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Vitamin E

Vitamin E is an antioxidant. It plays a role in your immune system and metabolic processes. Vitamin E is a nutrient that’s important for vision, fighting off diseases and the health of the blood, brain, and skin.

Vitamin E is an antioxidant. Antioxidants might protect cells from the effects of free radicals, which are molecules made when the body breaks down food or is in contact with tobacco smoke or radiation. These molecules might lead to heart disease, cancer, and other diseases. Foods rich in vitamin E include vegetable oils such as canola and olive oils, nuts, and seeds. Meats, dairy, leafy greens, and fortified cereals also have vitamin E. And the vitamin comes in capsules or drops to take by mouth.

Too little vitamin E can cause nerve pain, called neuropathy, and damage to the retina, called retinopathy. Retinopathy can cause vision loss. The recommended daily amount of vitamin E for adults is 15 milligrams a day.

Good sources of vitamin E include

  • Vegetable oils
  • Margarine
  • Nuts and seeds
  • Leafy greens

Vitamin E is also added to foods like cereals. Most people get enough vitamin E from the foods they eat. People with certain disorders, such as liver diseases, cystic fibrosis, and Crohn’s disease may need extra vitamin E.

Vitamin E supplements may be harmful for people who take blood thinners and other medicines. Check with your health care provider before taking the supplements.

Several studies suggest that vitamin E may be helpful in pain management for several conditions, including breast pain and neuropathic pain . Vitamin E might be able to reduce exercise-related damage to muscles, an Australian study found.

But another study found that vitamin E supplements might pose risks, including an increased risk for prostate cancer in men . Adult men and women should aim for about 15 mg or 22.4 IU of vitamin E daily; a typical multivitamin supplement provides that amount.

To boost vitamin E intake through food, use safflower or sunflower oil in recipes and munch on sunflower seeds and nuts including almonds, hazelnuts, and peanuts for nutrient-rich snacking. People on blood thinning medications should be careful not to take large amounts of vitamin E because it has been associated with increased bleeding risk. The highest safe supplement dose for adults is 1,500 IU or 1,000 mg a day.

How Much Vitamin E Should You Take?

The recommended dietary allowance (RDA) includes the vitamin E you get from both the food you eat and any supplements you take.

Category

Vitamin E (alpha-tocopherol): Recommended Dietary Allowance (RDA)

in milligrams (mg) and International Units (IU)

CHILDREN

1-3 years

6 mg/day (9 IU)

4-8 years

7 mg/day (10.4 IU)

9-13 years

11 mg/day (16.4 IU)

FEMALES

14 years and up

15 mg/day (22.4 IU)

Pregnant

15 mg/day (22.4 IU)

Breastfeeding

19 mg/day (28.5 IU)

MALES

14 years and up

15 mg/day (22.4 IU)

The tolerable upper intake levels of a supplement are the highest amount that most people can take safely. Higher doses might be used to treat vitamin E deficiencies.

But you should never take more unless a doctor says so.

Category

(Children & Adults)

Tolerable Upper Intake Levels (UL) of

Vitamin E (alpha-tocopherol)

in milligrams (mg) and International Units (IU)

1-3 years

200 mg/day (300 IU)

4-8 years

300 mg/day (450 IU)

9-13 years

600 mg/day (900 IU)

14-18 years

800 mg/day (1,200 IU)

19 years and up

1,000 mg/day (1,500 IU)

Because vitamin E is fat-soluble, supplements are best absorbed with food.

What the Research Says

Research on vitamin E use for certain conditions shows the following:

  • Alzheimer’s disease. Some research shows that high-dose vitamin E might slow mild to moderate Alzheimer’s disease. Other studies don’t show this. Vitamin E supplements appear to have no effect on whether people with mild cognitive impairment go on to get Alzheimer’s disease.
  • Liver disease. Studies show that vitamin E might improve symptoms of metabolic dysfunction-associated steatotic liver disease.
  • Preeclampsia. Increasing intake of vitamin E has not been shown to prevent this pregnancy condition that affects blood pressure.
  • Prostate cancer. Research shows that vitamin E and selenium supplements don’t prevent prostate cancer. There also is concern that vitamin E supplements might raise the risk of prostate cancer.

Caution of Taking Vitamin E

Most people get enough vitamin E from a balanced diet. So healthcare professionals don’t often suggest that people take vitamin E supplements. If you’ve been diagnosed with mild to moderate Alzheimer’s disease, some research suggests that vitamin E therapy might help slow the worsening of the disease.

But taking vitamin E by mouth might raise the risk of prostate cancer. Use of the supplement also may have other serious risks. This is mainly true at high doses and for people who have other health conditions or have had a heart attack or stroke.

Also, vitamin E acetate is used in some electronic cigarettes, also called e-cigarettes or vaping devices. Vitamin E acetate has been linked to lung injury in people who vape.

If you’re thinking of taking a vitamin E supplement, talk with your main healthcare professional about whether it’s right for you.

Safety and Side Effects of Vitamin E

Experts think that vitamin E, when taken by mouth or put on skin in typical amounts, mainly is safe. Rarely, taking vitamin E by mouth can cause:

  • Upset stomach.
  • Loose stools.
  • Belly cramps.
  • Tiredness.
  • Weakness.
  • Headache.
  • Blurred vision.
  • Rash.

Taking higher doses of vitamin E might raise the risk of side effects. Also, people with heart disease and some other conditions who take high doses of vitamin E have a higher risk of death.

Vitamin E can affect many conditions. For instance, some research suggests that taking vitamin E by mouth may raise the risk of prostate cancer. Other research suggests that vitamin E use may raise the risk of death in people with a history of heart attack or stroke.

Talk with your healthcare professional before taking vitamin E if you have:

  • Too little vitamin K.
  • An eye condition in which the retina is damaged, called retinitis pigmentosa.
  • Bleeding conditions.
  • Diabetes.
  • A history of heart attack or stroke.
  • Head and neck cancer.
  • Liver disease.

Vitamin E may raise the risk of bleeding. If you’re having surgery, stop taking vitamin E two weeks before the surgery. Also, talk with your healthcare professional about vitamin E use if you’re about to have or you just had a procedure to open blocked arteries and restore blood flow to the heart, called angioplasty.

Interactions With Other Drugs and Foods

Vitamin E can affect the way that some medicines and supplements work, including:

  • Alkylating agents and antitumor antibiotics. High doses of vitamin E may affect these chemotherapy medicines.
  • Anticoagulant and antiplatelet medicines, herbs, and supplements. Use of vitamin E with these medicines, herbs, and supplements that lessen blood clotting may raise the risk of bleeding.
  • Cytochrome P450 3A4 substrates, also called CYP3A4 substrates. Use caution when taking vitamin E and other medicines affected by these enzymes, such as omeprazole (Prilosec, Zegerid OTC).
  • Statins and niacin. Taking vitamin E with cholesterol-lowering medicines called statins and niacin could keep niacin from working as it should. Niacin helps raise high-density lipoprotein, also called HDL, the “good cholesterol.”
  • Vitamin K. Taking vitamin E with vitamin K might keep vitamin K from working as it should.

What Kinds of Foods Contain Vitamin E?

Vitamin E is a fat-soluble antioxidant that helps protect cells from oxidative damage. It’s found naturally in a variety of foods. Here are the main categories of foods rich in vitamin E:

1. Nuts and Seeds

  • Sunflower seeds – One of the best sources.
  • Almonds – High in vitamin E, especially when raw.
  • Hazelnuts, pine nuts, and peanuts also provide decent amounts.

2. Vegetable Oils

  • Sunflower oil, wheat germ oil, and safflower oil are particularly rich.
  • Olive oil and canola oil have moderate amounts.

3. Leafy Green Vegetables

  • Spinach, Swiss chard, and turnip greens contain vitamin E.
  • Broccoli and kale offer smaller but still beneficial amounts.

4. Fortified Foods

  • Many cereals, margarines, and fruit juices are fortified with vitamin E.

5. Fish

  • Salmon, rainbow trout, and mackerel provide vitamin E, plus healthy fats.

6. Fruits

  • Avocados – A good source and also rich in healthy fats.
  • Kiwi, mango, and blackberries offer smaller amounts.

7. Whole Grains

  • Foods like brown rice, oats, and whole wheat contain vitamin E, especially in the germ part of the grain.

What are the Symptoms of Vitamin E Deficiency ?

The body needs vitamin E to function, making it an essential vitamin. It is fat-soluble, meaning that it requires fat from the diet to be properly absorbed. Vitamin E is mainly stored in the liver before being released into the blood stream for use.

  • Vitamin E deficiency may cause impaired reflexes and coordination, difficulty walking, and weak muscles.

  • Preterm infants with the deficiency may develop a serious form of anemia.

  • The diagnosis is based on symptoms and results of a physical examination.

  • Taking vitamin E supplements corrects the deficiency.

Vitamin E (tocopherol) is an antioxidant: It protects cells against damage by free radicals, which are by-products of normal cell activity and which participate in chemical reactions within cells. Some of these reactions can be harmful.

Vitamin E, like vitamins A, D, and K, is a fat-soluble vitamin, which dissolves in fat and is best absorbed when eaten with some fat. Good sources of vitamin E include vegetable oils, nuts, seeds, green leafy vegetables, and wheat germ.

Newborns have a relatively low reserve of vitamin E because only small amounts of vitamin E cross the placenta. Thus, newborns, particularly preterm newborns, are at increased risk of vitamin E deficiency. However, with age, risk decreases because infants usually get enough vitamin E in breast milk or in commercial formulas. Adults can store large amounts of vitamin E in fat tissue, making the deficiency less likely.

Many people take vitamin E supplements to help prevent certain disorders. Vitamin E supplements do not protect against cancer or heart and blood vessel disorders. There is no convincing evidence that vitamin E, even in high doses, slows the progression of Alzheimer disease or decreases the risk of prostate cancer. Whether vitamin E supplements protect against tardive dyskinesia (repetitive involuntary movements of the mouth, tongue, arms, or legs—a side effect of antipsychotic medications) is controversial.

In children, symptoms may include slow reflexes, difficulty walking, loss of coordination, loss of position sense (knowing where the limbs are without looking at them), and muscle weakness.

In adults with vitamin E deficiency due to a malabsorption disorder, these symptoms rarely develop because adults store large amounts of vitamin E in fat (adipose) tissue.

Vitamin E deficiency can cause a form of anemia in which red blood cells rupture (hemolytic anemia). Preterm infants who have a vitamin E deficiency are at risk of this serious disorder.

In preterm infants, bleeding (hemorrhage) may occur within the brain, and blood vessels in the eyes may grow abnormally (a disorder called retinopathy of prematurity). Affected newborns also have weak muscles.

Vitamin E occurs in eight chemical forms. With a blood test, a doctor can learn how much of one form, alpha-tocopherolTrusted Source, a person has. Using this information, they can determine whether a person’s overall level of vitamin E.

A normal level is usually with the range of 5.5–17 milligrams per liter (mg/L). The normal range may be different for premature infants and children under 17. Normal ranges can also vary slightly among labs.

When an adult has less than 4 mg/L of vitamin E in their blood, they usually require supplementation.

Low levels of vitamin E can lead to:

  • Muscle weaknessTrusted Source: Vitamin E is essential to the central nervous system. It is among the body’s main antioxidants, and a deficiency results in oxidative stress, which can lead to muscle weakness.
  • Coordination and walking difficultiesTrusted Source: A deficiency can cause certain neurons, called the Purkinje neurons, to break down, harming their ability to transmit signals.
  • Numbness and tingling: Damage to nerve fibers can prevent the nerves from transmitting signals correctly, resulting in these sensations, which are also called peripheral neuropathy.
  • Vision deteriorationTrusted Source: A vitamin E deficiency can weaken light receptors in the retina and other cells in the eye. This can lead to loss of vision over time.
  • Immune system problems: Some research suggests that a lack of vitamin E can inhibit the immune cells. Older adultsTrusted Source may be particularly at risk.

Muscle weakness and difficulties with coordination are neurological symptoms that indicate damage to the central and peripheral nervous systems.

The peripheral system is the network of nerves located beyond the brain and spinal cord. These neurons pass messages throughout the body.

The central nervous system communicates between the brain and the spinal cord.

The sheaths of neurons are mostly composed of fats. When the body has too little vitamin E, it contains fewer antioxidants that protect these fats, and the function of the nervous system breaks down.

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