- Dennis Lipton, MD
Need more Vitamin E?
Updated: Jul 5, 2019
When I was a kid, I remember my parents breaking open vitamin E capsules and putting the oil on our skin to treat almost anything, from burns to cuts and scrapes. They also took the capsules regularly and put them in the daily supplements they gave me. I never thought much about it. Then when I was in my medical training, I remember vitamin E being part of the cocktail of drugs prescribed for heart patients, after a heart attack. Then, studies came out that showed that it didn’t work, and maybe even worsened outcomes, so this is no longer done. What happened to vitamin E? How can this potent antioxidant be bad?
It’s been known for years that people with higher levels of vitamin E in their blood overall do better. They have decreased markers of oxidative stress, fewer senescent cells, decreased lipid peroxidation and DNA damage, better cognitive function and decreased cardiac risk. What has NOT been proven, however, is that supplementing with vitamin E leads to any of these improved outcomes. It’s the same with almost every other supplement ever studied. Having higher blood levels of nutrients is a marker of being healthy. You can’t isolate one of those nutrients, supplement, and expect to enjoy the same health as the person who earned it through good diet and health habits. I’m not saying that taking a supplement is never the right thing to do. I AM saying that blindly taking high doses of any one vitamin or nutrient just because you read a study that says that higher levels of said nutrient is good, may NOT be the right thing to do.
Back to vitamin E. It turns out that ‘vitamin E’ actually has 8 different forms: alpha-tocopherol, beta-tocopherol, gamma-tocopherol, delta-tocopherol, alpha-tocotriene, beta-tocotriene, gamma-tocotriene, and delta-tocotriene. These different forms all have different structures, potencies, and actions in the body. When researchers used vitamin E supplementation in the studies that showed no benefit or possible harm, they were using alpha-tocopherol, since it was the first form of vitamin E discovered and is generally the most ubiquitous. It’s also the most stable and easiest to produce synthetically and what’s used in most supplements that contain vitamin E. Just like the carotenoids (the most famous one being beta-carotene) are a family of nutrients that work together in ways that we don’t fully understand, the same is true of ‘vitamin E’. It’s a family of nutrients that work in harmony, and are best obtained from dietary sources, in the right quantities and proportions.
Unfortunately, given the nature of our food supply and the dietary habits of most Americans and the developed world in general, our intake of alpha-tocopherol is generally much higher than the other tocopherols and tocotrienols. Alpha tocopherol is the most stable and least likely to suffer from oxidation and degradation with food transport and processing. Alpha tocopherol is also the most common type found in multivitamins, and studies have shown that excess alpha-tocopherol intake actually decreases levels of gamma-tocopherol.
I checked my own level of vitamin E and I was shocked to see that I was borderline too high on alpha-tocopherol, and borderline too low on gamma-tocopherol. I eat a whole food plant-based diet, and I take a multivitamin which contains a fairly low dose of alpha-tocopherol a few times a week. I use almond milk and I also eat almonds and macadamia nuts daily. As you can see in the chart above, my intake of vitamin E is slanted greatly toward excess alpha-tocopherol. Time to eat more pistachios, pecans, walnuts, flaxseed, pumpkin, and sesame seeds!