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Complementary and Alternative Medicine - Cam

Search Health Information    Vitamin E for Sports & Fitness

Vitamin E for Sports & Fitness

Why Use

Vitamin E

Why Do Athletes Use It?*

Some athletes say that vitamin E helps boost immunity and ease muscle cramps.

What Do the Advocates Say?*

Vitamin E is important to athletes because it is an antioxidant and may help to prevent some of the oxidative damage that may occur from exercise. This oxidative damage, caused by free radicals, may interfere with the cells’ ability to function normally and is believed to play a role in many different health conditions, including the aging process, cancer, and heart disease.

Vitamin E promotes a healthy immune system and may help to prevent the dip in immune function that may occur right after exercise. Vitamin E may also help to ease muscle cramps.

*Athletes and fitness advocates may claim benefits for this supplement based on their personal or professional experience. These are individual opinions and testimonials that may or may not be supported by controlled clinical studies or published scientific articles.

Dosage & Side Effects

Vitamin E

How Much Is Usually Taken by Athletes?

Most controlled studies show that vitamin E does not benefit exercise performance,1 except possibly at high altitudes. A controlled study of mountain climbers at high altitude found that 400 IU per day of vitamin E improved anaerobic threshold, a physiological measure of aerobic endurance.2 More research is needed to determine whether this improvement might affect actual performance of athletic activities at high altitudes.

Strenuous exercise increases production of harmful substances called free radicals, which can damage muscle tissue and result in inflammation and muscle soreness. Antioxidants such as vitamin E might reduce this damage by neutralizing free radicals before they can damage the body.3 , 4 While some research has reported that vitamin E supplementation in the amount of 800 to 1200 IU per day reduces biochemical measures of free radical activity and muscle damage caused by strenuous exercise,5 , 6 , 7 several studies have not found such benefit,8 , 9 , 10 , 11 and no research has investigated the effect of vitamin E on performance-related measures of strenuous exercise recovery.

Side Effects

Vitamin E toxicity is very rare and supplements are widely considered to be safe. The National Academy of Sciences has established the daily tolerable upper intake level for adults to be 1,000 mg of vitamin E, which is equivalent to 1,500 IU of natural vitamin E or 1,100 IU of synthetic vitamin E.12

In a double-blind study of healthy elderly people, supplementation with 200 IU of vitamin E per day for 15 months had no effect in the incidence of respiratory infections, but increased the severity of those infections that did occur.13 For elderly individuals, the risks and benefits of taking this vitamin should be assessed with the help of a doctor or nutritionist.

In contrast to trials suggesting vitamin E improves glucose tolerance in people with diabetes , one trial reported that 600 IU per day of vitamin E led to impairment in glucose tolerance in obese people with diabetes.14 The reason for the discrepancy between reports is not known.

In a double-blind study of people with established heart disease or diabetes , participants who took 400 IU of vitamin E per day for an average of 4.5 years developed heart failure significantly more often than did those taking a placebo.15 Hospitalizations for heart failure occurred in 5.8% of those in the vitamin E group, compared with 4.2% of those in the placebo group, a 38.1% increase. Considering that some other studies have shown a beneficial effect of vitamin E against heart disease, the results of this study are difficult to interpret. Nevertheless, individuals with heart disease or diabetes should consult their doctor before taking vitamin E.

A review of 19 clinical trials of vitamin E supplementation concluded that long-term use of large amounts of vitamin E (400 IU per day or more) was associated with a small (4%) but statistically significant increase in risk of death.16 Long-term use of less than 400 IU per day was associated with a small and statistically nonsignificant reduction in death rates. This research has been criticized because many of the studies on which it was based used a combination of nutritional supplements, not just vitamin E. For example, the adverse effects reported in some of the studies may have been due to the use of large amounts of zinc or synthetic beta-carotene, and may have had nothing to do with vitamin E. It is also possible that long-term use of large amounts of pure alpha-tocopherol may lead to a deficiency of gamma-tocopherol, with potential negative consequences. For that reason, some doctors recommend that people who need to take large amounts of vitamin E take at least part of it in the form of mixed tocopherols.

Interactions with Supplements, Foods, & Other Compounds

Patients on kidney dialysis who are given injections of iron frequently experience “oxidative stress.” This is because iron is a pro-oxidant, meaning that it interacts with oxygen molecules in ways that may damage tissues. These adverse effects of iron therapy may be counteracted by supplementation with vitamin E.17

A diet high in unsaturated fat increases vitamin E requirements. Vitamin E and selenium work together to protect fat-soluble parts of the body.

Interactions with Medicines

Certain medicines interact with this supplement.

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Carbamazepine

    Two studies showed that individuals taking phenytoin and phenobarbital had lower blood vitamin E levels than those who received no treatment for seizures.27 , 28 Though the consequences of lower blood levels of vitamin E are unknown, people taking multiple anticonvulsant drugs might supplement with 100 to 200 IU of vitamin E daily to help prevent a deficiency.

  • Cholestyramine

    Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , and K .36 , 37 Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption.38 Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.39

  • Colesevelam

    Bile acid sequestrants may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , and K .54 , 55 Other medications and vitamin supplements should be taken one hour before or four to six hours after bile acid sequestrants for optimal absorption.56 Animal studies suggest calcium and zinc may also be depleted by taking cholestyramine.57

  • Colestipol

    Bile acid sequestrants, including colestipol, may prevent absorption of folic acid and the fat-soluble vitamins A , D , E , K .58 , 59 People taking colestipol should consult with their doctor about vitamin malabsorption and supplementation. People should take other drugs and vitamin supplements one hour before or four to six hours after colestipol to improve absorption.60

    Animal studies suggest calcium and zinc may be depleted by taking cholestyramine, another bile acid sequestrant. 61 Whether these same interactions would occur with colestipol is not known.

  • Felbamate

    Two studies showed that individuals taking phenytoin and phenobarbital had lower blood vitamin E levels than those who received no treatment for seizures.89 , 90 Though the consequences of lower blood levels of vitamin E are unknown, people taking multiple anticonvulsant drugs might supplement with 100 to 200 IU of vitamin E daily to help prevent a deficiency.

  • Gemfibrozil

    In a randomized study of 21 men with combined hyperlipidemia, ten to twelve weeks of gemfibrozil therapy reduced alpha- and gamma-tocopherol blood levels to the levels seen in healthy men.107 The clinical significance of this finding is unknown and may reflect a normal physiological response to a reduction in serum cholesterol levels.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Isoniazid

    Isoniazid may interfere with the activity of other nutrients, including vitamin B3 (niacin) , vitamin B12 , vitamin D , and vitamin E , folic acid , calcium , and magnesium .126 , 127 Supplementation with vitamin B6 is thought to help prevent isoniazid-induced niacin deficiency; however, small amounts of vitamin B6 (e.g. 10 mg per day) appear to be inadequate in some cases.128 People should consider using a daily multivitamin-mineral supplement during isoniazid therapy.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Levetiracetam

    Two studies showed that individuals taking phenytoin and phenobarbital had lower blood vitamin E levels than those who received no treatment for seizures.130 , 131 Though the consequences of lower blood levels of vitamin E are unknown, people taking multiple anticonvulsant drugs might supplement with 100 to 200 IU of vitamin E daily to help prevent a deficiency.

  • Mineral Oil

    Mineral oil has interfered with the absorption of many nutrients, including beta-carotene , calcium , phosphorus , potassium , and vitamins A , D , K , and E in some,146 but not all,147 research. Taking mineral oil on an empty stomach may reduce this interference. It makes sense to take a daily multivitamin-mineral supplement two hours before or after mineral oil. It is important to read labels, because many multivitamins do not contain vitamin K or contain inadequate (less than 100 mcg per day) amounts.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Orlistat

    Taking orlistat dramatically reduces the absorption of vitamin E,148 which might result in deficiency symptoms. Therefore, people taking orlistat for long periods of time should supplement with vitamin E.

  • Oxcarbazepine

    Two studies showed that individuals taking phenytoin and phenobarbital had lower blood vitamin E levels than those who received no treatment for seizures.149 , 150 Though the consequences of lower blood levels of vitamin E are unknown, people taking multiple anticonvulsant drugs might supplement with 100 to 200 IU of vitamin E daily to help prevent a deficiency.

  • Phenytoin

    Two studies showed that individuals taking phenytoin and phenobarbital had lower blood vitamin E levels than those who received no treatment for seizures.158 , 159 Though the consequences of lower blood levels of vitamin E are unknown, people taking multiple anticonvulsant drugs should probably supplement with 100 to 200 IU of vitamin E daily to prevent a deficiency.

  • Primidone

    Two studies showed that individuals taking phenytoin and phenobarbital had lower blood vitamin E levels than those who received no treatment for seizures.167 , 168 Though the consequences of lower blood levels of vitamin E are unknown, people taking multiple anticonvulsant drugs might supplement with 100 to 200 IU of vitamin E daily to help prevent a deficiency.

  • Topiramate

    Two studies showed that individuals taking phenytoin and phenobarbital had lower blood vitamin E levels than those who received no treatment for seizures.179 , 180 Though the consequences of lower blood levels of vitamin E are unknown, people taking multiple anticonvulsant drugs might supplement with 100 to 200 IU of vitamin E daily to help prevent a deficiency.

  • Zonisamide

    Two studies showed that individuals taking phenytoin and phenobarbital had lower blood vitamin E levels than those who received no treatment for seizures.181 , 182 Though the consequences of lower blood levels of vitamin E are unknown, people taking multiple anticonvulsant drugs might supplement with 100 to 200 IU of vitamin E daily to help prevent a deficiency.

Reduce Side Effects

  • Amiodarone

    Test tube research on human lung tissue suggests that vitamin E might reduce lung toxicity caused by amiodarone.18 More research is needed to further investigate this possibility.

  • Anthralin

    Anthralin can cause inflammation of the skin. A preliminary study found that topical use of vitamin E was able to protect against this side effect.19 This report used a tocopherol form of the vitamin rather than tocopheryl. This makes sense, as there is no conclusive proof that the tocopheryl forms (which require an enzyme to split vitamin E from the fatty acid to which it is attached) have any activity on the skin.

  • Capecitabine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.20 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.21 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.22 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,23 and not all studies have found vitamin E to be effective.24 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).25 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.26

  • Carboplatin

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.29 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.30 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.31 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,32 and not all studies have found vitamin E to be effective.33 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).34 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.35

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Cisplatin

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.40 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.41 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.42 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,43 and not all studies have found vitamin E to be effective.44 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).45 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.46

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Cladribine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.47 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.48 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.49 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,50 and not all studies have found vitamin E to be effective.51 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).52 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.53

  • Cyclophosphamide

    Chemotherapy can injure cancer cells by creating oxidative damage. As a result, some oncologists recommend that patients avoid supplementing antioxidants if they are undergoing chemotherapy. Limited test tube research occasionally does support the idea that an antioxidant can interfere with oxidative damage to cancer cells.62 However, most scientific research does not support this supposition.

    Cyclophosphamide requires activation by the liver through a process called oxidation. In theory, antioxidant nutrients ( vitamin A , vitamin E , beta-carotene and others) might interfere with the activation of cyclophosphamide. There is no published research linking antioxidant vitamins to reduced cyclophosphamide effectiveness in cancer treatment. In a study of mice with vitamin A deficiency, vitamin A supplementation enhanced the anticancer action of cyclophosphamide.63 Another animal research report indicated that vitamin C may increase the effectiveness of cyclophosphamide without producing new side effects.64 Preliminary human research found that adding antioxidants (beta-carotene, vitamin A, and vitamin E) to cyclophosphamide therapy increased the survival of people with small-cell lung cancer treated with cyclophosphamide.65 It is too early to know if adding antioxidants to cyclophosphamide for cancer treatment is better than cyclophosphamide alone. Vitamin A can be toxic in high amounts.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Cytarabine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.67 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.68 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.69 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,70 and not all studies have found vitamin E to be effective.71 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).72 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.73

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Dapsone

    In large amounts, dapsone causes oxidative damage to red blood cells. This damage may be reduced by using lower amounts of dapsone. Fifteen people who took dapsone for dermatitis herpetiformis were given 800 IU of vitamin E per day for four weeks, followed by four weeks with 1,000 mg of vitamin C per day, followed by four weeks of vitamin E and vitamin C together.74 The authors reported only vitamin E therapy offered some protection against dapsone-induced hemolysis.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Doxorubicin

    Animal studies show that the antioxidant activity of vitamin E protects against doxorubicin-induced cardiotoxicity.75 , 76 Test tube evidence suggests that vitamin E might also enhance the anticancer action of the drug.77 Human trials exploring the cardioprotective action of vitamin E in people taking doxorubicin remain inconclusive; however, some evidence suggests that vitamin E may allow for higher drug doses without increasing toxicity.78

    Anecdotal reports indicate that very high (1,600 IU) amounts of vitamin E may reduce the amount of hair loss accompanying use of doxorubicin.79 However, while protection against hair loss was confirmed in a rabbit study, human research has not found this to be true.80

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Erlotinib

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.81 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.82 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.83 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,84 and not all studies have found vitamin E to be effective.85 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).86 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.87

  • Erythromycin-Benzoyl Peroxide

    Animal studies show that benzoyl peroxide promotes tumor growth, yet the significance of this finding in humans is unknown. A test tube study showed that when exposed to vitamin E, human skin cells were more resistant to damage caused by benzoyl peroxide.88 Controlled research is needed to determine whether use of benzoyl peroxide products by humans promotes tumor growth and whether vitamin E might prevent this damage.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Fenofibrate

    Several studies have shown that fenofibrate enhances the toxic effect of ultraviolet (UV) radiation from the sun, which might result in side effects such as skin rashes. One controlled study showed that taking 2 grams of vitamin C and 1,000 IU of vitamin E prior to ultraviolet exposure dramatically blocked UV-fenofibrate damage to red blood cells.91 though further controlled studies are needed, people taking fenofibrate should probably supplement with vitamins C and E until more information is available.

  • Floxuridine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.92 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.93 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.94 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,95 and not all studies have found vitamin E to be effective.96 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).97 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.98

    The chemotherapy drug cisplatin may cause kidney damage, resulting in depletion of calcium and phosphate.99

  • Fludarabine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.100 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.101 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.102 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,103 and not all studies have found vitamin E to be effective.104 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).105 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.106

  • Haloperidol

    Haloperidol and related antipsychotic drugs can cause a movement disorder called tardive dyskinesia . Several double-blind studies suggest that vitamin E may be beneficial for treatment of tardive dyskinesia.110 Taking the large amount of 1,600 IU per day of vitamin E simultaneously with antipsychotic drugs has also been shown to lessen symptoms of tardive dyskinesia.111 It is unknown if combining vitamin E with haloperidol could prevent tardive dyskinesia.

  • Hydroxyurea

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.112 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.113 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.114 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,115 and not all studies have found vitamin E to be effective.116 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).117 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.118

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Irinotecan

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.119 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.120 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.121 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,122 and not all studies have found vitamin E to be effective.123 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).124 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.125

  • Isotretinoin

    Preliminary research has found that combined administration of isotretinoin and vitamin E (alpha-tocopherol) substantially reduces the initial toxicity of high-dose isotretinoin without reducing drug efficacy.129 Additional research is needed to further clarify this potentially beneficial interaction.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Lindane

    Test tube studies reveal that vitamin E protects white blood cells from damage caused by lindane.132 Lindane is known to promote the formation of tumors,133 and more research is needed to determine whether vitamin E, when applied at the same time as lindane, can prevent this adverse effect.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Mercaptopurine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.134 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.135 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.136 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,137 and not all studies have found vitamin E to be effective.138 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).139 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.140

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Methotrexate

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.141 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.142 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.143 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,144 and not all studies have found vitamin E to be effective.145 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

  • Paclitaxel

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.151 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.152 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.153 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,154 and not all studies have found vitamin E to be effective.155 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form. In another study, supplementation with vitamin E orally (600 IU per day) reduced the incidence of paclitaxel-induced nerve damage.156

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Polifeprosan 20 with Carmustine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.160 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.161 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.162 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,163 and not all studies have found vitamin E to be effective.164 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).165 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.166

  • Risperidone

    Vitamin E along with vitamin B6 was used to treat a side effect of risperidone called neuroleptic malignant syndrome in a 74-year-old woman, and results were encouraging.169 However, whether vitamin E and vitamin B6 supplementation might help prevent this condition in people taking risperidone is unknown.

  • Sorafenib
    One of the side effects of sorafenib is a severe skin reaction (hand-foot skin syndrome) that often ends treatment. In a preliminary study, supplementing with 300 IU per day of vitamin E produced marked improvement in sorafenib-induced hand-foot skin syndrome within 10 to 12 days, even though the patients continued to take the sorafenib.171
    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Thioguanine

    Chemotherapy frequently causes mouth sores. In one trial, people were given approximately 400,000 IU of beta-carotene per day for three weeks and then 125,000 IU per day for an additional four weeks.172 Those taking beta-carotene still suffered mouth sores, but the mouth sores developed later and tended to be less severe than mouth sores that formed in people receiving the same chemotherapy without beta-carotene.

    In a study of chemotherapy-induced mouth sores, six of nine patients who applied vitamin E directly to their mouth sores had complete resolution of the sores compared with one of nine patients who applied placebo.173 Others have confirmed the potential for vitamin E to help people with chemotherapy-induced mouth sores.174 Applying vitamin E only once per day was helpful to only some groups of patients in another trial,175 and not all studies have found vitamin E to be effective.176 Until more is known, if vitamin E is used in an attempt to reduce chemotherapy-induced mouth sores, it should be applied topically twice per day and should probably be in the tocopherol (versus tocopheryl) form.

    In a preliminary study, the addition of oral vitamin E (300 IU per day) to cisplatin chemotherapy significantly reduced the incidence of drug-induced damage to the nervous system (neurotoxicity).177 A similar protective effect was seen in another trial in which 600 IU of vitamin E per day was used.178

Support Medicine

  • Cyclosporine

    Twenty-six liver transplant patients (both adults and children) unable to achieve or maintain therapeutic cyclosporine blood levels during the early post-transplant period were given water-soluble vitamin E in the amount of 6.25 IU/2.2 pounds of body weight two times per day.66 Addition of vitamin E in the early post-transplant period reduced the required amount of cyclosporine and the cost of cyclosporine therapy by 26%. These results imply that the addition of vitamin E to established cyclosporine therapy allows for a decrease in the amount of cyclosporine. Combining vitamin E and cyclosporine requires medical supervision to avoid cyclosporine toxicity.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Griseofulvin

    Adding 50 IU of vitamin E per day was reported to increase blood levels of this drug within four weeks in children, allowing the drug dose to be cut in half. Reducing the amount of griseofulvin should decrease the likelihood of side effects. This evidence is preliminary, so people taking griseofulvin should not supplement vitamin E on their own but may wish to discuss this matter with their doctor.108

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Pentoxifylline

    The combination of vitamin E and pentoxifylline has been used successfully to reduce damage to normal tissues caused by radiation therapy.157

  • Sodium Fluoride

    Vitamin E increases the resistance of tooth enamel to acids that cause cavities, and test tube studies show that fluoride, when added to vitamin E, enhances this effect.170 Controlled research is needed to determine whether people might develop fewer cavities when taking vitamin E and fluoride together.

Reduces Effectiveness

  • none

Potential Negative Interaction

  • Aspirin

    Although vitamin E is thought to act like a blood thinner, very little research has supported this idea. In fact, a double-blind trial found that very high amounts of vitamin E do not increase the effects of the powerful blood-thinning drug warfarin .183 Nonetheless, a double-blind study of smokers found the combination of aspirin plus 50 IU per day of vitamin E led to a statistically significant increase in bleeding gums compared with taking aspirin alone (affecting one person in three versus one in four with just aspirin).184 The authors concluded that vitamin E might, especially if combined with aspirin, increase the risk of bleedings.

Explanation Required

  • AZT

    Animal studies suggest that vitamin E may improve the efficacy of AZT.185 The practical importance of this finding remains unclear.

  • Lovastatin

    Oxidative damage to LDL (“bad”) cholesterol is widely believed to contribute to heart disease . In a double-blind trial, lovastatin was found to increase oxidative damage to LDL cholesterol and vitamin E was reported to protect against such damage, though not to completely overcome the negative effect of lovastatin.186 This study suggests that people taking lovastatin might benefit from supplemental vitamin E.

  • Simvastatin

    In a study of seven patients with hypercholesterolemia, eight weeks of simvastatin plus vitamin E 300 IU improved markers of blood vessel elasticity more than simvastatin alone.187

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Valproate

    Two studies showed that individuals taking phenytoin and phenobarbital had lower blood vitamin E levels than those who received no treatment for seizures.188 , 189 It is not known whether this same interaction occurs with valproic acid. Though the consequences of lower blood levels of vitamin E are unknown, people taking multiple anticonvulsant drugs should probably supplement with 100 to 200 IU of vitamin E daily to prevent a deficiency.

    On the basis of the biochemical actions of valproic acid, it has been suggested that people taking valproic acid should make sure they have adequate intakes of vitamin E and selenium .190 The importance of supplementation with either nutrient has not yet been tested, however.

More Resources

Vitamin E

Where to Find It

Wheat germ oil, nuts and seeds, whole grains, egg yolks, and leafy green vegetables all contain vitamin E. Certain vegetable oils should contain significant amounts of vitamin E. However, many of the vegetable oils sold in supermarkets have had the vitamin E removed in processing. The high amounts found in supplements, often 100 to 800 IU per day, are not obtainable from eating food.

Resources

See a list of books, periodicals, and other resources for this and related topics.

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