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Vitamin E is a fat-soluble organic compound that the body needs to remain healthy. Humans cannot make vitamin E, so they must get it from foods in their diet. Vitamin E comes in eight forms. The most biologically active form in humans is alpha-toco-pherol. Most vitamin E in dietary supplements is synthetically manufactured alpha-tocopherol.
Vitamin E is one of the more poorly understood and controversial vitamins. Its exact functions are not completely clear. Vitamin E is an antioxidant. Antioxidants help protect the body against damage caused by free radicals. Free radicals are formed during normal metabolic processes. The quantity of free radicals in the body may also be increased by exposure to environmental toxins, ultraviolet light, and radiation. Free radicals have a strong tendency to react with and damage other compounds, especially those in DNA (genetic material) and certain fats (lipids) in cell membranes. Antioxidants prevent this damage by reacting with free radicals to neutralneutralize
Age Recommended Dietary Allowance Tolerable Upper Intake Level
Children 0–6 mos. 6.0 IU (AI) 4 mg (AI) Not established
Children 7–12 mos. 7.5 IU (AI) 5 mg (AI) Not established
Children 1–3 yrs. 9.0 IU 6 mg 300 IU 200 mg
Children 4–8 yrs. 10.5 IU 7 mg 450 IU 300 mg
Children 9–13 yrs. 16.5 IU 11 mg 900 IU 600 mg
Children 14–18 yrs. 22.5 IU 15 mg 1,200 IU 800 mg
Adult 19≥ yrs. 22.5 IU 15 mg 1,500 IU 1,000 mg
Pregnant women 22.5 IU 15 mg 1,500 IU 1,000 mg
Breastfeeding women 28.5 IU 19 mg 1,500 IU 1,000 mg
Food Vitamin E (IU) Vitamin E (mg)
Wheat germ oil, 1 tbsp. 30.5 20.3
Almonds, roasted, 1 oz. 11 7.4
Sunflower oil, 1 tbsp. 8.5 5.6
Hazelnuts, roasted, 1 oz. 6.5 4.3
Peanut butter, fortified, 1 oz. 6 4.2
Safflower oil, 1 tbsp. 6 4.6
Avocado, 1 med. 5 3.4
Olive oil, 1 tbsp. 3 1.9
Peanuts, roasted, 1 oz. 3 2.2
Spinach, raw, ½cup 3 1.8
Spinach, cooked, ½cup 2.5 1.6
Kiwi, 1 med. 1.5 1.1
Mango, sliced, ½cup 1.5 0.9
(Illustration by GGS Information Services/Thomson Gale.)
them. The damage that free radicals cause to cells is believed to play a role in the development of certain diseases, especially cancer. Many of the health claims for vitamin E are based on its antioxidant properties.
Vitamin E is a collection of eight different, but closely related, compounds. These are alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol. Each of these compounds has a different degree of activity in humans. Alpha-tocopherol is the most active form. Vitamin E in dietary supplements is usually a synthetic compound called alpha-tocopherol acetate. Synthetic alpha-tocopherol is sometimes labeled dl-alpha-tocopherol.
Normal vitamin E requirements
The United States Institute of Medicine (IOM) of the National Academy of Sciences has developed values called Dietary Reference Intakes (DRIs) for vitamins and minerals. The DRIs consist of three sets of numbers. The Recommended Dietary Allowance (RDA) defines the average daily amount of the nutrient needed to meet the health needs of 97-98% of the population. The Adequate Intake (AI) is an estimate set when there is not enough information to determine an RDA. The Tolerable Upper Intake Level (UL) is the average maximum amount that can be taken daily without risking negative side effects. The DRIs are calculated for children, adult men, adult women, pregnant women, and breastfeeding women.
The IOM has not set RDA or UL values for vitamin E in children under one year old because of incomplete scientific information. Instead, it has set AI levels for this age group. Recently the UL level has become somewhat controversial and has been challenged by some researchers as being set too high. AI and UL levels are measured in both weight (milligrams or mg) and international units (IU). The IU measurement is the measurement used on dietary supplement labels. For the alpha-tocopherol form of vitamin E, 1 mg equals about 1.5 IU.
The following are the AIs, RDAs, and ULs for alpha-tocopherol for healthy individuals:
infants birth-6 months: AI 6 IU or 4 mg
infants 7-12 months: AI 7.5 IU or 5 mg
children 1-3 years: RDA 9 IU of 6 mg; UL 300 IU or 200 mg .
children 4-8 years: RDA 10.5 IU or 7 mg; UL 450 IU or 300 mg .
children 9-13 years: RDA 16.5 IU or 11 mg; UL 900 IU or 600 mg .
children 14-18 years: RDA 22.5 IU or 15 mg; UL 1,200 IU or 800 mg .
adults age 19 and older: RDA 22.5 IU or 15 mg; UL 1,500 IU or 1,000 mg .
pregnant women: RDA 22.5 IU or 15 mg; UL 1,500 IU or 1,000 mg .
breastfeeding women: RDA 28.5 IU or 19 mg; UL 1,500 IU or 1,000 mg
Sources of vitamin E
Vitamin E is found in limited amounts in a small number of foods. These include some oils, nuts, and green leafy vegetables. Vitamin E is also added to some breakfast cereals, which say"fortified with vitamin E" on the label. In addition, the Food and Drug Administration requires all foods containing olestra, a compound that reduces fat absorption, to be fortified with the fat-soluble vitamins A, D, E, and K.
The following list gives the approximate vitamin E (alpha-tocopherol) content for some common foods:
Antioxidant —A molecule that prevents oxidation. In the body antioxidants attach to other molecules called free radicals and prevent the free radicals from causing damage to cell walls, DNA, and other parts of the cell.
Dietary supplement —A product, such as a vitamin, mineral, herb, amino acid, or enzyme, that is intended to be consumed in addition to an individual's diet with the expectation that it will improve health.
Fat-soluble vitamin —A vitamin that dissolves in and can be stored in body fat or the liver.
Retina —The layer of light-sensitive cells on the back of the eyeball that function in converting light into nerve impulses.
Vitamin —A nutrient that the body needs in small amounts to remain healthy but that the body cannot manufacture for itself and must acquire through diet.
wheat germ oil, 1 Tablespoon: 30.5 UL or 20.3 mg
olive oil, 1 Tablespoon: 3 UL or 1.9 mg . sunflower oil, 1 Tablespoon: 8.5 UL or 5.6 mg
safflower oil, 1 Tablespoon: 6 UL or 4.6 mg . almonds, roasted, 1 ounce: 11 UL or 7.4 mg
peanuts, roasted, 1 ounce: 3 UL or 2.2 mg . peanut butter, fortified, 1 ounce: 6 UL or 4.2 mg
hazelnuts, roasted, 1 ounce: 6.5 UL or 4.3 mg . spinach, cooked ½ cup: 2.5 UL or 1.6 mg
spinach, raw ½ cup: 3 UL or 1.8 mg . mango, ½ cup sliced: 1.5 UL or 0.9 mg
kiwi, 1 medium: 1.5 UL or 1.1 mg . avocado, 1 medium: 5 UL or 3.4 mg
multivitamin: 30-60 IU or 20-40 mg . vitamin E dietary supplement: 400-800 IU or 270-530 mg
Vitamin E's role in health
Vitamin E's role in health not completely clear, but experts do agree on what happens when vitamin E is absent from the diet. Vitamin E deficiency results in damage to the nerves, especially the nerves of the hands and feet, loss of coordination, a poor sense of balance, and muscle weakness. The retina of the eye can also be damaged, resulting in loss of vision. Signs of vitamin E deficiency often take years to develop in adults; the results are seen much sooner in children.
Almost all healthy people living in the developed world get enough vitamin E through diet to prevent symptoms of vitamin E deficiency from developing. There is some debate, however, about the frequency with which deficiencies exist that do not produce obvious symptoms (subclinical deficiencies). Those at greatest risk for vitamin E deficiency include:
severely premature infants who weigh less that 3 lb 4 oz (1,500 g) at birth
people with gastrointestinal diseases such as Crohn's disease, cystic fibrosis, or inflammatory bowel disease that interfere with the absorption of fat from the intestine
people who have had part of their stomach or intestine surgically removed for weight loss or other reasons . people eating very low fat diets for an extended time
people with anorexia nervosa (self-starvation)
people with the rare inherited disorders abetalipo-proteinemia and ataxia and vitamin E deficiency (AVED), both of which prevent normal use of vitamin E
Controversy about vitamin E centers on its use as a dietary supplement to help prevent or treat disease. Many health claims are based on the antioxidant properties of vitamin E. Initially, it appeared that large doses of vitamin E could help prevent heart disease and some cancers. Then in 2004, researchers at the Johns Hopkins University School of Medicine re-analyzed the data (a meta-analysis) from 19 major clinical trials that included more than 136,000 individuals. They found that taking 400IU or more of vitamin E daily increased a person's risk of death by about 4%. However, some experts have questioned the validity of the Johns Hopkins analysis. The role of vitamin E is further complicated by the fact that it comes in many forms, and researchers are not completely clear on what, if any, roles the different forms play in maintaining human health. Clinical trials are currently underway to determine safety and effectiveness of vitamin E in a variety of situations. Individuals interested in participating in a clinical trial at no charge can find a list of open trials http://www.clinicaltrials.gov.
CARDIOVASCULAR DISEASE. Since the 1940s, researchers have suggested that vitamin E might protect against heart disease. This theory is based on its activity as an antioxidant. Because vitamin E oxidizes (neutralizes) LDL or"bad" cholesterol, researchers have suggested that large doses of vitamin E may slow or prevent the build-up of material on the wall of arteries and thus help prevent cardiovascular disease.
Results of studies testing this idea are mixed. Several large studies followed healthy people who took vitamin E and looked for a correlation between the amount of vitamin E in their diet and whether they were diagnosed with heart disease or died of a heart attack. Two studies found that people who got least 7 mg of alpha-tocopherol daily from food were about one-third less likely to die from heart disease than those people who consumed 5 mg of less of alpha-tocopherol. On the other hand, another large, well-designed study (the Heart Outcomes Prevention Evaluation) found no cardiovascular benefit to large doses of vitamin E. A well-controlled study (the CHAOS study) done in Great Britain found that when people who already had heart disease were given large doses (400 IU or 800 IU) of Vitamin E, the rate of non-fatal heart attacks dropped dramatically, but that the overall death rate from heart disease did not change.
The official position of the American Heart Association published in its"Diet and Lifestyle Recommendations Revision 2006" is that"Antioxidant supplements have not been shown to be helpful in preventing heart disease and are not recommended in these guidelines." The recommendations specifically mention the possibility of"an increased risk of heart failure and the possibility of increased total mortality (death) from high dose vitamin E supplements." More research needs to be done in this area.
CANCER. The antioxidant activities of vitamin E are also thought to help protect against the development of cancer by removing free radicals that damage cell membranes and DNA. Vitamin E is also believed to neutralize nitrosamines. Nitrosamines are known carcinogens found in tobacco and smoked meats. Much of the evidence for the action of vitamin E on cancer comes from animal studies. The results of human studies are inconclusive and often confusing. According to the American Cancer Society, there is some evidence that vitamin E may have a protective effect against coon, rectal, bladder, and prostate cancer, but not other cancers. There is no evidence that vitamin E slows the growth of cancer once it has already developed, and some conflicting evidence about whether it interferes with the effectiveness of chemotherapy and radiation therapy. Research on the relationship of vitamin E and cancer continues.
CATARACTS. Cataracts form on the lens of the eye, making it cloudy and reducing vision. They are thought to form because proteins in the lens are oxidized. Ten studies have been done to see if the antioxidant properties of vitamin E are effective in preventing cataracts. Five studies found a protective effect, while five others found no effect.
There is a great deal of debate about how much vitamin E is too much. The UL for healthy adults in the United States is 1,500 IU daily. However, some experts feel this is too high, especially since it is based on research done in the 1950s. They argue that UL should be lower since the Johns Hopkins study found that daily amounts over 400 IU increased the death rate and protective effects of larger doses of vitamin E are still unproven. In the United Kingdom, the recommended daily limit of vitamin E is 800 UI.
Large doses of vitamin E increase the chance of bleeding. People who are taking blood-thinning medications such as warfarin (Coumadin), heparin, and clopidogrel (Plavix) should discuss the use of vitamin E with their healthcare providers. Other people who should be wary of taking vitamin E as a dietary supplement are those who are vitamin K deficient, who have liver damage, and those with a history of bleeding ulcers. Vitamin E supplementation should be stopped about one month before surgery because of the increased risk of bleeding. Other possible, but uncommon, side effects of vitamin E supplementation include nausea, vomiting, diarrhea, damage to the retina, breast soreness, fatigue, emotional disturbances, and thyroid hormone disturbances.
Vitamin E may interact with the following:
When taken with blood-thinning drugs, vitamin E may increase the likelihood of bleeding.
When taken with nonsteroidal anti-inflammatory (NSAIDs) drugs such as ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn), vitamin E may increase the likelihood of bleeding.
Cholestyramine (Questran) and colestipol (Colestid) may decrease vitamin E absorption.
Orlistat (Xenical, Alli) decreases Vitamin E absorption.
Olestra, a fat substitute in foods, decreases the absorption of vitamin E.
No complications are expected when vitamin E is used in the recommended amounts. The complications resulting from insufficient or excess use are discussed above.
Gaby, Alan R., ed. A-Z Guide to Drug-Herb-Vitamin Interactions Revised and Expanded 2nd Edition: Improve Your Health and Avoid Side Effects When Using Common Medications and Natural Supplements Together. New York: Three Rivers Press, 2006.
Lieberman, Shari and Nancy Bruning. The Real Vitamin and Mineral Book: The Definitive Guide to Designing Your Personal Supplement Program, 4th ed. New York: Avery, 2007.
Preedy, Victor R. and Ronald R. Watson, eds. The Encyclopedia of Vitamin E. Wallingford, Oxfordshire, UK : CABI International, 2007.
Pressman, Alan H. and Sheila Buff. The Complete Idiot's Guide to Vitamins and Minerals, 3rd ed. Indianapolis, IN: Alpha Books, 2007.
Rucker, Robert B., ed. Handbook of Vitamins. Boca Raton, FL: Taylor & Francis, 2007.
Schardt, David."Is Vitamin E Dangerous?" Nutrition Action Healthletter 32, no.4 (May 1, 2005):12.
American Cancer Society. 1599 Clifton Road NE, Atlanta GA 30329-4251. Telephone: (800) ACS-2345. Website: <http://www.cancer.org.>
American Heart Association. 7272 Greenville Avenue, Dallas, TX 75231. Telephone: (800) 242-8721. Website: <http://www.americanheart.org.>
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: http://www.eatright.org/
Linus Pauling Institute. Oregon State University, 571 Weniger Hall, Corvallis, OR 97331-6512. Telephone: (541) 717-5075. Fax: (541) 737-5077. Website: <http://lpi.oregonstate.edu/>
Office of Dietary Supplements, National Institutes of Health. 6100 Executive Blvd., Room 3B01, MSC 7517, Bethesda, MD 20892-7517 Telephone: (301)435-2920. Fax: (301)480-1845. Website: <http://dietary-supplements.info.nih.gov/>
American Cancer Society"Vitamin E." American Cancer Society, June 1, 2005. <http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Vitamin_E.asp?sitearea=ETO.>
American Heart Association Nutrition Committee."Diet and Lifestyle Recommendations Revision 2006." American Heart Association, June 19, 2006. <http://www.americanheart.org/presenter.jhtml?identifier=3040741>
Higdon, Jane."Vitamin E."Linus Pauling Institute-Oregon State University, November 11, 2004. <http://lpi.oregonstate.edu/infocenter/vitamins/VitaminE
Harvard School of Public Health."Vitamins." Harvard University, November 10, 2006. <http://www.hsph.harvard.edu/nutritionsource/vitamins.html>
Johns Hopkins University School of Medicine. "Study Shows High-dose Vitamin E Supplements May Increase Risk of Dying." Johns Hopkins University, November 10. 2004. <http://www.hopkinsmedicine.org/Press_releases/2004/11_10_04.html>
Maryland Medical Center Programs Center for Integrative Medicine. "Vitamin E." University of Maryland Medical Center, April 2002. <http://www.umm.edu/altmed/ConsSupplements/VitaminEcs.html.>
Medline Plus."Vitamin E." U. S. National Library of Medicine, August 1, 2006. <http://www.nlm.nih/gov/medlineplus/druginfo/natural/patient-vitamine.html>
Office of Dietary Supplements."Vitamin E."National Institutes of Health, January 23, 2007. <http://dietary-supplements.info.nih.gov/factsheets/vitamine.asp>
Tish Davidson, A.M.
The Gale Encyclopedia of Diets: A Guide to Health and Nutrition
"Vitamin E ." The Gale Encyclopedia of Diets: A Guide to Health and Nutrition. . Encyclopedia.com. 17 Jan. 2023 <https://www.encyclopedia.com>.
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"Vitamin E ." The Gale Encyclopedia of Diets: A Guide to Health and Nutrition. . Retrieved January 17, 2023 from Encyclopedia.com: https://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/vitamin-e
views updated Jun 11 2018
Vitamin E is an antioxidant responsible for proper functioning of the immune system and for maintaining healthy eyes and skin. It is actually a group of fat soluble compounds known as tocopherols (i.e., alpha tocopherol and gamma tocopherol). Gamma tocopherol accounts for approximately 75% of dietary vitamin E. Vitamin E rich foods include nuts, cereals, beans, eggs, cold-pressed oils, and assorted fruits and vegetables. Because vitamin E is a fat soluble vitamin, it requires the presence of fat for proper absorption. Daily dietary intake of the recommended daily allowance (RDA) of vitamin E is recommended for optimum health.
Vitamin E is absorbed by the gastrointestinal system and stored in tissues and organs throughout the body. Certain health conditions may cause vitamin E depletion, including liver disease, celiac disease , and cystic fibrosis. Patients with end-stage renal disease (kidney failure) who are undergoing chronic dialysis treatment may be at risk for vitamin E deficiency. These patients frequently receive intravenous infusions of iron supplements, which can act against vitamin E.
Vitamin E deficiency can cause fatigue , concentration problems, weakened immune system, anemia , and low thyroid levels. It may also cause vision problems and irritability. Low serum (or blood) levels of vitamin E have also been linked to major depression .
Vitamin E is necessary for optimal immune system functioning, healthy eyes, and cell protection throughout the body. It has also been linked to the prevention of a number of diseases. The therapeutic benefits of vitamin E include:
Cancer prevention and treatment. Vitamin E is a known antioxidant, and has been associated with a reduced risk of gastrointestinal, cervical, prostate, lung, and possibly breast cancer . In addition to its role as a cancer preventive, vitamin E is being studied as a cancer treatment. It has been shown to inhibit the growth of prostate tumors and to induce apoptosis (cell self-destruction) in cancer cells. Vitamin E is also being investigated as an adjunctive treatment for cancer patients undergoing radiation therapy; it is thought that high doses of dietary antioxidants may increase the efficacy of the radiation treatment while protecting healthy cells against damage.
Immune system protection. Various studies have shown that vitamin E supplementation, particularly in elderly patients, boosts immune system function. Older patients have demonstrated improved immune response, increased resistance to infections , and higher antibody production. Vitamin E has also been used with some success to slow disease progression in HIV-positive patients.
Eye disease prevention. Clinical studies on vitamin E have shown that supplementation significantly reduces the risk for cataracts and for macular degeneration , particularly among women.
Memory loss prevention. Vitamin E deficiency has been linked to poor performance on memory tests in some elderly individuals.
Alzheimer's disease (AD) treatment. In a study performed at Columbia University, researchers found that Alzheimer's patients who took daily supplements of vitamin E maintained normal functioning longer than patients who took a placebo. In 2002, a group of Dutch epidemiologists reported on a much larger populationbased study conducted in the Netherlands between 1990 and 1993, with follow-up examinations in 1994 and 1999. The study confirmed the findings of the Columbia researchers, that high dietary intake of vitamin E lowers the risk of developing AD.
Liver disease treatment. Vitamin E may protect the liver against disease.
Diabetes treatment. Vitamin E may help diabetic patients process insulin more effectively. It has also been found to be effective in the treatment of diabetic neuropathy, a family of nerve disorders caused by diabetes. Vitamin E appears to reduce the symptoms of diabetic neuropathy and to improve the speed of transmission of nerve impulses.
Pain relief. Vitamin E acts as both an anti-inflammatory and analgesic (or pain reliever). Studies have indicated it may be useful for treatment of arthritis pain in some individuals.
Parkinson's disease prevention. High doses of vitamin E intake was associated with a lowered risk of developing Parkinson's disease in one 1997 Dutch study.
Tardive dyskinesia treatment. Individuals who take neuroleptic drugs for schizophrenia or other disorders may suffer from a side effect known as tardive dyskinesia, in which they experience involuntary muscle contractions or twitches. Vitamin E supplementation may lessen or eliminate this side effect in some individuals.
Porphyria treatment. Vitamin E has been found to be beneficial in treating patients with porphyria, a group of disorders characterized by abnormalities in the metabolism of blood pigments, by lowering the level of excretion of these blood pigments in the urine.
Other benefits of vitamin E are less clear cut, and have been called into question with conflicting study results or because of a lack of controlled studies to support them. These include:
Heart disease prevention. A number of epidemiological studies have indicated that vitamin E may prevent heart disease by lowering total blood cholesterol levels and preventing oxidation of LDL cholesterol. However, a large, controlled study known as the Heart Outcomes Prevention Evaluation (HOPE) published in early 2000 indicates that vitamin E does not have any preventative effects against heart disease. The study followed 9,500 individuals who were considered to be at a high risk for heart disease. Half the individuals were randomly chosen to receive vitamin E supplementation, and the other half of the study population received a placebo. After five years, there was no measurable difference in heart attacks and heart disease between the two patient populations. Still, vitamin E may still hold some hope for heart disease prevention. It is possible that a longer-term study beyond the five years of the HOPE study may demonstrate some heart protective benefits of vitamin E consumption. It is also possible that while the high-risk patient population that was used for the HOPE study did not benefit from vitamin E, an average-risk patient population might still benefit from supplementation. It is also possible that vitamin E needs the presence of another vitamin or nutrient substance to protect against heart disease. Further large, controlled, and long-term clinical studies are necessary to answer these questions.
Skin care. Vitamin E is thought to increase an individual's tolerance to UV rays when taken as a supplement in conjunction with vitamin C . Vitamin E has also been touted as a treatment to promote faster healing of flesh wounds . While its anti-inflammatory and analgesic properties may have some benefits in reducing swelling and relieving discomfort in a wound, some dermatologists dispute the claims of faster healing, and there are no large controlled studies to support this claim.
Hot flashes . In a small study conducted at the Mayo Clinic, researchers found that breast cancer survivors who suffered from hot flashes experienced a decrease in hot flashes after taking vitamin E supplementation.
Muscle maintenance and repair. Recent research has demonstrated that the antioxidative properties of vitamin E may prevent damage to tissues caused by heavy endurance exercises. In addition, vitamin E supplementation given prior to surgical procedures on muscle and joint tissues has been shown to limit reperfusion injury (muscle damage that occurs when blood flow is stopped, and then started again to tissues or organs).
Fertility. Vitamin E has been shown to improve sperm function in animal studies, and may have a similar effect in human males. Further studies are needed to establish the efficacy of vitamin E as a treatment for male infertility ; as of 2002, its role in such treatment is still controversial.
The U.S. recommended dietary allowance (RDA) of the alpha-tocopherol formulation of vitamin E is as follows:
men: 10 mg or 15 IU
women: 8 mg or 12 IU
pregnant women: 10 mg or 15 IU
lactating women: 12 mg or 18 IU
In April 2000, the National Academy of Sciences recommended changing the RDA for vitamin E to 22 international units (IUs), with an upper limit (UL), or maximum daily dose, of 1500 IUs. Daily values for the vitamin as recommended by the U.S. Food and Drug Administration, the values listed on food and beverage labeling, remain at 30 IUs for both men and women age four and older.
Many nuts, vegetable-based oils, fruits, and vegetables contain vitamin E. Foods rich in vitamin E include wheat germ oil (26.2 mg/tbsp), wheat germ cereal (19.5 mg/cup), peanuts (6.32 mg/half cup), soybeans (3.19 mg/cup), corn oil (2.87/tbsp), avocado (2.69 mg), and olive oil (1.68 mg/tbsp.). Grapes, peaches, broccoli, Brussels sprouts, eggs, tomatoes, and blackberries are also good sources of vitamin E. Fresh, raw foods contain the highest levels of the vitamin. Both heat and light can reduce vitamin and mineral potency in fresh foods, so overcooking and improper storage should be avoided. Sliced and chopped foods have more of their surface exposed to light, therefore keeping vegetables and fruits whole may also help to maintain full vitamin potency.
For individuals considered at risk for vitamin E deficiency, or those with an inadequate dietary intake, vitamin E supplements are available in a variety of different forms, including pills, capsules, powders, and liquids for oral ingestion. For topical use, vitamin E is available in ointments, creams, lotions, and oils. Vitamin E is also available commercially as one ingredient of a multivitamin formula.
The recommended daily dosage of vitamin E varies by individual need and by the amount of polyunsaturated fats an individual consumes. The more polyunsaturated fats in the diet, the higher the recommended dose of vitamin E, because vitamin E helps to prevent the oxidizing effects of these fats. Because vitamin E is fat soluble, supplements should always be taken with food.
Supplements are also available in either natural or synthetic formulations. Natural forms are extracted from wheat germ oil and other vitamin E food sources, and synthetic forms are extracted from petroleum oils. Natural formulas can be identified by a d prefix on the name of the vitamin (i.e., d-alpha-tocopherol).
Overdoses of vitamin E (over 536 mg) can cause nausea, diarrhea, headache , abdominal pain, bleeding, high blood pressure, fatigue, and weakened immune system function.
Patients with rheumatic heart disease, iron deficiency anemia, hypertension , or thyroid dysfunction should consult their healthcare provider before starting vitamin E supplementation, as vitamin E may have a negative impact on these conditions.
Vitamin E is well-tolerated, and side effects are rare. However, in some individuals who are vitamin K deficient, vitamin E may increase the risk for hemorrhage or bleeding. In some cases, side effects may be decreased or eliminated by adjusting the dosage of vitamin E and vitamin K.
Although the reasons are not yet clear, high intake of vitamin E has been associated with a statistically significant increased risk of breast cancer in men.
Vitamin E ointments, oils, or creams may trigger an allergic reaction known as contact dermatitis . Individuals who are considering using topical vitamin E preparations for the first time, or who are switching the type of vitamin E product they use, should perform a skin patch test to check for skin sensitivity to the substance. A small, dime sized drop of the product should be applied to a small patch of skin inside the elbow or wrist. The skin patch should be monitored for 24 hours to ensure no excessive redness, irritation, or rash occurs. If a reaction does occur, it may be in response to other ingredients in the topical preparation, and the test can be repeated with a different vitamin E formulation. Individuals who experience a severe reaction to a skin patch test of vitamin E are advised not to use the product topically. A dermatologist or other healthcare professional may be able to recommend a suitable alternative.
Individuals who take anticoagulant (blood thinning) or anticonvulsant medications should consult their healthcare provider before starting vitamin E supplementation. Vitamin E can alter the efficacy of these drugs.
It is important for persons taking supplemental vitamin E to tell their surgeon if they are scheduled for an operation. Vitamin E may interact with some of the medications given prior to or during surgery; it has also been shown to increase bleeding time if the patient is taking such other herbal preparations as feverfew or gingko biloba.
Non-heme, inorganic iron supplements destroy vitamin E, so individuals taking iron supplements should space out their doses (e.g., iron in the morning and vitamin E in the evening).
Large doses of vitamin A can decrease the absorption of vitamin E, so dosage adjustments may be necessary in individuals supplementing with both vitamins.
Alcohol and mineral oil can also reduce vitamin E absorption, and these substances should be avoided if possible in vitamin E deficient individuals.
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American Dietetic Association. 216 West Jackson Blvd., Chicago, IL 60606. (312) 899-0040. <www.eatright.org>.
United States Department of Agriculture. Center for Nutrition Policy and Promotion. 1120 20th Street NW, Suite 200, North Lobby, Washington, D.C. 20036. (202) 418-2312. <www.usda.gov/cnpp>.
United States Food and Drug Administration (FDA). 5600 Fishers Lane, Rockville, MD 20857. (888) 463-6332. <www.fda.gov>.
Paula Ford-Martin
Rebecca J. Frey, PhD
Gale Encyclopedia of Alternative Medicine Ford-Martin, Paula; Frey, Rebecca
Ford-Martin, Paula; Frey, Rebecca "Vitamin E ." Gale Encyclopedia of Alternative Medicine. . Encyclopedia.com. 17 Jan. 2023 <https://www.encyclopedia.com>.
Ford-Martin, Paula; Frey, Rebecca "Vitamin E ." Gale Encyclopedia of Alternative Medicine. . Encyclopedia.com. (January 17, 2023). https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/vitamin-e
Ford-Martin, Paula; Frey, Rebecca "Vitamin E ." Gale Encyclopedia of Alternative Medicine. . Retrieved January 17, 2023 from Encyclopedia.com: https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/vitamin-e
Vitamin E is absorbed by the gastrointestinal system and stored in tissues and organs throughout the body. Certain health conditions may cause vitamin E depletion, including liver disease, celiac disease, and cystic fibrosis . Patients with end-stage renal disease (kidney failure) who are undergoing chronic dialysis treatment may be at risk for vitamin E deficiency. These patients frequently receive intravenous infusions of iron supplements which can act against vitamin E.
Vitamin E deficiency can cause fatigue, concentration problems, weakened immune system, anemia, and low thyroid levels. It may also cause vision problems and irritability. Low serum (or blood ) levels of vitamin E have also been linked to major depression.
Cancer prevention. Vitamin E is a known antioxidant, and has been associated with a reduced risk of gastrointestinal, cervical, prostate, lung, and possibly breast cancer .
Immune system protection. Various studies have shown that vitamin E supplementation, particularly in elderly patients, boosts immune system function. Older patients have demonstrated improved immune response , increased resistance to infections, and higher antibody production. Vitamin E has also been used with some success to slow disease progression in HIV-positive patients.
Alzheimer's disease treatment. In a study performed at Columbia University, researchers found that Alzheimer's patients who took daily supplements of vitamin E maintained normal functioning longer than patients who took a placebo.
Diabetes treatment. Vitamin E may help diabetic patients process insulin more effectively.
Hot flashes. In a small study conducted at the Mayo Clinic, researchers found that breast cancer survivors who suffered from hot flashes experienced a decrease in those hot flashes after taking vitamin E supplementation.
Muscle maintenance and repair. Recent research has demonstrated that the antioxidative properties of vitamin E may prevent damage to tissues caused by heavy endurance exercises. In addition, vitamin E supplementation given prior to surgical procedures on muscle and joint tissues has been shown to limit reperfusion injury (muscle damage which occurs when blood flow is stopped, and then started again to tissues or organs).
Fertility. Vitamin E has been shown to improve sperm function in animal studies, and may have a similar effect in human males. Further studies are needed to establish the efficacy of vitamin E as a treatment for male infertility.
In April 2000, the National Academy of Sciences recommended changing the RDA for vitamin E to 22 international units (IUs), with an upper limit (UL), or maximum daily dose, of 1500 IUs. Daily values for the vitamin as recommended by the U.S. Food and Drug Administration, the values listed on food and beverage
labeling, remain at 30 IUs for both men and women age four and older.
Many nuts, vegetable-based oils, fruits, and vegetables contain vitamin E. Foods rich in vitamin E include wheat germ oil (26.2 mg/tbsp), wheat germ cereal (19.5 mg/cup), peanuts (6.32 mg/half cup), soy beans (3.19 mg/cup), corn oil (2.87/tbsp), avocado (2.69 mg), and olive oil (1.68 mg/tbsp.). Grapes, peaches, broccoli, Brussels sprouts, eggs, tomatoes, and blackberries are also good sources of vitamin E. Fresh, raw foods contain the highest levels of the vitamin. Both heat and light can reduce vitamin and mineral potency in fresh foods, so overcooking and improper storage should be avoided. Sliced and chopped foods have more of their surface exposed to light, therefore keeping vegetables and fruits whole may also help to maintain full vitamin potency.
The recommended daily dosage of vitamin E varies by individual need and by the amount of polyunsaturated fats an individual consumes. The more polyunsaturated fats in the diet, the higher the recommended dose of vitamin E, because vitamin E helps to prevent the oxidizing
Antioxidants —Enzymes which bind with free radicals to neutralize their harmful effects.
Contact dermatitis —Inflammation, redness, and irritation of the skin caused by an irritating substance.
Epidemiological study —A study which analyzes health events and trends in particular patient populations.
Free radicals —Reactive molecules created during cell metabolism that can cause tissue and cell damage like that which occurs in aging and with disease processes such as cancer.
Macular degeneration —Degeneration, or breakdown, of the retina that can lead to partial or total blindness.
Non-heme iron —Dietary or supplemental iron that is less efficiently absorbed by the body than heme iron (ferrous iron).
Reperfusion —The reintroduction of blood flow to organs or tissues after blood flow has been stopped for surgical procedures.
Vitamin A —An essential vitamin found in liver, orange and yellow vegetables, milk, and eggs that is critical for proper growth and development.
Vitamin K —A fat-soluble vitamin responsible for blood clotting, bone metabolism, and proper kidney function.
effects of these fats. Because vitamin E is fat soluble, supplements should always be taken with food.
Overdoses of vitamin E (over 536 mg) can cause nausea, diarrhea , headache, abdominal pain, bleeding, high blood pressure , fatigue, and weakened immune system function.
Patients with rheumatic heart disease, iron deficiency anemia , hypertension , or thyroid dysfunction should consult their healthcare provider before starting vitamin E supplementation, as vitamin E may have a negative impact on these conditions.
Vitamin E ointments, oils, or creams may trigger an allergic reaction known as contact dermatitis. Individuals who are considering using topical vitamin E preparations for the first time, or who are switching the type of vitamin E product they use, should perform a skin patch test to check for skin sensitivity to the substance. A small, dime sized drop of the product should be applied to a small patch of skin inside the elbow or wrist. The skin patch should be monitored for 24 hours to ensure no excessive redness, irritation, or rash occurs. If a reaction does occur, it may be in response to other ingredients in the topical preparation, and the test can be repeated with a different vitamin E formulation. Individuals who experience a severe reaction to a skin patch test of vitamin E are advised not to use the product topically. A dermatologist or other healthcare professional may be able to recommend a suitable alternative.
Large doses of vitamin A can decrease the absorption of vitamin E, so dosage adjustments may be necessary in individuals supplementing with both vitamins .
"Vitamin E: E for Exaggerated?" Harvard Health Letter 25, no. 5 (March 2000): 6.
United States Department of Agriculture. Center for Nutrition Policy and Promotion. 1120 20th Street NW, Suite 200, North Lobby, Washington, D.C. 20036. (202) 418-2312. <http://www.usda.gov/cnpp/>.
Gale Encyclopedia of Nursing and Allied Health
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Vitamin E is absorbed by the gastrointestinal system and stored in tissues and organs throughout the body. Certain health conditions may cause vitamin E depletion, including liver disease, celiac disease, and cystic fibrosis. Patients with end-stage renal disease(kidney failure) who are undergoing chronic dialysis treatment may be at risk for vitamin E deficiency. These patients frequently receive intravenous infusions of iron supplements which can act against vitamin E.
Cancer prevention. Vitamin E is a known antioxidant, and has been associated with a reduced risk of gastrointestinal, cervical, prostate, lung, and possibly breast cancer.
Immune system protection. Various studies have shown that vitamin E supplementation, particularly in elderly patients, boosts immune system function. Older patients have demonstrated improved immune response, increased resistance to infections, and higher antibody production. Vitamin E has also been used with some success to slow disease progression in HIV-positive patients.
Eye disease prevention. Clinical studies on vitamin E have shown that supplementation significantly reduces the risk for cataracts and for macular degeneration, particularly among women.
Skin care. Vitamin E is thought to increase an individual's tolerance to UV rays when taken as a supplement in conjunction with vitamin C. Vitamin E has also been touted as a treatment to promote faster healing of flesh wounds. While its anti-inflammatory and analgesic properties may have some benefits in reducing swelling and relieving discomfort in a wound, some dermatologists dispute the claims of faster healing, and there are no large controlled studies to support this claim.
In April 2000, the National Academy of Sciences recommended changing the RDA for vitamin E to 22 international units (IUs), with an upper limit (UL), or maximum daily dose, of 1,500 IUs. Daily values for the vitamin as recommended by the U.S. Food and Drug Administration, the values listed on food and beverage labeling, remain at 30 IUs for both men and women age four and older.
Many nuts, vegetable-based oils, fruits, and vegetables contain vitamin E. Foods rich in vitamin E include wheat germ oil (26.2 mg/tbsp), wheat germ cereal (19.5 mg/cup), peanuts (6.32 mg/half cup), soy beans (3.19 mg/cup), corn oil (2.87 mg/tbsp), avocado(2.69 mg), and olive oil (1.68 mg/tbsp). Grapes, peaches, broccoli, Brussels sprouts, eggs, tomatoes, and blackberries are also good sources of vitamin E. Fresh, raw foods contain the highest levels of the vitamin. Both heat and light can reduce vitamin and mineral potency in fresh foods, so overcooking and improper storage should be avoided. Sliced and chopped foods have more of their surface exposed to light, therefore keeping vegetables and fruits whole may also help to maintain full vitamin potency.
Overdoses of vitamin E (over 536 mg) can cause nausea, diarrhea, headache, abdominal pain, bleeding, high blood pressure, fatigue, and weakened immune system function.
Patients with rheumatic heart disease, iron deficiency anemia, hypertension, or thyroid dysfunction should consult their healthcare provider before starting vitamin E supplementation, as vitamin E may have a negative impact on these conditions.
Macular degeneration— Degeneration, or break-down, of the retina that can lead to partial or total blindness.
United States Department of Agriculture. Center for Nutrition Policy and Promotion. 1120 20th Street NW, Suite 200, North Lobby, Washington, D.C. 20036. (202) 418-2312. 〈http://www.usda.gov/cnpp/〉.
Vitamin E is a antioxidant vitamin found in many foods or can be taken as a supplement.
Vitamin E naturally exists in eight different forms; four tocopherols: alpha tocopherol, beta tocopherol, gamma tocopherol, delta tocopherol and four tocotrienols: alpha tocotrienol, beta tocotrienol, gamma tocotrienol and delta tocotrienol. Each form has a slightly different activity in the body. The most active form in humans is alpha tocopherol and vitamin E supplements are often sold as alpha tocopherol acetate.
Synthetic vitamin E is labeled as "D, L" or "d, l" tocopherol. Since only the "D" or "d" form of the vitamin is active, the D, L or d, l form is only half as active as the naturally occurring form, which is D or d. When vitamin E is supplied as a mixture of different forms it is often referred to as mixed tocopherols, which is considered by many to be the most useful form.
The most important role of vitamin E is as an antioxidant protecting cells against free radical damage. Damage by free radicals can lead to several diseases including heart disease and cancer . Although vitamin E deficiency in humans is rare, it can occur in several situations:
People with disorders that affect absorption of fat from the intestines including cystic fibrosis, Crohn's disease or the inherited conditions abetalipoproteinemia, and ataxia and vitamin E deficiency (AVED) may be at risk.
Premature or low birth weight infants and people on a very low fat diet.
Deficiencies in vitamin E are associated with unsteady walking or poor coordination, muscle weakness, nerve degeneration in hands and feet.
Prolonged and severe vitamin E deficiencies can lead to blindness, abnormal heart rhythms and dementia.
A number of investigations are underway to evaluate the ability of vitamin E to prevent chronic disease. Vitamin E has been promoted for the following uses:
as an immune stimulant
prevention of macular degeneration, cataracts, Parkinson's disease, premenstrual syndrome, and cancer
treatment for anemia and angina
prevention or treatment of atherosclerosis
reducing the side effects of cisplatin for chemotherapy
as a cancer treatment itself
prevention of heart disease in dialysis patients
prevention or slowing of dementia
prevention or improvement of diabetes
prevention of scars
lowering high cholesterol levels
Much of the research remains inconclusive or very preliminary. More significant research has been done in the areas of heart disease, cancer, and dementia or Alzheimer's disease.
Because oxidative injury is thought to play a role in the development of both cancer and heart disease it seems logical that taking antioxidants such as vitamin E should reduce the risk of both. Laboratory studies show several small benefits to alpha tocopherol related to cancer and heart disease, such as decreased platelet aggregation and inhibiting cell growth. Several epidemiology studies have also shown a lower risk of heart disease and cancer associated with people who have an increased ingestion of vitamin E either from diet or supplements. However, when randomized, controlled, clinical trials have been done to follow up and confirm a role for vitamin E supplementation in reducing cancer risks or cardiovascular disease risks the results have not usually been positive.
A study published in the Journal of the American Medical Association (JAMA) in 2005 compared individuals taking 400 IU/d of vitamin E (alpha tocopherol) to volunteers taking no vitamin E. After seven years there was no significant difference between groups in the occurrence of cancer or cardiovascular disease. In fact, researchers noticed a slight increase in heart failure in the vitamin E group. A second study from the same year evaluated all published results from studies involving vitamin E. The study concluded that regular high doses of vitamin E (400 IU/day or more) slightly increased the risk of death for any reason compared with individuals who did not take vitamin E. It is, therefore, recommended that doses higher than 400 IU/day be avoided.
In 2008, a review of studies that evaluated the use of vitamin E for Alzheimer's disease was published.
The review found that, although fewer patients taking vitamin E progressed to incapacity compared to control groups who took no vitamin E, more patients taking vitamin E experienced falls . The review concluded that as of yet there is no evidence that vitamin E is beneficial for those with Alzeheimer's disease or mild cognitive impairment.
QUESTIONS TO ASK YOUR PHARMACIST
Is vitamin E useful in treating my condition?
What is the recommended dose for vitamin E supplements?
How do I know if I have vitamin E deficiency?
Will vitamin E supplements interact with my other medications?
Although some studies show that deficiencies of vitamin E are linked to increased risk of heart disease, taking vitamin E supplements does not decrease the risk of heart disease or cancer. The best way to get vitamin E is through food. Foods high in vitamin E include vegetable oils, wheat germ oil in particular; nuts including peanuts; green leafy vegetables; eggs; and whole grains and fortified cereals. Food supplies all eight forms of vitamin E and other antioxidants. Eating a variety of foods is important in order to get enough vitamin E and other antioxidants. Cooking and storage of foods can be detrimental to vitamin E content.
The recommended daily allowance (RDA) for vitamin E in adults is 15 mg or 22.5 International Units (IU). RDAs for vitamin E are only based on alpha tocopherol. Amounts of vitamin E in foods are typically given as IUs. The upper tolerable limit recommended for vitamin E is 1,000 mg (1,500 IUs) daily. Vitamin E deficiency in North Americans is rare with most people getting adequate levels from foods.
Because the FDA does not regulate herbs and supplements, there is no guarantee of strength, purity or safety of these products. Contact dermatitis has been reported with topical use. Recent reports indicate that regular doses of 400 IU or greater per day can slightly increase the risk of death. It is wise to study current research on vitamin E and ask a physician about the latest recommendations. Very few long term studies have been done to document risks or benefits of vitamin E supplementation.
Use of vitamin E should be avoided if the patient has a rare eye condition called retinitis pigmentosa. Taking vitamin E with this condition has been associated with an increased loss of vision. The absorption of vitamin E is dependent on the presence of other fats so vitamin E supplements are best taken with a meal.
Antioxidants —Particles that seek out and destroy free radicals, by-products of oxygen use, to prevent damage to the body.
Contact dermatitis —Rash or irritation of the skin caused by contact with a substance.
Epidemiology —A branch of science that studies the frequency and distribution of disease in a population.
Free radicals —The by-products of oxidation, these molecules can cause damage throughout the body.
Recommended Daily Allowance (RDA) —The amount of a specific nutrient that should be consumed each day for optimal health. This standard is set and periodically updated by U.S. government agencies.
Vitamin E deficiency —Failure to obtain the necessary levels of vitamin E through food.
Vitamin E supplementation at doses higher than 400 IU/day have been associated with increased risk of bleeding, particularly in patients taking anticoagulants such as warfarin, heparin or aspirin . Regular high doses of vitamin E are also linked to increased risk of death from all causes. Caution should be taken when ingesting large amounts of vitamin E.
Side effects for short term use of vitamin E include contact dermatitis on the skin, abdominal pain, diarrhea , nausea, gonadal dysfunction, diminished kidney function, dizziness , fatigue, headache, weakness or blurred vision. These side effects are rare.
Zinc deficiency may also be related to decreases in vitamin E. Vitamin E can interfere with antidepressant drugs, antipsychotic drugs , aspirin, beta blockers for high blood pressure , chloroquine for malaria, and cyclosporine for cancer. Patients should notify their physician if they take any of these drugs with vitamin E.
Caregiver concerns
Caregivers should monitor the use of vitamin E supplements in older adults. Any adverse side effects from taking supplements should be reported to the patient's physician. Caregivers should also learn to recognize symptoms of vitamin E deficiency and discuss these concerns with the physician.
Lonn, E., et al. "Effects of Long-term Vitamin E Supplementation on Cardiovascular Events and Cancer: A Randomized Controlled Trial." Journal of the American Medical Association (JAMA) 293, no. 11 (March 16, 2005): 1338–1347.
Miller, E. R., et al. "Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality." Annals of Internal Medicine 142, no. 1 (January 4, 2005).
"Possible Interactions With: Vitamin E." Adam.com. 2002 [cited April 15, 2008]. http://www.ajc.com/health/altmed/shared/health/alt_medicine/ConsSupplements/Interactions/VitaminEcs.html.
"Vitamin E." Drugs & Supplements. November 1, 2005 [cited April 14, 2005]. The Natural Standard Research Collaboration. http://www.mayoclinic.com/health/vitamine/NS_patient-vitamin-e.
"Vitamin E." Office of Dietary Supplements, National Institutes of Health. January 23, 2007 [cited April 15, 2008]. http://dietary-supplements.info.nih.gov/factsheets/vitamine.asp.
Cindy L. A. Jones Ph.D.
The Gale Encyclopedia of Senior Health: A Guide for Seniors and Their Caregivers
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Vitamin E Deficiency
Vitamin E deficiency is a very rare problem that results in damage to nerves. When vitamin E deficiency does occur, it strikes people with diseases that prevent the absorption of dietary fats and fat-soluble nutrients. Since vitamin E is a fat-soluble vitamin, it has some of the properties of fat.
The recommended dietary allowance (RDA) for vitamin E is 10 mg/day for the adult man, 10 mg/day for the adult woman, and 3 mg/day for the infant. Vitamin E occurs in foods in a variety of related forms. The most potent and useful form of vitamin E is called alpha-tocopherol. The best sources of vitamin E are vegetable oils, such as corn oil, soy oil, and peanut oil. Animal fats, such as butter and lard, contain lower levels of the vitamin. Corn oil contains about 16 mg of alpha-tocopherol per 100 g oil. Wheat-germ oil contains 120 mg alpha-tocopherol per 100 g oil. Fish, eggs, and beef contain relatively low levels of the vitamin, with about 1 mg per 100 g food.
Vitamin E seems to have only one function in the body: the prevention of the natural and continual process of deterioration of all body tissues. This deterioration is provoked by a number of causes; one of these is toxic oxygen. During the body's metabolism of atmospheric oxygen, toxic oxygen is produced continuously in the body by the formation of by-products. These toxic by-products include hydrogen peroxide, superoxide, and hypochlorite.
Hypochlorite is a natural product, produced by cells of the immune system. It is also the active component of bleach. Once formed, toxic oxygen can damage various parts of the body, such as the membranes which form the boundaries of every cell. Vitamin E serves the body in protecting membranes from toxic oxygen damage. In contrast, vitamin C serves to protect the aqueous, or watery, regions of the cell from toxic oxygen damage. The membranes that are most sensitive to toxic oxygen damage are the membranes of nerves; therefore, the main symptom of vitamin E deficiency is damage to the nervous system.
Causes and symptoms
As mentioned, when vitamin E deficiency occurs, it strikes people with diseases that prevent the absorption of dietary fats and fat-soluble nutrients. These diseases include cystic fibrosis, pancreatitis, and cholestasis (bile-flow obstruction). Bile salts, produced in the liver, are required for the absorption of fats. Cholestasis causes a decrease in the formation of bile salts and the consequent failure of the body to absorb dietary fats. For this reason, this disease may result in vitamin E deficiency. Premature infants may be at risk for vitamin E deficiency because they may be born with low tissue levels of the vitamin, and because they have a poorly developed capacity for absorbing dietary fats. Infants suffering from fat-malabsorption diseases can develop symptoms of vitamin E deficiency by age two. In adults, the onset of a fat-malabsorption disease can provoke vitamin E deficiency after a longer period, as an example, ten years.
Patients with colorectal cancer caused by the socalled Ki-ras mutation have also been shown to absorb less vitamin E from their diet than either normal control subjects or cancer patients without the mutation. The relationship between genetic mutations and dietary factors requires more intensive study.
Vitamin E deficiency in humans results in ataxia (poor muscle coordination with shaky movements), decreased sensation to vibration, lack of reflexes, and paralysis of eye muscles. One particularly severe symptom of vitamin E deficiency is the inability to walk.
Another symptom of early vitamin E deficiency in children with cystic fibrosis is a decline in cognitive function, which results in difficulty with reading and falling behind in other intellectual skills during the elementary school years. Researchers have urged the introduction of neonatal screening in order to offset the potential effects of early vitamin E deficiency.
More recently, the suggestion has been made that vitamin E deficiency may be involved in the development of partial open-angle glaucoma (POAG), an eye disorder whose causes are not fully understood as of the early 2000s. The possibility that POAG is a vitamin-deficiency disorder, however, needs further research.
Vitamin E status is measured by assessment of the content of alpha-tocopherol in the blood plasma, using a method called high-pressure liquid chromatography. Blood plasma levels of alpha-tocopherol that are 5.0 mg/l, or above, indicate normal vitamin E status; levels below 5.0 mg/l indicate vitamin E deficiency.
Vitamin E deficiency that occurs with cholestatic liver disease or other malabsorption syndromes can be treated with weekly injections of 100 mg alpha-tocopherol that may continue for six months. Vitamin E deficiency in premature infants may require treatment for only a few weeks.
The prognosis for correcting the neurological symptoms of vitamin E deficiency is fair to excellent.
The prevention of vitamin E deficiency should not be a concern for most people, since the vitamin is found in a wide variety of foods. Attention has been given to the theory that vitamin E serves to protect against cancer and atherosclerosis. The evidence that normal levels of vitamin E protect against atherosclerosis is fairly convincing. However, there is little or no proof that vitamin E intake, above and beyond the recommended daily allowance (RDA), can prevent cancer or atherosclerosis.
Beers, Mark H., MD, and Robert Berkow, MD, editors. "Vitamin E Deficiency." Section 7, Chapter 86. In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.
Koscik, R. L., P. M. Farrell, M. R. Kosorok, et al. "Cognitive Function of Children with Cystic Fibrosis: Deleterious Effect of Early Malnutrition." Pediatrics 113 (June 2004): 1549-1558.
Laso, N., S. Mas, M. Jose Lafuente, et al. "Decrease in Specific Micronutrient Intake in Colorectal Cancer Patients with Tumors Presenting Ki-ras Mutation." Anticancer Research 24 (May-June 2004): 2011-2020.
Veach, J. "Functional Dichotomy: Glutathione and Vitamin E in Homeostasis Relevant to Primary Open-Angle Glaucoma." British Journal of Nutrition 91 (June 2004): 809-829.
Fat-soluble vitamin— Fat-soluble vitamins can be dissolved in oil or in melted fat.
Recommended dietary allowance (RDA)— The quantity of a given nutrient in the diet that is required to maintain good health in people. RDAs are established by the Food and Nutrition Board of the National Academy of Sciences, and may be revised every few years. A separate RDA value exists for each nutrient. The RDA values refer to the amount of nutrient expected to maintain good health in people. The actual amounts of each nutrient required to maintain good health in specific individuals differ from person to person.
Toxic oxygen— Oxygen is required for life, as it is needed for energy production. When oxygen is used by the body, most of it is converted to water. However, a small fraction of the oxygen breathed is converted to toxic oxygen. The body uses several different processes for preventing and repairing toxic-oxygen damage. One of these processes involves vitamin E.
Water-soluble vitamins— Water-soluble vitamins can be dissolved in water or juice.
Gale Encyclopedia of Medicine, 3rd ed. Brody, Tom; Frey, Rebecca
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Vitamin E is the name given to a group of eight chemicals with similar properties that are essential to health. Vitamin E was first isolated as a distinct substance in various green leafy vegetables in 1922. Vitamin E is classed as a micronutrient, a substance that is not required in large quantities through diet but which is otherwise essential to the maintenance of good health. In all of its forms, vitamin E is an organic (carbon-based) compound, of which alpha tocopherol is the most prolific. Vitamin E is often referred to as nature's antioxidant, a testament to the important function of these chemicals within the body.
Vitamin E, as with all micronutrients, is required in trace amounts for bodily function. The recommended daily requirement for adults of this substance is 15 mg per day. The consumption of dietary supplements to ensure the ingestion of the required quantities of vitamin E is unnecessary if the person is consuming a well-balanced diet, as the best sources of the chemical are commonly available food products, such as wheat and its large number of byproducts, many green leafy vegetables, and most nuts, seeds, and their oils. Vitamin E is the least toxic of all fat-soluble vitamins; the recommended upper daily limit of vitamin E consumption is 1,000 mg.
Vitamin E is a fat-soluble compound. It is processed for entry into the body at the small intestine, where the vitamin is parceled into chemical packages made from both high density lipoproteins (HDLs) and low density lipoproteins (LDLs) to facilitate the absorption of vitamin E into both the lymphatic system and the liver. From these locations, vitamin E then is released directly into the bloodstream.
With either its HDL or LDL transportation in the bloodstream, vitamin E is carried to various cells within the body. As a fat-soluble vitamin, vitamin E can be stored within the cell mitochondria (often described as the cellular powerhouse) of the adipose tissue, the cells designed for the storage of triglycerides (fats), for an indefinite period. Once utilized as an antioxidant, the spent vitamin E is disposed of by the body through the stomach bile; it is ultimately excreted from the body as feces.
Oxidation is a biological concept that is readily understood with reference to many daily life examples. Rusted metal, food that turns rancid, and the various aging processes observable within the body are examples of oxidation, which is the decay or the degradation of a cell due to the effect of oxygen. An antioxidant, such as vitamin E, is any substance that by its presence or its operation, serves to specifically delay, prevent, or reverse the rate of deterioration caused in the cells by oxygen. Antioxidants are classed as one of two types: metal sequestrants, which prevent metals from reacting with oxygen, and free radical scavengers, which operate to interrupt the destructive chain reactions that occur within the body that are precipitated by the compounds known as free radicals. Vitamin E and, in certain circumstances, vitamin C, are free radical scavengers within the body.
Free radicals are the most common cause of oxidation within the body. Occurring throughout the body, these chemical compounds are inherently unstable, as their electron structure is unbalanced due to one or more electrons within the structure not being paired, which creates either a positive or negative electric charge within the free radical. The free radical therefore seeks to obtain the necessary electrons to create electrical balance from nearby stable compounds. This "theft" of electrons by the free radicals renders the previously stable compound unstable and reactive. This use precipitates a chain reaction of electron use that is the essence of the oxidation that causes cell damage.
As an antioxidant, vitamin E traps the free radicals that it encounters, through its donation of a hydrogen atom to the free radical molecule, rendering it chemically neutral. Vitamin E ranges throughout the tissues of the body, and it provides its antioxidant benefits to all aspects of the cardiovascular and musculoskeletal systems. Vitamin E does not differentiate between the types of free radicals it may encounter, nor does vitamin E restrict its actions based on the place of origin of the target free radical.
There is no question from a scientific perspective that vitamin E is a very important compound within the body, as it protects the tissues from decay and degradation. The companion issue of whether megadoses of vitamin E, by daily supplement or otherwise, will provide enhanced health protection has not been conclusively determined. The actions of vitamin E must also be considered separately from the healing and repair of tissue that occurs within the body. Antioxidant function is separate from the cell repair that occurs within the body at all cell production points—bone, connective tissue, muscles, and blood cells may be degraded by the actions of free radicals. Vitamin E does not play a role in cell production.
see also Diet; Free fatty acids in the blood; Nutrition; Oxygen.
World of Sports Science
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Vitamin E was discovered in 1922 by Herbert M. Evans and K. S. Bishop. The researchers found that laboratory rats failed to reproduce when lard was their only source of food fat. According to the researchers, there was a compound in both wheat germ and lettuce that corrected the problem.
For a time, the unknown component was termed the "anti-sterility factor." In 1925 Evans decided that the component should be renamed vitamin E since the last vitamin to be discovered was vitamin D.
The new vitamin was fat-soluble. Studies by Evans and his coworker Gladys A. Emerson (1903-) showed that vitamin E deficiency caused two different problems. It caused reproductive problems in both sexes of small laboratory animals. It also caused a muscle dystrophy in many species of animals. But for almost three decades, investigators were not certain whether vitamin E had any effect on humans.
Vitamin E Isolated
Evans and Emerson isolated vitamin E from wheat germ oil, corn oil, and cotton seed oil in 1936. In 1938 it was synthesized by Paul Karrer (1889-1971) and his co-workers. The investigators decided the vitamin's biochemical function was primarily a protective one. Its purpose is to help prevent unsaturated fatty acids from combining with oxygen. When the acids and oxygen do combine, tissues break down. Other antioxidants include vitamin C and the trace element selenium.
At first, vitamin E was believed to regulate tissue-damaging oxidation almost entirely in animals. But nutritional surveys in the 1940s and 1950s revealed otherwise. Premature infants and patients with malabsorption illnesses were found to have low levels of blood tocopherol. Those same surveys also showed they had other blood irregularities as well. In 1968, vitamin E was finally recognized as an essential nutrient for humans.
Other Functions of the Vitamin
Vitamin E is believed to help maintain the structure of muscle tissue and various components of the reproductive system, vascular system, and nervous system. Even with this knowledge, there may be other functions the vitamin performs that researchers are not aware of. There is little evidence to suggest, however, that vitamin E supplements can help repair existing damage.
[See also Vitamin ]
Medical Discoveries
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vitamin E Generic descriptor for a group of fat‐soluble compounds essential for reproduction in animals. Essential for human beings (not for reproduction, so far as is known) but rarely, if ever, deficient in the diet. Two main groups of compounds have vitamin E activity: the tocopherols and the tocotrienols; there are 4 isomers of each: α‐, β‐, γ, and δ‐tocopherols and α‐, β‐, γ, and δ‐tocotrienols, with differing vitamin potencies.
Vitamin E functions primarily as an antioxidant in cell membranes, protecting unsaturated fatty acids from oxidative damage.
The vitamin E content of foods is expressed as mg α‐tocopherol equivalent (based on the different potency of the different vitamers). Vegetables, seeds, and most vegetable oils are good sources. In the UK and the EU an adequate intake is 0.4 mg/g dietary polyunsaturated fatty acid intake; the US/Canadian RDA is 15 mg/day. The obsolete international unit of vitamin E activity was equal to 1 mg of synthetic α‐tocopherol; on this basis natural‐source α‐tocopherol is 1.49 iu/mg.
A Dictionary of Food and Nutrition DAVID A. BENDER
DAVID A. BENDER "vitamin E ." A Dictionary of Food and Nutrition. . Encyclopedia.com. 17 Jan. 2023 <https://www.encyclopedia.com>.
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DAVID A. BENDER "vitamin E ." A Dictionary of Food and Nutrition. . Retrieved January 17, 2023 from Encyclopedia.com: https://www.encyclopedia.com/education/dictionaries-thesauruses-pictures-and-press-releases/vitamin-e
vitamin E (tocopherol) A fat-soluble vitamin consisting of several closely related compounds, deficiency of which leads to a range of disorders in different species, including muscular dystrophy, liver damage, and infertility. Good sources are cereal grains and green vegetables. Vitamin E prevents the oxidation of unsaturated fatty acids in cell membranes, so maintaining their structure (see antioxidants).
A Dictionary of Biology
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Antioxidants (nutrients) , Antioxidant is the descriptive term given to a group of organic substances that generally function within the body to promote health through their co… Smilax , Smilax Smilax is the name given to a number of different varieties of climbing vines that grow throughout South America, the Caribbean, and parts of… free radical , free radical An atom or group of atoms with an unpaired valence electron. Free radicals are formed when a bond is broken without forming ions. Becaus… Ascorbic Acid , Ascorbic acid or vitamin C is an antiscorbutic agent. Scurvy is a disease that potentially ranks as the second most important nutritional deficiency,… free radicals , free radicals A free radical is any chemical species which contains one or more unpaired electrons and which is capable of an independent existence.… Vitamin C , Vitamin C, also known as ascorbic acid, is one of the many micronutrients consumed through diet that is essential to life. Vitamin C is an organic (c…
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Costa wasn't on the bench long, with Willian clutching at his hamstring after the opener but it was good to see shades of his hunger for the ball rather than the players creeping back in. Baba and Azpilicueta together brought some much needed balance to our back line along with the improved pace of Cahill and Zouma. Oscar looked as if he might be prepared to make the most of Hazard's loss of centre stage and even Fabregas was lively enough to poach our 4th.
As for Rubén Loftus-cheek, he's the outstanding example of young talent we have pushing their way into contention this season and warmed our hearts after the recent cold spell.


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text:
The Phantom of Eldberg
Thaler Card
Crone: Whispess Card
Fiend Card
Arachas Card
Letter to the Lighthouse Keeper
Ashrune
Wraith Trophy
Gwent Players in this Area
Blacksmith - Random Card
Innkeep - Random Card
Arinbjorn
Here you'll find a notice board that has the notice "Contract: The Phantom of Eldeberg" on it, which starts a quest by the same name. Also in this town you'll find the Blacksmith - Sigurd - who is a big fan of Dandelion, and hence has an over-inflated opinion of both Geralt and the bard. He also plays Gwent, so it's worth putting up with his silliness.
The Phantom of Eldberg (Level 17)
Head into the tavern near the notice board, where you'll be accosted by some uppity Skelligers with a low opinion of "continentals'. Another Skelliger named Jorund will defuse the situation, then offer to talk about the contract. Indulge him and he'll tell you about their troubles. Mysterious fog, a lighthouse, wraiths… typical stuff for a Witcher. Haggle for more money (or not) then accept the quest.
Before you leave, be sure to talk to the Innkeeper, as he not only plays Gwent, but he sells the "Thaler" Card, the "Crone: Whispess" Card, the "Fiend" Card, and an "Arachas" Card. All of these cards are pretty decent: the **** "Crone: Whispess" is a 6 Strength Close Combat Unit Card with the "Muster" ability, while the "Arachas" is a 4 Strength Close Combat Unit Card with the "Muster" Ability. "Thaler" is the second best "Spy" card in the game, with a 1 Strength score, he's a great addition to the Northern Kingdoms deck. The weakest of the bunch, the "Fiend" is still a 6 Strength Close Combat Unit Card, if you need the extra muscle.
Return north and either sail to the northernmost of the three islands north of Arinbjorn, or do your best to make your way across broken bridges that used to connect the islands. If you went by boat, dock the boat on a jetty along the southern end of the island, then head north along a road… otherwise you should be following the roads up the islands already. Geralt will shortly reach the fog and comment on its obviously supernatural nature. Head into the fog and fight off some Wraiths (level fifteen) when they appear, continuing north as you do so. There are two bodies you can investigate on the road, but they reveal little. Make your way north until you find a house east of the road and knock on the door. Mikkjal, the lightkeeper will open the door and tell you what little he knows before giving you a key to the lighthouse.
For checking in on Mikkjal 25 XP
Note: If you want to grind Wraiths, this is a good place to do it. They'll respawn around Mikkjal's house - two to the south and two to the north - each time you rest. Wraiths often drop Infused Dust, Specter Dust, Amethyst Dust, and Emerald Dust. Much of this dust sells well, and Infused Dust can be used to create Glyphs. You'll want the money later, and you can get a good stock of components to sell off with even just an hour of grinding.
Continue north along the road and deeper into the fog, where you'll have to fend off another pair of Wraiths (level fifteen). A short distance alter you'll find the "Eldberg Lighthouse" signpost a short distance away from the actual structure. Head across a wooden bridge and up some wooden stairs to enter the lighthouse. Loot the first level, then climb a ladder to the second. Search some furniture to the north to find a "Letter to the Lighthouse Keeper" . Read it to find out about Mikkjal's dark secret, then leave the lighthouse and search the exterior along the stairs to identify what haunts this place, and why. Seems like you're going to have to have another chat with Mikkjal.
For discovering the nature of the Phantom of Eldberg 25 XP
Be sure to have Specter Oil applied to your blade, then return to Mikkjal's house and talk to the dishonest lighthouse operator. He'll make up an award-winningly lame excuse for his actions, then try to cower out of doing the right thing. Geralt convinces him to go, and, as Mikkjal predicted the Penitent shows up and attacks. Geralt decides to hold the wraith's attention while Mikkjal goes to light the lighthouse, giving him some good incentive, in the process.
The Penitent fights just like any normal Wraith; it'll vanish after you land a few hits and manifest elsewhere, usually nearby, unleashing a vicious sword combo in the process. Specter Oil works well, as does simply using the Active Shield alternate mode for Quen to absorb damage, mixed with Exploding Shield to subsequently knock the creature off guard. It's a combo the Penitent can't really do anything to bypass… at least not on its own.
Unfortunately the Penitent can split into several normal Wraiths, which are trickier to deal with than the lone Penitent, but nothing you haven't faced before. The same tactics detailed above work just as well, you just will have to spend a bit of time dodging until you're in a position to attack without suffering undue reprisals. On the plus side, dispatching the Wraiths the Penitent summons deals damage to the Penitent itself - all the more so when Mikkjal completes his task, leaving the Penitent more vulnerable.
Once it's banished, loot it for the sword "Ashrune" and the Wraith Trophy . After you claim your trophy, Mikkjal will come check on the situation. Decide whether to let him stay around, or force him to leave the island. Once done, there's only one thing left to do on the island. Head to the Eldberg Lighthouse and from there head west to the coast to find the mast and prow of a ship sticking out of the water. Dive and search around to find three chests and two parcels underwater. Score the quick loot, then return to shore.
Make your way back to the Eldberg Lighthouse signpost and use it to fast-travel back to the Arinbjorn, then head into the tavern and talk to Jorund and proclaim a job well done. Jorund grants you your coin, and all is well. As you go to leave, however, the two rude Skelligers from before will return and try to pick a fight. Whatever you say, a fight ensues, with Jorund supporting you. As you and Jorund gain the upper hand, however, the two miscreants will resort to steel. Respond in kind, then check on Jorund. When you're done talking to Jorund you'll find yourself embroiled in the quest "Stranger in a Strange Land" .
For slaying the Penitent 260 XP / 184+ Crowns
Leave the tavern and you'll be confronted by some angry Skelligers, including the father of the two thugs you slew. After threatening to take Geralt down through sheer weight of numbers (and presumably not being willing to test that, bluff or not) Geralt submits to be incarcerated and awaiting the judgment of "Madman Lugos".
For submitting to the citizens of Arinbjorn 50

redpajama_set_name: RedPajamaCommonCrawl


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Ásbyrgi in Northern Iceland
Asbyrgi (Shelter of the Gods) is a horseshoe-shaped canyon in Jokulsargljufur within the Vatnajokull National Park. Viking settlers believed to be a hoof-print formed by Sleipnir, Odin's eight-legged flying horse from Norse mythology.
Ásbyrgi Canyon in Northern Iceland
Ásbyrgi is a horseshoe-shaped canyon in Northeast Iceland
Ásbyrgi is one of the wonders of nature, a well forested horse-shoe shaped canyon in Oxarfjordur. Asbyrgi is a part of Jökulsárgljúfur canyon, within the Vatnajökull National Park. The Jökulsárgljúfur site of the National park reaches from highway 85, by Ásbyrgi south to Dettifoss, covering an area of 120 km2.
Hljóðaklettar (echo rocks) in North-East Iceland
The 'echo rocks' or Hljóðaklettar, are a collection of basalt columns lying in every which direction to create unique formations and arched caves that are known to create eerie echoes and reverberations. The rocks are located at the entrance to Vesturdalur, in the Vatnajökull National Park. The signs at the newly developed overlook parking area called this place "The Lava Church" now.
Hljodaklettar are a bizarre looking group of crater plugs, the remains of ancient volcanoes. They have been heavily eroded by the foaming glacial river, depicting basaltic columns in different positions. They create all kind of patterns – swirls, spirals, rosettes and honeycombs. This is what makes them unique in the world. It is a great experience to walk among the cliffs and strange rock formations. It's easy to imagine being on an alien planet in a far off solar system. Hljodaklettar ("Echo rocks" or "The Whispering Cliffs") derives its name from an acoustic effect and strange echoes, created by the numerous caves and uncommon rock formation. It makes it impossible to determine the directions of the noisy rivers. It is interesting to listen to the cliff acoustic near the river.
Selfoss waterfall on the Jökulsá á Fjöllum River in Northern Iceland
Located in Jökulsárgljúfur canyon in Northern Iceland, Selfoss waterfall is one kilometer south of the enormous waterfall Dettifoss. It is fed by the glacier river Jökulsá á Fjöllum with its routes in Vatnajökull glacier. Jökulsá á Fjöllum is also the second-longest river in Iceland with a length of 206 kilometers, flowing into the Greenland Sea. The glacier from which this river originates is the largest ice cap in Iceland that makes 8 percent of the country's landmass.
Located in Jökulsárgljúfur canyon in Northern Iceland, Selfoss waterfall is one kilometer south of the enormous waterfall Dettifoss. It is fed by the glacier river Jökulsá á Fjöllum with its routes in Vatnajökull glacier. Jökulsá á Fjöllum is also the second-longest river in Iceland with a length of 206 kilometers, flowing into the Greenland Sea.
Jökulsárgljúfur Canyon in Northeast Iceland
Collapsed wall of basalt columns at Jökulsárgljúfur Canyon between the waterfalls Selfoss and Dettifoss in Noertheast Iceland
Dettifoss Waterfall in Northeast Iceland
Dettifoss in Vatnajökull National Park is said to be the second most powerful waterfall in Europe after the Rhine Falls. The Dettifoss falls of the Jökulsá á Fjöllum river are 100 meters (330 feet) wide and have a drop of 44 meters (144 feet) down to the canyon Jökulsárgljúfur. It is the second largest waterfall in Iceland in terms of volume discharge, behind the Urriðafoss.
Dettifoss in Vatnajökull National Park is said to be the second most powerful waterfall in Europe after the Rhine Falls. The Dettifoss falls of the Jökulsá á Fjöllum river are 100 meters (330 ft) wide and have a drop of 44 meters (144 ft) down to the canyon Jökulsárgljúfur. It is the second largest waterfall in Iceland in terms of volume discharge, behind the Urriðafoss.
Frozen Grass at Dettifoss Waterfall in Northeast Iceland
On the brink of Dettifoss Waterfall in Northeast Iceland
Bridge over Jökulsá á Fjöllum in Northeast Iceland
Single lane bridge over Jökulsá á Fjöllum in Northeast Iceland. Jökulsá á Fjöllum is the second longest river in Iceland (206 km). Its source is the Vatnajökull glacier and it flows into the Greenland Sea.
The Golden Gate Bridge Of The Highlands, Iceland
A simple single-lane bridge takes Route #1 across a glacier stream in the highlands of Northeast Iceland. Google now calls it "The Golden Gate Bridge Of The Highlands". I think they are making this up - somewhere in Iceland is a Gylfi or a Guðrun having fun with that. . .
Perpetual Hot Shower near Krafla in Northeast Iceland
One of the most amazing bathrooms is located next to the geothermal station Krafla, in Iceland. In order to obtain heat directly from interaction with terrestrial magma, an experiment was conducted there from 2009 till 2011. So, the station receives energy from underground sources. On the side of the road leading to Krafla, in the middle of a large patch of bare ground, there is a shower. Not only it does not have walls (there is a picturesque landscape), but also the shower is working perfectly fine. It is connected to a thermal spring, as a result of which there is hot water in the shower all year round.