decline, but further research is needed before supplementation can be recommended specifically for Alzheimer’s and Parkinson’s treatment.

Vitamin E was one of the first two antioxidant compounds to be sold as dietary supplements, the second being vitamin C. It is sometimes used as the ‘reference’ antioxidant compound when fat soluble compounds are being researched. Vitamin E may function as a signaling molecule within cells and for phosphate groups.

Since the majority of vitamin E’s benefits are associated with low doses slightly above the Recommended Daily Allowance (RDA), vitamin E supplementation is not always necessary. Dietary changes can singlehandedly prevent a vitamin E deficiency and eliminate the need for supplementation. Sesame seeds in particular contain a lot of tocotrienols, as well as sesamin, which improves the retention of vitamin E. Low-dose vitamin E is safe to supplement, but it should not be mixed with coumarin-based anticoagulants like warfarin. High-dose long-term vitamin E supplementation (above 400IU per day), however, may be associated with increased risk of death and increased risk of prostate cancer.

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How to Take

Medical Disclaimer

Recommended dosage, active amounts, other details

Maintaining adequate levels of vitamin E in the body can be achieved through very low daily doses of 15mg (22.4 IU) or less. This dose of vitamin E can be acquired through the diet, making supplementation unnecessary in many cases. An elderly person supplementing vitamin E to improve immunity should take a 50-200mg dose.

Vitamin E supplements should contain α-tocopherol. Avocados, olives, vegetable oils and almonds are all high in vitamin E.

Vitamin E's antioxidant properties are improved when taken with unsaturated dietary fat. The minimum intake of vitamin E is 1 IU per gram of unsaturated fat. The ideal range is between 2-4 IU per gram of unsaturated fat.

In regards to an upper limit, while doses above 400IU α-tocopherol (268mg) are well tolerated in the short term it is the smallest dose associated with potential long-term adverse effects. If taking vitamin E as a daily supplement for no specific purpose (ie. as part of a multivitamin) then 150mg could be seen as a prudent upper limit.

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Human Effect Matrix

Unlocked for Examine members

The Human Effect Matrix summarizes human studies to tell you what effects Vitamin E has on your body, how much evidence there is, and how strong these effects are.

Full details are available to Examine members.
Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-a
Minor
- See all 7 studies
Minor increases in all cause mortality have been noted in mostly unhealthy cohorts with doses of vitamin E above 400IU (alpha-tocopherol) whereas lower doses exert a mild protective effect in the same cohorts. The magnitude is approximately 33-34 deaths per 10,000 subjects (both for the increase in mortality seen with vitamin E multinutrient supplements and the decrease seen with vitamin E alone), and it is unsure how this information applies to otherwise healthy persons.
grade-b Notable Low See all 9 studies
There appears to be a notable decrease in both ALT and γ-GPT in persons with non-alcoholic fatty liver (NAFLD) which may exceed 50% when vitamin E is supplemented above 300mg for half a year; there does not appear to be any influence whatsoever in healthy controls.
grade-b
Minor
- See all 3 studies
Similar to blood pressure, blood flow is differentially affected by vitamin E supplementation thought to be due to whether it is acting as a prooxidant or an antioxidant.
grade-b
Minor
- See all 3 studies
Blood pressure has been differentially affected by vitamin E supplementation, thought to be associated with whether it is an antioxidant or a prooxidant.
grade-b Minor Low See all 3 studies
A possible protective effect on overall cardiovascular disease mortality (not development of the disease states or incidences) has been reported with supplementation of 600 IU vitamin E every other day.
grade-b Minor Very High See all 3 studies
Primarily research has consistently found an improvement and 400-500 IU per day.
grade-b Minor High See all 6 studies
Supplementation of vitamin E appears to reduce oxidation in plasma, requiring over 500mg (if not more) α-tocopherol in states where there is abnormal elevations of oxidation. Vitamin E is without effect at lower doses or in persons without abnormal oxidation levels.
grade-b Minor Very High See all 6 studies
There appears to be an increase in T-cell mediated immunity in older subjects when supplementing low dose (50-200mg) vitamin E; this immunity enhancement does not appear to occur in youth due to it alleviating an age-related immune suppression.
grade-b
Minor
- See all 3 studies
IFNγ is increased when vitamin E is taken alongside a vaccination, and decrease in the elderly (alongside improvements in immunity) with no significant changes if neither of the above contexts are considered.
grade-b
Minor
- See all 3 studies
IL-4 is increased when taken alongside a vaccination and decrease when supplemented in the elderly (alongside immune enhancement) with no significant influence in persons outside of both scenarios.
grade-b
Minor
- See all 7 studies
Vitamin E tends to reduce lipid peroxidation in instances where there is elevated oxidation, and tends to have no effect in otherwise healthy persons. In instances where vitamin E is thought to greatly exceed the activity of co-antioxidants (vitamin C or ALA) it can exert a prooxidant effect.
grade-b
Minor
- See all 4 studies
Low doses of vitamin E (50mg) in smokers has been associated with significant decreases in prostate cancer risk, whereas moderate doses (400IU) of vitamin E in otherwise healthy older men is associated with a mild but significant increase in prostate cancer risk.
grade-b - Very High See all 4 studies
When supplemented by itself, vitamin E does not appear to significantly influence bleeding time. This differs from a combination of vitamin E and coumarin based anticoagulants (such as warfarin) where an adverse interaction may occur.
grade-b - Very High See all 5 studies
Vitamin E does not appear to influence blood glucose in otherwise healthy persons nor in diabetics (type I or type II) relative to placebo.
grade-b - Very High See all 3 studies
No significant protective effect of 600 IU vitamin E every other day in otherwise healthy women for preventing the development of breast cancer.
grade-b - High See all 3 studies
Most studies assessing C-reactive protein (an inflammatory biomarker) have failed to find a significant influence of vitamin E supplementation.
grade-b - High See all 3 studies
While a decrease in P-selectin has been noted with low dose (100mg) γ-tocopherol, most studies have failed to find an influence of vitamin E supplementation on adhesion factors.
grade-b - Very High See all 3 studies
600 IU vitamin E every other day for a decade does not appear to reduce the risk of developing colon cancer in otherwise healthy women.
grade-b - High See all 3 studies
While most evidence suggests no influence on DNA damage, it is possible based on some studies that when vitamin E turns prooxidative that it may damage DNA.
grade-b - Very High See all 4 studies
The majority of evidence has failed to find any influence of vitamin E supplementation on HDL total levels or particulates relative to placebo.
grade-b - Very High See all 7 studies
Vitamin E supplementation does not appear to alter the overall levels of LDL cholesterol.
grade-b - Very High See all 4 studies
The overall amount of red blood cells does not appear to be significantly altered with supplemental vitamin E.
grade-b - Very High See all 3 studies
There does not appear to be a protective effect of vitamin E on the development of stroke relative to placebo.
grade-b - High See all 4 studies
The majority of evidence has failed to find any significant interaction with vitamin E supplementation and circulating levels of T3.
grade-b - High See all 5 studies
Although one study noted a decrease with 600 IU, future studies in similar persons with multiple doses have failed to replicate these observations.
grade-b - Very High See all 4 studies
Studies assessing well being in otherwise healthy persons or those with disease states not associated with depression have failed to find any interaction with vitamin E supplementation.
grade-b - Very High See all 10 studies
There does not appear to be a significant influence of vitamin E supplementation on cholesterol levels whether used by a healthy person or one with elevated cholesterol.
grade-b - Very High See all 8 studies
No evidence to support changes in triglycerides associated with vitamin E supplementation in any tested person.
grade-b - Very High See all 7 studies
There does not appear to be any influence of vitamin E supplementation at any tested dose in any subject on weight loss nor gain.
grade-b - Very High See all 6 studies
Supplementation of vitamin E does not appear to alter overall content of white blood cells relative to placebo.
grade-c Notable - See study
There appears to be a large (27%) reduction in thromboembolism associated with vitamin E supplementation at 600 IU every other day, more pronounced in those who reported such an event previously (44%).
grade-c Notable Very High See 2 studies
Very high dose Vitamin E supplementation in the form of α-tocopherol (2,000 IU) appears to reduce the rate of cognitive decline in persons with moderate to severe Alzheimer's Disease with a potency comparable to selegiline. Currently no research on lower (more standard) doses, and there appears to be no influence on minor AD or cognitive decline not characterized by AD.
grade-c Minor - See study
Mixed evidence, but vitamin E has been implicated in improving arterial stiffness (thought to underlie decreased cardiovascular mortality)
grade-c Minor Very High See 2 studies
Topical application of vitamin E to scar tissue has, in some participants, caused significant increases in redness of the tissue associated with itching.
grade-c Minor - See study
One study noted that 100mg of mixed tocopherol was able to promote hair growth in persons with alopecia (androgen dependence not specified) relative to placebo.
grade-c Minor Moderate See 2 studies
IgG has been noted to be increased when vitamin E is used as a vaccination adjuvant, but not in otherwise healthy persons not subject to a vaccination.
grade-c Minor Very High See 2 studies
An increase in interleukin 2 (IL-2) concentrations has been noted in the elderly given supplementation of vitamin E alongside immunity enhancements.
grade-c Minor Moderate See 2 studies
Mixed evidence as to whether leukotriene B4 can be reduced in diabetics with vitamin E supplementation.
grade-c Minor - See 2 studies
Fibrotic scores may be slightly improved in persons with fatty liver associated with inflammation (steatohepatitis) although there may not be an effect in persons with NAFLD without evidence of inflammatory damage.
grade-c Minor Very High See all 3 studies
In persons with steatohepatitis, there may be a reduction in liver fat over time when taking vitamin E supplements; currently there is no evidence assessing otherwise healthy persons on this parameter
grade-c Minor - See study
One study found a reduction with 400 IU daily. More research is needed.
grade-c Minor - See study
In athletes who experienced a reduction in lipid peroxidation from vitamin E supplementation during exercise, there is also a reduction in biomarkers of muscle damage.
grade-c Minor Moderate See 2 studies
While vitamin E appears to retain the potential to reduce LDL oxidation, it requires high doses as lower doses are not significantly effective.
grade-c Minor - See study
May decrease prolactin in instances of uremia, but there is currently no evidence in otherwise healthy controls.
grade-c Minor - See study
There may be a minor reduction in PGE2 concentrations following supplementation of vitamin E.
grade-c Minor - See study
Supplementation of 400 IU vitamin E, despite not increasing overall cardiovascular mortality, increased the risk of heart failure in older persons with preexisting medical conditions (from 443 instances in placebo over seven years to 519 in supplemental).
grade-c Minor - See study
Supplementation of 200 IU vitamin E in elderly persons has been noted to reduce overall occurrence of upper, but not lower, respiratory tract infections.
grade-c Minor Very High See 2 studies
There appears to be an increased antibody response to vaccinations in otherwise healthy persons who supplement with a low dose of vitamin E relative to those receiving placebo with their vaccination; this applies to both youth and the elderly.
grade-c - Very High See 2 studies
Performance during aerobic exercise does not appear to be significantly altered with supplementation of vitamin E relative to placebo.
grade-c - Very High See 2 studies
The levels of antioxidant enzymes in red blood cells (glutathione, superoxide dismutase, catalase) does not appear to be influenced with supplementation of vitamin E.
grade-c - - See study
Supplementation of vitamin E in medicated asthmatics failed to exert any appreciable benefits to symptoms.
grade-c - - See study
Vitamin E does not appear to influence B cell count relative to placebo.
grade-c - Very High See 2 studies
Serum bilirubin does not appear to be influenced with supplementation of vitamin E relative to placebo.
grade-c - - See study
No known influence of vitamin E supplementation on the overall count of CD4+ lymphocytes relative to placebo.
grade-c - - See study
CD8+ Lymphocytes do not appear to be significantly influenced with supplementation of vitamin E relative to placebo.
grade-c - Moderate See 2 studies
Despite a small reduction in prostate cancer mortality seen in smokers with low dose (50mg) vitamin E, this does not appear to hold true as a general statement for all cancer types in most persons.
grade-c - - See study
In general, the development of various cardiovascular diseases is not prevented with supplementation of vitamin E.
grade-c - - See study
When supplemented by otherwise healthy elderly persons, the development of organic cognitive decline does not appear to be attenuated relative to placebo.
grade-c - - See study
No significant reduction in cortisol seen with supplementation of vitamin E relative to placebo.
grade-c - - See study
In otherwise healthy elderly person, creatinine does not appear to be significantly altered relative to placebo.
grade-c - - See study
Endothelin-1 has failed to be influenced with supplementation of vitamin E in diabetics.
grade-c - - See study
400IU of vitamin E does not appear to mitigate the risk of developing esophageal cancer relative to placebo.
grade-c - - See study
FSH does not appear to be influenced following supplementation of vitamin E.
grade-c - - See study
Vitamin E does not appear to alter the concentrations of free testosterone in serum following supplementation.
grade-c - - See study
In type II diabetics, there is no influence of vitamin E supplementation on glomerular filtration rate.
grade-c - Very High See 2 studies
HbA1c does not appear to be influenced in type II diabetics given supplementation of vitamin E.
grade-c - - See study
Heart rate during exercise in elite athletes is unaltered by supplementation of vitamin E.
grade-c - - See study
Hematocrit does not appear to be significantly influenced with supplementation of vitamin E relative to placebo.
grade-c - - See study
No significant influence of vitamin E supplementation on hemoglobin.
grade-c - Very High See 2 studies
There does not appear to be a significant influence of vitamin E supplementation on homocysteine concentrations.
grade-c - - See study
Supplementation of vitamin E does not appear to significantly influence circulating concentrations of IgA relative to placebo in otherwise healthy elderly adults.
grade-c - - See study
IgE concentrations in asthmatics has failed to be influenced with supplementation of vitamin E.
grade-c - - See study
IgM concentrations in the blood of older persons do not appear to be influenced with supplementation of vitamin E.
grade-c - - See study
Supplementation of vitamin E by otherwise healthy persons does not appear to influence the rates of developing type II diabetes.
grade-c - - See study
Basal insulin concentrations (fasted state) do not appear to be influenced by supplementation of vitamin E.
grade-c - Very High See 2 studies
There does not appear to be improvements in insulin sensitivity associated with vitamin E supplementation relative to placebo, even in instances where NAFLD is being treated therapeutically.
grade-c - - See study
IL-6 concentrations do not appear to be influenced relative to placebo.
grade-c - Very High See 2 studies
Biomarkers of kidney function are not significantly altered with supplementation of vitamin E relative to placebo.
grade-c - - See study
Lactate production during exercise does not appear to be influenced with supplementation of vitamin E.
grade-c - Moderate See 2 studies
Supplementation of vitamin E has failed to influence the activity of the cardiac tissue itself.
grade-c - - See study
Vitamin E supplementation does not appear to influence circulating levels of luteinizing hormone (LH).
grade-c - Very High See 2 studies
Vitamin E supplementation does not appear to influence overall lymphocyte count or its subdivisions.
grade-c - - See study
Supplementation of vitamin E by otherwise healthy women has failed to significantly improve memory formation.
grade-c - - See study
The overall amount of NK cells do not appear to be altered with supplementation of vitamin E.
grade-c - - See study
Similar to neutrophil count, there does not appear to be a significant influence of vitamin E on the activity of neutrophils.
grade-c - - See study
The overall amount of neutrophils in the blood does not appear to be influenced with supplementation of vitamin E.
grade-c - Moderate See 2 studies
While 100mg of γ-tocopherol has been once implicated in reducing platelet aggregation, higher doses and all tested dose of α-tocopherol by themselves do not appear to have an effect (there is still an interaction with warfarin, however).
grade-c - - See study
Vitamin E supplementation taken by otherwise healthy older adults does not appear to reduce the risk of developing Alzheimer's relative to placebo.
grade-c - - See study
Vitamin E in isolation at tested doses of 500 IU has failed to show any protective effect on cataract formation or continued pathology, despite multinutrient formulations showing benefit (likely due to other compounds in the formulation).
grade-c - Very High See 2 studies
In otherwise healthy women, supplementation of vitamin E does not appear to reduce the rate of developing lung cancer.
grade-c - - See study
Supplementation of 400IU vitamin E in older adults with preexisting medical conditions has failed to interact with the risk of developing melanoma.
grade-c - - See study
Vitamin E does not appear to reduce the incidence rates of myocardial infarctions despite a reduction in cardiovascular disease mortality.
grade-c - - See study
Supplementation of vitamin E does not appear to reduce the risk of developing rheumatoid arthritis.
grade-c - Very High See 2 studies
Topical application of vitamin E to scar tissue has failed to promote healing of scar tissue relative to placebo gels.
grade-c - - See study
Serum levels of cobalamin (vitamin B12) do not appear to be influenced with supplementation of vitamin E.
grade-c - - See study
Serum folate does not appear to be modified with supplementation of vitamin E.
grade-c - Very High See 2 studies
The overall content of platelets is not affected by supplementation of vitamin E.
grade-c - - See study
Vitamin E does not appear to influence sexual function or satisfaction in otherwise healthy persons with no known sexuality disorders.
grade-c - - See study
TNF-α does not appear to be influenced with supplementation of vitamin E relative to placebo.
grade-c - - See study
The production of thromboxane B2 does not appear to be significantly altered in type II diabetic adults.
grade-c - - See study
Verbal fluency does not appear to be significantly altered with vitamin E supplementation relative to placebo.
grade-d Notable - See study
Rectal administration of high doses of vitamin E appears to be effective in reducing symptoms of ulcerative colitis, with preliminary research noting remission in the majority of patients.
grade-d Minor - See study
One study found a reduction in PMS-associated anxiety with 100 mg of vitamin E daily.
grade-d Minor Very High See 2 studies
A small amount of low-quality evidence suggests an improvement in cyclic mastalgia pain when taking vitamin E. More research is needed.
grade-d Minor - See study
One study found a reduction in PMS-related depression with 100 mg daily.
grade-d Minor - See study
In those with inflammatory liver damage, supplementation of vitamin E appears to be capable of reducing damage over a long period of time.
grade-d Minor - See study
A decrease in serum TGF-β has been noted in persons with fatty liver given supplementation of 300mg vitamin E (as α-tocopherol)
grade-d - Low See all 3 studies
Mixed evidence. Some research suggests an improvement from daily supplementation, but another study didn't, and the negative study was more reliable. More research is needed.

Studies Excluded from Consideration

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Things to Note

Primary Function:

Also Known As

Tocopherols, Tocotrienols

Goes Well With

  • 'Co-antioxidants' (recycle vitamin E) including Vitamin C and Alpha-lipoic acid

  • Sesamin (increases bodily levels of γ-tocopherol and γ-tocotrienol)

  • CoQ10 (for antioxidant on LDL particles)

Caution Notice

Known Drug Interactions (See things to note section)

  • If otherwise unspecified, the term 'Vitamin E' tends to refer to α-tocopherol while the other seven vitamers tend to be referred to by their names rather than by 'Vitamin E'

  • Vitamin E is known to increase the action of coumarin based anticoagulants like Warfarin, and thus its ingestion alongside these drugs can increase the risk of bleeding; coingestion is contraindicted

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Click here to see all 486 references.