Also known as tocopherol, vitamin E was isolated in the 1920s. There is general agreement that tocopherols in foods can function as excellent antioxidants protecting cells from damage. tocopherols are fat soluble oil.

Types of natural Tocopherols
Several types of natural vitamin E compounds are available, including alpha-, beta-, gamma-and delta- tocopherol. Alpha tocopherol seems to be the most active, although we should not dismiss the importance of the others. It seems prudent to supplement with vitamin E products that have mixed tocopherols as opposed to just alpha- tocopherol. Supplementation of diets with alpha-tocopherol alone reduces serum concentrations of gamma- and delta- tocopherol in humans.

Synthetic Tocopherol versus natural Tocopherol
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. Many studies evaluating the role of Vitamin E in health and disease have focused mostly on synthetic Vitamin E supplements. Results of studies using natural and mixed forms of tocopherols may yield completely different outcomes.

Why take a combination?
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 tocopherols.

Heart disease
Alpha-tocopherol supplements in patients with coronary artery disease reduce plasma biomarkers of oxidative stress and inflammation but research is inconclusive as to the overall reduction in coronary artery or carotid artery disease. Some studies show alpha tocopherol supplements may be helpful in those with heart disease while others do not find much improvement.

Alpha tocopherol and tocopherol complex research study
Plasma carotene and {alpha}-tocopherol in relation to 10-y all-cause and cause-specific mortality in European elderly: the Survey in Europe on Nutrition and the Elderly, a Concerted Action (SENECA)
American Journal of Clinical Nutritionr 2005
The objective was to study the association of plasma carotene ({ alpha }-and beta-carotene) and alpha-tocopherol with all-cause and cause-specific mortality in elderly subjects who participated in a European prospective study. Plasma concentrations of carotene and alpha-tocopherol were measured in 1168 elderly men and women. After a follow-up period of 10 years, 388 persons had died. Results: Plasma carotene concentrations were associated with a lower mortality risk. This lower mortality risk was observed for both cancer and cardiovascular disease. The lower risk of cardiovascular death was confined to those with a body mass index (in kg/m2) <25. Plasma concentrations of alpha-tocopherol were not associated with all-cause or cause-specific mortality. Conclusions: This prospective study suggests that high plasma concentrations of carotene are associated both with lower mortality from all causes and with cancer in the elderly. For cardiovascular mortality, the inverse association was confined to elderly with body mass indexes <25.

Prostate cancer
Am J Clin Nutr. 2015. Carotenoids, retinol, tocopherols, and prostate cancer risk: pooled analysis of 15 studies. Overall prostate cancer risk was positively associated with retinol and inversely associated with α-tocopherol, and risk of aggressive prostate cancer was inversely associated with lycopene and α-tocopherol. Whether these associations reflect causal relations is unclear.

Serum alpha- tocopherol and gamma- tocopherol in relation to prostate cancer risk in a prospective study.
J Natl Cancer Inst. 2005. Weinstein SJ, Wright ME, Pietinen P, King I, Tan C, Taylor PR. Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
The Alpha- Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study demonstrated a 32% reduction in prostate cancer incidence in response to daily alpha-tocopherol supplementation. We examined baseline serum concentrations of alpha- tocopherol and gamma- tocopherol to compare their respective associations with prostate cancer risk. From the ATBC Study cohort of 29 133 Finnish men, 50-69 years old, we randomly selected 100 incident prostate cancer case patients and matched 200 control subjects. Odds ratios and 95% confidence intervals (CIs) were estimated for the serum tocopherols (measured by high-performance liquid chromatography) using logistic regression models. Odds ratios for the highest versus the lowest tertiles were 0.49 for alpha- tocopherol and 0.57 for gamma -tocopherol. Further analyses indicated that the association of high serum tocopherols with low prostate cancer risk was stronger in the alpha- tocopherol-supplemented group than in those not receiving alpha- tocopherol. Participants with higher circulating concentrations of the major vitamin E fractions, alpha- tocopherol and gamma-tocopherol, had similarly lower prostate cancer risk.

Questions
Q. 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.

Supplementation with {alpha}-tocopherol decreased red blood cell {gamma}-tocopherol, whereas mixed tocopherols increase both serum {alpha}-tocopherol and serum and cellular {gamma}-tocopherol. Changes in serum tocopherol closely reflect changes in cellular concentrations of tocopherols after supplementation.

Q. Your webpage has been very informative, however I have some questions about the use supplements. I have been taking alpha tocopherol for a while and I recently became interested on the benefits of green tea. My concern is that I found some articles stating that its use may diminish the absorption of lipids including alpha tocopherol, so I would like to know how much time appart should I take my supplements, or if there is something else I can do to benefit from both at the same time. To give you a general idea, I am a healthy female, on my mid twenties, without any weight or cholesterol problems.
     A. We have not seen any reliable studies that green tea will decrease the absorption of alpha tocopherol to any significant degree. Furthermore, most supplements that contain alpha tocopherol may have too much of this vitamin, anyway, so it may be better to take less, not more.

Q. I am a nutritionist practicing in Chicago and wanted your opinion on tocopherol 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 tocopherol megadoses beyond 200 units.

Q. Does tribulus terrestris extract interfere with tocopherol supplement ingestion?
   A. We don't see any reason why tribulus terrestris extract would interfere with tocopherol supplement or any vitamin E product.

I have read one should take vitamin E when consuming fish oils and flaxseed oil. Does D-alpha-tocopheryl acid succinate, a water soluable Vitamin E , provide the same benefit as d'alpha tocopherol with mixed tocopherols to prevent Fish oils and Flaxseed oil oxidising.
    I don't know for sure, but, as a general rule, I prefer using mixed tocopherols rather than individual ones alone.

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