Vitamin E - a comprehensive guide

Vitamin E

Summary

Vitamin E is a fat-soluble vitamin, like vitamins A, D, and K. Nuts, seeds and their oils are the best natural sources of this vitamin – especially sunflower seeds, almond and hazelnuts. There are actually eight different forms of vitamin E found in food – four ‘tocopherols’ and four ‘tocotrienols’. Alpha-tocopherol is thought to be the most biologically active form, and the only form that’s considered in meeting daily vitamin E requirements. Alpha-tocopherol is also the form most commonly found in supplements.

Vitamin E is best known for its role protecting against oxidative stress (free radical damage) in the body. Read on for more information about what vitamin E does, where you can find it and what to look for in a vitamin E supplement.

Primary functions of Vitamin E

  • Vitamin E helps to protect our cells against oxidative stress. This means that it acts as an antioxidant, helping to prevent the formation of free radicals and the damage they can cause to our cells and tissues. Being a fat-soluble vitamin, it may be particularly protective for the cell membranes (which are made primarily from fat) and preventing damage to other fats in the body.
  • Vitamin E may play role in reproduction. One of its functions may be to protect important fats such as DHA during the development of the embryo.[5] Vitamin E may also contribute to male fertility – low levels of vitamin E in the seminal fluid are associated with low sperm count and motility.[6]
  • Vitamin E may support and protect the skin. Vitamin E stored in the body is secreted onto the surface of the skin in sebum [3]. Dietary vitamin E has been found to protect against UV radiation and sunburn (when used in conjunction with vitamin C) [1,2].
  • Vitamin E may play a role in the immune system, through protecting the immune cells (white blood cells) [4] so that they can carry out their normal functions.
  • Vitamin E has anti-clotting properties – it inhibits platelet aggregation [8], which means the sticking together of platelets that causes blood to clot.

How much do we need?

The EU nutrient reference value (NRV) for adults is 12mg, or 18 IU (international units) of the alpha-tocopherol form of vitamin E.  Nutrient reference values replace the old ‘RDAs’ and refer to the amount needed to ensure that the needs of nearly all the population (97.5%) are being met.

Food sources

The best food sources of vitamin E are:

  • Sunflower seeds. They are the highest natural source, providing about 33mg of vitamin E per 100g – equivalent to 5mg per tablespoon, which is about 40 per cent of our NRV.
  • Nuts: especially almonds (26mg/100g), hazelnuts (15mg/100g), then followed by pine nuts, Brazil nuts, pecans and pistachios.
  • Nut and seed oils are also rich in vitamin E – however, we don’t encourage the use of standard sunflower oil or other seed-based cooking oils. Healthy alternatives are cold-pressed seeds or nut oils such as flaxseed oil or walnut oil, which should not be cooked with – they are best used as salad dressings.
  • Wheat germ may provide around 20mg per 100g.
  • Avocadoes can provide around 4mg or one third or our NRV per large avocado.

Deficiency signs and symptoms

Deficiency in vitamin E is rare – it’s not too difficult to get enough in our food. Deficiency mainly occurs in people who have a long-term health condition reducing their absorption of vitamin E, or those with a genetic abnormality that interferes with normal regulation of vitamin E in the blood. For these individuals, deficiency symptoms may include muscle weakness, poor immunity, and a type of anaemia. [7]

Forms and bioavailability

Types of alpha tocopherol

Most supplements provide vitamin E in the form of alpha-tocopherol, which is thought to be the most biologically active. Even within alpha tocopherol, there are different types:

  • A ‘natural’ form, usually labelled D-alpha tocopherol, and a ‘synthetic’ form, usually labelled DL-alpha tocopherol. The synthetic form is said to only have half the biological activity of the natural form [9], and so in supplements, the natural form is generally considered the best type to take.
  • Vitamin E esters, such as alpha-tocopherol succinate and alpha-tocopherol acetate (in either the D- or DL- forms). They can be absorbed and used by the body as easily as ‘free form’ alpha tocopherol, and may even be more useful in certain conditions – so don’t worry if your vitamin E or multivitamin supplement contains these forms.

Other tocopherols/tocotrienols

But what about the other forms of vitamin E apart from alpha tocopherol? As mentioned above, there are actually four types of tocopherols and four tocotrienols found in food, all of which can be called vitamin E. Although alpha tocopherol is generally considered the most biologically active of these, other types may have their own important and unique functions. Gamma tocopherol is said to be the primary form found in foods [9,10] and has been widely studied. The tocotrienols may also have specific protective effects in the body and possibly greater antioxidant activity than alpha tocopherol [11,12].

In the next section, we look at how you can incorporate these factors into your choice of supplements.

What to look for when buying a supplement

So considering the points above, the following may be the best types of vitamin E supplements to look for, in order of preference. (Note that these are just indications and should not be used over the advice of your healthcare practitioner.)

  1. A mixed tocopherols and tocotrienols supplement, or a ‘food form’ vitamin E supplement that naturally provides all eight forms. Because the tocopherols and tocotrienols are found together in foods, they may be best taken in supplements as a family too.
  2. Mixed tocopherols, or natural D-alpha tocopherol with mixed tocopherols – for the same reason as above. These is a greater choice of supplements containing mixed tocopherols compared to combinations of tocopherols and tocotrienols.
  3. Natural D-alpha tocopherol on its own. Again, vitamin E ‘esters’ such as succinate or acetate are equally effective.

Your healthcare practitioner may also advise specific types of vitamin E for certain purposes: for example, tocotrienols only, or a blend that has a higher amount of gamma tocopherol.

Dosages: Lifestyle Labs’ recommendations

Adults: Dosages in individual vitamin E supplements can vary from around 100 IU to 1,000 IU. For general daily or long-term use, we recommend sticking to 100–400 IU daily. 1,000 IU is considered a high dose and may be recommended by a practitioner for a specific purpose or for a certain period of time. For anyone taking an individual vitamin E supplement providing more than 200 IU, we would also recommend taking a vitamin C supplement (or a mixed antioxidant supplement), as vitamin C recycles vitamin E and converts it back to its antioxidant form.

Children: Individual vitamin E supplements are not generally used for children other than under the guidance of a practitioner.

Safety

If you are taking any medications or have any medical condition, please consult your healthcare practitioner before taking vitamin E. In particular, vitamin E should not be taken by those on anti-coagulant (blood-thinning) medication unless advised by a healthcare practitioner.

Also see above under ‘Dosages: Lifestyle Labs’ recommendations’ for more guidance on long-term use of vitamin E and advised dosages.

 

 

REFERENCES:

  1. 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 Dec;25(9):1006-12.
  2. Eberlein-König 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 Jan;38(1):45-8.
  3. Thiele JJ, Weber SU, Packer L. Sebaceous gland secretion is a major physiologic route of vitamin E delivery to skin. J Invest Dermatol. 1999 Dec;113(6):1006-10.
  4. Tengerdy RP. Vitamin E, immune response, and disease resistance. Ann N Y Acad Sci. 1989;570:335-44.
  5. Lebold KM et al. Interactions between α-tocopherol, polyunsaturated fatty acids, and lipoxygenases during embryogenesis. Free Radic Biol Med. 2014 Jan;66:13-9.
  6. Diafouka F, Gbassi GK. Deficiency of alpha-tocopherol in seminal fluid as a probable factor in low fertility in Côte d'Ivoire. Afr J Reprod Health. 2009 Sep;13(3):123-5.
  7. Osiecki, H. (n.d.). The Nutrient Bible. 9th ed. Bio Concepts Publishing, pp.78-79.
  8. Freedman JE, Keaney JF Jr. Vitamin E inhibition of platelet aggregation is independent of antioxidant activity. J Nutr. 2001 Feb;131(2):374S-7S.
  9. http://lpi.oregonstate.edu/mic/vitamins/vitamin-E [This link leads to a website provided by the Linus Pauling Institute at Oregon State University. Lifestyle Labs is not affiliated or endorsed by the Linus Pauling Institute or Oregon State University.]
  10. Jiang Q et al. gamma-tocopherol, the major form of vitamin E in the US diet, deserves more attention. Am J Clin Nutr. 2001 Dec;74(6):714-22.
  11. Osiecki, H. (n.d.). The Nutrient Bible. 9th ed. Bio Concepts Publishing, p.81.
  12. Patel V et al. Tocotrienols: the lesser known form of natural vitamin E. Indian J Exp Biol. 2011 Oct;49(10):732-8.

 

 

       

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      Dr. Lifestyle

      Dr. Lifestyle is our own collective of leading health, nutrition and fitness experts. Having several brains makes it really hard to decide what we feel like for breakfast (Chia Coconut Pudding, or a Green Smoothie?), but when it comes to health advice we are an all-knowing, hyper-intelligent, super human.