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Adriano dos Santos

Vitamin E


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. Vitamin E is also used for many other conditions, but there is no good scientific evidence to support these other uses.

The American Heart Association recommends obtaining antioxidants, including vitamin E, by eating a well-balanced diet high in fruits, vegetables, and whole grains rather than from supplements until more is known about the risks and benefits of taking supplements.

A type of vitamin E called vitamin E acetate is an ingredient in some vaping products. Using vaping products containing vitamin E acetate has been linked to serious lung injury.

How does it work?

Vitamin E is an important vitamin required for the proper function of many organs in the body. It is also an antioxidant. This means it helps to slow down processes that damage cells.


Effective for:


An inherited condition that affects motor control (ataxia with vitamin E deficiency or AVED). The genetic movement disorder called ataxia causes severe vitamin E deficiency. Vitamin E supplements are used as part of the treatment for ataxia.


Vitamin E deficiency. Taking vitamin E by mouth is effective for preventing and treating vitamin E deficiency.


Possibly Effective for:


Alzheimer disease. Some early research suggests that dietary intake of vitamin E is linked to a lower chance of developing Alzheimer disease. But not all research agrees. Taking vitamin E supplements doesn't seem to prevent Alzheimer disease from developing. In people who already have Alzheimer disease, taking vitamin E along with some anti-Alzheimer medicines might slow down the worsening of memory loss. Vitamin E might also delay the loss of independence and the need for caregiver assistance in people with mild-to-moderate Alzheimer disease.


Low levels of red blood cells in people with long-term illness (anemia of chronic disease). Some research shows that that taking vitamin E improves the response to the drug erythropoietin, which affects red blood cell production, in adults and children on hemodialysis.


A blood disorder that reduces levels of protein in the blood called hemoglobin (beta-thalassemia). Taking vitamin E by mouth seems to benefit children with the blood disorder called beta-thalassemia and vitamin E deficiency.


Leakage of intravenous (IV) drug from the vein into the surrounding skin and tissue (extravasation). Applying vitamin E to the skin together with dimethylsulfoxide (DMSO) seems to be effective for treating leakage of chemotherapy into surrounding tissues.


Nerve damage in the hands and feet caused by cancer drug treatment. Taking vitamin E (alpha-tocopherol) before and after treatment with the cancer drug cisplatin might reduce the risk of nerve damage. But taking vitamin E before and during treatment with the cancer drug oxaliplatin doesn't seem to help.


Menstrual cramps (dysmenorrhea). Taking vitamin E for 2 days before bleeding and for 3 days after bleeding starts seems to decrease pain and reduce menstrual blood loss. Taking vitamin E with fish oil might provide even more pain relief than taking vitamin E alone.


Scarring or hardening of blood vessels in the kidney (glomerulosclerosis).There is some evidence that taking vitamin E by mouth might improve kidney function in children with glomerulosclerosis.


An inherited disorder that causes red blood cells to break down in response to stress (G6PD deficiency). Some research shows that taking vitamin E by mouth, alone or together with selenium, might benefit people with an inherited disorder called G6PD deficiency.


A type of non-cancerous skin sore (granuloma annulare). Applying vitamin E to the skin seems to clear up skin sores called granuloma annulare.


An inherited brain disorder that affects movements, emotions, and thinking (Huntington disease). Natural vitamin E (RRR-alpha-tocopherol) can improve symptoms in people with early Huntington disease. However, it doesn't seem to help people with more advanced disease.


Bleeding within the skull (intracranial hemorrhage). Taking vitamin E by mouth seems to be effective for treating bleeding in the skull in premature infants.


Bleeding into or around the fluid-filled areas (ventricles) of the brain (intraventricular hemorrhage). Taking vitamin E by mouth seems to be effective for treating bleeding within the ventricular system of the brain in premature infants.


Conditions in a man that prevent him from getting a woman pregnant within a year of trying to conceive (male infertility). Taking vitamin E by mouth improves pregnancy rates for men with fertility problems. But taking high doses of vitamin E together with vitamin C doesn't seem to provide the same benefits.


Reduced benefit of nitrate therapy that happens when nitrates are used all day (nitrate tolerance). There is some evidence that taking vitamin E daily can help prevent nitrate tolerance.


Swelling (inflammation) and build up of fat in the liver in people who drink little or no alcohol (nonalcoholic steatohepatitis or NASH). Taking vitamin E daily seems to improve inflammation and liver markers of this form of liver disease in adults and children.


Parkinson disease. People who get more vitamin E in their diet might have a lower risk of Parkinson disease. Taking supplements containing vitamin E doesn't seem to benefit people already diagnosed with Parkinson disease.


Recovery from laser eye surgery (photoreactive keratectomy). Taking high doses of vitamin A along with vitamin E (alpha-tocopheryl nicotinate) daily seems to improve healing and vision in people undergoing laser eye surgery.


Premenstrual syndrome (PMS). Taking vitamin E by mouth seems to reduce anxiety, craving, and depression in some women with PMS.


Physical performance in elderly adults. Research suggests that increasing vitamin E intake in the diet is linked with improved physical performance and muscle strength in older people.


Scarring of tissue caused by radiation therapy. Taking vitamin E by mouth with the drug pentoxifylline seems to treat scarring caused by radiation. However, taking vitamin E alone doesn't seem to be effective.


An eye disorder in premature infants that can lead to blindness (retinopathy of prematurity). Taking vitamin E by mouth seems to be effective for preventing retinopathy in premature infants.


Rheumatoid arthritis (RA). Vitamin E taken along with standard treatment is better than standard treatment alone for reducing pain in people with RA. However, this combination doesn't reduce swelling.


Sunburn. Taking high doses of vitamin E (RRR-alpha-tocopherol) by mouth together with vitamin C protects against skin inflammation after exposure to UV radiation. However, vitamin E alone doesn't provide the same benefit. Applying vitamin E to the skin, together with vitamin C and melatonin, provides some protection when used before UV exposure.


A movement disorder often caused by antipsychotic drugs (tardive dyskinesia). Taking vitamin E by mouth seems to improve symptoms associated with the movement disorder called tardive dyskinesia. However, some other research suggests that it doesn't improve symptoms, but may prevent symptoms from worsening.


Swelling (inflammation) of the eye (uveitis). Taking vitamin E with vitamin C by mouth seems to improve vision, but doesn't reduce swelling, in people with uveitis.


Dosing

The following doses have been studied in scientific research:

By mouth:


For vitamin E deficiency: a typical dose in adults is 60-75 IU of RRR-alpha tocopherol (natural vitamin E) per day


For low levels of red blood cells in people with long-term illness (anemia of chronic disease): 447-745 IU of vitamin E daily with erythropoietin 93-74 U/kg/week.


For a movement disorder often caused by antipsychotic drugs (tardive dyskinesia): 1600 IU of RRR-alpha-tocopherol (natural vitamin E) daily.


For improving conditions in a man that prevent him from getting a woman pregnant within a year of trying to conceive (male infertility): 298-894 IU of vitamin E daily.


For Alzheimer disease: up to 2000 IU of vitamin E daily. Combination therapy with 5 mg of donepezil (Aricept) and 1000 IU of vitamin E per day has been used for slowing memory decline in people with Alzheimer disease.


For swelling (inflammation) and build up of fat in the liver in people who drink little or no alcohol (non-alcoholic steatohepatitis or NASH): 800 IU of vitamin E daily.


For an inherited brain disorder that affects movements, emotions, and thinking (Huntington disease): 3000 IU of RRR-alpha-tocopherol (natural vitamin E).


For rheumatoid arthritis (RA): 600 IU of vitamin E twice daily.


For preventing nerve damage in the hands and feet caused by cancer drugs: 447 IU of vitamin E (alpha-tocopherol) daily with each chemotherapy treatment and for up to 3 months after stopping cisplatin therapy.


For treating the reduced benefit of nitrate therapy that happens when nitrates are used all day (nitrate tolerance): 298 IU of vitamin E three times daily.


For an inherited disorder that causes red blood cells to break down in response to stress (G6PD deficiency): 800 IU of vitamin E daily.


For premenstrual syndrome (PMS): 400 IU of RRR-alpha-tocopherol (natural vitamin E) daily.


For menstrual cramps (dysmenorrhea): 200 IU to 500 IU of vitamin E daily starting 2 days before the menstrual period and continuing through the first 3 days of bleeding. 200 IU of vitamin E with 300 mg of fish oil has also been used.


For recovery from laser eye surgery (photoreactive keratectomy): 343 IU of vitamin E (alpha-tocopheryl nicotinate) and 25,000 units of vitamin A (retinol palmitate) have been used 3 times daily for 30 days, followed by twice daily for 2 months.


For scarring of tissue caused by radiation therapy: 1000 IU of vitamin E daily in combination with 800 mg of pentoxifylline.


For swelling (inflammation) of the eye (uveitis): 149 IU of vitamin E (unspecified forms) in combination with 500 mg of vitamin C twice daily.


For preventing sunburn: 1000 IU of RRR-alpha-tocopherol (natural vitamin E) in combination with 2 grams of ascorbic acid.


Applied to the skin:For treating leakage of intravenous (IV) drug from the vein into surrounding skin and tissue (extravasation): Vitamin E 10% in combination with dimethylsulfoxide (DMSO) 90% applied to the skin.


For preventing sunburn: Vitamin E in combination with topical vitamin C and melatonin applied to the skin prior to sun exposure.


CHILDREN

BY MOUTH:


For a blood disorder that reduces levels of protein in the blood called hemoglobin (beta-thalassemia): 298 mg of vitamin E daily for 4-8 weeks.


For scarring or hardening of blood vessels in the kidney (glomerulosclerosis): 200 Iu of vitamin E.


For treating bleeding within the skull (intracranial hemorrhage): 100 mg/kg of vitamin E (dl-alpha-tocopheryl acetate).


For treating bleeding into or around the fluid-filled areas (ventricles) of the brain (intraventricular hemorrhage): 29.8 IU/kg of vitamin E.


For swelling (inflammation) and build up of fat in the liver in people who drink little or no alcohol (non-alcoholic steatohepatitis or NASH): 400-1200 IU of vitamin E daily.For the most benefit, it's best to take vitamin E that has been made in a lab (all-rac-alpha-tocopherol) with food.

Dosing for vitamin E can be confusing. Current guidelines show recommended dietary allowance (RDA) and tolerable upper intake limits (UL) for vitamin E in milligrams. However, most products are still labeled in International Units (IUs).


References:


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Marmor MF. A randomized trial of vitamin A and vitamin E supplementation for retinitis pigmentosa. Arch Ophthalmol 1993;111:1460-1. View abstract.

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Moertel CG, Fleming TR, Creagan ET, et al. High-dose vitamin C versus placebo in the treatment of patients with advanced cancer who have had no prior chemotherapy. A randomized double-blind comparison. N Engl J Med 1985;312:137-41. View abstract.


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Morris M, Beckett L, Scherr P, et al. Vitamin E and vitamin C supplement use and risk of incident Alzheimer's disease. Alzheimer Dis Assoc Disord 1998;12:121-6. View abstract.


Motoyama T, Kawano H, Kugiyama K, et al. Vitamin E administration improves impairment of endothelium-dependent vasodilation in patients with coronary spastic angina. J Am Coll Cardiol 1998;32:1672-9. View abstract.


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Nemeth I, Turi S, Haszon I, Bereczki C. Vitamin E alleviates the oxidative stress of erythropoietin in uremic children on hemodialysis. Pediatr Nephrol 2000;14:13-7. View abstract.


Neunteufl T, Priglinger U, Heher S, et al. Effects of vitamin E on chronic and acute endothelial dysfunction in smokers. J Am Coll Cardiol 2000;35:277-83. View abstract.


Norton EW. A randomized trial of vitamin A and vitamin E supplementation for retinitis pigmentosa. Arch Ophthalmol 1993;111:1460. View abstract.


Ogunmekan AO, Hwang PA. A randomized, double-blind, placebo-controlled, clinical trial of D-alpha-tocopheryl acetate (vitamin E), as add-on therapy, for epilepsy in children. Epilepsia 1989;30:84-9. View abstract.


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