Category: Vitamin E

Vitamin E – the good and the bad

Admin

December 10. 2024

Vitamin E is a large family of active substances, with alpha-tocopherol being the most well-known and used, but it has good and bad relatives.

Atherosclerosis and cardiovascular disease are some of the most common causes of death worldwide, and also reduce the quality of life for millions of people. The authors of a new article have reviewed the recent scientific evidence on the effects of increased intake of the two main forms of vitamin E, tocotrienols and tocopherols, on patients with atherosclerosis and the cardiovascular diseases that accompany atherosclerosis (Rafique et al., 2024).

The article has focused on the fact that vitamin E is much more than the commonly known alpha-tocopherol, and that some of the other forms of vitamin E in the diet may contribute to better protection of the body’s cardiovascular system.

An attempt to illustrate the structure of vitamin E can be seen below, where the four tocotrienols are on the left with three double bonds in the long carbon chain, and the four tocopherols are on the right.

Tocotrienols                                                                  Tocopherols

Figure 1: The eight substances that naturally belong to the vitamin E group in plants. The tocotrienols are on the left, and the tocopherols on the right. Alpha-tocopherol is shown in red. The arrows in the figure show how trienols can be converted to alpha-tocopherol in our body. (Figure modified from Querchi et al. (2015)).

The new article is based on a review of 5 studies published in the 8 years from 2015-2022, which examined the effect of tocotrienol or tocopherol supplementation on the development of atherosclerosis or patients with already existing atherosclerosis and other cardiovascular diseases.

A study highlighted in the recently published article showed that tocotrienol at a dose of 250 mg per day for 16 weeks had a clear positive effect on reducing cholesterol and reducing important biomarkers of oxidative stress and inflammation in the body (Querishi et al 2015):

  • C-reactive protein (CRP): a 40% decrease

CRP is produced in the liver and is a frequently used marker for inflammation in the body in general and also for atherosclerosis, where a lower level gives patients a lower risk of having a blood clot.

  • Malondialdehyde (MDA): a decrease of 34%

Malondialdehyde is produced in the body’s tissues and high levels are a sign of oxidative stress and low antioxidant levels.

  • Gamma-glutamyl transferase (GGT): a decrease of 22%

High GGT levels in the blood are a sign of strain on the liver-biliary system and pancreas.

Along with the above positive changes, the total antioxidant status in the blood was increased by 22%, and cytokines that promote inflammation, such as interleukins (IL-1, IL-12), were reduced by 15-17%. Tocotrienol also had a positive effect on several types of micro-RNA, which are important in the regulation of inflammation and fatty acid metabolism.

Overall, the article showed that tocotrienol can help reduce the processes in the body that lead to atherosclerosis – especially in patients with already existing symptoms of cardiovascular problems.

However, the positive studies on tocotrienols mentioned in the new article are all of shorter duration – 3–6 months. In contrast, the studies the article compares with were all conducted with alpha-tocopherol, and of duration as long as 30 years.

These long-term studies of alpha-tocopherol have shown results with considerable variation. A Finnish study (Huang et al 2019), which followed 29,000 male smokers for 30 years, showed that a better diet with an approximately 30% higher content of natural alpha-tocopherol, initially reduced mortality by 22%, including atherosclerosis by 10-21%, heart attack by 2-17% and cerebral hemorrhage by 22-38%. A supplement of 50 mg/day RL alpha-tocopherol for approximately 6 years within the 30-year period, on the other hand, did not affect symptoms or mortality in the short or long term.

Another long-term American study followed 3,780 healthy women for 11 years, measuring the effect of an alpha-tocopherol supplement to double the level of alpha-tocopherol in the blood. The women were aged between 50 and 79 at the start of the study. The study found an 8% reduced incidence of cerebral hemorrhage with higher levels of alpha-tocopherol in the blood, but an increased incidence of other cardiovascular diseases, such that the overall incidence of cardiovascular problems increased by 8%.

Chemically produced “vitamin E”
Since vitamin E is a strong antioxidant that is known to reduce the unwanted oxidation of LDL cholesterol and other fats in the walls of cells, thereby counteracting atherosclerosis, etc. (Belcher et al 1993), it is relevant to ask why large and long-term studies do not unequivocally show that a supplement of vitamin E is super good.

One explanation could be that we somehow need free radicals, and that vitamin E, with its antioxidant effect, therefore removes something “good.” A more credible explanation, in my perspective, is that large-scale experiments have often used a cheap and poor form of chemically produced vitamin E.

When people talk about there being 8 forms of vitamin E, they are often referring to the 8 different molecules shown above (Figure 1). However, alpha-tocopherol is a complex molecule, and in three places in the molecule a carbon atom is linked to four other atoms/molecules. In the figure below, the positions of the three carbon atoms are marked with red stars (Figure 2).

Figure 2: Drawing of the molecular structure of alpha-tocopherol, where the stars mark the three places where a carbon has four different bonds. (Figure modified from Kohlmeier (2015)).

When you look at the drawing, you can easily imagine that the different molecules can rotate freely, but in reality they are very stable. If hydrogen (H) and the methyl molecule (CH3) are in just one of the places opposite to what is shown in the drawing – yes – then biologically you have seen a different molecule.

Unfortunately, this is exactly what happens when you produce vitamin E the old-fashioned chemical way. That is, atoms and molecules turn randomly, which means that they have two possible positions in three different places.

Therefore, 2 different x 2 different x 2 different = a total of 8 different forms of the molecule are chemically produced – see Figure 3 below. Of these, only one form is the natural form of vitamin E, which is found in plants and therefore in our diet, while the other seven versions of the molecule are unknown to plants and animals.

In particular, the four forms shown on the right in the figure below are broken down relatively quickly in the liver like other foreign substances. However, we know very little about what toxic effects they have before they are broken down, and what long-term toxic effects arise due to the more or less broken down substances.

Figure 3: Graphic illustration of the eight forms of vitamin E that are created when attempting to produce vitamin E using simple chemical methods. The natural alpha-tocopherol is marked in red. (Figure modified from Kohlmeier (2015)).

When you want to produce cheap supplements, such as cheap multivitamin pills, you often use chemically produced vitamin E. In these cheap products, the mixture of the eight forms of vitamin E is called rac alpha-tocopherol or DL ​​alpha-tocopherol. The natural alpha-tocopherol has been given first names such as D alpha-tocopherol or RRR alpha-tocopherol.

To increase the shelf life of various foods, vitamin E is often used as an antioxidant during production. Since the focus is on vitamin E’s antioxidant effect and not its effect as a vitamin, many manufacturers prefer to use the cheapest form of vitamin E, which is the chemically produced form that contains all 8 forms in equal amounts.

Figure 4 below graphically shows how the eight natural forms of vitamin E should be understood, compared to the seven additional forms that arise when alpha-tocopherol is produced chemically.

It can be seen that the variation in natural vitamin E is due to variation in the ring shown on the left, while the variation in chemically produced alpha-tocopherols is due to changes in the long chain extending from the rings.

Figure 4: At the top, the eight forms of vitamin E found in plants, and therefore naturally present in our diet, and then the eight forms of alpha-tocopherol – one natural and the other seven forms resulting from the chemical production of alpha-tocopherol, which are therefore also present in our diet when “vitamin E” is used as an antioxidant and in cheap dietary supplements. (The figure is modified from Kohlmeier (2015) and Querchi et al. (2015)).

Conclusion
It is now well documented that the different forms of vitamin E, in addition to their common effect as antioxidants, have quite different mechanisms of action in the body. The different natural forms of vitamin E contribute with different mechanisms to protect the body’s cardiovascular system, the central nervous system and also provide some protective effect against certain forms of cancer.

The chemical production of alpha-tocopherol, on the other hand, casts a shadow over the results achieved with long-term supplementation of alpha-tocopherol, so that it is not possible to determine whether a daily supplement of this vitamin E contributes to a healthy and long life or perhaps has negative effects.

Tocotrienols are always extracted from natural sources, and existing studies show that they have a safe effect even at relatively high daily intakes. It is therefore advantageous to choose a vitamin E with a high content of tocotrienols.

Klaus K. Sall
Biologist, Cand. Scient.
Sall&Sall Counseling

Notes

EFSA: The European Food Safety Authority EFSA estimates that a daily adequate intake of vitamin E measured as alpha tocopherol is 13 mg/day for men and 11 mg/day for women (EFSA 2015). In 2024, EFSA estimated that the highest daily intake for adults is 300 mg D alpha-tocopherol (EFSA 2024). In a previous specific case, EFSA estimated that a daily intake of 1000 mg mixed tocotrienols and tocopherols does not pose risks. (EFSA 2008).

Chirality: The eight forms of alpha-tocopherol that are formed during chemical production – are part of a phenomenon called chiral molecules. I have created a website that describes the importance of this phenomenon for all life (text in Danish): www.kiral.dk.

Mix: Studies have shown that alpha-tocopherol suppresses the body’s use of tocotrienols. Therefore, in supplements containing both alpha-tocopherol and tocotrienols, the tocopherols will be primarily utilized (Querishi et al 2015).

12: A total of 12 natural molecules have been found that have vitamin E effects. Four of them rarely occur in human food and are not known in dietary supplements.

Organic farming: In organic foods, it is not permitted to use the unnatural forms of alpha-tocopherol.

References and further reading

Belcher, J.D. et al. (1993) ‘Vitamin E, LDL, and endothelium. Brief oral vitamin supplementation prevents oxidized LDL-mediated vascular injury in vitro.’, Arteriosclerosis and Thrombosis: A Journal of Vascular Biology, 13(12), pp. 1779–1789. Available at: LINK.

EFSA (2008) ‘Opinion on mixed tocopherols, tocotrienol tocopherol and tocotrienols as sources for vitamin E added as a nutritional substance in food supplements, EFSA Journal, 6(3), p. 640. Available at: https://doi.org/10.2903/j.efsa.2008.640.

EFSA (2015) ‘Scientific Opinion on Dietary Reference Values for vitamin E as α-tocopherol’, EFSA Journal, 13(7), p. 4149. Available at: https://doi.org/10.2903/j.efsa.2015.4149.

EFSA (2024) ‘Scientific opinion on the tolerable upper intake level for vitamin E’, EFSA Journal, 22(8), p. e8953. Available at: https://doi.org/10.2903/j.efsa.2024.8953.

Huang, J. et al. (2019) ‘Relationship Between Serum Alpha-Tocopherol and Overall and Cause-Specific Mortality’, Circulation Research, 125(1), pp. 29–40. Available at: LINK.

Kohlmeier, M. (2015) Fat-Soluble Vitamins and Nonnutrients: Vitamin E, in: Nutrient Metabolism: Structures, Functions, and Genes, pp. 514–525. Elsevier. Available at: LINK.

Qureshi et al. (2015) ‘Pharmacokinetics and Bioavailability of Annatto δ-tocotrienol in Healthy Fed Subjects’, Journal of Clinical & Experimental Cardiology, 6(11). Available at: LINK.

Rafique, S. et al. (2024) ‘Comparative efficacy of tocotrienol and tocopherol (vitamin E) on atherosclerotic cardiovascular diseases in humans’, Journal of the Pakistan Medical Association, 74(6), pp. 1124–1129. Available at: https://doi.org/10.47391/JPMA.9227.

Sen, C. et al. (2000) ‘Molecular basis of Vitamin E action – Tocotrienol potently inhibits glutamate-induced pp60(c-Src) kinase activation and death of HT4 neuronal cells’, The Journal of biological chemistry, 275, pp. 13049–55. Available at: https://doi.org/10.1074/jbc.275.17.13049.

Sen, C.K. et al. (2007) ‘Tocotrienols: The Emerging Face of Natural Vitamin E’, Vitamins and hormones, 76, p. 203. Available at: https://doi.org/10.1016/S0083-6729(07)76008-9.

Healthy and Safe

Robert Verkerk

October 25, 2007

There are over 480,000 published peer-reviewed research studies on food supplements or ingredients used in food supplements, and the vast majority of these show positive effects. There are only a small handful of studies that have shown negative effects, these generally being associated with high doses or synthetic forms of ingredients like vitamin A, beta-carotene and vitamin E.

In the case of vitamin A, there is no doubt that high doses of this fat soluble vitamin can be harmful and an upper safe level or maximum permitted level for this vitamin makes perfect sense.

There are three key studies showing negative effects of beta-carotene on diseased or high-risk patients, but these have all used synthetic beta-carotene, in the absence of natural carotenoid complexes found in natural carotenoid-rich fruits and vegetables which have been found to be potent cancer-fighting nutrients. Ironically, these natural ‘mixed carotenoids’ are disallowed by the Food Supplements Directive.

Finally, there are four key negative studies on vitamin E, all of them conducted with synthetic vitamin E, which comprises only one of the eight vitamin E forms found in nature, but in its esterified form. This form, alpha-tocopherol, the only vitamin E form allowed by the Directive, actually reduces the body’s absorption of gamma-tocopherol which is the key antioxidant form of vitamin E found in food sources.

By: Robert Verkerk, The Alliance for Natural Health, United Kingdom

Again, uneasiness regarding the pill

Claus Hancke

July 31, 2006

The pill (contraception in pill form) drains the body of the antioxidants, vitamin E and Q10. This could mean that a supplement would make it much safer to take the pill.

More than 100 million women worldwide use the pill as contraception. The pill is believed to be remarkably safe, and it is easy to forget that it can have serious side effects. According to a Dutch report from 2003, users of the pill have a 3-6 times higher risk of developing blood clots in the veins, which is a dangerous condition. In addition, they have a 2-5 times higher risk of developing blood clots in the heart or of suffering from stroke. These numbers are the same for the modern forms of the pill, which have few other few side effects.

If the risk of disease is low, (because of being young and otherwise healthy) than a low percentage increased in risk does not so important. But why is there any increase at all? Light has been thrown on this question by researchers of the Albert Einstein College of Medicine in New York. They have proven that users of the pill have lower vitamin E and Q10 levels in their blood than women who do not take the pill. Vitamin E and Q10 are well known antioxidants.

This is nothing new. Already 15 years ago, researchers believed that vitamin E could reduce the risks associated with the pill. It was also known that the pill drains the body of antioxidants, which can be directly linked to an increased risk of blood clot formation. When one lacks vitamin E, the fats in the blood become oxidized, thereby stimulating the platelets to stick together causing the formation of blood clots. Logically, it was suggested that vitamin E should be combined with use of the pill.

The pill uses up the body’s vitamin E and Q10 reserves. This has been proven again, this time in a study where 15 users of the pill in their forties were compared with women in the same age group who did not take the pill. The differences found were statistically valid, and although this was a small study there were no doubts regarding the results. These results were known before the study was completed; the problem was that nobody had been paying any attention to them.

Unsolved problems
Why does the pill strain the bloods vitamin E and Q10 contents? The pill raises the body’s oestrogen levels. This is why the ovaries go into hibernation so that ovulation is inhibited. The body registers a hormone level high enough that the ovaries can take a break. Even normal (physiologic) levels of oestrogen stimulate the formation of free radicals and therefore cause an increased use of antioxidants. This has been shown in an American study of the cells which compose the inner walls of the blood vessels (endothelium cells). They also showed that free radicals resulting from the presence of oestrogen caused the cells to grow, causing the blood vessels to thicken. It is believed that this increases the risk of blood clots. It also indicates that antioxidants could prevent such side effects.

For practical purposes, women with an increased risk for side effects are advised not to take the pill. This includes women over the age of 35, women with high blood pressure, and so on. All women with an increased risk of blood clots should refrain from using the pill. This causes some amount of contemplation. Who knows if they are in the high risk group? Is their risk so low that a five fold increase in risk is acceptable?

Aside from these problems it is important to know that if you use the pill, your defence against the formation of free radicals is weakened. Even though this is well known, no one has, until recently, thought to reduce this risk with the use of antioxidants.

An important question follows: What is the long term prognosis for women who took the pill for many years when they were young? During the many years they took the pill, they had reduced levels of vitamin E and Q10 in their blood. In the short term, this increased the oxidation of the blood’s fats which increased the risk of blood clots. But does it cause problems in the long term like smoking and high blood pressure? As yet, we can only guess.

By: Vitality Council

References:
1. Palan PR Magneson AT, Castillo M, Dunne J, Mikhail MS. Effects of menstrual cycle and oral contraceptive use on serum levels of lipid soluble antioxidants. Am J Obstet Gynecol. 2006 May;194(5):e35-8. Epub 2006 Apr 21
2. Felty Q. Estrogen-induced DNA synthesis in vascular endothelial cells is mediated by ROS signaling. BMC Cardiovasc Disord 2006 Apr 11;6:16
3. Ciavatti M, Renaud S. Oxidative status and oral contraceptive. Its relevance to platelet abnormalities and cardiovascular risk. Free Radic Biol Med. 1991;10(5):325-38
4. Saha A, Roy K, De K, Sengupta C. Effects of oral contraceptive norethindron on blood lipid and lipid peroxidation parameters. Acta Pol Pharm. 2000 Nov-Dec;57(6):441-7.
5. Tanis BC, Rosendaal FR. Venous and arterial thrombosis during oral contraceptive use: Risks and risk factors. Semin Vasc Med. 2003 Feb;3(1):69-84
6. Crook D, Godsland I. Safety evaluation of modern oral contraceptives. Effect on lipoprotein and carbohydrate metabolism. Contraception. 1998 Mar;57(3):189-201

Smokers should get more vitamin C and E

Claus Hancke

April 1, 2006

Far too many people get too little vitamin E. The problem is especially large in smokers and can partially be solved by a supplement of vitamin C.

What do you do if you get too little vitamin E? Here is a suggestion: take more vitamin C.

Smokers have this problem more than any other group. They use vitamin E much faster than non-smokers. This is because tobacco smoke oxidizes and destroys the vitamin, which causes it to fail in the fight to protect the unsaturated fats of the body’s cells. Smokers therefore have a greater need for vitamin E than non-smokers. Because they have a greater need, it is easier for them to receive too little.

This is where vitamin C comes in. Vitamin C is easier to get a hold of than vitamin E. Because vitamin C is an antioxidant it can protect the vitamin E from oxidization by the free radicals of the tobacco smoke. This has long been believed, but, until recently, remained unproven in people. There has lately been a small scientific breakthrough in this field.

The study was done as a cooperative effort between a number of American universities and one Canadian university. 11 smokers and 13 non-smokers were given supplements of 50 mg vitamin E containing deuterium. By measuring the amount of deuterium in the blood the researchers were able to determine how fast the vitamin E disappeared from the smoker’s blood (plasma) and compare that to the changes in vitamin E levels in the non-smokers.

It disappeared, as expected, fastest in the smokers. In the course of 25 hours half of the marked vitamin E had disappeared. In the non-smokers this took 42 hours. But, when the smokers were given 500 mg vitamin C morning and evening, it took 34 hours for half of the marked vitamin E to disappear. The vitamin C protected the vitamin E reserves in the smokers, but did not bring them to the level of those in the non-smokers.

Far too few get enough
One can therefore see a normalising of vitamin E in smokers with the help of vitamin C. This is of course only true if the smokers receive enough vitamin E in the first place, which can be said of far too few.

To conclude the summary of this research is should be mentioned that only 8% of men and 2.4% of women receive the recommended 12 mg vitamin E (alpha-tocopherol) per day. This is highly likely no better in the U.K. The first and most important recommendation made is that smokers received the recommended amounts (for smokers) of both vitamins C and E (125 mg vit. C and 15 mg vit. E). The second recommendation is that more research be undertaken regarding whether other antioxidants can protect against the degradation of vitamin E. This is important.

But is it true that one needs 12 mg vitamin E per day? Yes it is! An earlier study has shown that the bodily tissue of healthy, young people uses about 5 mg vitamin E (alpha-tocopherol) per day.

Because one on average only absorbs about one third of ones food intake in the intestine, should one take a little bit more than the aforementioned 12 mg. But if one eats an especially light diet more should be taken. If breakfast is only cornflakes and low fat milk, taking a vitamin E supplement won’t do much good. Only a tenth of it will be absorbed.

Even young, healthy smokers should receive more vitamin E than others. Older people have an even greater need and it is apparent that most people don’t get enough.

By: Vitality Council

References
1. Bruno R S et al. Human vitamin E requirements assessed with the use of apples fortified with deuterium-labeled α-tocopheryl acetate. Am J Clin Nutr 2006;83:299-304
2. Bruno R S et al. α-Tocopherol acetate disappearance is faster i9n cigarette smokers and is inversely related to their ascorbic acid status- Am J Clin Nutr 2005;81:95.103.
3. Bruno R S et al. Faster plasma vitamin E disappearance in smokers is normalized by vitamin C supplementation. Free Radical Biology & Medicine 2006;40:689-97

Vitamin E May Be Diabetic’s Saviour

Admin

December 20, 2005

About one out of every two diabetics has a five times larger than average risk of dying from heart disease. This risk can be cut in half by vitamin E. This is a well justified theory which is now being tested in a large Israeli study.

It is well known that the heart’s of diabetics become easily atherosclerotic, often causing them to die due to blood clots in the heart. Therefore, health officials work hard to combat atherosclerosis in diabetics. For example, diabetics are encouraged to take cholesterol reducing medicine, even when their cholesterol levels are very low. Diabetics’ blood pressure should also be low.

If one believes the Israeli researcher, Andrew Levy, the lives of even more diabetics can be saved by taking 400 units of vitamin E daily. Levy’s theory is now being tested in Israel in a large randomised study with 5,000 middle aged diabetics. Half of them will receive vitamin E for the next four years while the other half will not. If it goes as is hoped, the result will have enormous significance for public health.

It is optimistic to implement such an expensive study with vitamin E. As every (Danish, ed.) TV watcher knows, vitamin E doesn’t work against anything. Why would Levy and his co-workers from the Israeli Technion Technical Institute, where many Nobel prise winners can be found, go against the flow?

The explanation involves an antioxidant which few non-experts know of. It is called haptoglobin and is a protein which is created in the body. Haptoglobin binds the blood’s colouring agent, the iron rich haemoglobin, if it becomes detached from the red blood cells. In this way it prevents iron poisoning and therefore against overloading of free radicals in a long list of conditions where red blood cells die.

Disregarded effects of vitamin E
Levy and his co-workers have shown time and time again that haptoglobin works as an antioxidant. There is more to the story; haptoglobin is found in two forms, which are not equally effective antioxidants. Type 1 haptoglobin works much better than type 2. If one has type 2 haptoglobin (like 40% of the Israeli diabetics) the risk of death due to heart disease is five times higher than normal! In other words, a very large part of diabetics’ high death rate due to heart disease is because one out of every two of them has an insufficiency defence against oxidation because of ineffective haptoglobin.

The logical consequence of this enormous difference is, according to Levy, that the poorly protected diabetics with type 2 haptoglobin should take supplementary antioxidants. This is where the vitamin E study comes in. Vitamin E should be able to help. On the other hand, if it does help, why have other studies with vitamin E not previously shown this effect?

Levy believes that this is presumably because they have not been analysed with this effect in mind. He studied serum from a large sample of the ca. 10,000 participants in the Canadian HOPE study, where atherosclerotic participants received 400 units of vitamin E daily. The people behind the HOPE study found no effect of the vitamin E. But what about the 1,000 diabetics in the study? About a year ago, Levy proved that vitamin E reduced the risk of heart disease by 50% in the diabetic participants who had type 2 haptoglobin.
This surprising result was hidden in the HOPE study and was apparently unknown. This is quite educational. If the most threatened diabetics’ very high risk of heart disease can be halved with a cheap, harmless, vitamin E pill, the signification is very large.

Until 2010 we only have these results. There are no other results to turn to. It is not even possible to find out which kind of haptoglobin you have. If you wish to prevent heart disease, you have to do it in the dark. It is however risk free.

By: Vitality Council

References:
1. Andrew P. Levy et al. The Effect of Vitamin E Supplementation on Cardiovascular Risk in Diabetic Individuals With Different Haptoglobin Phenotypes. Diabetes Care 27:2767, 2004.
2. Levy AP et al. Strong Heart Study. Haptoglobin phenotype is an independent risk factor for cardiovascular disease in individuals with diabetes: The Strong Heart Study. J Am Coll Cardiol. 2002 Dec 4;40(11):1984-90.
3. Suleiman M, et al. Haptoglobin polymorphism predicts 30-day mortality and heart failure in patients with diabetes and acute myocardial infarction. Diabetes. 2005 Sep;54(9):2802-6.
4. A survey of the study can be found at Clinical Trials.gov: www.clinicaltrials.gov/ct/gui/show/NCT00220831.

care.diabetesjournals.org
www.cardiosource.com/jacc/index.asp
www.clinicaltrials.gov/ct/gui/show/NCT00220831
www.iom.dk

Vitamin E Lowers Cholesterol Levels in Diabetics

Admin

December 13, 2005

There are at least eight different kinds of Vitamin E, but typically we only get one of those in vitamin pills. One of the other kinds prevents arteriosclerosis, while a third kind has been shown to effectively lower the blood cholesterol levels of diabetics.

When you buy vitamin E in pill form, you almost always get alpha-tocopherol. Alpha-tocopherol (natural and sometimes, unfortunately, synthetic) has also been used exclusively in almost all of the studies on vitamin E’s effectiveness against cardiovascular disease.

There are other tocopherols than alpha-tocopherol. They all share the same basic chemical structure but differ in their side chains. Tocopherol can come in alpha, beta, gamma, or delta forms depending on the position of its side chains. Apha-tocopherol, the type used in vitamin pills, has the greatest effect as a vitamin.

Tocotrienols, another vitamin E form, are less well known. They differ from the other forms by having three double binds in their side chain. They are found in palm oil as well as grains such as oats, barley, rice, and corn. Tocotrienols can also be found in alpha, beta, gamma, and delta forms.

These tocotrienols are coming into the spotlight. For many years, on the basis of animal studies and small studies using humans, there has been the suspicion that they are effective against atherosclerosis. For example, ten year ago an American randomised study with 50 test subjects showed that tocotrienols from palm oil definitely counteracted atherosclerosis of the carotid arteries. Unfortunately no follow up study has been preformed.

Recently an Indian randomised study has surfaced. It shows that tocotrienols from rice sources sink the cholesterol concentration in the blood of type 2 diabetics (old age diabetes). In this study 19 diabetics received placebos for a period of 60 days. Before or after this 60 period they received, for a similar period, capsules containing rice with high concentrations of tocotrienols (each participant received 3 mg tocotrienol per kilo bodyweight per day). The study was designed so that no one knew which participants received which pill at what time until the study was completed.

Unsolved problems
The results showed that the tocotrienols reduced the total cholesterol levels of the participant’s blood by no less than 30%. Even more encouraging, the “bad” cholesterol, (LDL cholesterol) which can become oxidised and cause atherosclerosis, fell by an astonishing 42%. This effect is just as pronounced as seen with traditional cholesterol lowering medication, the so called statins.

It seems that anyone who can get a hold of tocotrienols is free from seeking traditional cholesterol lowering treatment. But before this is certain and becomes common practice, a few things should be further looked analysed.

First and foremost, can the results of the aforementioned study be reproduced? As stated earlier tocotrienols were effective against atherosclerosis in the carotid arteries, but in the study which showed this effect, the participants’ total cholesterol was unchanged! Tocotrienol does not always lower cholesterol. But does it always counteract atherosclerosis? At best the answer is maybe, we don’t know. After looking at the results of the two studies we can hypothesise that the differences in their results could be the result of the different tocotrienol blends used. The first study used a palm oil extract while the second used a rice source. The differences between alpha, beta, gamma, and delta tocotrienol is sufficient, their effects should differ.

Other things which we understand even less could also play a role. The likely cholesterol lowering effect of the rice tocotrienol should also be tested for possible side effects and the results of this should be compared with the side effects of traditional cholesterol medicine. A big job awaits researchers.

Meanwhile, the studies have shown with certainty that (apart from that oatmeal and brown rice are healthy) we are not finished with vitamin E or, more to the point, the E vitamins. There are many of them, and they have different effects. Their potential is very promising.

By: Vitality Council

References:
1. Tomeo AC, Geller M, Watkins TR, Gapor A, Bierenbaum ML. Antioxidant effects of tocotrienols in patients with hyperlipidemia and carotid stenosis. Lipids. 1995 Dec;30(12):1179-83.
2. Qureshi AA, Salser WA, Parmar R, Emeson EE. Novel tocotrienols of rice bran inhibit atherosclerotic lesions in C57BL/6 ApoE-deficient mice. J Nutr. 2001 Oct;131(10):2606-18.
3. Baliarsingh S, Beg ZH, Ahmad J. The therapeutic impacts of tocotrienols in type 2 diabetic patients with hyperlipidemia. Atherosclerosis. 2005 Oct;182(2):367-74. Epub 2005 Apr 20.

www.aocs.org/press
www.nutrition.org
www.athero.org
www.iom.dk

Vitamin E Protects Against Blood Clots And Brain Haemorrhages

Admin

August 9, 2005

Healthy women over 65 can lower their risk of serious consequences of arthrosclerosis by 25 %. This is confirmed by the world’s longest study of vitamin E, so far.

In 1997 44 % of all American cardiologists regularly used antioxidants, especially vitamin E, to prevent coronary thrombosis and strokes. The confidence in vitamin E was so strong that it surpassed the confidence in aspirin, which was only used by 42 %.

The cardiologists relied on the universal theory that arthrosclerosis arises when cholesterol is oxidized and that vitamin E, amongst other things, prevents this oxidization. Unfortunately solid evidence that vitamin E truly protects against arthrosclerosis, and thereby prevents thromboses, has been lacking. Large randomized studies have been disappointing, but also encumbered by obvious faults. Everything is shrouded in doubt. But if the doctors have stopped using vitamin E in disappointment, maybe they will begin using it again now.

The occasion is the largest and longest randomized study up until now with vitamin E. It showed that when healthy women over 65 received vitamin E as a supplement, their risk of suffering a coronary thrombosis or a stroke decreased by 26 %. And not only was the incidence lowered, the diseases also became less dangerous. The total mortality rate was approximately halved (to 51 %).

Other studies of vitamin E have been relatively short, and have had participants who suffered from serious arthrosclerosis. However this study lasted ten years, and the participants were healthy. Exactly because they did not suffer seriously from arthrosclerosis from the beginning, it was hoped that it was not too late to prevent it. A total of 20,000 women received 600 units of natural vitamin E (alpha-tokoferol) every other day for ten years. Just as many other women were given a placebo (fake pills).

The women who were over 65 benefited. However, the large majority was younger than 65. They had no obvious benefits from the treatment. 18,000 women under 65 received vitamin E. 352 of these suffered a coronary thrombosis or a stroke, some with a fatal outcome. That number was eleven higher than amongst the 18,000 who received placebos. A small and random difference. Apparently vitamin E did not benefit the younger women.

For comparison only 2 times 2000 women over 65 participated. In the group receiving vitamin E, there were 130 cases of either cardiac thrombosis or stroke. In the placebo group there were 46 cases more. This difference is relatively large, and statistically quite certain.

But why does vitamin E not benefit the younger? The obvious answer is that maybe it does, but younger women more seldom suffer cardiac thrombosis, and the potential effect is difficult to measure. In the course of the ten years the study ran, less than two percent of those under 65 suffered a cardiac thrombosis or a stroke. Those older, of course had a bigger risk (about eight percent). One can speculate that despite the neutral numbers, the younger group did in fact become less atherosclerotic because of the vitamin E supplement. No one knows, since a direct measurement of the blood vessels was not conducted. The only measurement for the degree of arthrosclerosis was the rough numbers for cardiac thrombosis and stroke.

If seen under the same light, statistically there was only tendency towards benefit from vitamin E. It is a natural consequence of the fact that there were nine times as many young participants, as there were older. The researchers did however choose to conclude on the basis of this result. They believe that the study does not warrant a general recommendation of vitamin E for the prevention of cardio-vascular disease. With regards to those over 65, it is being said that the result deviates from “the total knowledge” and should be investigated further.

This is a somewhat weak comment. A more direct comment came from Maret Taber who is professor at the Linus Pauling Institute in California and one of the World’s leading vitamin E experts:

“Vitamin E has its clear value in the fight against cardiac disease and other degenerative sufferings. It is most important for smokers, persons suffering from hypertension and those who eat an unhealthy diet.”

By: Vitality Council

Reference:
Lee, I-Min. Vitamin E in the primary prevention of cardiovascular disease
and cancer. The Womens Health Study: A randomized controlled trial. JAMA
2005;294:56-65.

jama.ama-assn.org
www.iom.dk

New Type of Antioxidant Protects Against Sunburns

Claus Hancke

June 6, 2005

A new type of antioxidant protects against sunburns and is thought to have other, additional health benefits. Similarly, vitamins C and E have been found to work too.

French researchers have created an innovative substance, incorporating a special form of the important antioxidant/enzyme SOD (Super Oxide Dismutase), that can be taken orally without fear of the SOD being destroyed in the stomach prior to assimilation.

The human body itself creates SOD, an essential enzyme. So far, it has only been possible to supply SOD by injection. But thanks to a combination of the enzyme with the wheat protein gliadin, this difficulty has now been overcome. The product (Glisodin) can be bought in Denmark.

By. Vitality Council

(Shortened)

References:
1. CARD (Annual Congress of Dermatological Research) meeting in Brest on May 28th 2005, (report).
2. Placzek M et al. Ultraviolet B-induced DNA damage in human epidermis is modified by the antioxidants ascorbic acid and D-alpha-tocopherol. J Invest Dermatol. 2005 Feb;124(2):304-7.
3. Bialy TL et al. Dietary factors in the prevention and treatment of nonmelanoma skin cancer and melanoma. Dermatol Surg 2002;28:1143-52.

www.blackwell-synergy.com/loi/jid
www.blackwellpublishing.com/journal.asp
www.iom.dk

No Danger from Vitamin E and C

Niels Hertz

May 23, 2005

Many of the worlds reknown scientist state that vitamin E and C are safe to take, even in high dosages. At the same time, the theory that the two vitamins prevent chronic illnesses, is still very much alive.

A number of world-leading researchers in vitamin E and vitamin C have concluded that the two antioxidants are completely safe over a very wide dose range. Thus, they reject claims to the opposite which are expressed in particular to the public, and to a lesser degree to the scientific community.

The article draws attention to the hypothesis that antioxidants reduce the risk of Alzheimer’s, certain types of cancer, calcification of the coronary arteries of the heart, etc. – is still very viable. Although obvious deficiency diseases are rare in the Western world, low intake can accelerate more indicators of aging. This may at least be due in part to inadequate protection against free oxygen radicals.

………………………………………

By: Vitality Council

Reference:
Hathcock JN et al. Vitamins E and C are safe across a broad range of intakes. Am J Clin Nutr 2005;81:736-45.

www.ajcn.org
www.iom.dk

Depressed Due to Vitamin Deficiency?

Claus Hancke

April 11, 2005

Several reports show a connection between depression and Vitamin E deficiency. There is a similar relation between depression and lack of Vitamin C and selenium. So far this gives food for thought.

Could it be that lack of vitamin E plays a role in depression? Something in that direction according to a preliminary Australian survey.

By: Vitality Council

References:
1. Owen AJ et al. Low plasma vitamin E levels in major depression: Diet or disease? Eur J Clin Nutr 2005;59:304-6.
2. Tiemeier H et al. Vitamin E and depressive symptoms are not related. The Rotterdam Study. J Affect Disord 2002;72:79-83.
3. Maes M et al. Lower seriúm vitamin E concentration in major depression. Another marker of lowered antioxidant defense in that disease. J Affect Disord 2000;58:241-6.
4. Benton D et al. The impact of selenium supplementation on mood. Biol Psychiatry 1991;29:1092-8.

www.nature.com/ejcn/index.html
www.sciencedirect.com
www.iom.dk