Vitamin E

wound healing immune support antioxidant eye health macular degeneration cataracts diabetes skin health anti-aging heart health cardiovascular blood thinner vitamin tocopherol tocotrienol fat-soluble alpha-tocopherol gamma-tocopherol oxidative stress free radicals cell membrane protection

Published on December 20, 2025 by Guy

Vitamin E is a group of fat-soluble compounds, primarily tocopherols and tocotrienols, that serve as the body's primary lipid-soluble antioxidant. Found abundantly in nuts, seeds, vegetable oils, and wheat germ, it protects cell membranes and circulating fats from oxidative damage. People commonly take vitamin E for cardiovascular support, skin health, and general antioxidant protection, though recent research has raised important questions about optimal dosing.

Effects and Benefits

Core Identification

Common Names:
- Vitamin E
- Alpha-tocopherol
- Mixed tocopherols
- Tocopherols

Latin Name: N/A (synthesized compound / nutrient)

Category: Vitamin

Uses

Traditional Uses

  • Skin healing and wound care - Used topically since the mid-20th century
  • Fertility support - Historical use based on animal studies (name derived from Greek "tokos" meaning childbirth)
  • Cardiovascular support - Traditional use for heart and circulation health

Modern Uses

  • Antioxidant protection - Protects cell membranes, nerve sheaths, and circulating cholesterol from oxidative damage | Research quality: Strong
  • Key findings: Vitamin E is the body's primary fat-soluble antioxidant, preventing oxidation of polyunsaturated fatty acids in cell membranes

  • Source citations: Brewer, Sarah - TDT Encyclopedia of Vitamins; Weil, Andrew - Eating Well for Optimum Health

  • Cardiovascular health - Reduces LDL oxidation and may support blood vessel function | Research quality: Mixed

  • Key findings: Earlier studies (Nurses' Health Study, CHAOS trial) showed 50-77% reduction in cardiovascular events with supplementation; however, more recent large trials (HOPE-TOO, SELECT) showed neutral or potentially negative results at high doses (400+ IU/day)

  • Source citations: Brewer, Sarah - TDT Encyclopedia of Vitamins; Moyad, Mark - The Supplement Handbook; Cordain, Loren - The Paleo Answer

  • Type 2 diabetes support - May help improve insulin response and protect against diabetic complications | Research quality: Moderate

  • Key findings: Vitamin E helps protect against oxidative stress linked to diabetic complications including kidney and eye damage; may improve glucose utilization

  • Source citations: Tessmer, Kimberly - Your Nutrition Solution to Type 2 Diabetes; Brewer, Sarah - TDT Encyclopedia of Vitamins

  • Skin health (topical) - Promotes wound healing and reduces scar formation | Research quality: Moderate

  • Key findings: Applied topically to closed wounds, vitamin E reduces scar formation; up to 1 in 3 people may develop sensitivity to topical vitamin E

  • Source citations: Weil, Andrew - Eating Well for Optimum Health; Brewer, Sarah - TDT Encyclopedia of Vitamins

  • Alzheimer's disease - High-dose vitamin E may slow functional decline | Research quality: Moderate

  • Key findings: High-dose synthetic vitamin E (2,000 IU/day) has shown benefits in some Alzheimer's patients; should only be used under medical supervision

  • Source citations: Moyad, Mark - The Supplement Handbook

  • Eye health - May help protect against cataracts and age-related macular degeneration | Research quality: Moderate

  • Key findings: Those with high vitamin E levels had less than half the risk of cataracts compared to those with lowest levels
  • Source citations: Brewer, Sarah - TDT Encyclopedia of Vitamins; Balch, Phyllis - Prescription for Herbal Healing

Active Compounds

Primary Active Ingredients:
- Alpha-tocopherol - The most biologically active tocopherol; primary form in most supplements; protects cell membranes from lipid peroxidation
- Gamma-tocopherol - Research suggests it may be more powerful than alpha-tocopherol in preventing certain cancers; traps mutagenic electrophiles; absent from synthetic vitamin E
- Beta-tocopherol and Delta-tocopherol - Additional tocopherol forms found in natural food sources with antioxidant activity
- Tocotrienols (alpha, beta, gamma, delta) - Related compounds with emerging research on cardiovascular and neuroprotective benefits

Dosage Information

Standard Dosage:
- Form: Softgel capsule, liquid
- Amount: 15 mg (22.5 IU) per day (RDA for adults)
- Frequency: Once daily with food

Therapeutic Dosage:
- Form: Softgel capsule (natural d-alpha tocopherol with mixed tocopherols preferred)
- Amount: 100-400 IU per day for general antioxidant support
- Purpose: Cardiovascular support, antioxidant protection
- Duration: Ongoing with periodic evaluation

Maximum Safe Dosage:
- Daily maximum: 1,000 mg (1,500 IU natural / 1,100 IU synthetic) - Upper Tolerable Intake Level
- Warning threshold: Doses ≥400 IU/day have shown increased risks in multiple large trials; avoid exceeding this without medical supervision

Bioavailability Notes:
- Natural vitamin E (d-alpha tocopherol) has greater biological activity than synthetic (dl-alpha tocopherol)
- Fat-soluble; must be taken with dietary fat for optimal absorption
- Mixed tocopherols provide broader spectrum protection than alpha-tocopherol alone
- 1 IU = 0.67 mg alpha-tocopherol equivalents; 1 mg = 1.5 IU

How to Take It

Timing:
- Take with a meal containing fat for optimal absorption
- Can be taken morning or evening; consistency matters more than timing
- If taking with other fat-soluble vitamins (A, D, K), can be taken together

Synergies - What It Works Well With

Complementary Supplements:
1. Vitamin C - Regenerates vitamin E after it has neutralized free radicals; essential for maintaining vitamin E activity | Enhanced antioxidant protection
2. Selenium - Works together with vitamin E to increase antibody production and boost glutathione production; protects against hydrogen peroxide formation | Synergistic antioxidant and immune support
3. CoQ10 - Both are lipid-soluble antioxidants that protect cell membranes | Complementary cardiovascular and mitochondrial support
4. Omega-3 fatty acids - Vitamin E helps prevent oxidation of these beneficial fats | Protects and preserves omega-3 benefits

Avoidance - What NOT to Combine With

Supplement Interactions:
1. High-dose iron - Iron can promote oxidation and may counteract vitamin E's antioxidant effects | Take at different times of day

Drug Interactions:
1. Warfarin and anticoagulants - Vitamin E has natural blood-thinning properties | Increased bleeding risk | Severity: Moderate to Severe
2. Aspirin - Additive blood-thinning effects | Increased bleeding risk | Severity: Moderate
3. Chemotherapy drugs - May interfere with oxidative mechanisms of some cancer treatments | Consult oncologist before use | Severity: Moderate
4. Statin medications - May reduce some antioxidant benefits; discuss with healthcare provider | Severity: Mild

Food Interactions:
- No significant food interactions
- Best absorbed with dietary fat

Safety Information

Contraindications:
- Bleeding disorders or those on anticoagulant therapy (use with caution)
- Two weeks before and after surgery (may increase bleeding)
- Vitamin K deficiency
- History of hemorrhagic stroke

Side Effects:
- Common: Generally well-tolerated at recommended doses
- Uncommon: Nausea, diarrhea, stomach cramps, fatigue, weakness, headache
- Rare: Bleeding, hemorrhagic stroke (at high doses)
- Topical: Contact dermatitis in approximately 1 in 3 users

Long-Term Use:
- Doses under 400 IU/day generally considered safe for long-term use
- High-dose supplementation (≥400 IU/day) associated with increased all-cause mortality in meta-analyses
- SELECT trial showed increased prostate cancer risk in men taking 400 IU synthetic vitamin E
- HOPE-TOO trial showed increased heart failure risk at 400 IU natural vitamin E in patients with vascular disease or diabetes
- Regular monitoring recommended if taking therapeutic doses long-term

Special Precautions:
- Discontinue at least 2 weeks before scheduled surgery
- Pregnant and breastfeeding women should not exceed RDA without medical supervision
- Those with retinitis pigmentosa should avoid high doses
- May worsen bleeding tendency in those with vitamin K deficiency

Primary Uses At-a-Glance

Primary: Antioxidant protection, cardiovascular support (at moderate doses), skin health (topical), diabetic complication prevention

Secondary: Eye health support, immune function, muscle cramp relief, general aging support

Sources

Local Library:
- Brewer, Sarah - TDT Encyclopedia of Vitamins
- Moyad, Mark - The Supplement Handbook
- Weil, Andrew - Eating Well for Optimum Health
- Cordain, Loren - The Paleo Answer
- Tessmer, Kimberly A. - Your Nutrition Solution to Type 2 Diabetes
- Balch, Phyllis - Prescription for Herbal Healing
- Moline, Peg - The Doctors Book of Natural Health Remedies
- Gladstar, Rosemary - Herbs for Long-Lasting Health
- Ali, Naheed - Diabetes and You

General Knowledge:
- SELECT Trial (Selenium and Vitamin E Cancer Prevention Trial)
- HOPE-TOO Trial
- CHAOS (Cambridge Heart Antioxidant Study)
- Nurses' Health Study / Physicians' Health Study