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

• Provides immune boost to fight off invading bacteria and viruse.s
• Protects cell damage from oxidative stress from cigarette smoke, air pollution, UV light, and foods that we eat.
• Prevents blood from clotting.
• Helps maintain cell elasticity and widens blood vessels when needed
• Emerging evidence points to the cancer preventing effects of the tocotrienol form of vitamin E.
• In addition, tocotrienol form of vitamin E has more effective anti-inflammatory and downregulation of chronic diseases than tocopherols.
• Stabilized form of vitamin E is used in dermatology for mitigating the effects of UV exposure and inhibiting skin cancer development, atopic dermatitis along with treating yellow nail syndrome.
• Mixed reviews on topical use to help heal scars and post-surgery incisions, and contact dermatitis has been reported with vitamin E used topically.

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

Causes

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