Supplement - JASE Medical

Vitamin E

Vitamin E is a popular over the counter vitamin supplement that has many uses. But just like any medication and supplement, there are a few things you should be aware of before supplementing.

Discovery of vitamin E

Vitamin E was discovered in 1922 by Bishop and Evans. However, it wasn’t until the 1940s when the use of vitamin E in the role of nutrition in premature infants was investigated. This led to examining intestinal absorption of vitamin E in premature infants to prevent intracranial hemorrhage, pulmonary oxygen toxicity, hemolysis and more. Since that time, the use of vitamin E in premature infants has helped save many lives.

There are eight different natural forms of vitamin E which can be subdivided into two separate groups: the tocopherols and the tocotrienols. Both are plant based and fat soluble and each of these have four separate analogues. Each analogue has a different potency and effect on health.

Tocopherols are the saturated form of vitamin E and contain the analogues alpha, beta, delta, and gamma. This form of vitamin E is the major source in the U.S. diet.

Food sources of tocopherols include oils derived from walnuts, hazelnuts, peanuts, sunflower oil.

Tocotrienols are the unsaturated form of vitamin E and contain same name but different types of analogues- alpha beta, delta and gamma.

Food sources of tocotrienols are palm and rice bran oil, wheat germ, barley, oats, grapefruit seed oil, and annatto oil.

Vitamin E

Synthetic vitamin E

Synthetic forms of vitamin E contain both tocopherol and tocotrienols and include the four analogs of each. However there is evidence to suggest that synthetic E isn’t  absorbed by the body as efficiently as natural forms.

How to tell if your vitamin E supplement is synthetic or natural

Most vitamin E supplements are derived from natural sources. The natural (D-α-tocopherol) contains the prefix “D”, the synthetic form (DL-α-tocopherol acetate) contains the prefix “DL”.

Vitamin E deficiency


Vitamin E deficiency is rare; however some causes are:

  • Some genetic disorders that can cause malabsorption of dietary fats
  • Cystic fibrosis patients have trouble absorbing the fat-soluble vitamins- ADEK
  • Malnutrition
  • Short-bowel syndrome patients
  • Surgical resection
  • Mesenteric vascular thrombosis
  • Crohn’s disease
  • exocrine pancreatic insufficiency
  • liver disease
  • Cigarette smoking depletes vitamin E

Symptoms vitamin E deficiency

  • Impaired balance and coordination
  • Muscle weakness
  • Retinopathy

Consult with your care provider before supplementing with vitamin E

Vitamin E toxicity

Vitamin E toxicity occurs by supplementation, not diet alone. Symptoms include excessive bleeding, nausea, vomiting and muscle weakness. If toxicity is suspected, discontinuation of vitamin E and administration of vitamin K may be initiated by your care provider.

Drug interactions and cautions when supplementing with Vitamin E

  • Vitamin E inhibits platelet aggregation and can disrupt vitamin K1 clotting. Use with caution when on anticoagulation and antiplatelet medications as there is the potential risk of bleeding when taken together.
  • Niacin: vitamin E supplementation can reduce effects of niacin

Medical conditions that may be contraindicated with vitamin E supplementation

  • History heart attack or stroke
  • Bleeding disorders
  • Diabetes
  • Vitamin K deficiency
  • Retinitis pigmentosa
  • Kidney disease
  • Anemia
  • Liver disease

- Brooke Lounsbury, RN

Medical Content Writer

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