D-alpha tocopherol, more commonly known as vitamin E, is a fat-soluble vitamin that plays a significant role in human health. As an antioxidant, vitamin E helps maintain healthy cells and, subsequently, a healthy body. It is found in many foods including vegetable oils, cereals, meat, poultry, eggs, fruits, vegetables, and wheat germ oil. It is also available as a supplement.
Vitamin E is used for treating vitamin E deficiency, which is rare, but can occur in people with certain genetic disorders and in very low-weight premature infants.
Some people use vitamin E for treating and preventing diseases of the heart and blood vessels including hardening of the arteries, heart attack, chest pain, leg pain due to blocked arteries, and high blood pressure.
Vitamin E is also used for treating diabetes and its complications. It is used for preventing cancer, particularly lung and oral cancer in smokers; colorectal cancer and polyps; and gastric, prostate, and pancreatic cancer.
Some people use vitamin E for diseases of the brain and nervous system including Alzheimer’s disease and other dementias, Parkinson’s disease, night cramps, restless leg syndrome, and for epilepsy, along with other medications. Vitamin E is also used for Huntington’s chorea, and other disorders involving nerves and muscles.
Women use vitamin E for preventing complications in late pregnancy due to high blood pressure (pre-eclampsia), premenstrual syndrome (PMS), painful periods, menopausal syndrome, hot flashes associated with breast cancer, and breast cysts.
Sometimes vitamin E is used to lessen the harmful effects of medical treatments such as dialysis and radiation. It is also used to reduce unwanted side effects of drugs such as hair loss in people taking doxorubicin and lung damage in people taking amiodarone.
Vitamin E is sometimes used for improving physical endurance, increasing energy, reducing muscle damage after exercise, and improving muscle strength.
Vitamin E is also used for cataracts, asthma, respiratory infections, skin disorders, aging skin, sunburns, cystic fibrosis, infertility, impotence, chronic fatigue syndrome (CFS), peptic ulcers, for certain inherited diseases and to prevent allergies.
Some people apply vitamin E to their skin to keep it from aging and to protect against the skin effects of chemicals used for cancer therapy (chemotherapy).
See Precautions section.
Vitamin E is POSSIBLY UNSAFE if taken by mouth in high doses. If you have a condition such as heart disease or diabetes, do not take doses of 400 IU/day or more. Some research suggests that high doses might increase the chance of death and possibly cause other serious side effects. The higher the dose, the greater the risk of serious side effects.
There is some concern that vitamin E might increase the chance of having a serious stroke called hemorrhagic stroke, which is bleeding into the brain. Some research shows that taking vitamin E in doses of 300-800 IU each day might increase the chance of this kind of stroke by 22%. However, in contrast, vitamin E might decrease the chance of having a less severe stroke called an ischemic stroke.
There is contradictory information about the effect of vitamin E on the chance of developing prostate cancer. Some research suggests that taking large amounts of a multivitamin plus a separate vitamin E supplement might actually increase the chance of developing prostate cancer in some men.
High doses can also cause nausea, diarrhea, stomach cramps, fatigue, weakness, headache, blurred vision, rash, and bruising and bleeding.
Special Precautions & Warnings
Pregnancy: When used in the recommended daily amount, vitamin E is POSSIBLY SAFE for pregnant women. There has been some concern that taking vitamin E supplements might be harmful to the fetus when taken in early pregnancy. However, it is too soon to know if this is an important concern. Until more is known, do not take vitamin E supplements during early pregnancy without talking with your healthcare provider.
Breast-feeding: Vitamin E is LIKELY SAFE when taken by mouth in recommended daily amounts during breast-feeding.
Infants and children: Vitamin E is LIKELY SAFE when taken by mouth appropriately. The maximum amounts of vitamin E that are considered safe for children are based on age. Less than 200 mg daily is safe for children 1 to 3 years old. Less than 300 mg daily is safe for children 4 to 8 years old. Less than 600 mg daily is safe for children 9 to 13 years old. Less than 800 mg daily is safe for children ages 14 to 18 years old. Vitamin E (alpha-tocopherol) is POSSIBLY UNSAFE when given intravenously (by IV) to premature infants in high doses.
Angioplasty, a heart procedure: Avoid taking supplements containing vitamin E or other antioxidant vitamins (beta-carotene, vitamin C) immediately before and following angioplasty without the supervision of a health care professional. These vitamins seem to interfere with proper healing.
Diabetes: Vitamin E might increase the risk for heart failure in people with diabetes. People with diabetes should avoid high doses of vitamin E.
Heart attack: Vitamin E might increase the risk for death in people with a history of heart attack. People with a history of heart attack should avoid high doses of vitamin E.
Low levels of vitamin K (vitamin K deficiency): Vitamin E might worsen clotting problems in people whose levels of vitamin K are too low.
An eye condition called retinitis pigmentosa: All-rac-alpha-tocopherol (synthetic vitamin E) 400 IU seems to speed vision loss in people with retinitis pigmentosa. However, much lower amounts (3 IU) do not seem to produce this effect. If you have this condition, it is best to avoid vitamin E.
Bleeding disorders: Vitamin E might make bleeding disorders worse. If you have a bleeding disorder, avoid taking vitamin E supplements.
Head and neck cancer: Do not take vitamin E supplements in doses of 400 IU/day or more. Vitamin E might increase the chance that cancer will return.
Prostate cancer: There is concern that taking vitamin E might increase the chance of developing prostate cancer. The effect of vitamin E in men who currently have prostate cancer is not clear. However, in theory, taking vitamin E supplements might worsen prostate cancer in men who already have it.
Stroke: Vitamin E might increase the risk for death in people with a history of stroke. People with a history of stroke should avoid high doses of vitamin E.
Surgery: Vitamin E might increase the risk of bleeding during and after surgery. Stop using vitamin E at least 2 weeks before a scheduled surgery.
Interactions
Cyclosporine (Neoral, Sandimmune) interacts with VITAMIN E
Taking large amounts of vitamin E along with cyclosporine (Neoral, Sandimmune) might increase how much cyclosporine (Neoral, Sandimmune) the body absorbs. By increasing how much cyclosporine the body absorbs, vitamin E might increase the effects and side effects of cyclosporine (Neoral, Sandimmune).
Medications changed by the liver interact with VITAMIN E
Some medications are changed and broken down by the liver. Vitamin E might increase how quickly the liver breaks down some medications. Taking vitamin E along with some medications that are broken down by the liver can decrease the effectiveness of some medications. Before taking vitamin E talk to your healthcare provider if you are taking any medications that are changed by the liver.Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.
Medications for cancer (Chemotherapy) interact with VITAMIN E
Vitamin E is an antioxidant. There is some concern that antioxidants might decrease the effectiveness of some medications used for cancers. But it is too soon to know if the interaction occurs.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interact with VITAMIN E
Vitamin E might slow blood clotting. Taking vitamin E along with medications that also slow clotting might increase the chances of bruising and bleeding.Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
Medications used for lowering cholesterol (Statins) interact with VITAMIN E
Taking vitamin E, beta-carotene, vitamin C, and selenium together might decrease the effectiveness of some medications used for lowering cholesterol. It is not known if taking vitamin E alone decreases the effectiveness of some medications used for lowering cholesterol.Some medications used for lowering cholesterol include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), and pravastatin (Pravachol).
Niacin interacts with VITAMIN E
Taking vitamin E along with beta-carotene, vitamin C, and selenium might decrease some of the beneficial effects of niacin. Niacin can increase the good cholesterol. Taking vitamin E along with these other vitamins might decrease the good cholesterol.
Warfarin (Coumadin) interacts with VITAMIN E
Warfarin (Coumadin) is used to slow blood clotting. Vitamin E can also slow blood clotting. Taking vitamin E along with warfarin (Coumadin) can increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.
Overdose
In case of Vitamin E overdose, bring the person to the nearest hospital immediately. Overdose symptoms may include stomach pain, nausea, diarrhea, dizziness, headache, tiredness, blurred vision, or tiredness.
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