Product Images
GNC Vitamin E 400 IU - GNC - GNC Zoom
Product Videos

GNC Vitamin E 400 IU

Shop all GNC

180 Softgel

Item #077822 See Product Details

Price: $22.99

Member Price: $19.54 Become a Member

Availability: In Stock Details

Available Promotions:

  • 2 for $30 Sale - Add 2 to Cart for Discount! Details
  • $3.99 Flat Rate Shipping! Details

Auto-Delivery Available

Sign Up & Save! Enroll in Auto-Delivery and lock in your price for 12 months.

Learn More

Price: $22.99

Member Price: $19.54 Become a Member
Ship every:
Add to Cart
People Who Buy This Also Bought
You May Also Be Interested In
Similar Items
More Sizes Available
Description
100% Natural

Helps support a healthy cardiovascular system*

Provides strong antioxidant benefits*

* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Supplement Facts

As a dietary supplement, take one or two softgel capsules daily. For maximum benefits, take as directed every day.

Serving Size 1 Softgel Capsule
Servings Per Container 180
Amount Per Serving % DV
Vitamin E (as d-alpha Tocopherol) 400.00 IU 1333%
** Daily Value (DV) not established

Other Ingredients: Soybean Oil, Gelatin, Glycerin

No Sugar, No Artificial Colors, No Arftifical Flavors, No Preservatives, Sodium Free, No Wheat, No Gluten, No Corn, No Dairy, Yeast Free

Warning: KEEP OUT OF REACH OF CHILDREN

Distributed by: General Nutrition Corporation Pittsurgh, PA 15222

Health Notes

Vitamin E

Vitamin E
This nutrient has been used in connection with the following health goals
  • Reliable and relatively consistent scientific data showing a substantial health benefit.
  • Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
  • For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

This supplement has been used in connection with the following health conditions:

Intermittent Claudication
Dose: 400 to 600 IU daily
Taking vitamin E may improve blood flow and increase walking capacity.(more)
Anemia
Dose: 60 to 75 IU per day
Supplementing with vitamin E may improve anemia in cases of vitamin E deficiency.(more)
Anemia
Dose: 800 IU daily
Studies have reported that large amounts of vitamin E improve hemolytic anemia caused by a genetic deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD).(more)
Hypertension
Dose: 200 IU daily
In a study of people with high blood pressure, vitamin E was significantly more effective than placebo at reducing both systolic and diastolic blood pressure.(more)
Angina
Dose: 50 IU daily
Low levels of antioxidant vitamins in the blood, particularly vitamin E, are associated with greater rates of angina. In one study supplementing with small amounts of vitamin E had a minor benefit in people with angina.(more)
Heart Attack
Dose: 400 to 800 IU daily
Supplementing with vitamin E, synthetic or natural, may help reduce heart attack risk.(more)
Intermittent Claudication
Dose: 200 mg of EPA and 130 mg of DHA daily, plus small amounts of vitamin B6, folic acid, vitamin E, oleic acid, and alpha-linolenic acid
In one study, men with intermittent claudication who drank a milk product fortified with fish oil, vitamin B6, folic acid, vitamin E, oleic acid, and alpha-linolenic acid could walk further without pain than those who drank regular milk.(more)
Atherosclerosis
Dose: 100 to 200 IU daily
Vitamin E is an antioxidant that protects LDL cholesterol from oxidative damage and has been linked to heart disease prevention. Many doctors recommend supplementing with vitamin E to lower the risk of atherosclerosis and heart attacks.(more)
High Cholesterol
Dose: Refer to label instructions
In one trial, supplementing with vitamin E increased levels of protective HDL cholesterol.(more)
Stroke
Dose: Refer to label instructions
Studies have found that people who eat foods high in antioxidants such vitamin E have less carotid stenosis, a risk factor for stroke. Vitamin E plus aspirin has also been shown to be effective in reducing stroke risk.(more)
Sunburn
Dose: 2,000 to 3,000 mg vitamin C and 1,000 to 2,000 IU vitamin E
Antioxidants may protect the skin from sunburn due to free radical-producing ultraviolet rays. Combinations of vitamin E and C offer protection against ultraviolet rays.(more)
Sunburn
Dose: Apply a formula containing 2% vitamin E, 5% vitamin C, and 1% to 2.5% melatonin before sun exposure
A topically applied combination of melatonin, vitamin C, and vitamin E may boost the protection from traditional sunscreens.(more)
Sunburn
Dose: Apply a formula containing 2% vitamin E and 5% vitamin C before sun exposure
Studies have found sunscreen-like effects from topical application of the vitamin C and vitamin E combination.(more)
Wound Healing
Dose: 400 IU daily
Supplementing with vitamin E may enhance healing and prevent adhesion formation after surgery, applied topically, the vitamin may help prevent scarring.(more)
Dermatitis Herpetiformis
Dose: 10 IU daily
Supplementing with selenium and vitamin E has been shown to correct an antioxidant deficiency common in DH.(more)
Skin Ulcers
Dose: 400 IU daily
Antioxidants, such as vitamin E, are depleted in healing skin tissue. Studies have shown that vitamin E taken orally to be effective at preventing skin ulcers and promoting healing.(more)
Burns
Dose: Refer to label instructions
Using the antioxidant vitamin E topically on minor burns is a popular remedy. If applying vitamin E topically, use the tocopherol form.(more)
Skin Ulcers
Dose: Refer to label instructions
Antioxidants such as vitamin E, are depleted in healing skin tissue. One study found that topically applied vitamin E shortened the healing time of skin ulcers.(more)
Dysmenorrhea
Dose: 400 to 600 IU of vitamin E a day for five days, beginning two days before menstruation
Taking vitamin E beginning two days before menstruation may help prevent severe pain.(more)
Menopause
Dose: Refer to label instructions
Vitamin E may help reduce menopause symptoms. Many doctors suggest that women going through menopause try vitamin E for at least three months to see if symptoms improve.(more)
Premenstrual Syndrome
Dose: 300 IU daily
Vitamin E may decrease PMS symptoms, according to one study.(more)
Endometriosis
Dose: 1,000 mg vitamin C and 1,200 IU vitamin E daily
A combination of vitamin C and vitamin E can help lessen the pain of endometriosis.(more)
Fibrocystic Breast Disease
Dose: Refer to label instructions
Some studies have reported that vitamin E reduces symptoms of FBS, many women try it for three months to see if it helps.(more)
Female Infertility
Dose: Refer to label instructions
In one study, infertile couples given vitamin E showed significantly improved fertility.(more)
Menorrhagia
Dose: Refer to label instructions
In a study of women with menorrhagia associated with the use of an intrauterine device (IUD), supplementing with vitamin E corrected the problem in all cases within ten weeks.(more)
Vaginitis
Dose: Refer to label instructions
Some doctors recommend vitamin E (taken orally, topically, or vaginally) for certain types of vaginitis.(more)
Abnormal Pap Smear
Dose: Refer to label instructions
Women with cervical dysplasia may have lower blood levels of vitamin E compared with healthy women.(more)
Immune Function
Dose: 200 IU daily
Vitamin E enhances some measures of immune-cell activity in the elderly.(more)
Cold Sores
Dose: Apply cotton saturated with oil for 15 minutes every three hours on day one, then three times daily on days two and three
Applying vitamin E oil directly to a cold sore appears to accelerate healing.(more)
Pre- and Post-Surgery Health
Dose: Refer to label instructions
Some studies have found that vitamin E levels decrease after surgery, supplementation may correct a deficiency. Vitamin E may also prevent scarring when used topically after surgery.(more)
Bronchitis
Dose: Refer to label instructions
Vitamin E appears to help keep the lungs healthy and prevent damage from environmental pollution and cigarette smoke exposure.(more)
HIV and AIDS Support
Dose: Refer to label instructions
In test-tube studies, vitamin E improved the effectiveness of the anti-HIV drug zidovudine (AZT) while reducing its toxicity.(more)
Dysmenorrhea
Dose: 400 to 600 IU of vitamin E a day for five days, beginning two days before menstruation
Taking vitamin E beginning two days before menstruation may help prevent severe pain.(more)
Premenstrual Syndrome
Dose: 300 IU daily
Vitamin E may decrease PMS symptoms, according to one study.(more)
Endometriosis
Dose: 1,000 mg vitamin C and 1,200 IU vitamin E daily
A combination of vitamin C and vitamin E can help lessen the pain of endometriosis.(more)
Menorrhagia
Dose: Refer to label instructions
In a study of women with menorrhagia associated with the use of an intrauterine device (IUD), supplementing with vitamin E corrected the problem in all cases within ten weeks.(more)
Rheumatoid Arthritis
Dose: 1,200 to 1,800 IU daily
Vitamin E is an important antioxidant, protecting joints against oxidative damage. Supplementing with vitamin E can help ease symptoms, including pain.(more)
Osteoarthritis
Dose: 400 to 1,600 IU per day
As an antioxidant, vitamin E appears to help protect joints.(more)
Dupuytren's Contracture
Dose: Refer to label instructions
Supplementing with vitamin E may improve Dupuytren's contracture, although research on the topic has been conflicting.(more)
Wound Healing
Dose: 400 IU daily
Supplementing with vitamin E may enhance healing and prevent adhesion formation after surgery, applied topically, the vitamin may help prevent scarring.(more)
Fibromyalgia
Dose: Refer to label instructions
Vitamin E was used in one early study with beneficial and sometimes dramatic results.(more)
Shingles and Postherpetic Neuralgia
Dose: Refer to label instructions
Some doctors have found vitamin E supplements to be effective for people with postherpetic neuralgia. Vitamin E oil can also be applied to the skin.(more)
Burns
Dose: Refer to label instructions
Using the antioxidant vitamin E topically on minor burns is a popular remedy. If applying vitamin E topically, use the tocopherol form.(more)
Sprains and Strains and Exercise-Related Muscle Injury
Dose: Refer to label instructions
Antioxidant supplements, including vitamin E, may help prevent exercise-related muscle injuries by neutralizing free radicals produced during strenuous activities.(more)
Pancreatic Insufficiency
Dose: 270 IU daily
Taking antioxidant supplements, such as vitamin E, may lessen pain and prevent pancreatitis recurrences.(more)
Retinopathy and Retrolental Fibroplasia
Dose: Consult a qualified healthcare practitioner
Large amounts of vitamin E have been shown to reduce the incidence of severe retinopathy in premature infants.(more)
Type 1 Diabetes and Diabetic Nephropathy
Dose: 900 to 1,800 IU daily
Vitamin E supplementation may protect against diabetic neuropathy.(more)
Type 1 Diabetes and Diabetic Retinopathy
Dose: 1800 IU daily
Supplementing with vitamin E may combat free radicals associated with diabetic retinopathy.(more)
Type 2 Diabetes and Diabetic Neuropathy
Dose: 900 IU daily
Vitamin E supplementation may protect against neuropathy.(more)
Type 2 Diabetes and Diabetic Retinopathy
Dose: 1800 IU daily
Vitamin E supplementation may protect against diabetic retinopathy.(more)
Insulin Resistance Syndrome
Dose: Refer to label instructions
Vitamin E has been shown to increase insulin sensitivity in both healthy and hypertensive people and may have a similar effect on people with IRS.(more)
Hypoglycemia
Dose: Refer to label instructions
Vitamin E helps control blood sugar levels in people with diabetes, and since there are similarities in the way the body regulates high and low blood sugar levels, it might be helpful for hypoglycemia as well.(more)
Retinopathy
Dose: Refer to label instructions
Vitamin E has been found to prevent retinopathy in people with a rare genetic disease known as abetalipoproteinemia.(more)
Type 1 Diabetes
Dose: Refer to label instructions
A combination of the antioxidants selenium, vitamin A, vitamin C, and vitamin E has been shown to improve diabetic retinopathy.(more)
Type 1 Diabetes and Diabetic Retinopathy
Dose: Refer to label instructions
Antioxidant nutrients including selenium, vitamin A, vitamin C, and vitamin E may combat free radicals associated with diabetic retinopathy.(more)
Cold Sores
Dose: Apply cotton saturated with oil for 15 minutes every three hours on day one, then three times daily on days two and three
Applying vitamin E oil directly to a cold sore appears to accelerate healing.(more)
Leukoplakia
Dose: 800 IU daily
According to a review of clinical trials, the combination of beta-carotene and vitamin E has led to complete or partial remissions in six of eight trials studying people with leukoplakia.(more)
Halitosis
Dose: Refer to label instructions
Vitamin E is often recommended by doctors to help prevent and treat periodontitis.(more)
Gingivitis
Dose: Refer to label instructions
Vitamin E is often recommended by doctors to help prevent and treat periodontitis.(more)
Menopause
Dose: Refer to label instructions
Vitamin E may help reduce menopause symptoms. Many doctors suggest that women going through menopause try vitamin E for at least three months to see if symptoms improve.(more)
Hay Fever
Dose: 800 IU daily
In a study of people with hay fever, adding vitamin E to regular anti-allergy treatment during the pollen season significantly reduced the severity of hay fever symptoms.(more)
Asthma
Dose: Refer to label instructions
There is some evidence that a combination of antioxidants vitamin E, vitamin C, and selenium may help prevent asthma thought to be caused by air pollution. (more)
Alzheimer's Disease
Dose: 2,000 IU daily
Antioxidant supplements such as vitamin E have been associated with lower risk of Alzheimer's disease and improved brain function in middle-aged and older adults. (more)
Macular Degeneration
Dose: Refer to label instructions
Sunlight triggers oxidative damage in the eye, which in turn can cause macular degeneration. Vitamin E protects against oxidative damage and may reduce macular degeneration risk.(more)
Age-Related Cognitive Decline
Dose: Refer to label instructions
Use of vitamin E, alone or with vitamin C, has been associated with better cognitive function and a reduced risk of certain forms of dementia (but not Alzheimer's disease).(more)
Anti-Aging
Dose: Refer to label instructions
(more)
Prostate Cancer
Dose: 50 IU daily
Supplementing with vitamin E as mixed tocopherols may help lower prostate cancer risk, especially in smokers. (more)
Macular Degeneration
Dose: Refer to label instructions
Sunlight triggers oxidative damage in the eye, which in turn can cause macular degeneration. Vitamin E protects against oxidative damage and may reduce macular degeneration risk.(more)
Retinopathy
Dose: Refer to label instructions
Vitamin E has been found to prevent retinopathy in people with a rare genetic disease known as abetalipoproteinemia.(more)
Cataracts
Dose: Refer to label instructions
Low blood levels of vitamin E have been linked to increased risk of forming cataracts. Vitamin E supplements have been reported to protect against cataracts.(more)
Osgood-Schlatter Disease
Dose: 400 IU a day with 150 mcg a day of selenium
Taking a combination of vitamin E and selenium may help the healing.(more)
Childhood Diseases
Dose: Refer to label instructions
Healthy immune function requires adequate amounts of vitamin E. Animal studies have shown that vitamin E increases immune cell activity and reduces virus activity.(more)
Kidney Stones
Dose: Refer to label instructions
In one study, supplementing with synthetic vitamin E was found to reduce several risk factors for kidney stone formation in people with elevated levels of urinary oxalate.(more)
Male Infertility
Dose: Refer to label instructions
Vitamin E supplementation appears to enhance fertility, possibly by decreasing free-radical damage to sperm cells.(more)
Restless Legs Syndrome
Dose: Refer to label instructions
In one study, supplementing with vitamin E produced complete relief in seven out of nine people with restless leg syndrome.(more)
Age-Related Cognitive Decline
Dose: Refer to label instructions
Use of vitamin E, alone or with vitamin C, has been associated with better cognitive function and a reduced risk of certain forms of dementia (but not Alzheimer's disease).(more)
Athletic Performance, Exercise Recovery, and High-Altitude Exercise Performance
Dose: 400 IU daily
Antioxidants, including vitamin E, neutralize exercise-related free radicals before they can damage the body, so antioxidants may aid in exercise recovery. Vitamin E has been shown to benefit exercise performance at high altitudes.(more)
Yellow Nail Syndrome
Dose: 800 IU daily
Vitamin E has been used successfully with people who have yellow nail syndrome in several preliminary reports.(more)
Intermittent Claudication
Dose: 400 to 600 IU daily

Vitamin E supplementation has been shown in controlled trials to increase both walking distance and blood flow through arteries of the lower legs in people with intermittent claudication.1, 2 Increasing dietary intake of vitamin E was also associated with better blood flow to the legs.3 Some early studies did not find vitamin E useful. Possibly this failure was due to the short duration of the studies,4 as one review article suggested that a minimum of four to six months of vitamin E supplementation may be necessary before significant improvement is seen.5 Most clinical trials of vitamin E and intermittent claudication used 400 to 600 IU per day, although one study used 2,400 IU per day.

References

1. Haeger K. Long-time treatment of intermittent claudication with vitamin E. Am J Clin Nutr 1974;27:1179-81.

2. Williams HT, Fenna D, Macbeth RA. Alpha tocopherol in the treatment of intermittent claudication. Surg Gynecol Obstet 1971;Apr:662-6.

3. Donnan PT, Thomson M, Fowkes GR, et al. Diet as a risk factor for peripheral arterial disease in the general population: the Edinburgh Artery Study. Am J Clin Nutr 1993;57:917-21.

4. Livingstone PD, Jones C. Treatment of intermittent claudication with vitamin E. Lancet 1958;ii:602-4 [review].

5. Piesse JW. Vitamin E and peripheral vascular disease. Int Clin Nutr Rev 1984;4:178-82 [review].

Anemia
Dose: 60 to 75 IU per day

Hemolytic anemia refers to a category of anemia in which red blood cells become fragile and undergo premature death. Vitamin E deficiency, though quite rare, can cause hemolytic anemia because vitamin E protects the red blood cell membrane from oxidative damage. Vitamin E deficiency anemia usually affects only premature infants and children with cystic fibrosis.1, 2 Preliminary studies have reported that large amounts (typically 800 IU per day) of vitamin E improve hemolytic anemia caused by a genetic deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD)3, 4, 5 and anemia caused by kidney dialysis.6, 7

References

1. Mino M. Clinical uses and abuses of vitamin E in children. Proc Soc Exp Biol Med 1992;200:266-70 [review].

2. Swann IL, Kendra JR. Anaemia, vitamin E deficiency and failure to thrive in an infant. Clin Lab Haematol 1998;20:61-3.

3. Hafez M, Amar ES, Zedan M, et al. Improved erythrocyte survival with combined vitamin E and selenium therapy in children with glucose-6-phosphate dehydrogenase deficiency and mild chronic hemolysis. J Pediatr 1986;108:558-61.

4. Corash L, Spielberg S, Bartsocas C, et al. Reduced chronic hemolysis during high-dose vitamin E administration in Mediterranean-type glucose-6-phosphate dehydrogenase deficiency. N Engl J Med 1980;303:416-20.

5. Eldamhougy S, Elhelw Z, Yamamah G, et al. The vitamin E status among glucose-6 phosphate dehydrogenase deficient patients and effectiveness of oral vitamin E. Int J Vitam Nutr Res 1988;58:184-8.

6. Ono K. Reduction of osmotic haemolysis and anaemia by high dose vitamin E supplementation in regular haemodialysis patients. Proc Eur Dial Transplant Assoc Eur Ren Assoc 1985;21:296-9.

7. Ono K. Effects of large dose vitamin E supplementation on anemia in hemodialysis patients. Nephron 1985;40:440-5.

Anemia
Dose: 800 IU daily

Hemolytic anemia refers to a category of anemia in which red blood cells become fragile and undergo premature death. Vitamin E deficiency, though quite rare, can cause hemolytic anemia because vitamin E protects the red blood cell membrane from oxidative damage. Vitamin E deficiency anemia usually affects only premature infants and children with cystic fibrosis.1, 2 Preliminary studies have reported that large amounts (typically 800 IU per day) of vitamin E improve hemolytic anemia caused by a genetic deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD)3, 4, 5 and anemia caused by kidney dialysis.6, 7

References

1. Mino M. Clinical uses and abuses of vitamin E in children. Proc Soc Exp Biol Med 1992;200:266-70 [review].

2. Swann IL, Kendra JR. Anaemia, vitamin E deficiency and failure to thrive in an infant. Clin Lab Haematol 1998;20:61-3.

3. Hafez M, Amar ES, Zedan M, et al. Improved erythrocyte survival with combined vitamin E and selenium therapy in children with glucose-6-phosphate dehydrogenase deficiency and mild chronic hemolysis. J Pediatr 1986;108:558-61.

4. Corash L, Spielberg S, Bartsocas C, et al. Reduced chronic hemolysis during high-dose vitamin E administration in Mediterranean-type glucose-6-phosphate dehydrogenase deficiency. N Engl J Med 1980;303:416-20.

5. Eldamhougy S, Elhelw Z, Yamamah G, et al. The vitamin E status among glucose-6 phosphate dehydrogenase deficient patients and effectiveness of oral vitamin E. Int J Vitam Nutr Res 1988;58:184-8.

6. Ono K. Reduction of osmotic haemolysis and anaemia by high dose vitamin E supplementation in regular haemodialysis patients. Proc Eur Dial Transplant Assoc Eur Ren Assoc 1985;21:296-9.

7. Ono K. Effects of large dose vitamin E supplementation on anemia in hemodialysis patients. Nephron 1985;40:440-5.

Hypertension
Dose: 200 IU daily

In a double-blind study of people with high blood pressure, 200 IU of vitamin E per day taken for 27 weeks was significantly more effective than a placebo at reducing both systolic and diastolic blood pressure.1 This study was done in Iran, and it is not clear whether the results would apply to individuals consuming a Western diet.

References

1. Boshtam M, Rafiei M, Sadeghi K, Sarraf-Zadegan N. Vitamin E can reduce blood pressure in mild hypertensives. Int J Vitam Nutr Res 2002;72:309-14.

Angina
Dose: 50 IU daily

Low levels of antioxidant vitamins in the blood, particularly vitamin E, are associated with greater rates of angina.1 This is true even when smoking and other risk factors for angina are taken into account. Early short-term studies using 300 IU (International Units) per day of vitamin E could not find a beneficial action on angina.2 A later study supplementing small amounts of vitamin E (50 IU per day) for longer periods of time showed a minor benefit in people suffering angina.3 Those affected by variant angina have been found to have the greatest deficiency of vitamin E compared with other angina patients.4

References

1. Riemersma RA, Wood DA, Macintyre CC, et al. Risk of angina pectoris and plasma concentrations of vitamins A, C, and E and carotene. Lancet 1991;337:1-5.

2. Rinzler SH, Bakst H, Benjamin ZH, et al. Failure of alpha-tocopherol to influence chest pain in patients with heart disease. Circulation 1950;1:288-90.

3. Rapola RM, Virtamo J, Haukka JK, et al. Effect of vitamin E and beta carotene on the incidence of angina pectoris. A randomized, double-blind, controlled trial. JAMA 1996;275:693-8.

4. Miwa K, Miyagi Y, Igawa A, et al. Vitamin E deficiency in variant angina. Circulation 1996;94:14-8.

Heart Attack
Dose: 400 to 800 IU daily



Several studies[REF][REF] including two double-blind trials[REF][REF] have reported that 400 to 800 IU of natural vitamin E reduces the risk of heart attacks. However, other recent double-blind trials have found either limited benefit,[REF] or no benefit at all from supplementation with synthetic vitamin E.[REF] One of the negative trials used 400 IU of natural vitamin E[REF]-a similar amount and form to previous successful trials. In attempting to make sense of these inconsistent findings the following is clear: less than 400 IU of synthetic vitamin E, even when taken for years, does not protect against heart disease. Whether 400 to 800 IU of natural vitamin E is or is not protective remains unclear.

Taking antioxidant supplements may improve the outcome for people who have already had a heart attack. In one double-blind trial, people were given 50,000 IU of vitamin A per day, 1,000 mg of vitamin C per day, 600 IU of vitamin E per day, and approximately 41,500 IU of beta-carotene per day or placebo.1 After 28 days, the infarct size of those receiving antioxidants was significantly smaller than the infarct size of the placebo group.

References

1. Singh RB, Niaz MA, Rastogi SS, Tastogi S. Usefulness of antioxidant vitamins in suspected acute myocardial infarction (the Indian experiment of infarct survival-3). Am J Cardiol 1996;77:232-6.

Intermittent Claudication
Dose: 200 mg of EPA and 130 mg of DHA daily, plus small amounts of vitamin B6, folic acid, vitamin E, oleic acid, and alpha-linolenic acid

Men with intermittent claudication consumed a fortified milk product or regular milk daily for one year. The fortified product provided daily 130 mg of eicosapentaenoic acid and 200 mg of docosahexaenoic acid (EPA and DHA, two fatty acids in fish oil), small amounts of supplemental vitamin E, folic acid, and vitamin B6, and additional amounts of oleic acid and alpha-linolenic acid. Compared with regular milk, the fortified milk product significantly increased the distance the participants could walk before the onset of pain.1

References

1. Carrero JJ, Lopez-Huertas E, Salmeron LM, et al. Daily supplementation with (n-3) PUFAs, oleic acid, folic acid, and vitamins B-6 and E increases pain-free walking distance and improves risk factors in men with peripheral vascular disease. J Nutr2005;135:1393-9.

Atherosclerosis
Dose: 100 to 200 IU daily

Vitamin E is an antioxidant that serves to protect LDL from oxidative damage1 and has been linked to prevention of heart disease in double-blind research.2 Many doctors recommend 400-800 IU of vitamin E per day to lower the risk of atherosclerosis and heart attacks. However, some leading researchers suggest taking only 100-200 IU per day, as studies that have explored the long-term effects of different supplemental levels suggest no further benefit beyond that amount, and research reporting positive effects with 400-800 IU per day have not investigated the effects of lower intakes.3 In a double-blind trial, people with high cholesterol who took 136 IU of natural vitamin E per day for three years had 10% less progression of atherosclerosis compared with those taking placebo.4

References

1. Belcher JD, Balla J, Balla G, et al. Vitamin E, LDL, and endothelium: Brief oral vitamin supplementation prevents oxidized LDL-mediated vascular injury in vitro. Arterioscler Thromb 1993;13:1779-89.

2. Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996;347:781-6.

3. Rimm E. Micronutrients, Coronary Heart disease and cancer: Should we all be on supplements? Presented at the 60th Annual Biology Colloquium, Oregon State University, February 25, 1999.

4. Salonen JT, Nyyssonen K, Salonen R, et al. Antioxidant supplementation in atherosclerosis prevention (ASAP) study: a randomized trial of the effect of vitamin E and C on 3-year progression of carotid atherosclerosis. J Intern Med 2000;248:177-86.

High Cholesterol
Dose: Refer to label instructionsIn one double-blind trial,1vitamin E increased protective HDL cholesterol, but several other trials,2, 3, 4 found no effect of vitamin E. However, vitamin E is known to protect LDL cholesterol from damage.5 Most cardiologists believe that only damaged LDL increases the risk of heart disease. Studies of the ability of vitamin E supplements to prevent heart disease have produced conflicting results,6 but many doctors continue to recommend that everyone supplement 400 IU of vitamin E per day to lessen the risk of having a heart attack.
References

1. Cloarec MJ, Perdriset GM, Lamberdiere FA, et al., Alpha-tocopherol: effect on plasma lipoproteins in hypercholesterolemic patients. Isr J Med Sci 1987;23:869-72.

2. Kesaniemi YA, Grundy SM. Lack of effect of tocopherol on plasma lipids and lipoproteins in man. Am J Clin Nutr 1982;36:224-8.

3. Kalbfleisch JH, Barboriak JJ, Else BA, et al. alpha-Tocopherol supplements and high-density-lipoprotein-cholesterol levels. Br J Nutr 1986;55:71-7.

4. Stampfer MJ, Willett W, Castelli WP, et al. Effect of vitamin E on lipids. Am J Clin Pathol 1983;79:714-6.

5. Belcher JD, Balla J, Balla G, et al. Vitamin E, LDL, and endothelium: Brief oral vitamin supplementation prevents oxidized LDL-mediated vascular injury in vitro. Arterioscler Thromb 1993;13:1779-89.

6. Traber MG. Does vitamin E decrease heart attack risk? summary and implications with respect to dietary recommendations. J Nutr 2001;131:395S-7S. [review].

Stroke
Dose: Refer to label instructions

Narrowing of the neck arteries (carotid stenosis) caused by atherosclerosis is a risk factor for stroke. Preliminary diet studies have found that people who eat foods high in antioxidants such as vitamin C and vitamin E have less carotid stenosis.1, 2

In a double-blind trial, people with atherosclerosis in the carotid arteries were given a palm oil extract containing 160-240 mg of tocotrienols (a vitamin E-like supplement) and approximately 100-150 IU vitamin E per day. After 18 months, they had significantly less atherosclerosis or less progression of atherosclerosis compared to a group receiving placebo.3 Vitamin E plus aspirin, has been more effective in reducing the risk of strokes and other related events than has aspirin, alone.4 However, most preliminary trials have shown no protective effects from antioxidant supplementation.5, 6, 7, 8, 9, 10 A large Finnish trial concluded that supplementation with either vitamin E or beta-carotene conferred no protection against stroke in male smokers,11 although a later review of the study found that those smokers who have either hypertension (high blood pressure) or diabetesdo appear to have a reduced risk of stroke when taking vitamin E.12

People with high risk for stroke, such as those who have had TIAs or who have a heart condition known as atrial fibrillation,13 are often given aspirin or anticoagulant medication to reduce blood clotting tendencies. Some natural inhibitors of blood clotting such as garlic,14, 15, 16fish oil,17 and vitamin E,18, 19 may have protective effects, but even large amounts of fish oil are known to be less potent than aspirin.20 Whether any of these substances is an adequate substitute to control risk of stroke in high-risk people is unknown, and anyone taking anticoagulant medication should advise their prescribing doctor before beginning use of these natural substances.

References

1. Bonithon-Kopp C, Coudray C, Berr C, et al. Combined effects of lipid peroxidation and antioxidant status on carotid atherosclerosis in a population aged 59-71 y: The EVA Study. Etude sur le Vieillisement Arteriel. Am J Clin Nutr 1997;65:121-7.

2. Kritchevsky SB, Shimakawa T, Tell GS, et al. Dietary antioxidants and carotid artery wall thickness. The ARIC Study. Atherosclerosis Risk in Communities Study. Circulation 1995;92:2142-50.

3. Tomeo AC, Geller M, Watkins TR, et al. Antioxidant effects of tocotrienols in patients with hyperlipidemia and carotid stenosis. Lipids 1995;30:1179-83.

4. Steiner M, Glantz M, Lekos A. Vitamin E plus aspirin compared with aspirin alone in patients with transient ischemic attacks. Am J Clin Nutr 1995;62(6 Suppl):1381-4S.

5. Blot WJ, Li JY, Taylor PR, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993;85:1483-92.

6. Gaziano JM, Manson JE, Ridker PM, et al. Beta-carotene therapy for chronic stable angina. Circulation 1990;82(Suppl III):III-201 [abstract].

7. Ascherio A, Rimm EB, Hernan MA, et al. Relation of consumption of vitamin E, vitamin C, and carotenoids to risk for stroke among men in the United States. Ann Intern Med 1999;130:963-70.

8. Mark SD, Wang W, Fraumeni JF Jr, et al. Do nutritional supplements lower the risk of stroke or hypertension? Epidemiology 1998;9:9-15.

9. Hennekens CH, Buring JE, Manson JE, et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 1996;334:1145-9.

10. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029-35.

11. Leppala JM, Virtamo J, Fogelholm R, et al. Controlled trial of alpha-tocopherol and beta-carotene supplements on stroke incidence and mortality in male smokers. Arterioscler Thromb Vasc Biol 2000;20:230-5.

12. Leppala JM, Virtamo J, Fogelholm R, et al. Vitamin E and beta carotene supplementation in high risk for stroke: a subgroup analysis of the alpha-tocopherol, beta-carotene cancer prevention study. Arch Neurol 2000;57:1503-9.

13. Kopecky SL, Gersh BJ, McGoon MD, et al. Lone atrial fibrillation in elderly persons: a marker for cardiovascular risk. Arch Intern Med 1999;159:1118-22.

14. Bordia A, Verma SK, Srivastava KC. Effect of garlic (Allium sativum) on blood lipids, blood sugar, fibrinogen and fibrinolytic activity in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty Acids 1998;58:257-63.

15. Berthold HK, Sudhop T. Garlic preparations for prevention of atherosclerosis. Curr Opin Lipidol 1998;9:565-9 [review].

16. Kiesewetter H, Jung F, Pindur G, et al. Effect of garlic on thrombocyte aggregation, microcirculation and other risk factors. Int J Pharm Ther Toxicol 1991;29(4):151-5.

17. Leaf A, Weber PC. Cardiovascular effects of n-3 fatty acids. N Engl J Med 1988;318:549-57 [review].

18. Calzada C, Bruckdorfer KR, Rice-Evans CA. The influence of antioxidant nutrients on platelet function in healthy volunteers. Atherosclerosis 1997;128:97-105.

19. Steiner M. Vitamin E: more than an antioxidant. Clin Cardiol 1993;16:I16-8 [review].

20. Heemskerk JW, Vossen RC, van Dam-Mieras MC. Polyunsaturated fatty acids and function of platelets and endothelial cells. Curr Opin Lipidol 1996;7:24-9 [review].

Sunburn
Dose: 2,000 to 3,000 mg vitamin C and 1,000 to 2,000 IU vitamin E

Antioxidants may protect the skin from sunburn due to free radical-producing ultraviolet rays.1 Combinations of 1,000 to 2,000 IU per day of vitamin E and 2,000 to 3,000 mg per day of vitamin C, but neither given alone, have a significant protective effect against ultraviolet rays, according to double-blind studies.2, 3, 4

Oral synthetic beta-carotene alone was not found to provide effective protection when given in amounts of 15 mg per day or for only a few weeks' time in larger amounts of 60 to 90 mg per day, but it has been effective either in very large (180 mg per day) amounts or in smaller amounts (30 mg per day) in combination with topical sunscreen.5, 6, 7, 8, 9

Natural sources of beta-carotene or other carotenoids have been more consistently shown to protect against sunburn. One controlled study found that taking a supplement of natural carotenoids (almost all of which was beta-carotene) in daily amounts of 30 mg, 60 mg, and 90 mg gave progressively more protection against ultraviolet rays.10 In another controlled study, either 24 mg per day of natural beta-carotene or 24 mg per day of a carotenoid combination of equal amounts beta-carotene, lutein, and lycopene helped protect skin from ultraviolet rays.11 A preliminary study compared synthetic lycopene (10.1 mg per day), a natural tomato extract containing 9.8 mg of lycopene per day plus additional amounts of other carotenoids, and a solubilized tomato drink (designed to increase lycopene absorption) containing 8.2 mg of lycopene plus additional amounts of other carotenoids. After 12 weeks, only the two tomato-based products were shown to give significant protection against burning by ultraviolet light.12

Still other trials have tested combinations of several antioxidants. One preliminary study found that a daily combination of beta-carotene (6 mg), lycopene (6 mg), vitamin E (15 IU), and selenium for seven weeks protected against ultraviolet light.13 However, a double-blind trial of a combination of smaller amounts of several carotenoids, vitamins C and E, selenium, and proanthocyanidins did not find significant UV protection compared with placebo.14 Similarly, in a controlled trial, a combination of selenium, copper, and vitamins was found to be ineffective.15

It should be noted that while oral protection from sunburn has been demonstrated with several types of antioxidants, the degree of protection (typically less than an SPF of 2) is much less than that provided by currently available topical sunscreens. On the other hand, these modest effects will provide some added protection to skin areas where sunscreen is also used and will give a small amount of protection to sun-exposed areas where sunscreen is not applied. However, oral protection from sunburn is not instantaneous; maximum effects are not reached until these antioxidants have been used for about eight to ten weeks.16, 17

References

1. Fuchs J. Potentials and limitations of the natural antioxidants RRR-alpha-tocopherol, L-ascorbic acid and beta-carotene in cutaneous photoprotection. Free Radic Biol Med 1998;25:848-73 [review].

2. Werninghaus K, Meydani M, Bhawan J, et al. Evaluation of the photoprotective effect of oral vitamin E supplementation. Arch Dermatol 1994;130:1257-61.

3. Fuchs J, Kern H. Modulation of UV-light-induced skin inflammation by D-alpha-tocopherol and L-ascorbic acid: a clinical study using solar simulated radiation. Free Radic Biol Med 1998;25:1006-12.

4. Eberlein-Konig B, Placzek M, Przybilla B. Protective effect against sunburn of combined systemic ascorbic acid (vitamin C) and d-alpha-tocopherol (vitamin E). J Am Acad Dermatol 1998;38:45-8.

5. McArdle F, Rhodes LE, Parslew RA, et al. Effects of oral vitamin E and beta-carotene supplementation on ultraviolet radiation-induced oxidative stress in human skin. Am J Clin Nutr 2004;80:1270-5.

6. Garmyn M, Ribaya-Mercado JD, Russel RM, et al. Effect of beta-carotene supplementation on the human sunburn reaction. Exp Dermatol 1995;4:104-11.

7. Wolf C, Steiner A, Honigsmann H, et al. Do oral carotenoids protect human skin against UV erythema, psoralen phototoxicity, and UV-induced DNA damage? J Invest Dermatol 1988;90:55-57.

8. Mathews-Roth MM, Pathak MA, Parrish J, et al. A clinical trial of the effects of oral beta-carotene on the responses of human skin to solar radiation. J Invest Dermatol 1972;59:349-53.

9. Gollnick HP, Hopfenmuller W, Hemmes C, et al. Systemic B-carotene plus topical sunscreen are an optimal protection against harmful effects of natural UV-sunlight. Eur J Dermatol 1996;6:200-5.

10. Lee J, Jiang S, Levine N, Watson RR. Carotenoid supplementation reduces erythema in human skin after simulated solar radiation exposure. Proc Soc Exp Biol Med 2000;223:170-4.

11. Heinrich U, Gartner C, Wiebusch M, et al. Supplementation with beta-carotene or a similar amount of mixed carotenoids protects humans from UV-induced erythema. J Nutr 2003;133:98-101.

12. Aust O, Stahl W, Sies H, et al. Supplementation with tomato-based products increases lycopene, phytofluene, and phytoene levels in human serum and protects against UV-light-induced erythema. Int J Vitam Nutr Res 2005;75:54-60.

13. Cesarini JP, Michel L, Maurette JM, et al. Immediate effects of UV radiation on the skin: modification by an antioxidant complex containing carotenoids. Photodermatol Photoimmunol Photomed 2003;19:182-9.

14. Greul AK, Grundmann JU, Heinrich F, et al. Photoprotection of UV-irradiated human skin: an antioxidative combination of vitamins E and C, carotenoids, selenium and proanthocyanidins. Skin Pharmacol Appl Skin Physiol 2002;15:307-15.

15. La Ruche G, Cesarini JP. Protective effect of oral selenium plus copper associated with vitamin complex on sunburn cell formation in human skin. Photodermatol Photoimmunol Photomed 1991;8:232-5.

16. Sies H, Stahl W. Nutritional protection against skin damage from sunlight. Annu Rev Nutr 2004;24:173-200 [review].

17. Sies H, Stahl W. Carotenoids and UV protection. Photochem Photobiol Sci 2004;3:749-52 [review].

Sunburn
Dose: Apply a formula containing 2% vitamin E, 5% vitamin C, and 1% to 2.5% melatonin before sun exposure

Antioxidants have been studied as topical agents for protection against sunburn. Animal studies have found sunscreen-like effects from topical application of a vitamin C and vitamin E combination, and a controlled human study reported ultraviolet protection from the use of a lotion containing 0.02% to 0.05% of the selenium-containing amino acid known as selenomethionine.1, 2 The topical use of the hormone melatonin has been shown to protect human skin against ultraviolet rays in double-blind research.3, 4 A double-blind human trial tested topical vitamins C and E and melatonin, alone and in combinations, and found the highest degrees of protection from combination formulations containing 2% vitamin E, 5% vitamin C, and 1% to 2.5% melatonin.5 Other studies in which topical antioxidants were applied after ultraviolet exposure have found no benefits.6, 7

References

1. Lin JY, Selim MA, Shea CR, et al. UV photoprotection by combination topical antioxidants vitamin C and vitamin E. J Am Acad Dermatol 2003;48:866-74.

2. Burke KE, Burford RG, Combs GF Jr, et al. The effect of topical L-selenomethionine on minimal erythema dose of ultraviolet irradiation in humans. Photodermatol Photoimmunol Photomed 1992;9:52-7.

3. Bangha E, Elsner P, Kistler GS. Suppression of UV-induced erythema by topical treatment with melatonin (N-acetyl-5-methoxytryptamine). Influence of the application time point. Dermatology 1997;195:248-52.

4. Bangha E, Elsner P, Kistler GS. Suppression of UV-induced erythema by topical treatment with melatonin (N-acetyl-5-methoxytryptamine). A dose response study. Arch Dermatol Res 1996;288:522-6.

5. Dreher F, Gabard B, Schwindt DA, Maibach HI. Topical melatonin in combination with vitamins E and C protects skin from ultraviolet-induced erythema: a human study in vivo. Br J Dermatol 1998;139:332-9.

6. Dreher F, Denig N, Gabard B, et al. Effect of topical antioxidants on UV-induced erythema formation when administered after exposure. Dermatology 1999;198:52-5.

7. Fuchs J. Potentials and limitations of the natural antioxidants RRR-alpha-tocopherol, L-ascorbic acid and beta-carotene in cutaneous photoprotection. Free Radic Biol Med 1998;25:848-73 [review].

Sunburn
Dose: Apply a formula containing 2% vitamin E and 5% vitamin C before sun exposure

Antioxidants have been studied as topical agents for protection against sunburn. Animal studies have found sunscreen-like effects from topical application of a vitamin C and vitamin E combination, and a controlled human study reported ultraviolet protection from the use of a lotion containing 0.02% to 0.05% of the selenium-containing amino acid known as selenomethionine.1, 2 The topical use of the hormone melatonin has been shown to protect human skin against ultraviolet rays in double-blind research.3, 4 A double-blind human trial tested topical vitamins C and E and melatonin, alone and in combinations, and found the highest degrees of protection from combination formulations containing 2% vitamin E, 5% vitamin C, and 1% to 2.5% melatonin.5 Other studies in which topical antioxidants were applied after ultraviolet exposure have found no benefits.6, 7

References

1. Lin JY, Selim MA, Shea CR, et al. UV photoprotection by combination topical antioxidants vitamin C and vitamin E. J Am Acad Dermatol 2003;48:866-74.

2. Burke KE, Burford RG, Combs GF Jr, et al. The effect of topical L-selenomethionine on minimal erythema dose of ultraviolet irradiation in humans. Photodermatol Photoimmunol Photomed 1992;9:52-7.

3. Bangha E, Elsner P, Kistler GS. Suppression of UV-induced erythema by topical treatment with melatonin (N-acetyl-5-methoxytryptamine). Influence of the application time point. Dermatology 1997;195:248-52.

4. Bangha E, Elsner P, Kistler GS. Suppression of UV-induced erythema by topical treatment with melatonin (N-acetyl-5-methoxytryptamine). A dose response study. Arch Dermatol Res 1996;288:522-6.

5. Dreher F, Gabard B, Schwindt DA, Maibach HI. Topical melatonin in combination with vitamins E and C protects skin from ultraviolet-induced erythema: a human study in vivo. Br J Dermatol 1998;139:332-9.

6. Dreher F, Denig N, Gabard B, et al. Effect of topical antioxidants on UV-induced erythema formation when administered after exposure. Dermatology 1999;198:52-5.

7. Fuchs J. Potentials and limitations of the natural antioxidants RRR-alpha-tocopherol, L-ascorbic acid and beta-carotene in cutaneous photoprotection. Free Radic Biol Med 1998;25:848-73 [review].

Wound Healing
Dose: 400 IU daily

Animal studies have shown that supplementing with vitamin E can decrease the formation of unwanted adhesions following a surgical wound. In addition, wound healing was more rapid in animals fed a vitamin E-rich diet than in those fed a standard diet.1 In another study, however, wound healing was inhibited by supplementation with a massive amount of vitamin E (equivalent to about 35,000 IU).2 This adverse effect of vitamin E was prevented by supplementation with vitamin A. Although the relevance of these studies to humans is not clear, many doctors recommend supplementing with both vitamins A and E in order to enhance wound healing and prevent adhesion formation. Typical amounts recommended are 25,000 IU of vitamin A per day and 400 IU of vitamin E per day, beginning two weeks prior to surgery and continuing for four weeks after surgery.

Topical application of vitamin E is sometimes recommended for preventing or treating post-injury scars, although only three controlled studies have been reported. Two of these trials found no effect on scar prevention after surgery,3, 4 and one trial found vitamin E improved the effect of silicon bandages on large scars called keloids.5

References

1. Bartolomucci E. Action of vitamin E on healing of experimental wounds on parenchymatous organs. JAMA 1939;113:1079 [abstract].

2. Ehrlich HP, Tarver H, Hunt TK. Inhibitory effects of vitamin E on collagen synthesis and wound repair. Ann Surg 1972;175:235-40.

3. Jenkins M, Alexander JW, MacMillan BG, et al. Failure of topical steroids and vitamin E to reduce postoperative scar formation following reconstructive surgery. J Burn Care Rehabil 1986;7:309-12.

4. Bates B. Vitamin E gets an 'F' for wound healing, scarring. Family Practice News 1996;Sept 1:22.

5. Palmieri B, Gozzi G, Palmieri G. Vitamin E added silicone gel sheets for treatment of hypertrophic scars and keloids. Int J Dermatol 1995;34:506-9.

Dermatitis Herpetiformis
Dose: 10 IU daily

A deficiency in the selenium-containing antioxidant enzyme known as glutathione peroxidase has been reported in DH.1, 2 Preliminary3 and double-blind4 trials suggest that supplementation with 10 IU of vitamin E and 200 mcg of selenium per day for six to eight weeks corrected this deficiency but did not lead to symptom improvement in the double-blind trial.

References

1. Juhlin L, Edqvist LE, Ekman LG, et al. Blood glutathione-peroxidase levels in skin diseases: effect of selenium and vitamin E treatment. Acta Derm Venereol 1982;62:211-4.

2. Ljunghall K, Juhlin L, Edqvist LE, Plantin LO. Selenium, glutathione-peroxidase and dermatitis herpetiformis. Acta Derm Venereol 1984;64:546-7.

3. Juhlin L, Edqvist LE, Ekman LG, et al. Blood glutathione-peroxidase levels in skin diseases: effect of selenium and vitamin E treatment. Acta Derm Venereol 1982;62:211-4.

4. Ljunghall K, Juhlin L, Edqvist LE, Plantin LO. Selenium, glutathione-peroxidase and dermatitis herpetiformis. Acta Derm Venereol 1984;64:546-7.

Skin Ulcers
Dose: 400 IU daily

Antioxidants such as vitamin C, vitamin E, and glutathione are depleted in healing skin tissue.1 One animal study found that vitamin E (alpha-tocopherol) applied to the skin shortened the healing time of skin ulcers.2 Another animal study reported that administration of oral vitamin E before skin lesions were introduced into the skin prevented some of the tissue damage associated with the development of pressure ulcers.3 A controlled human trial found that 400 IU of vitamin E daily improved the results of skin graft surgery for chronic venous ulcers.4 No further research has investigated the potential benefit of vitamin E for skin ulcers.

References

1. Houwing R, Overgoor M, Kon M, et al. Pressure-induced skin lesions in pigs: reperfusion injury and the effects of vitamin E. J WoundCare 2000; 9:36-40.

2. Lucero MJ, Vigo J, Rabasco AM, et al. Protection by alpha-tocopherol against skin necrosis induced by doxorubicin hydrochloride. Pharmazie 1993;48:772-5.

3. Shukla A, Rasik AM, Patnaik GK. Depletion of reduced glutathione, ascorbic acid, vitamin E, and antioxidant defence enzymes in a healing cutaneous wound. Free RadicRes 1997;26:93-101.

4. Ramasastry, SS, Angel MF, Narayanan K, et al. Biochemical evidence of lipoperoxidation in venous stasis ulcer: Beneficial role of vitamin E as antioxidant. Ann NY Acad Sci 1989; 506-8.

Burns
Dose: Refer to label instructions

Despite a lack of research on the subject, using vitamin E topically on minor burns is a popular remedy. This makes sense, because some of the damage done to the skin is oxidative, and vitamin E is an antioxidant. Some doctors suggest simply breaking open a capsule of vitamin E and applying it to the affected area two or three times per day. Vitamin E forms are listed as either "tocopherol" or "tocopheryl" followed by the name of what is attached to it, as in "tocopheryl acetate." While both forms are active when taken by mouth, the skin utilizes the tocopheryl forms very slowly.1, 2 Therefore, those planning to apply vitamin E to the skin should buy the tocopherol form.

References

1. Beijersbergen van Henegouwen GM, Junginger HE, de Vries H. Hydrolysis of RRR-alpha-tocopheryl acetate (vitamin E acetate) in the skin and its UV protecting activity (an in vivo study with the rat). J Photochem Photobiol B 1995;29:45-51.

2. Norkus EP, Bryce GF, Bhagavan HN. Uptake and bioconversion of alpha-tocopheryl acetate to alpha-tocopherol in skin of hairless mice. Photochem Photobiol 1993;57:613-5.

Skin Ulcers
Dose: Refer to label instructions

Antioxidants such as vitamin C, vitamin E, and glutathione are depleted in healing skin tissue.1 One animal study found that vitamin E (alpha-tocopherol) applied to the skin shortened the healing time of skin ulcers.2 Another animal study reported that administration of oral vitamin E before skin lesions were introduced into the skin prevented some of the tissue damage associated with the development of pressure ulcers.3 A controlled human trial found that 400 IU of vitamin E daily improved the results of skin graft surgery for chronic venous ulcers.4 No further research has investigated the potential benefit of vitamin E for skin ulcers.

References

1. Houwing R, Overgoor M, Kon M, et al. Pressure-induced skin lesions in pigs: reperfusion injury and the effects of vitamin E. J WoundCare 2000; 9:36-40.

2. Lucero MJ, Vigo J, Rabasco AM, et al. Protection by alpha-tocopherol against skin necrosis induced by doxorubicin hydrochloride. Pharmazie 1993;48:772-5.

3. Shukla A, Rasik AM, Patnaik GK. Depletion of reduced glutathione, ascorbic acid, vitamin E, and antioxidant defence enzymes in a healing cutaneous wound. Free RadicRes 1997;26:93-101.

4. Ramasastry, SS, Angel MF, Narayanan K, et al. Biochemical evidence of lipoperoxidation in venous stasis ulcer: Beneficial role of vitamin E as antioxidant. Ann NY Acad Sci 1989; 506-8.

Dysmenorrhea
Dose: 400 to 600 IU of vitamin E a day for five days, beginning two days before menstruation

In a double-blind trial, supplementation with 500 IU of vitamin E per day for two months, beginning two days before menstruation and continuing for three days after the onset of menstruation, was significantly more effective than a placebo at relieving menstrual pain.1 Similar benefits were seen in four-month double-blind trial using 400 IU per day, beginning two days before the expected start of menstruation and continuing through the first three days of bleeding.2

References

1. Ziaei S, Faghihzadeh S, Sohrabvand F, et al. A randomised placebo-controlled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoea. Br J Obstet Gynaecol 2001;108:1181-3.

2. Ziaei S, Zakeri M, Kazemnejad A. A randomised controlled trial of vitamin E in the treatment of primary dysmenorrhoea. BJOG2005;112:466-9.

Menopause
Dose: Refer to label instructions

Many years ago, researchers studied the effects of vitamin E supplementation in reducing symptoms of menopause. Most,1, 2, 3, 4, 5 but not all,6 studies found vitamin E to be helpful, and the benefit of vitamin E was confirmed more recently in a double-blind trial.7 Many doctors suggest that women going through menopause take 400 to 800 IU per day of vitamin E for a trial period of at least three months to see if symptoms are reduced. If helpful, this amount may be continued or a lower amount may be tried for maintenance.

References

1. Perloff WH. Treatment of the menopause. Am J Obstet Gynecol 1949;58:684-94.

2. Gozan HA. The use of vitamin E in treatment of the menopause. NY State J Med 1952;52:1289.

3. Christy CJ. Vitamin E in menopause: Preliminary report of experimental and clinical study. Am J Obstet Gynecol 1945:50:84.

4. Finkler RS. The effect of vitamin E in the menopause. J Clin Endocrinol Metab 1949;9:89-94.

5. Rubenstein BB. Vitamin E diminishes the vasomotor symptoms of menopause. Fed Proc 1948;7:106 [abstract].

6. Blatt MHG, Weisbader H, Kupperman HS. Vitamin E and climacteric syndrome: failure of effective control as measured by menopausal index. Arch Intern Med 1953;91:792-9.

7. Ziaei S, Kazemnejad A, Zareai M. The effect of vitamin E on hot flashes in menopausal women. Gynecol Obstet Invest 2007;64:204-7.

Premenstrual Syndrome
Dose: 300 IU daily

Although women with PMS do not appear to be deficient in vitamin E,1 a double-blind trial reported that 300 IU of vitamin E per day may decrease symptoms of PMS.2

References

1. Chuong CJ, Dawson EB, Smith ER. Vitamin E levels in premenstrual syndrome. Am J Obstet Gynecol 1990;163:1591-5.

2. London RS, Sundaram GS, Murphy L, Goldstein PJ. The effect of alpha-tocopherol on premenstrual symptomatology: a double blind study. J Am Coll Nutr 1983;2(2):115-22.

Endometriosis
Dose: 1,000 mg vitamin C and 1,200 IU vitamin E dailyIn a double-blind study of women with pelvic pain presumed to be due to endometriosis, supplementation with vitamin E (1,200 IU per day) and vitamin C (1,000 mg per day) for eight weeks resulted in an improvement of pain in 43% of women, whereas none of the women receiving a placebo reported pain relief.1
References

1. Santanam N, Kavtaradze N, Murphy A, et al. Antioxidant supplementation reduces endometriosis-related pelvic pain in humans. Transl Res 2013;161:189-95.

Fibrocystic Breast Disease
Dose: Refer to label instructions

While several studies report that 200-600 IU of vitamin E per day, taken for several months, reduces symptoms of FBD,1, 2 most double-blind trials have found that vitamin E does not relieve FBD symptoms.3, 4 Nonetheless, many women take 400 IU of vitamin E for three months to see if it helps.

References

1. Abrams AA. Use of vitamin E in chronic cystic mastitis. N Engl J Med 1965;272(20):1080-1.

2. London RS, Sundaram GS, Schultz M, et al. Endocrine parameters and alpha-tocopherol therapy of patients with mammary dysplasia. Cancer Res 1981;41:3811-3.

3. Ernster VL, Goodson WH, Hunt TK, et al. Vitamin E and benign breast "disease": a double-blind, randomized clinical trial. Surgery 1985;97:490-4.

4. London RS, Sundaram GS, Murphy L, et al. The effect of vitamin E on mammary dysplasia: a double-blind study. Obstet Gynecol 1985;65:104-6.

Female Infertility
Dose: Refer to label instructions

Vitamin E deficiency in animals leads to infertility.1 In a preliminary human trial, infertile couples given vitamin E (200 IU per day for the female and 100 IU per day for the male) showed a significant increase in fertility.2

References

1. Thiessen DD, Ondrusek G, Coleman RV. Vitamin E and sex behavior in mice. Nutr Metab 1975;18:116-9.

2. Bayer R. Treatment of infertility with vitamin E. Int J Fertil 1960;5:70-8.

Menorrhagia
Dose: Refer to label instructions

In a study of women with menorrhagia associated with the use of an intrauterine device (IUD) for birth control, supplementing with 100 IU of vitamin E every other day corrected the problem in all cases within ten weeks (63% responded within four weeks).1 The cause of IUD-induced menstrual blood loss is different from that of other types of menorrhagia; therefore, it's possible that vitamin E supplements might not help with menorrhagia not associated with IUD use.

References

1. Dasgupta PR, Dutta S, Banerjee P, Majumdar S. Vitamin E (alpha tocopherol) in the management of menorrhagia associated with the use of intrauterine contraceptive devices (ICUD). Int J Fertil 1983;28:55-6.

Vaginitis
Dose: Refer to label instructions

Some doctors recommend vitamin E (taken orally, topically, or vaginally) for certain types of vaginitis. Vitamin E as a suppository in the vagina or vitamin E oil can be used once or twice per day for 3 to 14 days to soothe the mucous membranes of the vagina and vulva. Some doctors recommend vaginal administration of vitamin A to improve the integrity of the vaginal tissue and to enhance the function of local immune cells. Vitamin A can be administered vaginally by inserting a vitamin A capsule or using a prepared vitamin A suppository. Vitamin A used this way can be irritating to local tissue, so it should not be used more than once per day for up to seven consecutive days.

Abnormal Pap Smear
Dose: Refer to label instructions

Women with cervical dysplasia may have lower blood levels of beta-carotene and vitamin E1, 2 compared to healthy women.

References

1. Palan PR, Mikhail MS, Basu J, Romney SL. Plasma levels of antioxidant beta-carotene and alpha-tocopherol in uterine cervix dysplasias and cancer. Nutr Cancer l991;15:13-20.

2. Ho GY, Palan PR, Basu J, et al. Viral characteristics of human papillomavirus infection and antioxidant levels as risk factors for cervical dysplasia. Int J Cancer 1998;78:594-9.

Immune Function
Dose: 200 IU daily

Most,1, 2 but not all,3 double-blind studies have shown that elderly people have better immune function and reduced infection rates when taking a multiple vitamin-mineral formula. In one double-blind trial, supplements of 100 mcg per day of selenium and 20 mg per day of zinc, with or without additional vitamin C, vitamin E, and beta-carotene, reduced infections in elderly people, though vitamins without minerals had no effect.4 Burn victims have also experienced fewer infections after receiving trace mineral supplements in double-blind research.5 These studies suggest that trace minerals may be the most important micronutrients for enhancing immunity and preventing infections in the elderly.

References

1. Pike J, Chandra RK. Effect of vitamin and trace element supplementation on immune indices in healthy elderly. Int J Vitam Nutr Res 1995;65:117-21.

2. Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet 1992;340:1124-7.

3. Chavance M, Herbeth B, Lemoine A, et al. Does multivitamin supplementation prevent infections in healthy elderly subjects? A controlled trial.Int.J Vitam Nutr Res 1993;63:11-6.

4. Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab 1997;41:98-107.

5. Berger MM, Spertini F, Shenkin A, et al. Trace element supplementation modulates pulmonary infection rates after major burns: a double-blind, placebo-controlled trial. Am J Clin Nutr 1998;68:365-71.

Cold Sores
Dose: Apply cotton saturated with oil for 15 minutes every three hours on day one, then three times daily on days two and three

In a preliminary trial, a piece of cotton saturated with vitamin E oil was applied to newly erupted cold sores and held in place for 15 minutes. The first application was performed in the dentist's office. Participants were instructed to repeat the procedure every three hours for the rest of that day, and then three times daily for two more days. In nearly all cases, pain disappeared in less than eight hours. Application of vitamin E oil appeared to accelerate healing of the cold sores.1 Similar results were reported in another study.2

References

1. Nead DE. Effective vitamin E treatment for ulcerative herpetic lesions. Dent Survey 1976;52(7):50-1.

2. Fink M, Fink J. Treatment of herpes simplex by alpha-tocopherol (vitamin E). Br Dent J 1980;148:246 [letter].

Pre- and Post-Surgery Health
Dose: Refer to label instructions

Some studies of surgery patients,1, 2 though not all, 3 have found that blood levels of vitamin E decrease during and after surgery. Animal research suggests that vitamin E may prevent skin scarring when used topically after surgery,4 but a human study reported disappointing results.5 Vitamin E taken by mouth may interfere with blood clotting6; therefore, use of vitamin E before surgery should be discussed with the surgeon. No research on either the usefulness or hazards of vitamin E supplementation around surgery has been done.

References

1. Zunic J, Stavljenic-Rukavina A, Granic P, et al. Changes in vitamin E concentration after surgery and anesthesia. Coll Antropol 1997;21:327-34.

2. Kawamura T, Ohisa Y, Abe Y, et al. Plasma lipid peroxides in the operation of esophageal cancer. Rinsho Byori 1992;40:881-4 [in Japanese].

3. Hans P, Canivet JL, Pincemail J, et al. Plasma vitamin E, total lipids and myeloperoxidase levels during spinal surgery. A comparison between two anesthetic agents: propofol and isoflurane. Acta Anaesthesiol Scand 1991;35:302-5.

4. Greenwald DP. Zone II flexor tendon repair: effects of vitamins A, E and beta-carotene. J Surg Res 1990;49:98-102.

5. Jenkins M, Alexander JW, MacMillan BG, et al. Failure of topical steroids and vitamin E to reduce postoperative scar formation following reconstructive surgery. J Burn Care Rehabil 1986;7:309-12.

6. Anastasi J, Steiner M. Effect of alpha-tocopherol on human platelet aggregation. Am J Clin Nutr 1976;29:467 [abstract].

Bronchitis
Dose: Refer to label instructions

Vitamin C and vitamin E may prevent oxidative damage to the lung lipids by environmental pollution and cigarette smoke exposure. It has been suggested that amounts in excess of the RDA (recommended dietary allowance) are necessary to protect against the air pollution levels currently present in North America,1 although it is not known how much vitamin E is needed to produce that protective effect.

References

1. Menzel DB. Antioxidant vitamins and prevention of lung disease.Ann N Y Acad Sci 1992;669:141-55.

HIV and AIDS Support
Dose: Refer to label instructions

In test-tube studies, vitamin E improved the effectiveness of the anti-HIV drug zidovudine (AZT) while reducing its toxicity.1Similarly, animal research suggests that zinc and NAC supplementation may protect against AZT toxicity.2 It is not known whether oral supplementation with these nutrients would have similar effects in people taking AZT.

References

1. Gogu SR, Beckman BS, Rangan SR, Agrawal KC. Increased therapeutic efficacy of zidovudine in combination with vitamin E. Biochem Biophys Res Commun 1989;165:401-7.

2. Gogu SR, Agrawal KC. The protective role of zinc and N-acetylcysteine in modulating zidovudine induced hematopoietic toxicity. Life Sci 1996;59:1323-9.

Dysmenorrhea
Dose: 400 to 600 IU of vitamin E a day for five days, beginning two days before menstruation

In a double-blind trial, supplementation with 500 IU of vitamin E per day for two months, beginning two days before menstruation and continuing for three days after the onset of menstruation, was significantly more effective than a placebo at relieving menstrual pain.1 Similar benefits were seen in four-month double-blind trial using 400 IU per day, beginning two days before the expected start of menstruation and continuing through the first three days of bleeding.2

References

1. Ziaei S, Faghihzadeh S, Sohrabvand F, et al. A randomised placebo-controlled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoea. Br J Obstet Gynaecol 2001;108:1181-3.

2. Ziaei S, Zakeri M, Kazemnejad A. A randomised controlled trial of vitamin E in the treatment of primary dysmenorrhoea. BJOG2005;112:466-9.

Premenstrual Syndrome
Dose: 300 IU daily

Although women with PMS do not appear to be deficient in vitamin E,1 a double-blind trial reported that 300 IU of vitamin E per day may decrease symptoms of PMS.2

References

1. Chuong CJ, Dawson EB, Smith ER. Vitamin E levels in premenstrual syndrome. Am J Obstet Gynecol 1990;163:1591-5.

2. London RS, Sundaram GS, Murphy L, Goldstein PJ. The effect of alpha-tocopherol on premenstrual symptomatology: a double blind study. J Am Coll Nutr 1983;2(2):115-22.

Endometriosis
Dose: 1,000 mg vitamin C and 1,200 IU vitamin E dailyIn a double-blind study of women with pelvic pain presumed to be due to endometriosis, supplementation with vitamin E (1,200 IU per day) and vitamin C (1,000 mg per day) for eight weeks resulted in an improvement of pain in 43% of women, whereas none of the women receiving a placebo reported pain relief.1
References

1. Santanam N, Kavtaradze N, Murphy A, et al. Antioxidant supplementation reduces endometriosis-related pelvic pain in humans. Transl Res 2013;161:189-95.

Menorrhagia
Dose: Refer to label instructions

In a study of women with menorrhagia associated with the use of an intrauterine device (IUD) for birth control, supplementing with 100 IU of vitamin E every other day corrected the problem in all cases within ten weeks (63% responded within four weeks).1 The cause of IUD-induced menstrual blood loss is different from that of other types of menorrhagia; therefore, it's possible that vitamin E supplements might not help with menorrhagia not associated with IUD use.

References

1. Dasgupta PR, Dutta S, Banerjee P, Majumdar S. Vitamin E (alpha tocopherol) in the management of menorrhagia associated with the use of intrauterine contraceptive devices (ICUD). Int J Fertil 1983;28:55-6.

Rheumatoid Arthritis
Dose: 1,200 to 1,800 IU daily

People with RA have been reported to have an impaired antioxidant system, making them more susceptible to free radical damage.1Vitamin E is an important antioxidant, protecting many tissues, including joints, against oxidative damage. Low vitamin E levels in the joint fluid of people with RA have been reported.2 In a double-blind trial, approximately 1,800 IU per day of vitamin E was found to reduce pain from RA.3 Two other double-blind trials (using similar high levels of vitamin E) reported that vitamin E had approximately the same effectiveness in reducing symptoms of RA as anti-inflammatory drugs.4, 5 In other double-blind trials, 600 IU of vitamin E taken twice daily was significantly more effective than placebo in reducing RA, although laboratory measures of inflammation remained unchanged.6, 7

References

1. Ozturk HS, Cimen MY, Cimen OB, et al. Oxidant/antioxidant status of plasma samples from patients with rheumatoid arthritis. Rheumatol Int 1999;19:35-7.

2. Fairburn K, Grootveld M, Ward RJ, et al. Alpha-tocopherol, lipids and lipoproteins in knee-joint synovial fluid and serum from patients with inflammatory joint disease. Clin Sci 1992;83:657-64.

3. Scherak O, Kolarz G. Vitamin E and rheumatoid arthritis. Arthrit Rheum 1991;34:1205-6 [letter].

4. Wittenborg A, Petersen G, Lorkowski G, Brabant T. Effectiveness of vitamin E in comparison with diclofenac sodium in treatment of patients with chronic polyarthritis. Z Rheumatol 1998;57:215-21 [in German].

5. Kolarz G, Scherak O, El Shohoumi M, Blankenhorn G. High dose vitamin E for chronic arthritis. Akt Rheumatol 1990;15:233-7 [in German].

6. Edmonds SE, Winyard PG, Guo R, et al. Putative analgesic activity of repeated oral doses of vitamin E in the treatment of rheumatoid arthritis. Results of a prospective placebo controlled double-blind trial. Ann Rheum Dis 1997;56:649-55.

7. Miehle W. Vitamin E in active arthroses and chronic polyarthritis. What is the value of alpha-tocopherol in therapy? Fortschr Med 1997;115:39-42.

Osteoarthritis
Dose: 400 to 1,600 IU per day

People who have osteoarthritis and eat large amounts of antioxidants in food have been reported to exhibit a much slower rate of joint deterioration, particularly in the knees, compared with people eating foods containing lower amounts of antioxidants.1 Of the individual antioxidants, only vitamin E has been studied as a supplement in controlled trials. Vitamin E supplementation has reduced symptoms of osteoarthritis in both single-blind2 and double-blind research.3, 4 In these trials, 400 to 1,600 IU of vitamin E per day was used. Clinical effects were obtained within several weeks. However, in a six-month double-blind study of patients with osteoarthritis of the knee, 500 IU per day of vitamin E was no more effective than a placebo.5

References

1. McAlindon TE, Jacques P, Zhang Y. Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis? Arthrit Rheum 1996;39:648-56.

2. Machtey I, Ouaknine L. Tocopherol in osteoarthritis: a controlled pilot study. J Am Geriatr Soc 1978;25(7):328-30.

3. Blankenhorn G. Klinische Wirtsamkeit von Spondyvit (vitamin E) bei aktiverten arthronsen. Z Orthop 1986;124:340-3 [in German].

4. Scherak O, Kolarz G, Schodl Ch, Blankenhorn G. Hochdosierte Vitamin-E-Therapie bei Patienten mit aktivierter Arthrose. Z Rheumatol 1990;49:369-73 [in German].

5. Brand C, Snaddon J, Bailey M, Cicuttini F. Vitamin E is ineffective for symptomatic relief of knee osteoarthritis: a six month double blind, randomised, placebo controlled study. Ann Rheum Dis 2001;60:946-9.

Dupuytren's Contracture
Dose: Refer to label instructions

Many decades ago, researchers investigated the effects of taking vitamin E to treat Dupuytren's contracture. Several studies reported that taking 200-2,000 IU of vitamin E per day for several months was helpful.1 Other studies, however, did not find it useful.2 Overall, there are more positive trials than negative ones,3 although none of the published research is recent. Nonetheless, some doctors believe that a three-month trial using very high amounts of vitamin E (2,000 IU per day) is helpful in some cases.

References

1. Thomson GR. Treatment of Dupuytren's contracture with vitamin E. BMJ 1949;Dec 17:1382-3.

2. Richards HJ. Dupuytren's contracture treated with vitamin E. BMJ 1952;June 21:1328.

3. Kirk JE, Chieffi M. Tocopherol administration to patients with Dupuytren's contracture: effect on plasma tocopherol levels and degree of contracture. Pro Soc Exp Biol Med 1952;80:565 [review].

Wound Healing
Dose: 400 IU daily

Animal studies have shown that supplementing with vitamin E can decrease the formation of unwanted adhesions following a surgical wound. In addition, wound healing was more rapid in animals fed a vitamin E-rich diet than in those fed a standard diet.1 In another study, however, wound healing was inhibited by supplementation with a massive amount of vitamin E (equivalent to about 35,000 IU).2 This adverse effect of vitamin E was prevented by supplementation with vitamin A. Although the relevance of these studies to humans is not clear, many doctors recommend supplementing with both vitamins A and E in order to enhance wound healing and prevent adhesion formation. Typical amounts recommended are 25,000 IU of vitamin A per day and 400 IU of vitamin E per day, beginning two weeks prior to surgery and continuing for four weeks after surgery.

Topical application of vitamin E is sometimes recommended for preventing or treating post-injury scars, although only three controlled studies have been reported. Two of these trials found no effect on scar prevention after surgery,3, 4 and one trial found vitamin E improved the effect of silicon bandages on large scars called keloids.5

References

1. Bartolomucci E. Action of vitamin E on healing of experimental wounds on parenchymatous organs. JAMA 1939;113:1079 [abstract].

2. Ehrlich HP, Tarver H, Hunt TK. Inhibitory effects of vitamin E on collagen synthesis and wound repair. Ann Surg 1972;175:235-40.

3. Jenkins M, Alexander JW, MacMillan BG, et al. Failure of topical steroids and vitamin E to reduce postoperative scar formation following reconstructive surgery. J Burn Care Rehabil 1986;7:309-12.

4. Bates B. Vitamin E gets an 'F' for wound healing, scarring. Family Practice News 1996;Sept 1:22.

5. Palmieri B, Gozzi G, Palmieri G. Vitamin E added silicone gel sheets for treatment of hypertrophic scars and keloids. Int J Dermatol 1995;34:506-9.

Fibromyalgia
Dose: Refer to label instructions

One early preliminary study described the use of vitamin E supplements in the treatment of "fibrositis"-the rough equivalent of what is today called fibromyalgia. Several dozen individuals were treated with vitamin E using amounts ranging from 100-300 IU per day. The results were positive and sometimes dramatic.1 Double-blind trials are needed to confirm these preliminary observations.

References

1. Steinberg CL. The tocopherols (vitamin E) in the treatment of primary fibrositis. J Bone Joint Surg 1942;24:411-23.

Shingles and Postherpetic Neuralgia
Dose: Refer to label instructions

Some doctors have found vitamin E to be effective for people with postherpetic neuralgia-even those who have had the problem for many years.1, 2 The recommended amount of vitamin E by mouth is 1,200-1,600 IU per day. In addition, vitamin E oil (30 IU per gram) can be applied to the skin. Several months of continuous vitamin E use may be needed in order to see an improvement. Not all studies have found a beneficial effect of vitamin E;3 however, in the study that produced negative results, vitamin E may not have been used for a long enough period of time.

References

1. Ayres S Jr, Mihan R. Post-herpes zoster neuralgia: response to vitamin E therapy. Arch Dermatol 1973;108:855-66.

2. Ayres S Jr, Mihan R. Post-herpes zoster neuralgia: response to vitamin E therapy. Arch Dermatol 1975;111:396.

3. Ayres S Jr, Mihan R. Post-herpes zoster neuralgia: response to vitamin E therapy. Arch Dermatol 1975;111:396.

Burns
Dose: Refer to label instructions

Despite a lack of research on the subject, using vitamin E topically on minor burns is a popular remedy. This makes sense, because some of the damage done to the skin is oxidative, and vitamin E is an antioxidant. Some doctors suggest simply breaking open a capsule of vitamin E and applying it to the affected area two or three times per day. Vitamin E forms are listed as either "tocopherol" or "tocopheryl" followed by the name of what is attached to it, as in "tocopheryl acetate." While both forms are active when taken by mouth, the skin utilizes the tocopheryl forms very slowly.1, 2 Therefore, those planning to apply vitamin E to the skin should buy the tocopherol form.

References

1. Beijersbergen van Henegouwen GM, Junginger HE, de Vries H. Hydrolysis of RRR-alpha-tocopheryl acetate (vitamin E acetate) in the skin and its UV protecting activity (an in vivo study with the rat). J Photochem Photobiol B 1995;29:45-51.

2. Norkus EP, Bryce GF, Bhagavan HN. Uptake and bioconversion of alpha-tocopheryl acetate to alpha-tocopherol in skin of hairless mice. Photochem Photobiol 1993;57:613-5.

Sprains and Strains and Exercise-Related Muscle Injury
Dose: Refer to label instructions

Antioxidant supplements, including vitamin C and vitamin E, may help prevent exercise-related muscle injuries by neutralizing free radicals produced during strenuous activities.1 Controlled research, some of it double-blind, has shown that 400-3,000 mg per day of vitamin C may reduce pain and speed up muscle strength recovery after intense exercise.2, 3 Reductions in blood indicators of muscle damage and free radical activity have also been reported for supplementation with 400-1,200 IU per day of vitamin E in most studies,4, 5, 6 but no measurable benefits in exercise recovery have been reported.7 A combination of 90 mg per day of coenzyme Q10 and a very small amount of vitamin E did not produce any protective effects in one double-blind trial.8

References

1. Kanter M. Free radicals, exercise and antioxidant supplementation. Proc Nutr Soc 1998;57:9-13 [review].

2. Jakeman P, Maxwell S. Effect of antioxidant vitamin supplementation on muscle function after eccentric exercise. Eur J Appl Physiol 1993;67:426-30.

3. Kaminski M, Boal R. An effect of ascorbic acid on delayed-onset muscle soreness. Pain 1992;50:317-21.

4. McBride JM, Kraemer WJ, Triplett-McBride T, Sebastianelli W. Effect of resistance exercise on free radical production. Med Sci Sports Exerc 1998;30:67-72.

5. Rokitzki L, Logemann E, Huber G, et al. alpha-Tocopherol supplementation in racing cyclists during extreme endurance training. Int J Sport Nutr 1994;4:253-64.

6. Meydani M, Evans WJ, Handelman, et al. Protective effect of vitamin E on exercise-induced oxidative damage in young and older adults. Am J Physiol 1993;264(5 pt 2):R992-8.

7. Tiidus PM, Houston ME. Vitamin E status and response to exercise training. Sports Med 1995;20:12-23 [review].

8. Kaikkonen J, Kosonen L, Nyyssonen K, et al. Effect of combined coenzyme Q10 and d-alpha-tocopheryl acetate supplementation on exercise-induced lipid peroxidation and muscular damage: a placebo-controlled double-blind study in marathon runners. Free Radic Res 1998;29:85-92.

Pancreatic Insufficiency
Dose: 270 IU dailyThere are few controlled trials of antioxidant supplementation to patients with pancreatitis. One small controlled study of acute pancreatitis patients found that sodium selenite at a dose of 50 micrograms (mcg) daily resulted in decreased levels of a marker of free radical activity, and no patient deaths occurred.1 In a small double-blind trial including recurrent acute and chronic pancreatitis patients, supplements providing daily doses of 600 mcg selenium, 9,000 IU beta-carotene, 540 mg vitamin C, 270 IU vitamin E, and 2,000 mg methionine significantly reduced pain, normalized several blood measure of antioxidant levels and free radical activity, and prevented acute recurrences of pancreatitis.2 These researches later reported that continuing antioxidant treatment in these patients for up to five years or more significantly reduced the total number of days spent in the hospital and resulted in 78% of patients becoming pain-free and 88% returning to work.3
References

1. Kulinski B, Buchner M, Schweder R, Nagel R. Acute pancreatitis-a free radical disease. Decrease in fatality with sodium selenite (Na2SeO3) therapy. Z Gesamte Inn Med 1991;46:145-9 [in German].

2. Uden S, Bilton D, Nathan L, et al. Antioxidant therapy for recurrent pancreatitis: placebo-controlled trial. Aliment Pharmacol Ther 1990;4:357-71.

3. McCloy R. Chronic pancreatitis at Manchester, UK. Focus on antioxidant therapy. Digestion 1998;59(suppl 4):36-48 [review].

Retinopathy and Retrolental Fibroplasia
Dose: Consult a qualified healthcare practitioner

Free radicals have been implicated in the development and progression of several forms of retinopathy.1 Retrolental fibroplasia, a retinopathy that occurs in some premature infants who have been exposed to high levels of oxygen, is an example of free radical-induced damage to the retina. In an analysis of the best published trials, large amounts of vitamin E were found to reduce the incidence of severe retinopathy in premature infants by over 50%.2, 3 Some of the evidence supporting the use of vitamin E in the prevention of retrolental fibroplasia comes from trials that have used 100 IU of vitamin E per 2.2 pounds of body weight in the form of oral supplementation.4 Use of large amounts of vitamin E in the prevention of retrolental fibroplasia requires the supervision of a pediatrician.

Vitamin E has also been found to prevent retinopathy in people with a rare genetic disease known as abetalipoproteinemia.5 People with this disorder lack a protein that transports fat-soluble nutrients, and can therefore develop deficiencies of vitamin E and other nutrients.

In one trial, vitamin E failed to improve vision in people with diabetic retinopathy,6 although in a double-blind trial, people with type 1 diabetes given very high amounts of vitamin E were reported to show a normalization of blood flow to the retina.7 This finding has made researchers hopeful that vitamin E might help prevent diabetic retinopathy. However, no long-term trials have yet been conducted with vitamin E in the actual prevention of diabetic retinopathy.

Because oxidation damage is believed to play a role in the development of retinopathy, antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C for several years to 20 people with diabetic retinopathy. During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy.8 People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.

References

1. Alieva ZA, Gadzhiev RV, Sultanov M. Possible role of the antioxidant system of the vitreous body in delaying the development of diabetic retinopathy. Oftalmol Zh 1985;(3):142-5 [in Russian].

2. Johnson L, Quinn GE, Abbasi S, et al. Effect of sustained pharmacological vitamin E levels on incidence and severity of retinopathy of prematurity: A controlled clinical trial. J Pediatr 1989;114:827-38.

3. Raju TN, Langenberg P, Bhutani V, Quinn GE. Vitamin E prophylaxis to reduce retinopathy of prematurity: a reappraisal of published trials. J Pediatr 1997;131:844-50.

4. Hittner HM, Godio LB, Rudoph AJ, et al. Retrolental fibroplasia: efficacy of vitamin E in a double-blind clinical study of preterm infants. N Engl J Med 1981;305:1365-71.

5. Runge P, Muller DP, McAllister J, et al. Oral vitamin E supplements can prevent the retinopathy of abetalipoproteinaemia. Br J Ophthalmol 1986;70:166-73.

6. De Hoff JB, Ozazewski J. Alpha tocopherol to treat diabetic retinopathy. Am J Ophthalmol 1954;37:581-2.

7. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

8. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77-98.

Type 1 Diabetes and Diabetic Nephropathy
Dose: 900 to 1,800 IU dailyPeople with low blood levels of vitamin E are more likely to develop type 1 diabetes,1 but no studies have been done using vitamin E supplements to try to prevent type 1 diabetes. Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic eye damage and nephropathy,2, 3 serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence. Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,4, 5, 6although not all, studies of people with type 1 diabetes.7, 8
References

1. Knekt P, Reunanen A, Marniumi J, et al. Low vitamin E status is a potential risk factor for insulin-dependent diabetes mellitus. J Intern Med 1999;245:99-102.

2. Ross WM, Creighton MO, Stewart-DeHaan PJ, et al. Modelling cortical cataractogenesis: 3. In vivo effects of vitamin E on cataractogenesis in diabetic rats. Can J Ophthalmol 1982;17:61.

3. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

4. Ceriello A, Giugliano D, Quatraro A, et al. Vitamin E reduction of protein glycosylation in diabetes. Diabetes Care 1991;14:68-72.

5. Duntas L, Kemmer TP, Vorberg B, Scherbaum W. Administration of d-alpha-tocopherol in patients with insulin-dependent diabetes mellitus. Curr Ther Res 1996;57:682-90.

6. Jain SK, McVie R, Smith T. Vitamin E supplementation restores glutathione and malondialdehyde to normal concentrations in erythrocytes of type 1 diabetic children. Diabetes Care 2000;23:1389-94.

7. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

8. Fuller CJ, Chandalia M, Garg A, et al. RRR-alpha-tocopheryl acetate supplementation at pharmacologic doses decreases low-density-lipoprotein oxidative susceptibility but not protein glycation in patients with diabetes mellitus. Am J Clin Nutr 1996;63:753-9.

Type 1 Diabetes and Diabetic Retinopathy
Dose: 1800 IU dailyPeople with low blood levels of vitamin E are more likely to develop type 1 diabetes,1 but no studies have been done using vitamin E supplements to try to prevent type 1 diabetes. Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic eye damage and nephropathy,2, 3 serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence. Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,4, 5, 6although not all, studies of people with type 1 diabetes.7, 8
References

1. Knekt P, Reunanen A, Marniumi J, et al. Low vitamin E status is a potential risk factor for insulin-dependent diabetes mellitus. J Intern Med 1999;245:99-102.

2. Ross WM, Creighton MO, Stewart-DeHaan PJ, et al. Modelling cortical cataractogenesis: 3. In vivo effects of vitamin E on cataractogenesis in diabetic rats. Can J Ophthalmol 1982;17:61.

3. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

4. Ceriello A, Giugliano D, Quatraro A, et al. Vitamin E reduction of protein glycosylation in diabetes. Diabetes Care 1991;14:68-72.

5. Duntas L, Kemmer TP, Vorberg B, Scherbaum W. Administration of d-alpha-tocopherol in patients with insulin-dependent diabetes mellitus. Curr Ther Res 1996;57:682-90.

6. Jain SK, McVie R, Smith T. Vitamin E supplementation restores glutathione and malondialdehyde to normal concentrations in erythrocytes of type 1 diabetic children. Diabetes Care 2000;23:1389-94.

7. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

8. Fuller CJ, Chandalia M, Garg A, et al. RRR-alpha-tocopheryl acetate supplementation at pharmacologic doses decreases low-density-lipoprotein oxidative susceptibility but not protein glycation in patients with diabetes mellitus. Am J Clin Nutr 1996;63:753-9.

Type 2 Diabetes and Diabetic Neuropathy
Dose: 900 IU daily

People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes.1, 2 Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most,3, 4, 5 but not all,6 double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes.7, 8 Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent.

In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months.9 Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy,10, 11 serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence.

Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,12, 13, 14, 15, 16 although not all,17, 18, 19 studies.

In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes.20 The reason for the discrepancy between reports is not known.

Vitamin E appears to lower the risk of cerebral infarction, a type of stroke, in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension) can benefit from small amounts of vitamin E (50 IU per day).21

References

1. Knekt P, Reunanen A, Marniumi J, et al. Low vitamin E status is a potential risk factor for insulin-dependent diabetes mellitus. J Intern Med 1999;245:99-102.

2. Salonen JT, Nyssonen K, Tuomainen T-P, et al. Increased risk of non-insulin dependent diabetes mellitus at low plasma vitamin E concentrations: a four year follow up study in men. BMJ 1995;311:1124-7.

3. Bierenbaum ML, Noonan FJ, Machlin LJ, et al. The effect of supplemental vitamin E on serum parameters in diabetics, post coronary and normal subjects. Nutr Rep Int 1985;31:1171-80.

4. Paolisso G, D'Amore A, Giugliano D, et al. Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin dependent diabetic patients. Am J Clin Nutr 1993;57:650-6.

5. Paolisso G, D'Amore A, Galzerano D, et al. Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients. Diabetes Care 1993;16:1433-7.

6. Tutuncu NB, Bayraktar M, Varli K. Reversal of defective nerve condition with vitamin E supplementation in type 2 diabetes. Diabetes Care 1998;21:1915-8.

7. Paolisso G, Di Maro G, Galzerano D, et al. Pharmacological doses of vitamin E and insulin action in elderly subjects. Am J Clin Nutr 1994;59:1291-6.

8. Paolisso G, Gambardella A, Galzerano D, et al. Antioxidants in adipose tissue and risk of myocardial infarction. Lancet 1994;343:596 [letter].

9. Tutuncu NB, Bayraktar M, Varli K. Reversal of defective nerve condition with vitamin E supplementation in type 2 diabetes. Diabetes Care 1998;21:1915-8.

10. Ross WM, Creighton MO, Stewart-DeHaan PJ, et al. Modelling cortical cataractogenesis: 3. In vivo effects of vitamin E on cataractogenesis in diabetic rats. Can J Ophthalmol 1982;17:61.

11. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

12. Ceriello A, Giugliano D, Quatraro A, et al. Vitamin E reduction of protein glycosylation in diabetes. Diabetes Care 1991;14:68-72.

13. Duntas L, Kemmer TP, Vorberg B, Scherbaum W. Administration of d-alpha-tocopherol in patients with insulin-dependent diabetes mellitus. Curr Ther Res 1996;57:682-90.

14. Paolisso G, D'Amore A, Galzerano D, et al. Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients. Diabetes Care 1993;16:1433-7.

15. Jain SK, McVie R, Jaramillo JJ, et al. Effect of modest vitamin E supplementation on blood glycated hemoglobin and triglyceride levels and red cell indices in type I diabetic patients. J Am Coll Nutr 1996;15:458-61.

16. Jain SK, McVie R, Smith T. Vitamin E supplementation restores glutathione and malondialdehyde to normal concentrations in erythrocytes of type 1 diabetic children. Diabetes Care 2000;23:1389-94.

17. Reaven PD, Barnett J, Herold DA, Edelman S. Effect of vitamin E on susceptibility of low-density lipoprotein and low-density lipoprotein subfractions to oxidation and on protein glycation in NIDDM. Diabetes Care 1995;18:807.

18. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

19. Fuller CJ, Chandalia M, Garg A, et al. RRR-alpha-tocopheryl acetate supplementation at pharmacologic doses decreases low-density-lipoprotein oxidative susceptibility but not protein glycation in patients with diabetes mellitus. Am J Clin Nutr 1996;63:753-9.

20. Skrha J, Sindelka G, Kvasnicka J, Hilgertova J. Insulin action and fibrinolysis influenced by vitamin E in obese type 2 diabetes mellitus. Diabetes Res Clin Pract 1999;44:27-33.

21. Leppala JM, Virtamo J, Fogelholm R, et al. Vitamin E and beta carotene supplementation in high risk for stroke: a subgroup analysis of the alpha-tocopherol, beta-carotene cancer prevention study. Arch Neurol 2000;57:1503-9.

Type 2 Diabetes and Diabetic Retinopathy
Dose: 1800 IU daily

People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes.1, 2 Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most,3, 4, 5 but not all,6 double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes.7, 8 Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent.

In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months.9 Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy,10, 11 serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence.

Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,12, 13, 14, 15, 16 although not all,17, 18, 19 studies.

In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes.20 The reason for the discrepancy between reports is not known.

Vitamin E appears to lower the risk of cerebral infarction, a type of stroke, in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension) can benefit from small amounts of vitamin E (50 IU per day).21

References

1. Knekt P, Reunanen A, Marniumi J, et al. Low vitamin E status is a potential risk factor for insulin-dependent diabetes mellitus. J Intern Med 1999;245:99-102.

2. Salonen JT, Nyssonen K, Tuomainen T-P, et al. Increased risk of non-insulin dependent diabetes mellitus at low plasma vitamin E concentrations: a four year follow up study in men. BMJ 1995;311:1124-7.

3. Bierenbaum ML, Noonan FJ, Machlin LJ, et al. The effect of supplemental vitamin E on serum parameters in diabetics, post coronary and normal subjects. Nutr Rep Int 1985;31:1171-80.

4. Paolisso G, D'Amore A, Giugliano D, et al. Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin dependent diabetic patients. Am J Clin Nutr 1993;57:650-6.

5. Paolisso G, D'Amore A, Galzerano D, et al. Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients. Diabetes Care 1993;16:1433-7.

6. Tutuncu NB, Bayraktar M, Varli K. Reversal of defective nerve condition with vitamin E supplementation in type 2 diabetes. Diabetes Care 1998;21:1915-8.

7. Paolisso G, Di Maro G, Galzerano D, et al. Pharmacological doses of vitamin E and insulin action in elderly subjects. Am J Clin Nutr 1994;59:1291-6.

8. Paolisso G, Gambardella A, Galzerano D, et al. Antioxidants in adipose tissue and risk of myocardial infarction. Lancet 1994;343:596 [letter].

9. Tutuncu NB, Bayraktar M, Varli K. Reversal of defective nerve condition with vitamin E supplementation in type 2 diabetes. Diabetes Care 1998;21:1915-8.

10. Ross WM, Creighton MO, Stewart-DeHaan PJ, et al. Modelling cortical cataractogenesis: 3. In vivo effects of vitamin E on cataractogenesis in diabetic rats. Can J Ophthalmol 1982;17:61.

11. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

12. Ceriello A, Giugliano D, Quatraro A, et al. Vitamin E reduction of protein glycosylation in diabetes. Diabetes Care 1991;14:68-72.

13. Duntas L, Kemmer TP, Vorberg B, Scherbaum W. Administration of d-alpha-tocopherol in patients with insulin-dependent diabetes mellitus. Curr Ther Res 1996;57:682-90.

14. Paolisso G, D'Amore A, Galzerano D, et al. Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients. Diabetes Care 1993;16:1433-7.

15. Jain SK, McVie R, Jaramillo JJ, et al. Effect of modest vitamin E supplementation on blood glycated hemoglobin and triglyceride levels and red cell indices in type I diabetic patients. J Am Coll Nutr 1996;15:458-61.

16. Jain SK, McVie R, Smith T. Vitamin E supplementation restores glutathione and malondialdehyde to normal concentrations in erythrocytes of type 1 diabetic children. Diabetes Care 2000;23:1389-94.

17. Reaven PD, Barnett J, Herold DA, Edelman S. Effect of vitamin E on susceptibility of low-density lipoprotein and low-density lipoprotein subfractions to oxidation and on protein glycation in NIDDM. Diabetes Care 1995;18:807.

18. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

19. Fuller CJ, Chandalia M, Garg A, et al. RRR-alpha-tocopheryl acetate supplementation at pharmacologic doses decreases low-density-lipoprotein oxidative susceptibility but not protein glycation in patients with diabetes mellitus. Am J Clin Nutr 1996;63:753-9.

20. Skrha J, Sindelka G, Kvasnicka J, Hilgertova J. Insulin action and fibrinolysis influenced by vitamin E in obese type 2 diabetes mellitus. Diabetes Res Clin Pract 1999;44:27-33.

21. Leppala JM, Virtamo J, Fogelholm R, et al. Vitamin E and beta carotene supplementation in high risk for stroke: a subgroup analysis of the alpha-tocopherol, beta-carotene cancer prevention study. Arch Neurol 2000;57:1503-9.

Insulin Resistance Syndrome
Dose: Refer to label instructions

Vitamin E, 800-1,350 IU per day, has been shown to increase insulin sensitivity in both healthy1 and hypertensive2 people in double-blind studies. Research is needed to investigate this effect in people with IRS.

References

1. Paolisso G, Di Maro G, Galzerano D, et al. Pharmacological doses of vitamin E and insulin action in elderly subjects. Am J Clin Nutr 1994;59:1291-6.

2. Barbagallo M, Dominguez LJ, Tagliamonte MR, et al. Effects of vitamin E and glutathione on glucose metabolism: role of magnesium. Hypertension 1999;34:1002-6.

Hypoglycemia
Dose: Refer to label instructions

Research has shown that supplementing with chromium (200 mcg per day)1 or magnesium (340 mg per day)2 can prevent blood sugar levels from falling excessively in people with hypoglycemia. Niacinamide (vitamin B3) has also been found to be helpful for hypoglycemic people.3 Other nutrients, including vitamin C, vitamin E, zinc, copper, manganese, and vitamin B6, may help control blood sugar levels in diabetics.4 Since there are similarities in the way the body regulates high and low blood sugar levels, these nutrients might be helpful for hypoglycemia as well, although the amounts needed for that purpose are not known.

References

1. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

2. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

3. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

4. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

Retinopathy
Dose: Refer to label instructions

Free radicals have been implicated in the development and progression of several forms of retinopathy.1 Retrolental fibroplasia, a retinopathy that occurs in some premature infants who have been exposed to high levels of oxygen, is an example of free radical-induced damage to the retina. In an analysis of the best published trials, large amounts of vitamin E were found to reduce the incidence of severe retinopathy in premature infants by over 50%.2, 3 Some of the evidence supporting the use of vitamin E in the prevention of retrolental fibroplasia comes from trials that have used 100 IU of vitamin E per 2.2 pounds of body weight in the form of oral supplementation.4 Use of large amounts of vitamin E in the prevention of retrolental fibroplasia requires the supervision of a pediatrician.

Vitamin E has also been found to prevent retinopathy in people with a rare genetic disease known as abetalipoproteinemia.5 People with this disorder lack a protein that transports fat-soluble nutrients, and can therefore develop deficiencies of vitamin E and other nutrients.

In one trial, vitamin E failed to improve vision in people with diabetic retinopathy,6 although in a double-blind trial, people with type 1 diabetes given very high amounts of vitamin E were reported to show a normalization of blood flow to the retina.7 This finding has made researchers hopeful that vitamin E might help prevent diabetic retinopathy. However, no long-term trials have yet been conducted with vitamin E in the actual prevention of diabetic retinopathy.

Because oxidation damage is believed to play a role in the development of retinopathy, antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C for several years to 20 people with diabetic retinopathy. During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy.8 People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.

References

1. Alieva ZA, Gadzhiev RV, Sultanov M. Possible role of the antioxidant system of the vitreous body in delaying the development of diabetic retinopathy. Oftalmol Zh 1985;(3):142-5 [in Russian].

2. Johnson L, Quinn GE, Abbasi S, et al. Effect of sustained pharmacological vitamin E levels on incidence and severity of retinopathy of prematurity: A controlled clinical trial. J Pediatr 1989;114:827-38.

3. Raju TN, Langenberg P, Bhutani V, Quinn GE. Vitamin E prophylaxis to reduce retinopathy of prematurity: a reappraisal of published trials. J Pediatr 1997;131:844-50.

4. Hittner HM, Godio LB, Rudoph AJ, et al. Retrolental fibroplasia: efficacy of vitamin E in a double-blind clinical study of preterm infants. N Engl J Med 1981;305:1365-71.

5. Runge P, Muller DP, McAllister J, et al. Oral vitamin E supplements can prevent the retinopathy of abetalipoproteinaemia. Br J Ophthalmol 1986;70:166-73.

6. De Hoff JB, Ozazewski J. Alpha tocopherol to treat diabetic retinopathy. Am J Ophthalmol 1954;37:581-2.

7. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

8. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77-98.

Type 1 Diabetes
Dose: Refer to label instructionsBecause oxidation damage is believed to play a role in the development of diabetic eye damage (retinopathy), antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C for several years to 20 people with diabetic eye damage (retinopathy). During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy.1 People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.
References

1. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77-98.

Type 1 Diabetes and Diabetic Retinopathy
Dose: Refer to label instructionsBecause oxidation damage is believed to play a role in the development of diabetic eye damage (retinopathy), antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C for several years to 20 people with diabetic eye damage (retinopathy). During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy.1 People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.
References

1. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77-98.

Cold Sores
Dose: Apply cotton saturated with oil for 15 minutes every three hours on day one, then three times daily on days two and three

In a preliminary trial, a piece of cotton saturated with vitamin E oil was applied to newly erupted cold sores and held in place for 15 minutes. The first application was performed in the dentist's office. Participants were instructed to repeat the procedure every three hours for the rest of that day, and then three times daily for two more days. In nearly all cases, pain disappeared in less than eight hours. Application of vitamin E oil appeared to accelerate healing of the cold sores.1 Similar results were reported in another study.2

References

1. Nead DE. Effective vitamin E treatment for ulcerative herpetic lesions. Dent Survey 1976;52(7):50-1.

2. Fink M, Fink J. Treatment of herpes simplex by alpha-tocopherol (vitamin E). Br Dent J 1980;148:246 [letter].

Leukoplakia
Dose: 800 IU daily

According to a review of clinical trials, the combination of beta-carotene and vitamin E has led to complete or partial remissions in six of eight trials studying people with leukoplakia.1 In one trial, administration of 50,000 IU of beta-carotene, 1 gram of vitamin C, and 800 IU of vitamin E per day for nine months led to improvement in 56% of people with leukoplakia, with stronger effects in those who also stopped using tobacco and alcohol.2 In a double-blind trial, a group of men with leukoplakia was given a combination of vitamin A (100,000 IU per week), beta-carotene approximately 67,000 IU per day), and vitamin E (80 IU per week).3 A 38% decrease in the incidence of leukoplakia was observed after six months of treatment.

Although vitamin E has been used in successful trials in which patients are also given beta-carotene, few trials have investigated the effects of vitamin E when taken by itself. One trial used 400 IU of vitamin E two times per day.4 After 24 weeks, 46% showed some improvement in signs or symptoms of leukoplakia or related conditions and 21% showed microscopic evidence of improvement.

References

1. Garewal H. Antioxidants in oral cancer prevention. Am J Clin Nutr 1995;62(suppl):1410S-6S [review].

2. Kaugars GE, Silverman S Jr, Lovas JG, et al. A clinical trial of antioxidant supplements in the treatment of oral leukoplakia. Oral Surg Oral Med Oral Pathol 1994 Oct;78:462-8.

3. Zaridze D, Evstifeeva T, Boyle P. Chemoprevention of oral leukoplakia and chronic esophagitis in an area of high incidence of oral and esophageal cancer. Ann Epidemiol 1993;3:225-34.

4. Benner SE, Winn RJ, Lippman SM, et al. Regression of oral leukoplakia with alpha-tocopherol: a community clinical oncology program chemoprevention study. J Natl Cancer Inst 1993;85:44-7.

Halitosis
Dose: Refer to label instructions

Nutritional supplements recommended by some doctors for prevention and treatment of periodontitis include vitamin C (people with periodontitis are often found to be deficient),1vitamin E, selenium, zinc, coenzyme Q10, and folic acid.2 Folic acid has also been shown to reduce the severity of gingivitis when taken as a mouthwash.3

References

1. Vaananen MK, Markkanen HA, Tuovinen VJ, et al. Periodontal health related to plasma ascorbic acid. Proc Finn Dent Soc 1993;89:51-9.

2. Murray M, Pizzorno J. Encyclopedia of Natural Medicine, rev2d ed. Rocklin, CA: Prima Publishing, 1998, 722-9.

3. Pack ARC. Folate mouthwash: effects on established gingivitis in periodontal patients. J Clin Periodontol 1984;11:619-28.

Gingivitis
Dose: Refer to label instructions

Nutritional supplements recommended by some doctors for prevention and treatment of periodontitis include vitamin C (people with periodontitis are often found to be deficient),1vitamin E, selenium, zinc, coenzyme Q10, and folic acid.2 Folic acid has also been shown to reduce the severity of gingivitis when taken as a mouthwash.3

References

1. Vaananen MK, Markkanen HA, Tuovinen VJ, et al. Periodontal health related to plasma ascorbic acid. Proc Finn Dent Soc 1993;89:51-9.

2. Murray M, Pizzorno J. Encyclopedia of Natural Medicine, rev2d ed. Rocklin, CA: Prima Publishing, 1998, 722-9.

3. Pack ARC. Folate mouthwash: effects on established gingivitis in periodontal patients. J Clin Periodontol 1984;11:619-28.

Menopause
Dose: Refer to label instructions

Many years ago, researchers studied the effects of vitamin E supplementation in reducing symptoms of menopause. Most,1, 2, 3, 4, 5 but not all,6 studies found vitamin E to be helpful, and the benefit of vitamin E was confirmed more recently in a double-blind trial.7 Many doctors suggest that women going through menopause take 400 to 800 IU per day of vitamin E for a trial period of at least three months to see if symptoms are reduced. If helpful, this amount may be continued or a lower amount may be tried for maintenance.

References

1. Perloff WH. Treatment of the menopause. Am J Obstet Gynecol 1949;58:684-94.

2. Gozan HA. The use of vitamin E in treatment of the menopause. NY State J Med 1952;52:1289.

3. Christy CJ. Vitamin E in menopause: Preliminary report of experimental and clinical study. Am J Obstet Gynecol 1945:50:84.

4. Finkler RS. The effect of vitamin E in the menopause. J Clin Endocrinol Metab 1949;9:89-94.

5. Rubenstein BB. Vitamin E diminishes the vasomotor symptoms of menopause. Fed Proc 1948;7:106 [abstract].

6. Blatt MHG, Weisbader H, Kupperman HS. Vitamin E and climacteric syndrome: failure of effective control as measured by menopausal index. Arch Intern Med 1953;91:792-9.

7. Ziaei S, Kazemnejad A, Zareai M. The effect of vitamin E on hot flashes in menopausal women. Gynecol Obstet Invest 2007;64:204-7.

Hay Fever
Dose: 800 IU daily

In a double-blind trial, supplementation with a specific probiotic strain (Bifidobacterium longum strain BB536) during the pollen season significantly decreased symptoms such as sneezing, runny nose, nasal blockage, compared with a placebo.1

References

1. Xiao JZ, Kondo S, Yanagisawa N, et al. Probiotics in the treatment of Japanese cedar pollinosis: a double-blind placebo-controlled trial. Clin Exp Allergy 2006;36:1425-35.

Asthma
Dose: Refer to label instructions

There is some evidence that combinations of antioxidants such as vitamin E, vitamin C, and selenium may help improve symptoms of asthma throught to be caused by air pollution.1 In one double-blind study, 46 Dutch bicyclists were randomly assigned to receive a placebo or 100 mg of vitamin E and 500 mg of vitamin C daily for 15 weeks.2 Lung function was measured before and after each training session on 380 different occasions, and ambient ozone concentrations were measured during each training session. After analysis, researchers concluded that bicyclists with the vitamins C and E blunted the adverse effects of ozone on measures of lung function. In another double-blind study, 17 adults (18 to 39 years old) were randomly assigned to receive either 400 IU per day of vitamin E and 500 mg per day of vitamin C or a placebo for five weeks.3 Tests showing improved measures of lung function led researchers to conclude that supplementation with vitamins C and E inhibited the decline in pulmonary function induced in asthmatics by exposure to air pollutants. Also using a double-blind design, another study of 158 children with asthma living in Mexico City were randomly assigned to receive, a daily supplement containing 50 mg of vitamin E and 250 mg of vitamin C or a placebo.4 Tests results suggested that supplementing with vitamins C and E may reduce the adverse effect of ozone exposure on lung function of children with moderate to severe asthma.

References

1. Ames BN, Shigenaga MK, Hagen TM. Oxidants, antioxidants, and the degenerative diseases of aging. Proc Natl Acad Sci 1993;90:7915-22.

2. Grievink L, Zijlstra AG, Ke X, Brunekreef B. Double-blind intervention trial on modulation of ozone effects on pulmonary function by antioxidant supplements. Am J Epidemiol 1999;149:306-14.

3. Trenga CA, Koenig JQ, Williams PV. Dietary antioxidants and ozone-induced bronchial hyperresponsiveness in adults with asthma. Arch Environ Health 2001;56:242-9.

4. Romieu I, Sienra-Monge JJ, Ramirez-Aguilar M, Tellez-Rojo MM, Moreno-Macias H, Reyes-Ruiz NI, et al. Antioxidant supplementation and lung functions among children with asthma exposed to high levels of air pollutants. Am J Respir Crit Care Med 2002;166:703-9.

Alzheimer's Disease
Dose: 2,000 IU daily

In a preliminary study, people who used antioxidant supplements (vitamin C or vitamin E) had a lower risk of Alzheimer's disease compared with people who did not take antioxidants.1 Other preliminary research shows that higher blood levels of vitamin E correlate with better brain functioning in middle-aged and older adults.2 The possible protective effect of antioxidants may be explained by the observation that oxidative damage appears to play a role in the development of dementia.3 Large amounts of supplemental vitamin E may slow the progression of Alzheimer's disease. A double-blind trial found that 2,000 IU of vitamin E per day for two years extended the length of time people with moderate Alzheimer's disease were able to continue caring for themselves (e.g., bathing, dressing, and other necessary daily functions), compared with people taking a placebo.4

References

1. Morris MC, Beckett LA, Scherr PA, et al. Vitamin E and vitamin C supplement use and risk of incident Alzheimer disease. Alzheimer Dis Assoc Disord 1998;12:121-6.

2. Schmidt R, Hayn M, Reinhart B, et al. Plasma antioxidants and cognitive performance in middle-aged and older adults: results of the Austrian Stroke Prevention Study. J Am Geriatr Soc 1998;46:1407-10.

3. Lethem R, Orrell M. Antioxidants and dementia. Lancet 1997;349:1189-90 [commentary].

4. Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. N Engl J Med 1997;336:1216-22.

Macular Degeneration
Dose: Refer to label instructions

Sunlight triggers oxidative damage in the eye, which in turn can cause macular degeneration.1 Animals given antioxidants-which protect against oxidative damage-have a lower risk of this vision problem.2 People with high blood levels of antioxidants also have a lower risk.3 Those with the highest levels (top 20th percentile) of the antioxidants selenium, vitamin C, and vitamin E may have a 70% lower risk of developing macular degeneration, compared with people with the lowest levels of these nutrients (bottom 20th percentile).4 People who eat fruits and vegetables high in beta-carotene, another antioxidant, are also at low risk.5 Some doctors recommend antioxidant supplements to reduce the risk of macular degeneration; reasonable adult levels include 200 mcg of selenium, 1,000 mg of vitamin C, 400 IU of vitamin E, and 25,000 IU of natural beta-carotene per day. However, a preliminary study found no association between age-related macular degeneration and intake of antioxidants, either from the diet, from supplements, or from both combined.6 Moreover, in a double-blind study of male cigarette smokers, supplementing with vitamin E (50 IU per day), synthetic beta-carotene (about 33,000 IU per day), or both did not reduce the incidence of age-related macular degeneration.7 Another double-blind trial found that supplementing with 600 IU of vitamin E every other day did not reduce the incidence of age-related macular degeneration in healthy women.8

References

1. Young RW. Solar radiation and age-related macular degeneration. Surv Ophthalmol 1988:32:252-69.

2. Katz ML, Parker KR, Handelman GJ, et al. Effects of antioxidant nutrient deficiency on the retina and retinal pigment epithelium of albino rats: a light and electron microscopic study. Exp Eye Res 1982;34:339-69.

3. West S, Vitale S, Hallfrisch J, et al. Are anti-oxidants or supplements protective of age-related macular degeneration? Arch Ophthalmol 1994:112:222-7.

4. Eye Disease Case-Control Study Group. Antioxidant status and neovascular age-related macular degeneration. Arch Ophthalmol 1993:111:104-9.

5. Goldberg J, Flowerdew G, Smith E, et al. Factors associated with age-related macular degeneration. Am J Epidemiol 1988:128:700-10.

6. Smith W, Mitchell P, Webb K, Leeder SR. Dietary antioxidants and age-related maculopathy: the Blue Mountains Eye Study. Ophthalmology 1999;106:761-7.

7. Teikari JM, Laatikainen L, Virtamo J, et al. Six-year supplementation with alpha-tocopherol and beta-carotene and age-related maculopathy. Acta Ophthalmol Scand 1998;76:224-9.

8. Christen WG, Glynn RJ, Chew EY, Buring JE. Vitamin E and age-related macular degeneration in a randomized trial of women. Ophthalmology 2010;117:1163-8.

Age-Related Cognitive Decline
Dose: Refer to label instructions

Use of vitamin C or vitamin E supplements, or both, has been associated with better cognitive function and a reduced risk of certain forms of dementia (not including Alzheimer's disease).1 Clinical trials of these antioxidants are needed to confirm the possible benefits suggested by this study.

References

1. Masaki KH, Losonczy KG, Izmirlian G, et al. Association of vitamin E and C supplement use with cognitive function and dementia in elderly men. Neurology 2000;54:1265-72.

Anti-Aging
Dose: Refer to label instructions
Prostate Cancer
Dose: 50 IU daily

Relatively high blood levels of vitamin E have been associated with relatively low levels of hormones linked to prostate cancer.1 In a double-blind trial studying smokers, vitamin E supplementation (50 IU per day for an average of six years) led to a 32% decrease in prostate cancer incidence and a 41% decrease in prostate cancer deaths.2 Both findings were statistically significant.3 However, in a double-blind study of 35,533 healthy men, supplementing with 400 IU per day of vitamin E for an average of 5.5 years (with a total follow-up period of 7 years) significantly increased the incidence of prostate cancer by 17%.4 The effects of vitamin E have yet to be studied in men already diagnosed with prostate cancer.

The conflicting results in these studies may be due to the fact that all of the studies used pure alpha-tocopherol, which is only one of the four different forms of vitamin E that occur naturally in food (alpha-, beta-, gamma-, and delta-tocopherol). Treatment with large doses of alpha-tocopherol by itself (such as 400 IU per day or more) has been shown to deplete gamma-tocopherol, potentially upsetting the natural balance of the different forms of vitamin E in the body. "Mixed tocopherols," on the other hand, a supplement that contains all four types of vitamin E, would not be expected to cause such an imbalance.

Both alpha-tocopherol and gamma-tocopherol have been found to inhibit the growth of human prostate cancer cells in a test tube, but gamma-tocopherol was the more potent of the two.5 In another study, higher blood levels of alpha-tocopherol and gamma-tocopherol were each associated a lower risk of developing prostate cancer, but the protective effect of gamma-tocopherol was greater than that of alpha-tocopherol.6 These observations raise the possibility that both alpha- and gamma-tocopherol have a protective effect against prostate cancer. However, when alpha-tocopherol is given by itself in large doses (such as 400 IU per day or more), it depletes gamma-tocopherol, which could more than negate any beneficial effect that alpha-tocopherol might have. If that is the case, then taking vitamin E as mixed tocopherols would not be expected to increase prostate cancer risk, and might even help prevent prostate cancer. Further research is needed to examine that possibility.

References

1. Hartman TJ, Dorgan JF, Virtamo J, et al. Association between serum a-tocopherol and serum androgens and estrogens in older men. Nutr Cancer 1999;35:10-5.

2. Heinonen OP, Albanes D, Virtamo J, et al. Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst 1998;90:440-6.

3. Heinonen OP, Albanes D, Virtamo J, et al. Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst 1998;90:440-6.

4. REF: Klein EA, Thompson IM Jr, Tangen CM, et al. Vitamin E and the risk of prostate cancer. The Seleniun and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2011;306:1549-56.

5. Saldeen K, Saldeen T. Importance of tocopherols beyond alpha-tocopherol: evidence from animal and human studies. Nutr Res 2005;25:877-9.

6. REF:Helzlsouer KJ, Huang HY, Alberg AJ, al. Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer. J Natl Cancer Inst 2000;92:2018-23.

Macular Degeneration
Dose: Refer to label instructions

Sunlight triggers oxidative damage in the eye, which in turn can cause macular degeneration.1 Animals given antioxidants-which protect against oxidative damage-have a lower risk of this vision problem.2 People with high blood levels of antioxidants also have a lower risk.3 Those with the highest levels (top 20th percentile) of the antioxidants selenium, vitamin C, and vitamin E may have a 70% lower risk of developing macular degeneration, compared with people with the lowest levels of these nutrients (bottom 20th percentile).4 People who eat fruits and vegetables high in beta-carotene, another antioxidant, are also at low risk.5 Some doctors recommend antioxidant supplements to reduce the risk of macular degeneration; reasonable adult levels include 200 mcg of selenium, 1,000 mg of vitamin C, 400 IU of vitamin E, and 25,000 IU of natural beta-carotene per day. However, a preliminary study found no association between age-related macular degeneration and intake of antioxidants, either from the diet, from supplements, or from both combined.6 Moreover, in a double-blind study of male cigarette smokers, supplementing with vitamin E (50 IU per day), synthetic beta-carotene (about 33,000 IU per day), or both did not reduce the incidence of age-related macular degeneration.7 Another double-blind trial found that supplementing with 600 IU of vitamin E every other day did not reduce the incidence of age-related macular degeneration in healthy women.8

References

1. Young RW. Solar radiation and age-related macular degeneration. Surv Ophthalmol 1988:32:252-69.

2. Katz ML, Parker KR, Handelman GJ, et al. Effects of antioxidant nutrient deficiency on the retina and retinal pigment epithelium of albino rats: a light and electron microscopic study. Exp Eye Res 1982;34:339-69.

3. West S, Vitale S, Hallfrisch J, et al. Are anti-oxidants or supplements protective of age-related macular degeneration? Arch Ophthalmol 1994:112:222-7.

4. Eye Disease Case-Control Study Group. Antioxidant status and neovascular age-related macular degeneration. Arch Ophthalmol 1993:111:104-9.

5. Goldberg J, Flowerdew G, Smith E, et al. Factors associated with age-related macular degeneration. Am J Epidemiol 1988:128:700-10.

6. Smith W, Mitchell P, Webb K, Leeder SR. Dietary antioxidants and age-related maculopathy: the Blue Mountains Eye Study. Ophthalmology 1999;106:761-7.

7. Teikari JM, Laatikainen L, Virtamo J, et al. Six-year supplementation with alpha-tocopherol and beta-carotene and age-related maculopathy. Acta Ophthalmol Scand 1998;76:224-9.

8. Christen WG, Glynn RJ, Chew EY, Buring JE. Vitamin E and age-related macular degeneration in a randomized trial of women. Ophthalmology 2010;117:1163-8.

Retinopathy
Dose: Refer to label instructions

Free radicals have been implicated in the development and progression of several forms of retinopathy.1 Retrolental fibroplasia, a retinopathy that occurs in some premature infants who have been exposed to high levels of oxygen, is an example of free radical-induced damage to the retina. In an analysis of the best published trials, large amounts of vitamin E were found to reduce the incidence of severe retinopathy in premature infants by over 50%.2, 3 Some of the evidence supporting the use of vitamin E in the prevention of retrolental fibroplasia comes from trials that have used 100 IU of vitamin E per 2.2 pounds of body weight in the form of oral supplementation.4 Use of large amounts of vitamin E in the prevention of retrolental fibroplasia requires the supervision of a pediatrician.

Vitamin E has also been found to prevent retinopathy in people with a rare genetic disease known as abetalipoproteinemia.5 People with this disorder lack a protein that transports fat-soluble nutrients, and can therefore develop deficiencies of vitamin E and other nutrients.

In one trial, vitamin E failed to improve vision in people with diabetic retinopathy,6 although in a double-blind trial, people with type 1 diabetes given very high amounts of vitamin E were reported to show a normalization of blood flow to the retina.7 This finding has made researchers hopeful that vitamin E might help prevent diabetic retinopathy. However, no long-term trials have yet been conducted with vitamin E in the actual prevention of diabetic retinopathy.

Because oxidation damage is believed to play a role in the development of retinopathy, antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C for several years to 20 people with diabetic retinopathy. During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy.8 People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.

References

1. Alieva ZA, Gadzhiev RV, Sultanov M. Possible role of the antioxidant system of the vitreous body in delaying the development of diabetic retinopathy. Oftalmol Zh 1985;(3):142-5 [in Russian].

2. Johnson L, Quinn GE, Abbasi S, et al. Effect of sustained pharmacological vitamin E levels on incidence and severity of retinopathy of prematurity: A controlled clinical trial. J Pediatr 1989;114:827-38.

3. Raju TN, Langenberg P, Bhutani V, Quinn GE. Vitamin E prophylaxis to reduce retinopathy of prematurity: a reappraisal of published trials. J Pediatr 1997;131:844-50.

4. Hittner HM, Godio LB, Rudoph AJ, et al. Retrolental fibroplasia: efficacy of vitamin E in a double-blind clinical study of preterm infants. N Engl J Med 1981;305:1365-71.

5. Runge P, Muller DP, McAllister J, et al. Oral vitamin E supplements can prevent the retinopathy of abetalipoproteinaemia. Br J Ophthalmol 1986;70:166-73.

6. De Hoff JB, Ozazewski J. Alpha tocopherol to treat diabetic retinopathy. Am J Ophthalmol 1954;37:581-2.

7. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 1999;22:1245-51.

8. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77-98.

Cataracts
Dose: Refer to label instructions

People with low blood levels of antioxidants and those who eat few antioxidant-rich fruits and vegetables have been reported to be at high risk for cataracts.1, 2

Low blood levels of vitamin E have been linked to increased risk of forming cataracts.3, 4 Dietary vitamin E intake has not been consistently associated with protection from cataracts.5, 6 Vitamin E supplements have been reported to protect against cataracts in animals7 and people,8 though the evidence remains inconsistent.9 In one trial, people who took vitamin E supplements had less than half the risk of developing cataracts, compared with others in the five-year study.10 Doctors typically recommend 400 IU of vitamin E per day as prevention. Smaller amounts (approximately 50 IU per day) have been proven in double-blind research to provide no protection.11

References

1. Jacques PF, Chylack LT Jr. Epidemiologic evidence of a role for the antioxidant vitamins and carotenoids in cataract prevention. Am J Clin Nutr 1991;53:352S-5S.

2. Knekt P, Heliovaara M, Rissanen A, et al. Serum antioxidant vitamins and risk of cataract. BMJ 1992;305:1392-4.

3. Rouhiainen P, Rouhiainen H, Salonen JT. Association between low plasma vitamin E concentration and progression of early cortical lens opacities. Am J Epidemiol 1996;144:496-500.

4. Lyle BJ, Mares-Perlman JA, Klein BE, et al. Serum carotenoids and tocopherols and incidence of age-related nuclear cataract. Am J Clin Nutr 1999;69:272-7.

5. Lyle BJ, Mares-Perlman JA, Klein BE, et al. Antioxidant intake and risk of incident age-related nuclear cataracts in the Beaver Dam Eye Study. Am J Epidemiol 1999;149:801-9.

6. Chasan-Taber L, Willett WC, Seddon JM, et al. A prospective study of vitamin supplement intake and cataract extraction among U.S. women. Epidemiology 1999;10:679-84.

7. Trevithick JR, Creighton MO, Ross WM, et al. Modelling cortical cataractogenesis: 2. In vitro effects on the lens of agents preventing glucose- and sorbitol-induced cataracts. Can J Ophthalmol 1981;16:32-8.

8. Robertson J McD, Donner AP, Trevithick JR. A possible role for vitamins C and E in cataract prevention. Am J Clin Nutr 1991;53:346S-51S.

9. Seddon JM, Christen WG, Manson JE, et al. The use of vitamin supplements and the risk of cataract among US male physicians. Am J Public Health 1994;84:788-92.

10. Leske MC, Chylack LT Jr, He Q, et al. Antioxidant vitamins and nuclear opacities. The Longitudinal Study of Cataract. Ophthalmology 1998;105:831-6.

11. Teikari JM, Virtamo J, Rautalahti M, et al. Long-term supplementation with alpha-tocopherol and beta-carotene and age-related cataract. Acta Ophthalmol Scand 1997;75:634-40.

Osgood-Schlatter Disease
Dose: 400 IU a day with 150 mcg a day of selenium

Based on the personal experience of a doctor who reported his findings,1 some physicians recommend vitamin E (400 IU per day) and selenium (50 mcg three times per day). One well-known, nutritionally oriented doctor reports anecdotally that he has had considerable success with this regimen and often sees results in two to six weeks.2

References

1. Reich, CJ. Vitamin E, selenium, and knee problems. Lancet 1976;i:257 [letter].

2. Wright JW. Personal correspondence, April 1997.

Childhood Diseases
Dose: Refer to label instructions

Healthy immune function also requires adequate amounts of vitamin E. Vitamin E deficiency is associated with increased severity of viral infections in mice.1, 2, 3 Supplementation with vitamin E during viral infections has been shown to increase immune cell activity4 and reduce virus activity5 in mice. Research into the effects of vitamin E supplementation on childhood exanthems has not been done.

References

1. Beck MA, Levander OA. Host nutritional status and its effect on a viral pathogen. J Infect Dis 2000;182:S93-S96 [review].

2. Beck MA. Nutritionally induced oxidative stress: effect on viral disease. Am J Clin Nutr 2000;71:1676S-81S [review].

3. Beck MA, Levander OA. Dietary oxidative stress and the potentiation of viral infection. Annu Rev Nutr 1998;18:93-116 [review].

4. Han SN, Wu D, Ha WK, et al. Vitamin E supplementation increases T helper 1 cytokine production in old mice infected with influenza virus. Immunology 2000;100:487-93.

5. Hayek MG, Taylor SF, Bender BS, et al. Vitamin E supplementation decreases lung virus titers in mice infected with influenza. J Infect Dis 1997;176:273-6.

Kidney Stones
Dose: Refer to label instructions

In a double-blind trial, supplementation with 200 IU of synthetic vitamin E per day was found to reduce several risk factors for kidney stone formation in people with elevated levels of urinary oxalate.1

References

1. Anbazhagan M, Hariprasad C, Amudram P, et al. Effect of oral supplementation of vitamin E on urinary risk factors in patients with hyperoxaluria. J Clin Biochem Nutr 1999;27:37-47.

Male Infertility
Dose: Refer to label instructions

Vitamin E deficiency in animals leads to infertility.1 In a preliminary human trial, 100-200 IU of vitamin E given daily to both partners of infertile couples led to a significant increase in fertility.2 Vitamin E supplementation may enhance fertility by decreasing free-radical damage to sperm cells. In another preliminary study, men with low fertilization rates in previous attempts at in vitro fertilization were given 200 IU of vitamin E per day for three months.3 After one month of supplementation, fertilization rates increased significantly, and the amount of oxidative stress on sperm cells decreased. However, the evidence in favor of vitamin E remains preliminary. A review of research on vitamin E for male infertility concluded that there is no justification for its use in treating this condition.4 Controlled trials are needed to validate these promising preliminary findings.

References

1. Thiessen DD, Ondrusek G, Coleman RV. Vitamin E and sex behavior in mice. Nutr Metab 1975;18:116-9.

2. Bayer R. Treatment of infertility with vitamin E. Int J Fertil 1960;5:70-8.

3. Geva E, Bartoov B, Zabludovsky N, et al. The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program. Fertil Steril 1996;66:430-4.

4. Martin-Du Pan RC, Sakkas D. Is antioxidant therapy a promising strategy to improve human reproduction? Are anti-oxidants useful in the treatment of male infertility? Hum Reprod 1998;13:2984-5.

Restless Legs Syndrome
Dose: Refer to label instructions

In a group of nine people with RLS, 300 IU of vitamin E per day produced complete relief in seven.1 Doctors who give vitamin E to people with RLS generally recommend at least 400 IU of vitamin E per day, and the full benefits may not become apparent for three months.2

References

1. Ayres S Jr, Mihan R. "Restless legs" syndrome: Response to vitamin E. J Appl Nutr 1973;25:8-15.

2. Ayres S, Mihan R. Leg cramps and "restless leg" syndrome responsive to vitamin E. Calif Med 1969;111:87-91.

Age-Related Cognitive Decline
Dose: Refer to label instructions

Use of vitamin C or vitamin E supplements, or both, has been associated with better cognitive function and a reduced risk of certain forms of dementia (not including Alzheimer's disease).1 Clinical trials of these antioxidants are needed to confirm the possible benefits suggested by this study.

References

1. Masaki KH, Losonczy KG, Izmirlian G, et al. Association of vitamin E and C supplement use with cognitive function and dementia in elderly men. Neurology 2000;54:1265-72.

Athletic Performance, Exercise Recovery, and High-Altitude Exercise Performance
Dose: 400 IU daily

Most research has demonstrated that strenuous exercise increases production of harmful substances called free radicals, which can damage muscle tissue and result in inflammation and muscle soreness. Exercising in cities or smoggy areas also increases exposure to free radicals. Antioxidants, including vitamin C and vitamin E, neutralize free radicals before they can damage the body, so antioxidants may aid in exercise recovery. Regular exercise increases the efficiency of the antioxidant defense system, potentially reducing the amount of supplemental antioxidants that might otherwise be needed for protection. However, at least theoretically, supplements of antioxidant vitamins may be beneficial for older or untrained people or athletes who are undertaking an especially vigorous training protocol or athletic event.1, 2

Placebo-controlled research, some of it double-blind, has shown that taking 400 to 3,000 mg of vitamin C per day for several days before and after intense exercise may reduce pain and speed up muscle strength recovery.3, 4, 5 However, taking vitamin C only after such exercise was not effective in another double-blind study.6 While some research has reported that vitamin E supplementation in the amount of 800 to 1,200 IU per day reduces biochemical measures of free radical activity and muscle damage caused by strenuous exercise,7, 8, 9 several studies have not found such benefits,10, 11, 12, 13 and no research has investigated the effect of vitamin E on performance-related measures of strenuous exercise recovery. A combination of 90 mg per day of coenzyme Q10 and a very small amount of vitamin E did not produce any protective effects for marathon runners in one double-blind trial,14 while in another double-blind trial a combination of 50 mg per day of zinc and 3 mg per day of copper significantly reduced evidence of post-exercise free radical activity.15

In most well-controlled studies, exercise performance has not been shown to improve following supplementation with vitamin C, unless a deficiency exists, as might occur in athletes with unhealthy or irrational eating patterns.16, 17 Similarly, vitamin E has not benefited exercise performance, 18, 19 except possibly at high altitudes. 20, 21

References

1. Kanter M. Free radicals, exercise and antioxidant supplementation. Proc Nutr Soc 1998;57:9-13 [review].

2. Dekkers JC, Van Doornen LJ, Kemper HC. The role of antioxidant vitamins and enzymes in the prevention of exercise-induced muscle damage. Sports Med 1996;21(3):213-38 [review].

3. Jakeman P, Maxwell S. Effect of antioxidant vitamin supplementation on muscle function after eccentric exercise. Eur J Appl Physiol 1993;67:426-30.

4. Kaminski M, Boal R. An effect of ascorbic acid on delayed-onset muscle soreness. Pain 1992;50:317-21.

5. Thompson D, Williams C, McGregor SJ, et al. Prolonged vitamin C supplementation and recovery from demanding exercise. Int J Sport Nutr Exerc Metab 2001;11:466-81.

6. Thompson D, Williams C, Garcia-Roves P, et al. Post-exercise vitamin C supplementation and recovery from demanding exercise. Eur J Appl Physiol 2003;89:393-400.

7. Itoh H, Ohkuwa T, Yamazaki Y, et al. Vitamin E supplementation attenuates leakage of enzymes following 6 successive days of running training. Int J Sports Med 2000;21:369-74.

8. McBride JM, Kraemer WJ, Triplett-McBride T, Sebastianelli W. Effect of resistance exercise on free radical production. Med Sci Sports Exerc 1998;30:67-72.

9. Evans WJ. Vitamin E, vitamin C, and exercise. Am J Clin Nutr 2000;72:647S-52S [review].

10. Dawson B, Henry GJ, Goodman C, et al. Effect of Vitamin C and E supplementation on biochemical and ultrastructural indices of muscle damage after a 21 km run. Int J Sports Med 2002;23:10-5.

11. Beaton LJ, Allan DA, Tarnopolsky MA, et al. Contraction-induced muscle damage is unaffected by vitamin E supplementation. Med Sci Sports Exerc 2002;34:798-805.

12. Petersen EW, Ostrowski K, Ibfelt T, et al. Effect of vitamin supplementation on cytokine response and on muscle damage after strenuous exercise. Am J Physiol Cell Physiol 2001;280:C1570-5.

13. Kanter MM, Nolte LA, Holloszy JO. Effects of an antioxidant vitamin mixture on lipid peroxidation at rest and postexercise. J Appl Physiol 1993;74:965-9.

14. Kaikkonen J, Kosonen L, Nyyssonen K, et al. Effect of combined coenzyme Q10 and d-alpha-tocopheryl acetate supplementation on exercise-induced lipid peroxidation and muscular damage: a placebo-controlled double-blind study in marathon runners. Free Radic Res 1998;29:85-92.

15. Singh A, Failla ML, Deuster PA. Exercise-induced changes in immune function: effects of zinc supplementation. J Appl Physiol 1994;76:2298-303.

16. Johnston CS, Swan PD, Corte C. Substrate utilization and work efficiency during submaximal exercise in vitamin C depleted-repleted adults. Int J Vitam Nutr Res 1999;69:41-4.

17. Gerster H. The role of vitamin C in athletic performance. J Am Coll Nutr 1989;8:636-43 [review].

18. Tiidus PM, Houston ME. Vitamin E status and response to exercise training. Sports Med 1995;20:12-23 [review].

19. Akova B, Surmen-Gur E, Gur H, et al. Exercise-induced oxidative stress and muscle performance in healthy women: role of vitamin E supplementation and endogenous oestradiol. Eur J Appl Physiol 2001;84:141-7.

20. Simon-Schnass I, Pabst H. Influence of vitamin E on physical performance. Int J Vitam Nutr Res 1988;58:49-54.

21. Shepard RJ. Vitamin E and athletic performance. J Sports Med 1983;23:461-70 [review].

Yellow Nail Syndrome
Dose: 800 IU daily

Supplementation with vitamin E has been used successfully with people who have yellow nail syndrome in several preliminary reports.1, 2, 3 Although topical use of the vitamin has also been reported to be effective,4 taking vitamin E supplements is much easier and less messy. A typical amount is 800 IU per day, with results beginning to appear after several months.

References

1. Norton L. Further observations on the yellow nail syndrome with therapeutic effects of oral alpha-tocopherol. Cutis 1985;36:457-62.

2. Ayres S Jr, Hihan R. Yellow nail syndrome: response to vitamin E. Arch Dermatol 1973;108:267-8.

3. Ayres S Jr. Yellow nail syndrome controlled by vitamin E therapy. J Am Acad Dermatol 1986;15:714-6 [letter].

4. Williams HC, Buffham R, du Vivier A. Successful use of topical vitamin E solution in the treatment of nail changes in yellow nail syndrome. Arch Dermatol 1991;127:1023-8.

Vitamin E is an antioxidant that protects cell membranes and other fat-soluble parts of the body, such as low-density lipoprotein (LDL; "bad" cholesterol) cholesterol, from damage.

Copyright 2014 Aisle7. All rights reserved. Aisle7.com

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2015.

Label
To view the Label you will need Adobe Acrobat Reader installed. You can download a free copy of the Adobe Acrobat Reader at: http://www.adobe.com/acrobat/readstep.html
Ratings and Reviews
Ask A Question