Outcome
    Strong Evidence

    Vitamin E for Oxidative Damage Repair

    High-dose vitamin E supplementation does not reduce disease risk and has been associated with increased mortality and prostate cancer risk.

    Overview

    High-dose vitamin E supplementation does not reduce disease risk and has been associated with increased mortality and prostate cancer risk.

    Verdict

    Not supported

    How It Works

    As a lipid-phase antioxidant vitamin E interrupts lipid peroxidation chains, but in isolation and at high doses it can become pro-oxidant and disrupt redox signalling.

    Dosing & Protocol

    Typical dose

    Recommended dose
    Obtain from food (nuts, seeds, olive oil); avoid high-dose supplements
    Expected timeframe
    n/a

    Protocol

    form
    Alpha-tocopherol; dietary vitamin E from nuts, seeds and vegetable oils meets the 15 mg/day RDA
    duration
    Prevention trials ran 3-10 years
    co factor
    Evidence indicates no clinical benefit. Vitamin E is the principal lipid-soluble chain-breaking antioxidant in cell membranes and reliably lowers F2-isoprostanes and other lipid peroxidation markers, so the biochemical effect is genuine. It did not translate: HOPE found no cardiovascular benefit and more heart failure, SELECT found increased prostate cancer, the Miller meta-analysis found increased mortality above 400 IU/day, and cancer and cognitive prevention trials were null. Note also that vitamin E does not repair damage - DNA and protein repair are enzymatic processes; antioxidants at best slow new oxidation.
    titration
    Not applicable - marker improvements did not translate to outcomes. The tolerable upper intake level is 1,000 mg/day
    starting dose
    Not recommended as an antioxidant strategy. Trials used 400-800 IU/day of alpha-tocopherol

    Evidence

    What the studies say

    The SELECT trial found increased prostate cancer incidence with 400 IU/day. A widely cited meta-analysis linked doses above 400 IU/day to increased all-cause mortality. Large prevention trials have consistently failed to show cardiovascular or cancer benefit.

    Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases

    Score: 9/10
    2012
    meta_analysis
    n=296707

    Bjelakovic G, Nikolova D, Gluud LL +2 more

    Antioxidant supplements did not reduce mortality; beta-carotene and vitamin E were associated with increased mortality

    View source

    Safety

    Caveats

    Interacts with warfarin and other anticoagulants. This is one of the clearest "do not supplement" cases in the antioxidant literature.

    Less likely to help if

    Everyone - marker changes did not translate into any clinical benefit.

    Medical Disclaimer

    The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

    Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.