Natural Standard Monograph, Copyright © 2014 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified health care professional before making decisions about therapies and/or health conditions.
Uses based on scientific evidence
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare professional.
Vitamin E deficiency
Vitamin E deficiency is rare and may occur in people with reduced fat absorption through the gut (due to surgery, Crohn's disease, or cystic fibrosis), malnutrition, very low-fat diets, or genetic disorders. It may also occur in very low-birthweight, premature infants or infants taking unfortified formulas. Vitamin E supplementation is considered an effective therapy for vitamin E deficiency. Diagnosis and management should be under the care of a medical professional.
Vitamin E has been proposed for the prevention of type 1 or 2 diabetes, blood sugar control, clotting problems or clogged arteries in diabetes, vitamin E deficiency in diabetic people, and for the prevention of diabetic complications. Vitamin E deficiency has been seen in people with diabetic foot ulcers. Further evidence is needed.
A daily dose of 800 IU of vitamin E is recommended by experts for non-diabetic people with non-alcoholic fatty liver disease. There is some evidence that vitamin E may also benefit children with liver disease. More evidence is needed.
Age-related macular degeneration (eye disease that may cause vision loss)
Like other antioxidants, vitamin E has been suggested to prevent, slow progression of, or improve macular degeneration. The scientific evidence in this area is unclear, although there is some suggestion that vitamin E alone, or in combination with beta-carotene, may not have benefit. More research is needed.
Although antioxidants are thought to reduce allergy symptoms, vitamin E intake may not be effective. However, current evidence is limited, and more research is needed.
Vitamin E may benefit altitude sickness. Antioxidant supplementation (vitamin E with beta-carotene, vitamin C, selenium, and zinc) may improve breathing at high altitudes. However, antioxidants may not reduce inflammation after exercise at high altitudes. More research is needed.
Amyotrophic lateral sclerosis (disease of nerve cells in the brain)
Vitamin E has been studied for the prevention and treatment of diseases such as ALS. There is unclear evidence with respect to vitamin E for treatment of ALS. More research is needed.
Antioxidants have been studied for the prevention and treatment of various types of anemia. Studies of vitamin E supplementation for anemia have found mixed results. More research is needed.
The antioxidant effects of vitamin E are unclear in humans. The American Heart Association recommends the intake of antioxidants such as vitamin E by eating a well-balanced diet high in fruits, vegetables, and whole grains, rather than from supplements, until further evidence is available.
In children, lower levels of vitamin E have been linked to poorly controlled asthma. Vitamin E intake during pregnancy may reduce rates of asthma in children. However, there is evidence that vitamin E supplementation may not benefit people with asthma. More research is needed.
Atopic eczema (disorder causing skin itching)
Vitamin E has been applied to the skin to prevent scars. However, because of a risk of allergic skin reaction, some researchers have advised against the use of this therapy. Further studies are needed.
There is early evidence that long-term vitamin E supplementation may reduce the risk of death in people with bladder cancer. Further study is needed.
Vitamin E has been suggested as a possible therapy for the prevention or treatment of breast cancer. Evidence remains unclear. More research is needed.
Breast cancer-related hot flashes
Vitamin E taken by mouth may help reduce hot flash frequency associated with breast cancer. Further research is required.
Cancer prevention (general)
Evidence suggests that vitamin E may lack effect on the development of cancer. Vitamin E has been studied for various types of cancer, including prostate, colon, or stomach cancer. More research is needed.
There is a lack of evidence that vitamin E is effective as a treatment for any specific type of cancer. Caution is advised in people undergoing treatment with chemotherapy or radiation. High doses of vitamin E may cause harm in people with cancer, and should be discussed with a medical professional.
There is conflicting evidence on the use of vitamin E to prevent cataracts. Some studies suggest some protective effects, while others have reported a lack of benefit. More research is needed.
Chemotherapy side effects
Vitamin E has been suggested as a therapy to prevent complications due to chemotherapy, such as nerve pain. There is some evidence of benefit when it is used with cisplatin. However, caution is needed, because it is not known if the use of high-dose antioxidants during chemotherapy may reduce therapy effectiveness. This should be discussed with a medical professional.
Vitamin E has been studied in people with chest pain, although possible benefits remain unclear. Further evidence is necessary before a clear conclusion can be made.
Claudication (leg pain from clogged arteries)
Multiple studies have looked at the use of vitamin E in people with leg pain from clogged arteries. It remains unclear if vitamin E is beneficial in this condition.
Vitamin E may help prevent or treat clogged arteries. Studies have suggested that a high dietary intake of vitamin E may be linked to lower rates of heart disease. More research is needed.
Colon cancer prevention
Evidence is lacking to determine if vitamin E prevents colon cancer. A combination of vitamins A, C, and E has been reported to reduce the risk of developing colon cancer, but there are conflicting results. More research is needed.
Diet changes and vitamin E supplementation have been studied for improvement in developmental coordination disorder in children. However, more research is needed.
Cystic fibrosis (mucus build-up in lungs)
Vitamin E supplementation has been studied in people with cystic fibrosis. Further research is needed.
Dementia / Alzheimer's disease
Vitamin E has been studied for preventing or slowing dementia (including the Alzheimer's type). There is some evidence that all-rac-alpha-tocopherol (man-made vitamin E) is as effective as selegiline (Eldepryl®) for slowing cognitive function decline in people with moderately severe Alzheimer's disease. Long-term combination therapy with donepezil (Aricept®) may also help slow cognitive decline in people with Alzheimer's disease. Other research suggests that vitamin E from diet or supplements may not affect the risk of developing Alzheimer's disease or dementia. Overall, the evidence remains unclear in his area.
Diabetic eye disease
Micronutrients have been studied for improvement in diabetic eye disease, and vitamin E has been proposed to reduce oxidative stress related to diabetic complications. However, evidence of benefit is lacking, and more research is needed.
Vitamin E supplementation has been studied for G6PD deficiency, a genetic disorder in which red blood cells break down when the body is exposed to drugs or infection. More research is needed before a clear conclusion can be made.
Glomerulosclerosis (kidney disease)
It has been suggested that protein in the urine may be reduced with the use of vitamin E in people with kidney disease. However, further research is needed before a clear conclusion can be made.
Healing after photorefractive keratectomy (laser eye surgery)
High-dose vitamin E plus vitamin A taken by mouth may improve eye healing and vision after laser surgery for vision correction. Research suggests that applying vitamin E to the eye may also be helpful. More research is needed.
Many vitamins, including vitamin E, have been studied for heart disease, with mixed results. Numerous studies suggest a lack of benefit of vitamin E, and high doses may be harmful. Further research is required.
Heart disease (in people with undergoing kidney disease treatment)
People undergoing dialysis (a treatment for kidney disease) may benefit from antioxidant use, which may lower the risk of heart disease. Results are unclear as to whether high-dose, long-term vitamin E use may benefit this population. More research is needed.
Hepatitis (hepatitis C)
In people with hepatitis C on antiviral therapy, vitamin E has been proposed to prevent inflammation. More research is needed to examine the effects of vitamin E in chronic hepatitis.
High blood pressure associated with pregnancy
Vitamin E has been studied for the prevention of high blood pressure in pregnant women. However, most studies have been in combination with vitamin C or other micronutrients. Evidence on vitamin E alone is lacking, and further research is needed.
The effects of vitamin E on cholesterol levels and clogged arteries have been studied. It remains unclear whether it may have benefits, and it is not known what the effects of vitamin E are compared to (or in combination with) other cholesterol-lowering agents. Further research is needed before a clear conclusion can be made.
H. pylori infection
Vitamin E combined with vitamin C has been studied for H. pylori infection. Further study is needed to determine the effects of vitamin E alone.
Immune system function
Studies of the effects of vitamin E supplementation on immune system function have found mixed results. More research is needed.
Vitamin E has been studied in various types and stages of kidney disease with mixed results. Further study is warranted.
Kidney disease (IgA nephropathy)
Vitamin E has been studied for IgA nephropathy, a type of kidney disease in which an antibody causes inflammation that may lead to kidney dysfunction. Limited study has looked at the effects of vitamin E supplementation in long-term kidney disease with mixed results. Further study is needed.
Kwashiorkor is a poor nutrition disorder caused by a lack of protein in the diet. Treatment involves increasing calorie and protein intake as well as supplementation with vitamins and minerals. It is not clear if vitamin E supplementation is effective in the prevention of kwashiorkor. Further research is needed.
Studies have looked at the effects of vitamin E for preventing various types of cancer, including prostate, colon, or stomach cancer. Results have been mixed for lung cancer. More research is needed.
There is early evidence of possible benefits of vitamin E supplementation to reduce menstrual pain, although more research is needed in this area before a firm conclusion can be reached.
Evidence suggests that regular use of high-dose vitamin E supplements may increase the risk of death from all causes by a small amount. However, some research found a lack of effect on risk of death. Overall, the results have not shown a strong link between vitamin E intake and decreased risk of death. Further research is needed in this area.
Mouth sores are a common side effect of chemotherapy. The effect of vitamin E on this condition is unclear. Further research is needed.
Oxidative stress is thought to play a role in osteoarthritis. Vitamin E has shown mixed results in reducing symptoms or preventing cartilage loss in osteoarthritis. More research is needed.
Vitamin E has been studied for the prevention or treatment of Parkinson's disease, with mixed results. Further research is needed.
Premenstrual syndrome (PMS)
Vitamin E has been studied for the improvement of PMS symptoms, with mixed results. Further research is needed.
Prostate cancer prevention
The role of vitamin E supplementation for the prevention of prostate cancer is controversial. There are numerous laboratory studies that support possible anticancer properties. However, the results of population research and human research have been mixed.
Respiratory infection prevention
Supplementation with vitamin E has shown mixed effects on the length and severity of pneumonia in elderly nursing home residents. There may be a protective effect against colds. More research is needed.
Vitamin E, taken by mouth, does not appear to reduce the risk of developing rheumatoid arthritis in women. More research is needed.
Vitamin E has been studied as an addition to other drugs used to prevent seizures. This evidence is unclear and further study is needed. The management of seizure disorder should be under medical supervision.
Stomach cancer (prevention)
Vitamin supplementation has been studied for stomach cancer. However, there is some evidence suggesting that vitamin E lacks effect. More research is needed to examine whether vitamin E has any effects on stomach cancer.
Supplementation in preterm and very low birthweight infants
Premature infants are at risk of vitamin E deficiency, particularly when they are born with very low birth weight. Numerous studies have looked at the use of vitamin E to help prevent serious complications. However, evidence is unclear. Premature infants should be under strict medical supervision. Decisions should be made with the infant's physician.
Tardive dyskinesia (disorder causing uncontrolled movements)
Vitamin E has been studied in the management of tardive dyskinesia. Vitamin E may be more effective in higher doses and in people who have had tardive dyskinesia for less than five years. Further research is required.
Uveitis (eye inflammation)
Antioxidants have been studied for uveitis. Four-month supplementation with vitamin E taken by mouth was found to lack benefit in one study. More research is needed before a clear conclusion can be made.
Data suggest that supplementation with vitamin E may reduce the risk of vein clots in women. Those with a history or higher risk may benefit the most. Further research is needed.
Peyronie's disease (connective tissue disorder)
Vitamin E has been studied for Peyronie's disease, with evidence of lack of benefit. Until further evidence is available, vitamin E may not be advisable in this condition.
Vitamin E taken by mouth does not appear to slow vision loss in people with damage to the retina of the eye. Until further evidence is available, vitamin E may not be advisable in this condition. Therapy decisions should be under medical supervision.
Vitamin E applied to the skin does not appear to reduce surgical wound scarring. Because of a risk of allergic skin reaction, some researchers have advised against the use of this therapy.
Recent evidence suggests that daily vitamin E supplementation does not reduce the risk of stroke. At this time, based on the best available evidence and recent safety concerns, vitamin E is not advised for this use.
*Key to grades:
A: Strong scientific evidence for this use;B: Good scientific evidence for this use; C: Unclear scientific evidence for this use;D: Fair scientific evidence against this use (it may not work);F: Strong scientific evidence against this use (it likely does not work).
For full grading rationale, click here.
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified health care professional
Acne, air pollution protection, alopecia (hair loss), amiodarone toxicity (an agent that treats abnormal heart rhythms), anti-aging, athletic performance enhancement, bee stings, benign breast diseases, beta-thalassemia (blood disorder causing low hemoglobin levels), blood disorders (problems with hemoglobin production), blood thinner, breast tenderness, bronchopulmonary dysplasia in premature infants (chronic lung disorder), bursitis (inflammation between the muscles and joints), cardiomyopathy (disease of the heart muscle), celiac disease, childhood growth promotion, chorea (movement disorder), Crohn's disease, diabetic foot ulcers, diaper rash, digestive disorders, doxorubicin hair loss prevention (an anticancer drug), Duchenne muscular dystrophy (worsening muscle weakness), dyspraxia (motor skill development disorder), energy enhancement, enlarged prostate, exercise recovery, extravasation (fluid leakage into tissue), frostbite, granuloma annulare (skin disease causing circular rashes), hair loss, hematopoiesis (stimulation of blood cell production), hereditary spherocytosis (low amounts of red blood cells), HIV, Huntington's disease (genetic disease causing nerve cell death), impotence, infertility, labor pain, leg cramps, liver spots, male fertility, menopause, menstrual disorders, miscarriage, mouth and throat cancers, muscle strength, muscle weakness/pain, myotonic dystrophy (muscle wasting in limbs, neck, and face), neuromuscular disorders, nitrate tolerance, pancreatitis (pancreas inflammation), peptic ulcers, physical endurance, postural stability (poor posture), radiation side effects, recovery after surgery, reperfusion injury protection during heart surgery (tissue damage), restless leg syndrome, sexual performance, sickle cell disease, skin aging, skin damage caused by the sun, skin disorders (skin blisters after injury), sperm motility, stomach ulcer, stretch marks, sunburn, sun protection, thrombophlebitis (vein inflammation caused by blood clot), transplant rejection prevention (heart), ulcerative colitis (inflammatory bowel disease), water retention, wound and burn healing.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy. Consult a healthcare professional immediately if you experience side effects.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy.
Natural Standard developed the above evidence-based information based on a systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
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