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Vitamin E, Are We Getting Enough?

by Penny Crowther(more info)

listed in nutrition, originally published in issue 247 - July 2018


Vitamin E is not actually a single vitamin, but a group of fat soluble vitamins known as tocopherols and tocotrienols. There are eight naturally occurring forms of vitamin E, which are the alpha, beta, gamma and delta forms of tocopherol and tocotrienol.

Tocopherols Form and Structure
Tocopherols Form and Structure

Whilst overt vitamin E deficiency is considered to be relatively rare in humans, it is highly questionable as to whether we are obtaining enough in our diet. A study in 2012 found that over three quarters of Britons and Americans were obtaining less than the minimum government recommended daily intake of vitamin E.

So where do we find vitamin E? Good dietary sources of vitamin E are principally seeds, nuts, vegetable oils and avocado. These foods do not necessarily feature heavily in an average diet high in processed food. The recommended daily intake of vitamin E is 15mg (22 i.u).  To obtain that amount in one day you would need to eat, for example, one tablespoon (uncooked) sunflower oil, 23 almonds and 2 tablespoons peanut butter or an avocado. Low fat diets, which are still popular are at high risk of being vitamin E deficient. See the end of this article for a table showing foods with the highest vitamin E content.        

What Are the Benefits of Vitamin E?

Vitamin E is a powerful antioxidant. This means it protects the body from oxidation which occurs continuously through normal processes such as breathing, digestion, energy production, immune function, hormonal activity and the detoxification of harmful substances such as alcohol, drugs or pollution. These processes all produce destructive substances known as free radicals. Oxidative stress, which accelerates ageing and chronic disease, occurs when antioxidant supply in the body is insufficient to destroy the number of free radicals being produced.

The antioxidant action of vitamin E means it has a role to play in diseases in which increased oxidative damage is a major factor, such as cancer, arthritis, cataracts, cardiovascular disease, allergies and asthma.

When researchers gave a gamma tocopherol rich vitamin E supplement to 8 people with allergic asthma for 3 weeks, they were able to measure a reduction in levels of oxidative stress and inflammation, compared to a control group.

Alzheimer’s disease involves oxidative stress. There have been numerous studies positively linking vitamin E with this disease. For example, The Alzheimer’s Disease Cooperative Study in 1997 showed that vitamin E may slow disease progression in patients with moderately severe Alzheimer’s disease. High doses of vitamin E delayed the loss of the patient’s ability to carry out daily activities and their consequent placement in residential care for several months. In another study blood levels of vitamin E were used as biomarkers to determine which patients had Alzheimer’s rather than mild cognitive impairment.

As it has an anti-clotting effect on the blood, vitamin E is particularly helpful for maintaining cardiovascular health.  However, researchers do not currently recommend vitamin E supplements for heart patients or Alzheimer’s sufferers due to interactions with prescribed medications, including those to lower cholesterol, which are not yet fully understood.

Another important function of Vitamin E is its proven effect on immunity, particularly in relation to infections. For example, in elderly people, higher levels of vitamin E in the blood correlated with a reduced number of viral  infections over a 3 year period.

30 Signs That You Might Need More Vitamin E

Before reading this, bear in mind that the following symptoms can be related to many factors other than vitamin E and that you should take vitamin E supplements under the guidance of a practitioner.

  • Mild anaemia, sickle cell anaemia, beta thalassemia
  • Nonspecific neurological deficits
  • Disorders related to reproduction and infertility including miscarriages, pregnancy complications, PMS, menopausal symptoms including hot flushes
  • Fragile red blood cells
  • Age spots
  • Dry skin
  • Eczema, psoriasis
  • Eye problems, blurred vision
  • Easy bruising
  • Ataxia (lack of muscle coordination, shaking), in severe cases, inability to walk
  • Muscle weakness
  • Cataracts
  • Immune dysfunction
  • Cardiovascular disease
  • Neurological damage
  • Decrease in sex drive
  • Metabolic syndrome (use of vitamin E in body is impaired)
  • Osgood- Schlatter disease
  • Muscle, liver, bone marrow and brain function abnormalities
  • Gastrointestinal diseases
  • Dry hair or loss of hair
  • Muscular weakness
  • Slow tissue healing
  • Leg cramps
  • Mild cognitive problems
  • Poor blood circulation
  • Enlarged prostate
  • Muscle wasting
  • Diseases which affect fat absorption e.g. pancreatitis, cystic fibrosis, cholestasis (decrease in bile flow which causes impaired fat absorption)
  • Low vitamin E is linked with greater risk of cardiovascular problems and cancer
  • Vitamin E is of particular importance for children. A lack of vitamin E can be a contributing factor in slow growth, weight loss, muscle weakness, growing pains, eye disease and physical and mental developmental problems. Fussy eaters are very vulnerable to vitamin E deficiency.

Should I Supplement Vitamin E?

Although there are studies suggesting vitamin E supplementation has a positive role to play in chronic diseases, in general, the scientific literature has not produced conclusive evidence of its effectiveness yet. Some high profile studies have even found vitamin E had a negative effect on health. Many experts believe that the poor study outcomes are likely to be due to the fact that tocopherol is usually studied on its own, rather than as part of a mixture of tocopherols and tocotrienols. Moreover, a synthetic version known as DL- Alpha tocopherol is commonly used, instead of the natural form and it appears to have toxic effects.

To get the most benefit from vitamin E supplements it is best to take mixed tocopherols and tocotrienols. It makes sense to include a mixture of the different forms rather than take one, such as alpha tocopherol (even if in the natural form) in isolation, in case it causes an imbalance of the other (beta, gamma, delta) tocopherols and tocotrienols. The different forms appear to have their own specific functions.  For instance, research has found that the principle function of alpha- tocopherol is to prevent the production of new free radicals, whilst gamma-tocopherol quenches the existing free radicals. Mixed tocopherols were found to be more effective at preventing platelet aggregation (sticky blood) than alpha tocopherol alone. Again, it was a combination of different forms of vitamin E that were used in the Alzheimer’s study mentioned above, which found that older patients with high plasma levels of vitamin E had a reduced risk of Alzheimer’s.

Synthetic vitamin E (written on labels as dl-alpha tocopherol rather than d-alpha-tocopherol) is definitely to be avoided.

Taking your vitamin E with some healthy fat such as coconut yoghurt, avocado or nut butter will enhance its absorption and use in the body.  Vitamin E works best in tandem with vitamin C, so make sure your supplement contains some vitamin C as well.


Table of Vitamin E Content of Foods
Food and recommended intake Alpha-tocopherol content in mg per serving
Wheat germ oil, 1 tablespoon 20.3
Sunflower seeds, dry roasted, 28g 7.4
Almonds, dry roasted, 28g (23 nuts) 6.8
Sunflower oil, 1 tablespoon 5.6
Safflower oil, 1 tablespoon
Hazelnuts, dry roasted, 1 ounce (12 nuts) 4.3
Peanut butter, 2 tablespoons 2.9
1 avocado 4mg
Spinach, boiled,30g 1.9
Broccoli, chopped, cooked,78g
Olives 100g (average) 2.3
Adapted from: United States Department of Agriculture (USDA), Agricultural Research Service. USDA National Nutrient Database for Standard Reference.


Troesch B1, Hoeft B, McBurney M, Eggersdorfer M, Weber P. Dietary surveys indicate vitamin intakes below recommendations are common in representative Western countries. Br J Nutr. 108(4):692-8. Aug 2012.

Chavance M, Herbeth B, et al., Vitamin status, immunity and infections in an elderly population. 43(12):827-835. 1989.

Wiser J, Alexis NE, Jiang Q, et al, In vivo gamma-tocopherol supplementation decreases systemic oxidative stress and cytokine responses of human monocytes in normal and asthmatic subjects. Free Radical Biology & Medicine. 1;45(1):40-9. 2008.

Saliha Rizvi, Syed T. Raza et al., The Role of Vitamin E in Human Health and Some Diseases.  Sultan Qaboos Univ Med J. 14(2): e157–e165. 2014.

Mangialasche F, Westman E, Kivipelto M., et al., Classification and prediction of clinical diagnosis of Alzheimer's disease based on MRI and plasma measures of α-/γ-tocotrienols and γ-tocopherol. J Intern Med.  273(6):602-21. 2013.

Pavlik VN, Doody RS, Rountree SD, Darby EJ, Dement Geriatr Cogn Disord: Vitamin E use is associated with improved survival in an Alzheimer's disease cohort. 28(6):536-40. 2009

Singh I, Turner AH, Sinclair AJ, Li D, Hawley JA. Effects of gamma-tocopherol supplementation on thrombotic risk factors. Asia Pac J Clin Nutr.16:422–8. 2007.


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About Penny Crowther

Penny Crowther BANT CNHC qualified as a nutritional therapist in 1997 and has been in clinical practice ever since. She has seen several thousand clients over the years, at her practice in London and online. Penny now specializes in nutrition for women in their 40s and beyond, particularly around peri and post menopause. Mid Life for women can be a time when fluctuating hormones play havoc with your wellbeing. In the midst of all the publicity around HRT, it's easy to forget just how powerful diet and lifestyle changes can be when it comes to navigating the menopausal years.

Penny will guide and support you through specific changes to your diet, targeted to you specifically, in midlife. She provides practical, easy to follow menu plans with easy and delicious recipes. The food you eat affects every cell and system in your body. It optimizes how you look and feel, both mentally and physically.

To book an appointment view consultation options here >>

As well as being a regular columnist for Positive Health, Penny has written for Holland and Barrett, and contributed to articles for the Daily TelegraphThe Times Literary supplement, Pregnancy & Birth and Marie Claire. She has been featured in the Daily Express, Daily Mirror and on local radio.

Penny is a registered nutritional therapist with standards of training endorsed by BANT (British Association for Applied Nutrition and Nutritional Therapy) and CNHC. This includes completing 30 hours of continuing professional development, annually.

Penny’s approach to health is holistic, and takes into account emotional, mental and environmental factors as well as nutrition. She has trained in coaching and studied many complementary therapies before qualifying as a nutritionist, which provides a broad foundation of knowledge in her nutrition practice. Penny may be contacted on Tel: 07761 768 754;

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