Vitamin E

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:  Frankp@chiro.org

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Vitamin E Articles

	Flawed Meta-Analysis Misrepresents Vitamin E Research November 16, 2004 –– A flawed "retrospective review" published in the Annals of Internal Medicine took a narrow look at only 19 of the more than 2,170 published papers addressing the efficacy and safety of Vitamin E. Strangely, "18 of those 19 clinical studies showed no increase in the risk for health complications or fatalities with Vitamin E versus a control group. Only one study out of the 19 demonstrated a higher risk and that study was with patients who were using estrogen hormone replacement therapy (HRT) along with Vitamin E."
	Advice to Patients: Don't Throw Away Your Vitamin E Dietary Supplement Information Bureau "Do not throw away your vitamin E," said C. Wayne Callaway, MD, Internal Medicine, Endocrinology, Metabolism and Clinical Nutrition. "One study does not outweigh the many studies that document the benefits of vitamin E in people who need it and the lack of harm in people who do not." In response to the meta-analysis, the DSIB launched a new Web site - www.vitaminEfacts.org - to help consumers obtain accurate information on vitamin E.
	Vitamin E's Powerful Family Of Antioxidants Functional Foods & Nutraceuticals (July 2003) Eight natural compounds have vitamin E activity. These are the four tocopherols, designated as alpha, beta, gamma and delta, and four tocotrienols also designated as alpha, beta, gamma and delta. Yet, alpha-tocopherol has become synonymous with vitamin E. It is the most bioactive form based on the rat foetal resorption test, the classical assay for vitamin E activity. Recent research, however, shows that the other tocopherols and tocotrienols have important and unique antioxidant and other biological effects in nutrition and health. [1, 2] This paper will review the biological function of tocopherols and tocotrienols and their role in health and disease.
	Vitamin E 2000 Nutrition Science News For decades vitamin E has maintained a position along with vitamin C and calcium as one of the three most popular single-ingredient dietary supplements. As scientists continue to examine the role of free radicals in disease initiation and promotion, research substantiates this potent antioxidant's ability to treat stroke, cardiovascular disease and cancer.
	Vitamin E Gains New Protective Role for the Heart Nutrition Science News (January 2001) Researchers have discovered a new role for vitamin E in heart disease protection. Vitamin E supplements lowered blood levels of two key substances that contribute to atherosclerosis, according to a study conducted at the University of Texas Southwestern Medical Center in Dallas. This may be especially important for diabetics who are at high risk of heart disease and have circulatory problems.
	Vitamin E: Weighing the Tocopherols Nutrition Science News (January 1999) Next to vitamin C, vitamin E is probably the most well-known vitamin. In an informal survey I conducted among acquaintances, adults could tell me that alpha-tocopherol is vitamin E and that it is an antioxidant. Many people were aware of claims that vitamin E supplementation slows aging, improves immunity, protects against cancer and heart disease, and is generally good for health. But not many people knew if they got enough. Not even doctors are clear if vitamin E supplements are necessary to prevent deficiency.
	Military Program Proposes Saving Money Through Vitamin E Supplementation WASHINGTON, May 22, 1997 –– A new report by the National Defense Council Foundation finds that the federal government could save up to $6.3 billion annually by increasing the health of active and retired military personnel through a anti–aging program that includes the use of Vitamin E supplementation.

Synthetic vs. Natural Vitamins

	Infants Discriminate Between Natural and Synthetic Vitamin E Am J Clin Nutr. 2003 (Apr); 77 (4): 899–906 ~ FULL TEXT Animal and human studies show that the biological activity of tocopherols is dependent on their particular stereochemistry and chemical form. [1-8] Tocopherols have a saturated phytyl group attached to the 2 position of the chromanol ring. Natural vitamin E (2R,4'R,8'R-α-tocopherol or more simply, RRR-α-tocopherol) has a particular stereochemistry in which the methyl groups in the 2, 4', and 8' positions are all in the R configuration. For synthetic vitamin E (all-rac-α-tocopherol), the configuration at the 2, 4', and 8' positions can be R or S. Natural vitamin E is a single stereoisomer, whereas synthetic vitamin E contains equimolar amounts of 8 isomers, half of which are 2R isomers.
	Vitamin E: Function and Metabolism FASEB J. 1999 (Jul); 13 (10): 1145–1155 ~ FULL TEXT Although vitamin E has been known as an essential nutrient for reproduction since 1922, we are far from understanding the mechanisms of its physiological functions. Vitamin E is the term for a group of tocopherols and tocotrienols, of which alpha–tocopherol has the highest biological activity. Due to the potent antioxidant properties of tocopherols, the impact of alpha–tocopherol in the prevention of chronic diseases believed to be associated with oxidative stress has often been studied, and beneficial effects have been demonstrated. Recent observations that the alpha–tocopherol transfer protein in the liver specifically sorts out RRR–alpha–tocopherol from all incoming tocopherols for incorporation into plasma lipoproteins, and that alpha–tocopherol has signaling functions in vascular smooth muscle cells that cannot be exerted by other forms of tocopherol with similar antioxidative properties, have raised interest in the roles of vitamin E beyond its antioxidative function.
	Synthetic As Compared With Natural Vitamin E Is Preferentially Excreted As Alpha-CEHC in Human Urine: Studies Using Deuterated Alpha-tocopheryl Acetates FEBS Lett. 1998 (Oct 16); 437 (1-2): 145–148 ~ FULL TEXT Following dosing, plasma was enriched with d3RRR-alpha-tocopherol, while urine was enriched with alpha-CEHC derived from d6all rac-alpha-tocopherol. Thus, synthetic compared with natural vitamin E is preferentially metabolized to alpha-CEHC and excreted.
	Human Plasma and Tissue Alpha-tocopherol Concentrations in Response to Supplementation with Deuterated Natural and Synthetic Vitamin E Am J Clin Nutr. 1998 (Apr); 67 (4): 669–684 We report a comparison of natural and synthetic vitamin E in humans using deuterium labeling to permit the two forms of vitamin E to be measured independently in plasma and tissues of each subject. Differences in natural and synthetic vitamin E concentrations were measured directly under equal dosage conditions using an equimolar mixture of deuterated RRR-alpha-tocopheryl acetate and all-rac-alpha-tocopheryl acetate. Two groups of five adults took 30 mg of the mixture as a single dose and as eight consecutive daily doses, respectively. After a 1-mo interval the schedule was repeated but with a 10-fold higher dose (ie, 300 mg). In each case, the ratio of plasma d3-RRR-alpha-tocopherol to d6-all-rac-alpha-tocopherol (RRR:rac) increased from approximately 1.5-1.8 to approximately 2 after dosing ended.
	Biodiscrimination of Alpha-tocopherol Stereoisomers in Humans After Oral Administration Am J Clin Nutr. 1997 (Mar); 65 (3): 785–789 We investigated changes in the concentrations of the stereoisomers of alpha-tocopherol in serum and lipoproteins in seven normal, healthy women aged 21-37 y who had received oral administration of natural and synthetic alpha-tocopheryl acetate. When bioavailability was estimated from the increase in the concentration of RRR- or all-rac-alpha-tocopherol in serum, bioavailability of RRR-alpha-tocopherol administered at 100 mg/d was not different from that of all-rac-alpha-tocopheryl acetate administered at 300 mg/d.
	Two New Studies Find Natural Vitamin E Better Absorbed, Retained Than Synthetic Researchers have long known that natural vitamin E, milligram for milligram, is about 36 percent more potent than the synthetic form of the vitamin. In fact, the "international unit," or IU, standard was developed to compensate for these differences. But two new studies using different groups of people - not laboratory animals - have found that natural vitamin E is utilized twice as efficiently as the synthetic form.
	Natural vs. Synthetic Vitamin E Nutrition Science News (November 2001) On a supplement label, natural vitamin E is listed as d-alpha tocopherol, d-alpha tocopheryl acetate, or d-alpha tocopheryl succinate. In contrast, synthetic forms of vitamin E are labeled with a dl- prefix. Alpha-tocopherol is the most biologically active form of vitamin E, and its natural form consists of one isomer. In contrast, synthetic alpha-tocopherol contains eight different isomers, of which only one (about 12 percent of the synthetic molecule) is identical to natural vitamin E. The other seven isomers range in potency from 21 percent to 90 percent of natural d-alpha-tocopherol.

Vitamin E and Cancer

	Does Vitamin E Protect Salivary Glands From I-131 Radiation Damage In Patients With Thyroid Cancer? Nucl Med Commun. 2013 (May 23) [Epub ahead of print] Vitamin E consumption may be associated with a significant protective effect against radiation-induced dysfunction in salivary glands following single-dose I therapy in patients with differentiated thyroid cancer.
	Vitamin E δ-tocotrienol Induces p27(Kip1)-dependent Cell-cycle Arrest In Pancreatic Cancer Cells Via An E2F-1-dependent Mechanism PLoS One 2013 (Feb 5); 8 (2): e52526 ~ FULL TEXT Finally, decreased proliferation, mediated by Ki67 and p27(Kip1) expression by δ-tocotrienol, was confirmed in vivo in a nude mouse xenograft pancreatic cancer model. Our findings reveal a new mechanism, dependent on p27(Kip1) induction, by which δ-tocotrienol can inhibit proliferation in PDCA cells, providing a new rationale for p27(Kip1) as a biomarker for δ-tocotrienol efficacy in pancreatic cancer prevention and therapy.
	Antioxidant Status and Lipid Peroxidation in Colorectal Cancer J Toxicol Environ Health A 2001 (Oct 12); 64 (3): 213–222 The obtained results indicate significant changes in antioxidant capacity of colorectal cancer tissues, which lead to enhanced action of oxygen radicals, resulting in lipid peroxidation.
	Molecular Epidemiologic Studies Within the Selenium and Vitamin E Cancer Prevention Trial (SELECT) Cancer Causes Control 2001 (Sep); 12 (7): 627–633 To conduct timely epidemiologic investigations of molecular/genetic markers that may contribute to the development of prostate, lung, colorectal, or other cancers within the Selenium and Vitamin E Cancer Prevention Trial (SELECT), and to evaluate interactions between these markers and the study interventions.
	Prostate Cancer and Supplementation with Alpha-tocopherol and Beta-carotene: Incidence and Mortality in a Controlled Trial J Natl Cancer Inst 1998 (Mar 18); 90 (6): 440—446 Long-term supplementation with alpha-tocopherol substantially reduced prostate cancer incidence and mortality in male smokers. Other controlled trials are required to confirm the findings. NOTE: This trial caused enough of a stir to stimulate the initiation of the SELECT (Selenium and Vitamin E Cancer Prevention Trial).
	Estrogenic and Antiproliferative Properties of Genistein and Other Flavonoids in Human Breast Cancer Cells in Vitro Eur J Cancer B Oral Oncol 1993 (Oct); 29B (4): 313–318 These observations suggest that vitamin E may inhibit cancer formation by stimulating the expression of a cancer suppressor gene.

Vitamin E and Heart Disease

Therapeutic Uses of Vitamin E in Prevention of Atherosclerosis Alternative Medicine Review 1999 (Dec); 4 (6): 414–423 ~ FULL TEXT On the basis of the literature search, the authors recommend 400 IU or more per day of vitamin E to patients at high risk or already diagnosed with coronary artery disease. Vitamin E supplementation may also be beneficial in the prevention of cerebro- and peripheral vascular diseases.

The Role of Vitamin E in the Prevention of Heart Disease Arch Fam Med. 1999 (Nov); 8 (6): 537–542 The Iowa Women's Health Study found a 47% reduction in cardiac mortality. Results of randomized, controlled clinical trials have not found consistent benefit, however. The best known of these trials, the Cambridge Heart Antioxidant Study, found a 47% reduction in fatal and nonfatal myocardial infarction in patients with proven coronary atherosclerosis who were given 400 or 800 IU of vitamin E daily. There was, however, no effect on mortality. While emerging and promising data suggest the potential benefit of vitamin E for high-risk cardiac patients, physicians should be alert to the results of randomized, controlled clinical trials already in progress.

Vitamin E and the Immune System

	Nutritional Strategies to Boost Immunity and Prevent Infection in Elderly Individuals Clin Infect Dis 2001 (Dec 1); 33 (11): 1892–1900 Older adults are at risk for malnutrition, which may contribute to their increased risk of infection. Nutritional supplementation strategies can reduce this risk and reverse some of the immune dysfunction associated with advanced age.
	Vitamin E Supplementation Enhances Cell-mediated Immunity in Healthy Elderly Subjects Am J Clin Nutr 1990 (Sep); 52 (3): 557–563 Short-term vitamin E supplementation improves immune responsiveness in healthy elderly individuals; this effect appears to be mediated by a decrease in PGE2 and/or other lipid-peroxidation products.

Vitamin E and Aging

Vitamin E and Macrophage Cyclooxygenase Regulation in the Aged J Nutr 2001 (Feb); 131 (2): 382S–388S Researchers have found that vitamin E supplements can improve rheumatoid arthritis symptoms and reduce markers of inflammation. In a recent study with laboratory mice, Simin Nikbin Meydani, D.V.M., Ph.D., of Tufts University in Boston, found that peroxynitrite, a free radical built around an oxygen and nitrogen molecule, in-creased activity of cyclooxygenase-2 (cox-2), an enzyme involved in making inflammatory prostaglandins. Giving the mice extra vitamin E reduced cox-2 and proinflammatory prostaglandin E2 levels.

Cognitive Decline is Associated with Systemic Oxidative Stress: The EVA study. Etude du Vieillissement Arteriel J Am Geriatr Soc 2000 (Oct); 48 (10): 1285–1291 These results suggest that increased levels of oxidative stress and/or antioxidant deficiencies may pose risk factors for cognitive decline. The direct implication of oxidative stress in vascular and neurodegenerative mechanisms that lead to cognitive impairment should be further explored.

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