MultiVit Rx with Vitamin E
High Quality Daily Vitamins and Minerals with Natural Vitamin E
Physician Formulas - Developed by Ray Sahelian, M.D.

This MultiVit Rx product has 100 units of natural vitamin E complex of mixed tocopherols per serving. Click the link for full details.

Why take a combination of tocopherols?
Supplementation of diets with alpha-tocopherol reduces serum concentrations of gamma- and delta-tocopherol in humans. Therefore, it appears that it is healthier to take a combination of different natural forms of vitamin E.

Natural Vitamin E - Tocopherol Complex supplement, 60 softgels, Now Foods

Tocotrienols and tocopherols are potent antioxidants that are 100% natural. These nutrients have been combined with d-alpha vitamin E, and yeast-free Selenium. The result is a synergistic combination of nutritional antioxidants.

60 softgels per bottle

Serving Size: 1 Softgel


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Subscribe to a FREE Supplement Research Update newsletter. Twice a month we email a brief abstract of several studies on various supplements and natural medicine topics - including natural vitamin E - and their practical interpretation by Ray Sahelian, M.D.




Use: As a dietary supplement, take one vitamin E softgel 2 or 3 times a week with food. Since vitamin E is fat soluble and is stored if fat tissue in the body, it need not be taken every day.

Vitamin E (as d-alpha tocopherol) - 230 IU  - 765% 
Selenium (as Selenomethionine) - 70 mcg  - 100% 
Mixed Tocotrienols (Rice Bran) - 150 mg
Alpha Tocotrienol - 2 mg
Gamma Tocotrienol - 23 mg
Mixed Tocopherols - (Vitamin E) 
   Beta Tocopherol - (17 mg) - 7 IU
   Gamma Tocopherol - (15 mg) - 2.9 iu
   Delta Tocopherol - (12 mg) - 0.2 iu

Benefit of Vitamin E - synthetic or natural
Vitamin E is beneficial as an antioxidant, and may play a role in the prevention or treatment of cardiovascular or ocular diseases, and perhaps Parkinson's disease. However we still need more research to make sure that it does work, and to find out the appropriate vitamin E dosages and frequency of use. The benefit of vitamin E supplementation is constantly debated in the medical community.
   Much of the confusion regarding the benefit of vitamin E supplements is due to the fact that researchers have used and analyzed different forms of vitamin E and different dosages. For instance, much of the research regarding the benefit of vitamin E has been done with synthetic vitamin E, specifically dl-alpha tocopherol as opposed to natural alpha tocopherol. Making this even more complicated, researchers have rarely analyzed the benefit of a natural vitamin E complex that includes a mix of tocopherols and tocotrienols. Hence, we you read a study that comments on the benefits and risks of vitamin E supplementation, always look to see what form of vitamin E they are talking about.
  
Vitamin E and cataracts
A study from Sweden indicates that Vitamin E can protect against cataracts caused by ultraviolet radiation in laboratory rats. The study exposed two groups of rats to ultraviolet light and found that the group given Vitamin E developed only slight opacities while the group deprived of Vitamin E developed cataracts.

Vitamin E and cancer
The role of vitamin E and cancer is a hotly debated topic, and you can find viewpoints on both ends of the spectrum, each quoting their own fact on vitamin E. Some researchers feel a vitamin E supplementation could reduce the risk of certain cancers, while others disagree. There have been tons of studies on this topic, yet no firm conclusions can be made regarding the role of vitamin E supplements and cancer prevention. Part of the problem lies in calculating or determining the ideal vitamin E dosage, and also the form of vitamin E, whether natural vitamin E, or synthetic vitamin E.

Vitamin E and heart disease
The role of vitamin E in heart disease is another hotly debated topic in the medical community, and again you can find viewpoints on both ends of the spectrum, each quoting their own fact on vitamin E. Over the years there have been several studies on the role of vitamin E in heart disease, with some studies indicating that vitamin E supplements could be helpful, whereas other results are not so promising. Part of the problem lies in calculating or determining the ideal vitamin E dosage, and also the form of vitamin E, whether natural vitamin E with the full tocopherol complex, or synthetic vitamin E.

Vitamin E side effects
Very high dosages of vitamin E supplements, such as 1,000 units or more, can lead to an increase in bleeding tendency, tiredness, weakness, headache, nausea, and possibly impaired immune function. The benefit of vitamin E probably diminishes after a dosage of 200 units and vitamin E side effects start after 1000 units. The side effects of vitamin E excess go away relatively quickly after stopping the supplement. It is nearly impossible to become vitamin E toxic from food alone.
   An infrequent vitamin E side effect is allergy which may be in the form of breathing difficulty and swelling of the lips, tongue or face.

Vitamin E in food
Vitamin E is found in many foods including nut oils, sunflower seeds, whole grains, wheat germ, and spinach.

Vitamin E supplement Recommendations
The average American diet contains between 10 and 22 international units of vitamin E. Additional intake may be beneficial. Most healthy adults should do well with supplementing with 20 to 200 units of natural Vitamin E a few times a week. I do not recommend daily doses above 200 units. Since vitamin E is fat soluble, it need not be taken daily. Avoid synthetic vitamin E supplements and choose natural vitamin E complex.

Vitamin E and Scar Formation
The effects of topical vitamin E on the cosmetic appearance of scars.
Dermatol Surg. 1999 Apr;25(4):311-5. Baumann LS, Spencer J.
University of Miami Department of Dermatology and Cutaneous Surgery, Miami, Florida
Anecdotal reports claim that vitamin E speeds wound healing and improves the cosmetic outcome of burns and other wounds. Many lay people use vitamin E on a regular basis to improve the outcome of scars and several physicians recommend topical vitamin E after skin surgery or resurfacing. OBJECTIVE: We attempted to determine whether topically applied vitamin E has any effect on the cosmetic appearance of scars as suggested by multiple anectodal reports. Fifteen patients who had undergone skin cancer removal surgery were enrolled in the study. All wounds were primarily closed in 2 layers. After the surgery, the patients were given two ointments each labeled A or B. A was Aquaphor, a regular emollient, and the B was Aquaphor mixed with vitamin E. The scars were randomly divided into parts A and B. Patients were asked to put the A ointment on part A and the B ointment on part B twice daily for 4 weeks. The study was double blinded. The physicians and the patients independently evaluated the scars for cosmetic appearance on Weeks 1, 4, and 12. The criteria was simply to recognize which side of the scar looked better if there was any difference. The patients' and the physicians' opinions were recorded. A third blinded investigator was shown photographs of the outcomes and their opinion was also noted. RESULTS: The results of this study show that topically applied vitamin E does not help in improving the cosmetic appearance of scars and leads to a high incidence of contact dermatitis. CONCLUSIONS: This study shows that there is no benefit to the cosmetic outcome of scars by applying vitamin E after skin surgery and that the application of topical vitamin E may actually be detrimental to the cosmetic appearance of a scar. In 90% of the cases in this study, topical vitamin E either had no effect on, or actually worsened, the cosmetic appearance of scars. Of the patients studied, 33% developed a contact dermatitis to the vitamin E.

Vitamin E Research Update - A look at the Benefit of Vitamin E
Eating food rich in vitamin E may help protect against Parkinson's disease. A review of eight studies that looked into whether vitamins C and E and beta carotene had an impact on the odds of developing the progressive brain disease showed that a moderate intake of vitamin E lowered the risk. Neither vitamin C nor beta carotene seemed to have a protective effect against the illness. The researchers said they did not know whether vitamin E supplements would have any benefits. Parkinson's is a chronic, irreversible neurodegenerative disease that affects 1 percent of people over the age of 65 worldwide. In the United States alone at least 500,000 people suffer from the illness. The illness occurs when brain cells that produce a chemical called dopamine malfunction and die. Symptoms include tremors, stiffness, slow movement and poor coordination and balance. The scientists, who looked at relevant studies from 1966 to March 2005, said more research is needed to confirm their findings. Vitamin E is an antioxidant that protects cells from damage. Foods rich in the vitamin include nuts, seeds, wheat germ, spinach and other green leafy vegetables.

Women may find some relief from menstrual cramps by taking vitamin E a few days a month. The study, of teenage girls in Iran, found that those who took vitamin E starting two days before their periods suffered far less cramping than their peers who used only standard pain medication. After four months, the girls who took vitamin E had cramps for less than two hours, on average, during their periods. That compared with 17 hours for those who did not take the vitamin. Dr. Saeideh Ziaei and her colleagues at Tarbiat Modarres University in Tehran report the findings in the British Journal of Obstetrics and Gynaecology. Common menstrual cramps, or primary dysmenorrhea, are thought to result from the release of hormone-like substances called prostaglandins. Prostaglandins cause the uterus to contract in order to expel the uterine lining, resulting in menstrual blood flow. Vitamin E, by acting on two enzymes in the body, can inhibit the formation of prostaglandins -- and, potentially, menstrual cramps, according to Ziaei and her colleagues. To investigate, the researchers randomly assigned 278 girls, 15 to 17 years old, with primary dysmenorrhea to take either vitamin E or an inactive placebo pill. Girls in the vitamin E group took 200 milligrams (mg) of the vitamin twice a day, starting two days before they expected their periods and continuing through the third day of menstruation.] Both groups were allowed to take ibuprofen if they needed to. After four months, girls in the vitamin E group showed a sharp reduction in the number of hours they suffered menstrual cramps each month. Few -- 4 percent -- reported using ibuprofen, compared with 89 percent of girls in the placebo group. Girls in both groups tended to say their periods got lighter during the study period, but the change was greater in the vitamin group. The dose of vitamin E used in the study -- 200 mg twice a day -- is significantly higher than the recommended daily intake of 20 mg, but still well within the range that experts consider unlikely to cause adverse effects. U.S. health officials set the "upper tolerable intake level" for vitamin E at 1,000 mg per day. "The use of vitamin E for menstrual cramps  in adolescent women is attractive," Ziaei's team writes, "because of the marked effect we have demonstrated, coupled with the absence of significant side effects from vitamin E at therapeutic doses." SOURCE: British Journal of Gynecology, April 2005.

Taking high-dose vitamin E supplements for an extended period doesn't protect against cancer; in fact, it may even speed up the development of latent cancers, according to a study by researchers from Hotel-Dieu de Quebec Research Centre and Universite Laval. Their results are published in the April issue of the prestigious Journal of the National Cancer Institute. Dr. Isabelle Bairati, professor at the Universite Laval Faculty of Medicine and researcher at Hotel-Dieu de Quebec's Oncology Research Centre, and colleagues conducted the study among 540 volunteers over an eight-year period. All the participants were treated for early stage head and neck cancer and were at high risk of developing another cancer. During the first three years, half of the participants received 400 international units of vitamin E daily, while the rest were given a placebo. Researchers put forth an initial hypothesis that people who eat a lot of fruits and vegetables are less likely to develop cancer. This beneficial effect might come from the many antioxidant vitamins contained in those types of foods. Dr. Bairati and her colleagues thus decided to analyze the impact of vitamin E intake, in the form of a daily food supplement, among a population at high risk of developing a second cancer.
   The main results were as follows: - In the three years during which participants were given either vitamin E supplements or a placebo, researchers recorded more cancer cases in the vitamin E group than in the placebo group. In the vitamin E group, 20% of participants developed cancer as opposed to only 10% in the placebo group. The expected protective effect of vitamin E was thus disproved. - In the period after the supplements were stopped, the situation was reversed: more cancer cases were recorded in the placebo group than in the vitamin E group. - At the end of the eight-year period, the percentage of patients who developed cancer was the same in both groups (30%). - Researchers suggest that the use of vitamin E supplements may have sped up the development of latent cancers in the patients who were part of the vitamin E group. Although these results may appear surprising when compared to the researchers' initial hypothesis, they are consistent with other recent studies indicating that vitamin E, in the form of a food supplement, may have adverse effects on health. "This cancer chemoprevention trial was conducted in a population of patients at high risk of second cancers. There is some concern about the generalization of the study results to individuals in the general population who are at low risk of a first cancer. Nevertheless, our results suggest that caution should be advised regarding the use of high-dose vitamin E supplements for cancer prevention," explained Dr. Bairati.
   Dr. Sahelian comments: I wish the researchers had used a lower amount of Vitamin E, such as 100 to 200 units -- and in the natural, mixed form -- and perhaps the results would have been much different.

High blood levels of alpha- and gamma-tocopherol, seem to cut the risk of prostate cancer by about 50 percent each. The findings are based on an analysis of 100 individuals with prostate cancer and 200 cancer-free "controls" participating in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, which included nearly 30,000 Finnish men. Men with the highest levels of alpha-tocopherol in their blood at baseline were 51 percent less likely to develop prostate cancer than those with the lowest levels. Similarly, men with the highest levels of gamma-tocopherol were 43 percent less likely to develop the disease compared with men with the lowest levels. Further analysis showed that the link between high tocopherol levels and low cancer risk was stronger among subjects using alpha-tocopherol supplements than among non-users. This supports the original findings from the ATBC study, which showed that daily vitamin E supplementation reduced the risk of prostate cancer by 32 percent. SOURCE: Journal of the National Cancer Institute, March 2, 2005.

Relation of the tocopherol forms to incident Alzheimer disease and to cognitive change.
American Journal of Clinical Nutrition, Vol. 81, No. 2, 508-514, February 2005
Background: High intake of vitamin E from food (tocopherol), but not from supplements (which usually contain -tocopherol), is inversely associated with Alzheimer disease. Objective: We examined whether food intakes of vitamin E, -tocopherol equivalents (a measure of the relative biologic activity of tocopherols and tocotrienols), or individual tocopherols would protect against incident Alzheimer disease and cognitive decline over 6 y in participants of the Chicago Health and Aging Project. Design: The 1993–2002 study of community residents aged 65 y included the administration of 4 cognitive tests and clinical evaluations for Alzheimer disease. Dietary assessment was by food-frequency questionnaire. Results: Tocopherol intake from food was related to the 4-y incidence of Alzheimer disease determined by logistic regression in 1041 participants who were clinically evaluated (n = 162 incident cases) and to change in a global cognitive score determined by mixed models in 3718 participants. Higher intakes of vitamin E and -tocopherol equivalents were associated with a reduced incidence of Alzheimer disease in separate multiple-adjusted models that included intakes of saturated and trans fats and docosahexaenoic acid. - and -Tocopherol had independent associations. In separate mixed models, a slower rate of cognitive decline was associated with intakes of vitamin E, -tocopherol equivalents, and - and -tocopherols. Conclusion: The results suggest that various tocopherol forms rather than - tocopherol alone may be important in the vitamin E protective association with Alzheimer disease.

The gamma form of vitamin E found in many plant seeds -– but not in most manufactured nutritional supplements -– might halt the growth of prostate and lung cancer cells, according to a Purdue University study. A team led by Prof. Qing Jiang has found that gamma-tocopherol, which occurs naturally in walnuts, pecans, sesame seeds, and in corn and sesame oils, inhibits the proliferation of lab-cultured human prostate and lung cancer cells.

High-dose vitamin E linked to increased mortality?
Taking a high dose of vitamin E routinely does not increase your chances of living longer, and in fact it seems to have a negative effect. Vitamin E supplementation at doses higher than 400 International Units (IU) per day apparently raises all-cause mortality rates and should be avoided, a research team reported at the American Heart Association meeting. Because of its antioxidant properties, vitamin E supplementation has been studied in many trials to prevent chronic diseases. Several of those studies have hinted at increased mortality rates, but the number of participants in the each study was too small to tell if the results were real or occurred by chance. To further investigate, Dr. Edgar R. Miller III, at Johns Hopkins Medical Institutions in Baltimore, and his team pooled data from 19 trials of vitamin E supplementation. These included nearly 136,000 subjects who were randomly assigned to take vitamin E or placebo capsules and were followed for more than a year. Overall, vitamin E supplementation did not affect mortality rates, the team found. However, the 11 trials testing doses of 400 IU daily or higher showed 39 more deaths occurred per 10,000 people taking high-dose vitamin E than among the same number of people taking a placebo. Miller's group calculates that the risk of dying was increase by 4 percent with high-dose vitamin E. For low doses of vitamin E -- less than 150 IU daily -- all-cause mortality rates were slightly decreased, although this difference was not significant from a statistical standpoint. When the researchers factored in the simultaneous use of other vitamins or minerals, the reduction in the risk of dying with low-dosage vitamin E was toned down, but the risk at higher doses was increased. SOURCE: Annals of Internal Medicine, November 10 online, 2004.

Regular users of vitamin E are at decreased risk for death from Lou Gehrig's disease, also called amyotrophic lateral sclerosis (ALS), compared with nonusers. Given that vitamin E is an antioxidant, the new findings support the hypothesis that oxidants play a key role in the development of ALS. Moreover, the results are consistent with earlier findings showing that increased brain levels of vitamin E seem to delay the onset of ALS in lab animals. Still, use of another antioxidant, vitamin C, seemed to confer no protection against ALS, the report in the Annals of Neurology indicates. In the study, Dr. Alberto Ascherio, from Harvard School of Public Health in Boston, and colleagues analyzed data from nearly 1 million subjects enrolled in the American Cancer Society Cancer Prevention Study II. All of the subjects were at least 30 years of age when the study began in 1982. Information on vitamin E use was collected at enrollment and the subjects were followed from 1989 through 1998. During follow-up, 525 deaths from ALS were recorded, the investigators note. Compared with nonusers, patients who took vitamin E for less than 15 days per month did not reduce the risk of death from ALS.
However, patients who used vitamin E for 15 or more days per month for at least 10 years had a reduced risk of ALS death of 62 percent. As noted, the use of vitamin C, even on a regular basis for many years, did not protect against ALS. As to why no benefit was seen with vitamin C, the authors believe it may be because vitamin C is "a water-soluble antioxidant with different properties than vitamin E and thus may not" act the same in the body. Further studies are needed to confirm the apparent anti-ALS effect for vitamin E, the authors note. Also, because most cases in the current study occurred spontaneously, it remains to be determined whether or not a relationship exists for hereditary ALS, they add. SOURCE: Annals of Neurology, November 2004.

Cosupplementation with vitamin E and coenzyme Q10 reduces circulating markers of inflammation in baboons.
Am J Clin Nutr. 2004 Sep;80(3):649-55.
Inflammation and oxidative stress are processes that mark early metabolic abnormalities in vascular diseases.  We explored the effects of a high-fat, high-cholesterol (HFHC) diet on vascular responses in baboons and the potential response-attenuating effects of vitamin E and coenzyme Q(10) (CoQ10) supplementation. We used a longitudinal design by subjecting 21 baboons (Papio hamadryas) to sequential dietary challenges. After being maintained for 3 mo on a baseline diet (low in fat and cholesterol), 21 baboons were challenged with an HFHC diet for 7 wk. The serum C-reactive protein (CRP) concentrations did not change. Subsequent supplementation of the HFHC diet with the antioxidant vitamin E (250, 500, or 1000 IU/kg diet) for 2 wk reduced serum CRP concentrations. Additional supplementation with CoQ10 (2 g/kg diet) further reduced serum CRP to approximately 30% of baseline. Introduction of the HFHC diet itself significantly decreased serum P-selectin and von Willebrand factor concentrations. However, neither vitamin E alone nor vitamin E plus CoQ10 significantly altered the serum concentrations of P-selectin or von Willebrand factor. Dietary supplementation with vitamin E alone reduces the baseline inflammatory status that is indicated by the CRP concentration in healthy adult baboons. Cosupplementation with CoQ10, however, significantly enhances this antiinflammatory effect of vitamin E.

A daily dose of vitamin E may help delay the onset of type 2 diabetes in people at high risk of the disease. Researchers in New Zealand found that high-dose vitamin E appeared to temporarily improve insulin resistance -- a precursor to type 2 diabetes -- among 41 overweight adults. Though the improvement was short-lived, another diabetes risk factor -- elevations in a liver enzyme called alanine transferase -- changed for the better throughout the six-month study. Some past studies have reached similar conclusions. A recent study found that people whose diets had a healthy dose of antioxidants, including vitamin E, had a lower diabetes risk than those with lower antioxidant intakes.

Cosupplementation with vitamin E and coenzyme Q10 reduces circulating markers of inflammation in baboons
American Journal of Clinical Nutrition, Vol. 80, No. 3, 649-655, September 2004
Background: Inflammation and oxidative stress are processes that mark early metabolic abnormalities in vascular diseases. Objectives: We explored the effects of a high-fat, high-cholesterol (HFHC) diet on vascular responses in baboons and the potential response-attenuating effects of vitamin E and coenzyme Q10 (CoQ10) supplementation. Design: We used a longitudinal design by subjecting 21 baboons (Papio hamadryas) to sequential dietary challenges. Results: After being maintained for 3 mo on a baseline diet (low in fat and cholesterol), 21 baboons were challenged with an HFHC diet for 7 wk. The serum C-reactive protein (CRP) concentrations did not change. Subsequent supplementation of the HFHC diet with the antioxidant vitamin E (250, 500, or 1000 IU/kg diet) for 2 wk reduced serum CRP concentrations from 0.91 to 0.43 mg/dL. Additional supplementation with CoQ10 (2 g/kg diet) further reduced serum CRP to 30% of baseline. Introduction of the HFHC diet itself significantly decreased serum P-selectin and von Willebrand factor concentrations. However, neither vitamin E alone nor vitamin E plus CoQ10 significantly altered the serum concentrations of P-selectin or von Willebrand factor. Conclusions: Dietary supplementation with vitamin E alone reduces the baseline inflammatory status that is indicated by the CRP concentration in healthy adult baboons. Cosupplementation with CoQ10, however, significantly enhances this antiinflammatory effect of vitamin E.

Giving nursing home residents a daily dose of vitamin E may offer a little help in reducing the risk of upper respiratory tract infections, such as the common cold, according to new study findings released Tuesday. Studies have shown that vitamin E can boost the immune system in the elderly, and in the current study, slightly fewer people who received vitamin E supplements developed one or more respiratory infection of any kind during the study period. Vitamin E recipients also appeared somewhat less likely to develop the common cold. SOURCE: Journal of the American Medical Association, August 18, 2004

Vitamin E and respiratory tract infections in elderly nursing home residents: a randomized controlled trial.
JAMA. 2004 Aug 18;292(7):828-36.
Respiratory tract infections are prevalent in elderly individuals, resulting in increased morbidity, mortality, and use of health care services. Vitamin E supplementation has been shown to improve immune response in elderly persons especially if they have vitamin E deficiency. However, the clinical importance of these findings has not been determined. To determine the effect of 1 year of vitamin E supplementation on respiratory tract infections in elderly nursing home residents. A randomized, double-blind, placebo-controlled trial was conducted from April 1998 to August 2001 at 33 long-term care facilities in the Boston, Mass, area. A total of 617 persons aged at least 65 years and who met the study's eligibility criteria were enrolled; 451 (73%) completed the study. Vitamin E (200 IU) or placebo capsule administered daily; all participants received a capsule containing half the recommended daily allowance of essential vitamins and minerals. Incidence of respiratory tract infections, number of persons and number of days with respiratory tract infections (upper and lower), and number of new antibiotic prescriptions for respiratory tract infections among all participants randomized and those who completed the study. Vitamin E had no significant effect on incidence or number of days with infection for all, upper, or lower respiratory tract infections. However, fewer participants receiving vitamin E acquired 1 or more respiratory tract infections, or upper respiratory tract infections. When common colds were analyzed in a post hoc subgroup analysis, the vitamin E group had a lower incidence of common cold and fewer participants in the vitamin E group acquired 1 or more colds. Vitamin E had no significant effect on antibiotic use. Supplementation with 200 IU per day of vitamin E did not have a statistically significant effect on lower respiratory tract infections in elderly nursing home residents. However, we observed a protective effect of vitamin E supplementation on upper respiratory tract infections, particularly the common cold, that merits further investigation.

Vitamin E and CoQ10 work well together for heart and circulation
One of the early signs of vascular disease is inflammation within the walls of the arteries. This inflammation attracts white blood cells and other types of cells floating in the blood to the damaged inner lining of the arteries, resulting in plaque formation and increased likelihood of clotting. The initial inflammation and subsequent damage can result from a number of factors, including oxidation or free radical damage, high cholesterol, and high homocysteine.
     Researchers gave 21 baboons a high fat, high-cholesterol diet (just like my Thanksgiving meal) daily for 7 weeks and measured the blood level of a substance you will hear of more in the future called CRP, short for C-reactive protein. CRP is a marker for inflammation. The higher the CRP, the more damage to the inner lining of a blood vessel, like the coronary arteries in the heart. At the end of the 7 weeks, they continued with this high fat, high cholesterol diet, but this time they added vitamin E. The addition of vitamin E reduced the level of CRP. Then they added COQ10 on top of the vitamin E for another 2 weeks. They discovered that the levels of CRP dropped even further. The researchers conclude, "Dietary supplementation with vitamin E alone reduces the baseline inflammatory status that is indicated by the CRP concentration in healthy adult baboons. Co-supplementation with CoQ10 significantly enhances this effect of vitamin E."
     Dr. Sahelian says: For those of you with a heart condition or high cholesterol, or a family history of heart disease, it would make sense to take vitamin E complex and CoQ10. Discuss with your doctor if these are appropriate for your condition. A reasonable amount would be 30 to 200 units daily of natural vitamin E complex, or 100 to 300 units two or three times a week since vitamin E is fat soluble and can be stored in fat cells. As to CoQ10, a range of 20 to 60 mg is appropriate, a few times a week. CoQ10 is also fat soluble and is best taken with breakfast. Vitamin E can be taken with any meal.

Are you taking too much vitamin E?
Researchers at Johns Hopkins University in Baltimore pooled data from 19 trials of vitamin E supplementation. These included nearly 136,000 subjects who were randomly assigned to take vitamin E or placebo capsules and were followed for more than a year. Overall, vitamin E supplementation did not affect mortality rates. However, the trials testing doses of 400 IU daily or higher showed 39 more deaths occurred per 10,000 people taking high-dose vitamin E than among the same number of people taking a placebo. For low doses of vitamin E -- less than 150 IU daily --  mortality rates were slightly decreased.
     Dr. Sahelian says: I always thought that, for most people, taking more than 100 to 200 units a day of vitamin E was not necessary. The one problem with this study, though, is that it probably did not make a distinction between synthetic vitamin E supplements and natural vitamin E. On a supplement label, natural vitamin E is listed as d-alpha tocopherol. In contrast, synthetic forms of vitamin E are labeled with a dl- prefix.
Also, the study did not account for the d-alpha form of vitamin E versus a natural Vitamin E supplement that includes all the tocopherols and tocotrienols. Even though it is a flawed study, I still think 50 to 200 units of vitamin E a few times a week is quite adequate.

Menstrual Cramps
Women may find some relief from menstrual cramps by taking vitamin E a few days a month. The study, of teenage girls in Iran, found that those who took vitamin E starting two days before their periods suffered far less cramping than their peers who used only standard pain medication. After four months, the girls who took vitamin E had cramps for less than two hours, on average, during their periods. That compared with 17 hours for those who did not take the vitamin. Dr. Saeideh Ziaei and her colleagues at Tarbiat Modarres University in Tehran report the findings in the British Journal of Obstetrics and Gynaecology. Common menstrual cramps, or primary dysmenorrhea, are thought to result from the release of hormone-like substances called prostaglandins. Prostaglandins cause the uterus to contract in order to expel the uterine lining, resulting in menstrual blood flow. Vitamin E, by acting on two enzymes in the body, can inhibit the formation of prostaglandins -- and, potentially, menstrual cramps, according to Ziaei and her colleagues. To investigate, the researchers randomly assigned 278 girls, 15 to 17 years old, with primary menstrual cramps to take either vitamin E or an inactive placebo pill. Girls in the vitamin E group took 200 milligrams (mg) of the vitamin twice a day, starting two days before they expected their periods and continuing through the third day of menstruation.] Both groups were allowed to take ibuprofen if they needed to. After four months, girls in the vitamin E group showed a sharp reduction in the number of hours they suffered menstrual cramps each month. Few -- 4 percent -- reported using ibuprofen, compared with 89 percent of girls in the placebo group. Girls in both groups tended to say their periods got lighter during the study period, but the change was greater in the vitamin group. The dose of vitamin E used in the study -- 200 mg twice a day -- is significantly higher than the recommended daily intake of 20 mg, but still well within the range that experts consider unlikely to cause adverse effects. U.S. health officials set the "upper tolerable intake level" for vitamin E at 1,000 mg per day. "The use of vitamin E for menstrual cramps  in adolescent women is attractive," Ziaei's team writes, "because of the marked effect we have demonstrated, coupled with the absence of significant side effects from vitamin E at therapeutic doses." Vitamin E Source: British Journal of Gynecology, April 2005.

Vitamin E emails
Q. What is vitamin E oil used for?
   A. I don't have a good understanding of vitamin E oil at this time and don't have a good idea what benefit vitamin E oil can have.

Q. What foods have vitamin E?
   A. The food content of vitamin E is well known. Foods high in Vitamin E most commonly include wheat germ oil, almonds, and a number of oils.

Q. What about use of vitamin E for skin?
   A. The topical use of vitamin E for skin has a long history, initially recommended for minimizing scars, but that gave inconsistent results and vitamin E is hardly used for skin scars anymore. Some people think they break out with acne or pimples if they use vitamin E oil or vitamin E cream or vitamin E gel on their face.

Q. Is vitamin E overdosage possible?
   A. As with any supplement, overdosage or taking too much vitamin E is quite possible. Overdosage  or toxicity with vitamin E can lead to gastrointestinal disturbances, but I have not heard of fatalities with vitamin E overdosage or any major danger from taking too many vitamin E supplement pills.

Q. Vitamins A E C are recommended by my doctor as antioxidants, would you agree?
   A. Although these 3 vitamins are quite helpful, most doctors don't realize that there are hundreds of supplements and herbs that have as good or better antioxidant properties.

Q. What's the RDA for vitamin E?
   A. The vitamin E RDA is about 15 units per day. It's quite possible that higher amounts could be more beneficial.

Q. Hi Dr. Sahelian, How are you? I hope all is well. I'm hoping you could help me for an article I'm writing on anti-aging antioxidants for Remedies magazine. I'm looking for someone to comment on vitamin E. Since there is so much information (and misinformation) out there, I was wondering if you could just offer a comment or two on your stance on vitamin E. Does it work/not work, is it safe/unsafe? What role, if any, does it play in anti-aging? I'd appreciate any help you could give me.
   A. There is no proof as of now, that supplementing with vitamin E has anti-aging benefits, but most of the research points to the possibility that vitamin E supplements could have health improving benefits, and maybe reduce the risk of heart disease and cancer. The ideal dosage and frequency of intake is currently not known. Research does point to the fact that high doses may be counterproductive. If someone were to supplement with vitamin E, daily amounts should be less than 200 units, and it is highly recommended that vitamin E be natural and include most of the different forms of vitamin E, such as alpha, delta, gamma tocopherols, etc since in foods we find many different forms. In my opinion, some of the research with vitamin E has been flawed since scientists often evaluated supplementation with only the alpha form, and excluded the rest. In addition, the research sometimes focused on the synthetic form of vitamin E, known as dl-alpha-tocopherol, as opposed to the natural form, d-alpha-tocopherol. The outcomes may have been different if natural forms of vitamin E were used rather than synthetic.

Q. I am a nutritionist practicing in Chicago and wanted your opinion on vitamin E optimal intake. I came across an editorial in the American Journal of Clinical Nutrition by Maret G Traber who is at the Linus Pauling Institute at Oregon State University in Corvallis, OR. Here is the last paragraph of the editorial: "And so we are left with the good news that the serum concentration of {alpha} - tocopherol is associated with decreased chronic disease risk, but we still do not know how much vitamin E to recommend for consumption to achieve that concentration. It may be that large vitamin E supplements are not necessary to achieve optimal serum {alpha} - tocopherol concentrations, in that the vitamin E recommended dietary allowance of 15 mg per day may yield optimal serum concentrations to achieve significant reductions in chronic disease mortality. However, 15 mg a day may be a vitamin E intake that is achieved only with supplements, given the dietary habits of most Americans and the observation that vitamin E–rich food sources are less popular foods, such as nuts, seeds, and vegetable oils, including olive, sunflower, or safflower oils.
   A. A person's optimal vitamin E supplement requirement is influenced by many factors, particularly diet. I think a daily vitamin E supplement intake of 10 to 100 units a few times a week is reasonable, and frankly I don't see the need to take megadoses beyond 200 units.

Additional links of interest
Saw palmetto used for bph
Pygeum is often found together with saw palmetto in prostate formulas.
Tongkat ali herb for sexual enhancement

Additional Antioxidants that could be taken with vitamin E:
Aceytylcysteine is a potent antioxidant used to protect the liver from acetaminophen toxicity.
Acetyl l Carnitine is an antioxidant and a mental stimulant.
Carnosine is an antioxidant and improves energy levels.
Curcumin is a spice that has become very popular over the past few years.
Lipoic acid is often used by those with diabetes.