Vitamin E Health Benefits
Vitamin E Health Benefits
Most of the health benefits attributed to vitamin E relate either directly or indirectly to its antioxidant properties. It is amazing that one nutrient can be perceived as being beneficial in the treatment of such a wide variety of health problems. But vitamin E is being used to for everything from the treatment of muscle aches and skin lesions to impotence, infertility, and the symptoms of menopause to the prevention of Alzheimer’s disease, heart disease, and cancer. In some cases, the existing research findings do show significant benefits from taking vitamin E, while, in many other instances, the results are less clear-cut. The picture is further complicated by substantial individual differences in both the need for and the ability to utilize vitamin E. Prescribing vitamin E to treat or prevent a certain condition might be helpful for one person, not make a difference one way or the other in someone else, and in others actually be contraindicated. Clearly, additional research is necessary to gain a more workable understanding of which types of conditions, and for whom, how much, and how long, vitamin E supplementation is a viable form of treatment. Meanwhile, without necessarily advocating the use of vitamin E for all of the following conditions, we will highlight here what vitamin E can presumably do to help and why, along with the relevant research findings.
Treating and preventing vitamin E deficiency.
Infants who are born premature or have a low birth weight are one group who can benefit from being given additional vitamin E. Premature infants are at increased risk for vitamin E deficiency due to their limited lipid absorption capacity. These babies are also at risk for heart and lung problems, which vitamin E may help prevent as well.
Similarly, at all stages of life, if a deficiency is diagnosed, or the individual is at high risk and has a greater need for vitamin E than most people, vitamin E supplementation is appropriate. Some of the factors that might indicate an increased need for vitamin E are malnutrition, a fat malabsorption disorder, alcoholism, or serious gastrointestinal or wasting illness.
Vitamin E deficiency can be diagnosed by measuring vitamin E (alpha-tocopherol) blood levels, with concentrations of less than 5 ug/mL suggesting deficiency, or by the RBC fragility test.
Improving muscle strength, stamina, and endurance.
Vitamin E may help improve stamina and endurance by enabling heart and muscle cells to function with less oxygen.
Preventing premature aging and promoting longevity.
This is a controversial area and subject for further investigation. However, there is no doubt that skin changes and overall tissue degeneration caused by damage from free radicals can hasten the aging process. The oxidation of free radicals and resulting changes to the cells, along with a weakened immune system, all of which vitamin E can help prevent, make the body more susceptible to age-associative degenerative diseases that can shorten the lifespan.
Improving women’s health.
Research studies show that vitamin E supplementation is beneficial in relieving problems relating to the menstrual cycle. Vitamin E can also alleviate some of the unpleasant symptoms of menopause such as hot flashes, headaches, and vaginal dryness.
Tocopherols used with birth control pills may reduce some of the side effects of the latter. Vitamin E, presumably because of its protection against the effects of estrogen, is also used both topically and orally in the treatment of fibrocystic breast disease and shown to be helpful.
Enhancing male virility and female fertility.
Presumably because vitamin E was initially discovered in connection with its key role in animal fertility, many men take it, believing it will enhance their sexuality. In addition, many women take vitamin E, believing it will improve their chances of becoming pregnant and then when they become pregnant, to prevent miscarriage. However, there is no clear evidence that vitamin E is associated with any of these outcomes in humans in the absence of a preexisting deficiency. If vitamin E does increase male virility, it could be primarily due to its antioxidant properties and resulting improved circulation. If vitamin E helps a woman becomes pregnant and carry the baby to term, it is probably because, in addition, she is practicing a healthy lifestyle and eating a balanced diet that is plentiful in other essential nutrients.
Preventing age-related disorders of the eye such as cataracts and macular degeneration.
Cataracts, which are very common in the elderly, are cloudy growths on the lens of the eye, which interfere with a person’s vision and, if left, untreated, can eventually cause blindness. Smokers and people who are exposed to a lot of sunlight are also at increased risk for cataracts. However, including significant amounts of antioxidants such as vitamin E in the diet may be useful in preventing cataracts from developing or in delaying their growth. Some studies have shown that older people who take vitamin E supplements are at less risk for developing both cataracts and another major cause of blindness in the elderly, age-related macular degeneration. One problem with these studies, however, is the use of multivitamin preparations so it is unclear to what extent the results can be attributed to vitamin E and not to other nutrients included in the supplement.
One study examined the efficacy of a daily supplement of 500 IU vitamin E in soy oil taken by patients with early or no evidence of cataracts. There was no significant difference in the increase of cataracts or early age-related macular degeneration in the experimental group as compared to those receiving a placebo.
Likewise, among participants in the Alpha-Tocopherol Beta-Carotene (ATBC) Cancer Prevention Study, supplementation with 50 mg alpha-tocopherol daily had no effect on the incidence of cataracts in middle-aged male smokers. However, the Beaver Dam Eye Study investigating nuclear opacity in 1,354 subjects reported an inverse relationship between serum levels of alpha- and gamma-tocopherol and the incidence of cataracts. (These results were obtained after adjusting for such factors as age, smoking, cholesterol levels, heavy drinking, adiposity, and dietary linoleic acid intake).
Improving pulmonary function.
The ATBC study did not find any significant reduction in symptoms of chronic obstructive pulmonary disease (COPD) in middle-aged smokers as a result of taking supplements of 50 mg/day of alpha-tocopherol. However, eating a diet of vitamin E and beta-carotene rich fruits and vegetables was found to be beneficial. The ATBC study also found no significant reduction in the incidence of lung cancer associated with vitamin E supplements.
Treating viral infections.
Vitamin E has been used to treat various viral infections. For example, vitamin E is prescribed to reduce pain symptoms in shingles, a viral infection of the nerves and skin.
Vitamin E has been successfully used to treat a wide variety of inflammatory ailments, including bursitis, gout, and arthritis. It has also been proven helpful in relieving leg cramps, circulatory problems in diabetes, gum infections, peptic ulcers, and certain types of headaches.
Treating skin disorders.
Vitamin E may be helpful in preventing varicose veins. Vitamin E is also frequently used both orally and topically for treatment of numerous skin problems, including all of the following:
Rash associated with lupus
Preventing and treating diabetes.
Preliminary research findings have shown improved metabolic parameters in diabetic patients given high doses of vitamin E. In addition, data obtained from the Atherosclerotic Risk in Communities Study indicted a 50% reduction in the risk for diabetic retinopathy in those taking vitamin E for more than 3 years. Further research is needed regarding the possible benefits of vitamin E supplements in treating diabetes.
Improving immune function in the elderly.
There is little evidence that high doses of vitamin E supplementation improve immune function in the elderly. In one study, 83 healthy individuals, all over age 65, were randomly assigned to receive either 100 mg alpha-tocopherol or a placebo drug for 3 months. Vitamin E produced no significant beneficial effect on overall cellular immune response as measured by immunoglobulin levels. Another study included 652 healthy elderly individuals in independent living in the Netherlands. Vitamin E supplements of 200 mg/day for 18 months had no effect on a number of respiratory infections and severity of infection was greater.
These results suggest that routine use of vitamin E supplements in well-nourished elderly persons is contraindicated. Possibly, the use of supplements with older adults whose diet or serum level is deficient in vitamin E would produce different results.
Another study of 617 nursing home residents (a population more likely to have health problems and inadequate nutrition) explored this very question. Subjects were randomly assigned to receive either 200 IU of vitamin E or a placebo daily. While there was a non-significant reduction in the frequency of common colds associated with taking vitamin E supplements, the supplement was ineffective in reducing the incidence of lower respiratory infections.
Based on these findings, older adults should probably try to increase their consumption of vitamin E-rich plant foods and, if necessary, take low-dose supplements. Since there is no indication that any more than a minimal dose of vitamin E supplements would be more beneficial, increasing the dose does not appear to be warranted unless there is a valid medical reason.
Treating tardive dyskinesia.
Vitamin E appears to be beneficial in reducing the symptoms of tardive dyskinesia. Tardive dyskinesia (TD) is a condition characterized by involuntary body movements that tend to occur in connection with long-term use of antipsychotic medications in patients with neuropsychiatric disorders like schizophrenia or bipolar disorder. 35 patients diagnosed with TD were randomly assigned to receive either 1,600 IU (1,056 mg) of alpha-tocopherol or a placebo for two months. Before and after measures on the Abnormal Involuntary Movement Scale (AIMS) and other instrumental measures of dyskinesia showed a significant reduction in dyskinesia in the experimental group as compared to the control group.
Treating Alzheimer’s disease and other dementias.
The idea that vitamin E might be beneficial in the treatment of neurodegenerative diseases like Alzheimer’s disease and other types of dementia comes from the link between oxidative stress and susceptibility to these conditions. However, the published data on this subject to date are equivocal.
The Alzheimer’s Disease Cooperative Study included 341 patients with Alzheimer’s disease, randomly assigned to receive one of four treatments daily over a 2 year period: 2,000 IU (1,320 mg) alpha-tocopherol, 10 mg Selegilene, both treatments, or a placebo. Treatment with vitamin E did not significantly reduce the likelihood of loss of ability to perform basic daily living activities, or the occurrence of severe dementia, institutionalization, or death.
Another study comparing the Vitamin E plasma levels of 86 dementia patients with matched controls showed no significant relationship between plasma vitamin E levels and the diagnosis of dementia as measured by the Mini-Mental Status Examination.
In contrast to these two studies, other research findings suggest that high doses of vitamin E may slow down cognitive decline and the progression of Alzheimer’s disease. However, there is no conclusive evidence that taking vitamin E supplements can prevent the onset of Alzheimer’s disease, other forms of dementia, and other neurodegenerative diseases such as Parkinson’s disease. Additional research is necessary.
Improving heart health and preventing and treating cardiovascular disease.
Vitamin E is a nutrient that is believed to be beneficial in multiple ways to those who have or are at risk for heart disease. Some of these presumed benefits include:
Reducing symptoms of angina, intermittent claudication (leg pain on walking), and arterial spasm.
Preventing atherosclerosis (hardening of the arteries) by inhibiting thrombin formation and blood clotting and minimizing platelet aggregation (clumping).
Reducing the symptoms of rheumatic heart disease caused by impaired tissue oxygenation.
Together with vitamin A, helping to decrease cholesterol. However, vitamin E by itself has very little effect on raising blood levels of HDL, the good cholesterol.
The oxidation of LDL cholesterol, which vitamin E helps prevent, contributes to atherosclerosis, which is a major risk factor for serious heart disease. Vitamin E also inhibits the formation of thrombin, a hormone that stimulates platelet aggregation, while it facilitates the production of enzymes that cause the release of prostacyclin, a potent vasodilator.
Knowing that vitamin E has all of these cardio-protective capabilities, an understandable conclusion is that including plenty of vitamin E rich foods in the diet or taking vitamin E supplements should reduce the risk of cardiovascular disease substantially. However, the actual data do not consistently support this finding. On the one hand, numerous animal studies show that vitamin E slows the rate of plaque formation in the arteries, thus suggesting that a diet high in vitamin E is heart healthy. On the other hand, most of the recent research suggests that taking vitamin E supplements (400 mg/day or more) might actually be counterproductive and increase, rather than decrease, the risk of mortality in those with chronic heart disease.
Some epidemiological studies offer support for the widespread view that vitamin E can help prevent heart disease. For example, three large studies the Nurses’ Health Study, the Health Professional’s Follow-Up Study, and the Established Populations for Epidemiologic Studies of the Elderly, found that patients taking vitamin E supplements (in dosages exceeding 100 IU or 66 mg/day) for two or more years averaged a 40% lower rate of coronary heart disease.
On the other hand, numerous studies of the effects of different dosages of vitamin E supplements have not shown them to be beneficial in reducing heart disease risk either in healthy individuals or those with one or more risk factors for heart disease. Only a few studies have shown slowed progression of atherosclerosis and reduced risk of venous thromboembolism and mortality in cardiac patients, while more studies have indicated either no beneficial effect or increased risk to health as a result of taking vitamin E supplements.
A meta-analysis published in 2003, based on 81,788 patients taking varying amounts of vitamin E from 50 to 800 IU/day for 1.4 to 12 years indicated no significant reduction in cardiovascular events or lower cardiovascular mortality. Similarly, another meta-analysis using a sample of 51,000 subjects found that vitamin E had no effect on either non-fatal myocardial infarction or on cardiovascular disease-related mortality.
The Heart Outcome Prevention Evaluation (HOPE) and HOPE-TOO Studies found no difference in mortality rates from heart attack, stroke, or other heart-related conditions in those who took 400 IU of alpha-tocopherol for seven years as compared with those who took a placebo. Furthermore, in the HOPE-TOO study, 5.8% of the participants who took vitamin E supplements were hospitalized with heart failure, compared with 4.2% of those taking a placebo. The sample for these studies included more than 10,000 men and women in 19 countries with heart disease, peripheral vascular disease, a previous stroke, or diabetes.
The ATBC Cancer Prevention Study randomly assigned 27,271 Finnish male smokers, age 50-69 with no history of myocardial infarction (MI) to receive 50 mg alpha-tocopherol, 20 mg beta-carotene, both, or a placebo. After following the subjects for a period of 5-8 years, the researchers reported that neither supplement had any effect on the incidence of non-fatal MI, while treatment with vitamin E did produce a slight, but not significant, decrease in coronary disease mortality. Vitamin E supplements were also associated with an increased number of deaths due to hemorrhagic stroke. However, the risk of death from all kinds of stroke was unaffected, and the risk of ischemic stroke did decrease. Follow-up ATBC studies likewise showed no significant cardiovascular benefit associated with supplementary vitamin E in patients with a history of angina or MI.
Another study of 423 postmenopausal women with heart disease found that those who received 400 IU of vitamin E and 500 mg of vitamin C twice a day actually had significantly higher mortality rates (both cardiac and non-cardiac-related) than those receiving a placebo. Similarly, a study of 14,000 male physicians, age 50+, who were randomly assigned to receive a daily supplement of 400 IU of synthetic alpha-tocopherol or a placebo found no difference in incidence of cardiovascular events. However, the incidence of hemorrhagic stroke was significantly greater among those receiving the synthetic vitamin E.
The Heart Protection Study was undertaken to determine whether adding antioxidants to treatment with statins would reduce mortality in a sample of 20,536 at-risk adults. Compared to the statins, which reduced total mortality by 12% and CHD events by 24%, daily supplementation with 650 mg vitamin E, 250 mg vitamin C, and 20 mg beta-carotene had no effect.
Another study reported on the lipid panels of men with mildly elevated cholesterol before and after treatment with vitamin E. 40 men with mildly elevated cholesterol levels were randomly assigned to receive a supplement consisting of either 80 mg alpha-tocopherol or 80 mg of alpha-tocopherol plus 140 mg tocotrienol for a period of 6 weeks. The results showed no significant differences in LDL and HDL cholesterol, triglycerides, lipoprotein A, or lipid peroxide concentrations compared to those receiving a placebo.
All of these results, taken together, strongly suggest that the risks associated with vitamin E supplements could possibly outweigh the benefits in the prevention and treatment of heart disease. Furthermore, back in 1999 the American Heart Association issued a statement, which it has yet to update, that while the existing evidence pertaining to the benefits of vitamin E in the prevention of heart disease looked promising, it was not conclusive.
Based on the most recent evidence that for some individuals, supplemental vitamin E may not only not be beneficial but harmful, caution for everyone is advised. Clearly, additional research is necessary to determine if and when treatment with vitamin E supplements with patients with or at risk for heart disease might be beneficial. Meanwhile, do not fall for unsubstantiated claims and only take vitamin E supplements for heart-related reasons if medically advised to do so.
Reducing cardiovascular surgery risks.
Vitamin E has been shown to be capable of neutralizing free radicals generated during cardiopulmonary bypass surgery. It also provides protection against some of the toxic gasses used in anesthesia. Tocopherol administered before and after surgery (but in doses not exceeding 300 IUs) may diminish scars, facilitate healing, and minimize the risk of blood clots.
Oxidative damage to the cells due to free radicals is believed to trigger cancer by producing toxic compounds and by activating certain signaling pathways which cause alterations in gene expression and interfere with normal cell repair, cell growth and differentiation, and enzyme activity. Because of the strong protective effect of vitamin E on the cell membrane, diets that are high in vitamin E are associated with decreased risk of cancer. Presumably this relationship is based on the ability of vitamin E to help protect DNA from free radical damage. However, there is little empirical evidence that vitamin E, by itself, either in the diet or taken as a supplement, fights cancer. More likely, the effect is achieved by its interaction with other nutrients that serve the same function. In other words, the cancer protective attributes of vitamin E may come largely from the synergistic effects of vitamin E combined with other cancer-protective nutrients and phytochemicals in the diet.
Studies with mice have shown that vitamin E given orally or applied topically was effective in reducing not only acute and chronic skin damage, but also the incidence of cancer. However, the anti-carcinogenic effect was only demonstrated with the alpha-tocopherol form of vitamin E.
Early studies with human subjects reported a 32% reduction in the risk of prostate cancer in those who took vitamin E supplements. The Finnish ATBC Cancer Prevention Study also reported significantly fewer cases of prostate cancer among those subjects taking vitamin E supplements. However, other studies such as the Cancer Prevention Study II failed to replicate those findings.
In the ATBC Cancer Prevention Study, 29,122 Finnish male smokers were randomly assigned to receive either 50 mg alpha-tocopherol, 30 mg beta-carotene, both or a placebo daily for 5-9 years. Out of this group, 135 men developed colorectal cancer, and while the incidence was slightly lower among those who took vitamin E, the difference was not statistically significant. A follow-up study with additional cases also showed no significant association between alpha-tocopherol supplementation and the incidence of colorectal cancer. Among those ATBC study participants who were diagnosed with atrophic gastritis, vitamin E supplements had no bearing on the likelihood of gastric neoplasia five years later.
The U.S. Cancer Prevention Study II also produced data on the possible benefit of vitamin E supplements in preventing other types of cancer. No significant relationship was reported between taking vitamin E supplements and the prevention of colorectal cancer. However, in a sample of 991,522 patients followed for 10 years, the use of vitamin E supplements was associated with a 40% reduction in risk for bladder cancer. It is interesting that shorter term use was not effective in reducing the risk for this disease, suggesting that carcinogenesis is a slow process that can take place over the course of multiple decades.
The HOPE study, in which subjects were given a mean dose of 400 IU of vitamin E daily and followed for an average of seven years, was already extensively discussed in the section on prevention of heart disease. The results of that study not only indicated that vitamin E was not effective in reducing the incidence of cardiac events and mortality, but also was not associated with a decrease in the incidence of cancer and cancer mortality.
In summary, despite the many postulated medicinal uses for vitamin E, the research findings thus far on their actual effectiveness are somewhat disappointing. That is not to say that all of the theories about the supposed beneficial effects of vitamin E on the immune system, cardiovascular and respiratory system, nervous system, and cancer prevention should be thrown out the window. On the contrary, vitamin E appears to play an important role in these and other aspects of our health, but in conjunction with many other factors, which suggests, in most cases, a conservative rather than aggressive approach to treatment is warranted. If you have any questions or concerns about whether vitamin E supplementation is right for you, you are strongly advised to consult with your doctor.