Macular Degeneration Cataracts And Visual Loss
The effects of topically applied tocotrienol on cataracts were evaluated in streptozotocin-induced diabetic rats. In rats receiving a twice-daily topical microemulsion of tocotrienol, there was a delay in cataract progression beginning from week 5 onward. This effect was noted despite persistent hyperglycemia in the rats. Tocotrienol decreased lenticular aldose reductase activity, polyol levels, and oxidative-nitrosative stress.Abdul 2017
Results from the Age-Related Eye Disease Study showed that high levels of antioxidants and zinc reduced the risk of advanced age-related macular degeneration and its associated vision loss. These same nutrients had no effect on the development or progression of cataracts. The antioxidant formulation used consisted of vitamin E 400 units, vitamin C 500 mg, beta-carotene 15 mg, zinc oxide 80 mg, and cupric oxide 2 mg.NEI 2013
In a Cochrane review of antioxidant supplement use in patients with AMD, only 1 study evaluating use of natural vitamin E was identified. Subjects were randomized to receive vitamin E or placebo, with a follow-up of 4 years. Participants were from the general population 19% had AMD, and the number of those with late AMD was low . The estimate of the effect of vitamin E was uncertain .Evans 2017
Limitations Of The Study
The ATBC participants were all male smokers and they were born before WWII. Thus, their childhood and youth were very different compared to those of later generations. In that respect, it is not evident how far various findings of the ATBC cohort can be extrapolated to the general current Western population. However, having such a background does not compromise the use of the ATBC cohort for the examination of the validity of the EAR level. The EAR level for vitamin E is the same for smokers and nonsmokers , and therefore, smokers are an appropriate subpopulation for this type of investigation. In addition, there is no upper limit for the age of people for whom the EAR is intended and no restrictions in the cultural and childhood backgrounds . Therefore, the ATBC cohort contributes appropriate data for the investigation of the biological relevance of the EAR and the RDA .
Finally, the EAR for vitamin E is based on two small laboratory-based studies by Horwitt in the 1950s, in which hydrogen peroxide-induced hemolysis was used as the outcome . Thus, the potential limitations of the current study should not be considered in isolation, but should be considered in parallel with the limitations of the Horwitt studies.
Why Is Vitamin E Important For My Health
As an antioxidant, vitamin E helps protect your body against damage caused by exposure to harmful substances in the environment such as cigarette smoke and radiation. Vitamin E also plays a role in keeping your immune system healthy, as well as promoting healthy vision and skin.
Vitamin E may also have a role to play in maintaining heart health.
Many studies have investigated the role of a diet rich in vitamin E for the prevention of a range of cancers. There is, however, no conclusive evidence that having a high dietary intake or adding vitamin E supplements to your diet will reduce your likelihood of getting cancer.
Vitamin E in combination with vitamin C, beta carotene and zinc has been shown to provide some protection against the eye disease AMD in people who are at high risk of developing the condition. Vitamin E alone will not, however, reduce this risk.
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What Do The National Institutes Of Health Recommend
According to the National Institutes of Health , the average adult needs to consume 15mg of Vitamin E per day. They also recommend you receive the majority of your vitamin E intake from dietary sources, although this is not always possible or practical. The NIH acknowledges that many dietary sources of Vitamin E are high in fat, which isnt always conducive to an individuals health. Above all, the NIH recommends getting 15mg daily, no matter where its from.
Is Vitamin E Deficiency Common
According to a study published on the Journal of Nutrition with more than 4,000 participants, most people who follow a standard American diet fail to consume the recommended daily intake of vitamin E. Hence, researchers suggest that we should greatly increase the consumption of whole seeds, nuts, fruits and vegetables, in order, to meet our daily vitamin E needs.
On the contrary, Americans consume most vitamin E from soybean, canola, corn, and other vegetable oils. Most vegetable oils are high in omega-6s, as well. Although, omega-6 fatty acids are necessary for good health, we shouldnt consume too much because high consumption of omega-6s may lead to chronic inflammation and disease. Especially, if we dont consume lots of omega-3s.
Certainly, following a well-balanced diet rich in seeds, nuts, fruits, and vegetables provides enough vitamin E for healthy adults.
People who follow a low-fat diet should be extra careful. Firstly, the digestive tract requires fat to absorb vitamin E. Secondly, most vegetable oils are rich in vitamin E.
Keep in mind, that vitamin E deficiency symptoms arent always obvious, so if you dont follow a well-balanced diet, might be good for you to take a vitamin E supplement. You can compare prices on Amazon.
Above all, consult your doctor before taking any supplementation.
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Should I Take A Vitamin E Supplement
Vitamin E deficiency is rare. People with disorders that result in fat malabsorption, such as Crohns disease, ulcerative colitis or cystic fibrosis, premature infants, and those with an inability to secrete bile from the liver are at greater risk for deficiency.
Vitamin E supplements most often provide alpha-tocopherol. If the vitamin E supplement is synthetically sourced, people need about 50% more to obtain the same amount of the nutrient in the active form. In addition, vitamin E supplements may be harmful for people who take medications that function as blood thinners. You should always consult with your health care provider before taking any supplement.
What Is The Recommended Dosage For Vitamin E
The adequate intake set by the Australian Government varies, depending on your life stage and your sex. The AI for vitamin E ranges from 4mg daily for infants 0-6 months of age, to 10mg daily for men and 7mg daily for women. If you are pregnant or breastfeeding, consult a dietitian for specific nutrition advice.
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Do I Need Dietary Supplements With Vitamin E
People who follow the standard Western diet, or a diet low in fat, may fail to meet the recommended daily intake of vitamin E.
Eating reasonable amounts of healthy fats found in seeds, nuts, avocado, and olive oil could significantly increase the daily intake of vitamin E.
Certainly, healthy people who follow a well-balanced diet dont need vitamin E supplements. We can get more than enough from food.
Common foods high in vitamin E are seeds, nuts, and certain vegetables. Sunflower seeds are the richest foods in vitamin E, providing almost 50% of the recommended daily intake per serving!
Almonds, hazelnuts, peanuts, broccoli, kiwis, mango, tomato, and spinach are also great dietary sources of vitamin E.
Vitamin E Other Nutritional Factors
It has been suggested that vitamin E requirements depend on a variety of other nutritional factors, primarily on the ingestion of polyunsaturated fatty acids . Based on this factor, an increased demand for vitamin E should be regarded for RDA calculation, which has been estimated to oscillate between 15 and 25 mg/d or more .
Generaly, the recommended intake of vitamin E should correlate with the amount of polyunsaturated fatty acids in food: 1 g of diene fatty acid or rather diene equivalent requires an intake of 0.5 mg RRR–TOH.
An optimal daily intake of vitamin E may be broken down into two categories: a required daily intake that provides enough vitamin E for the molecule to exhibit its basic biological effects, as well as a second one, which is determined by a higher ingestion range that promotes its additional beneficial properties that may assist in the disease prevention. The most favorable intake of vitamin E in healthy subjects, defined as the actual dose that is associated with its major positive attributes in the absence of possible adverse effects, remains to be determined in appropriately designed and executed trials, which represents a considerable hurdle to be overcome in the definition process of appropriate nutritional vitamin E recommendations .
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Critique Of The Dri Approach By Max Horwitt
The two trials on which the EAR level for vitamin E were based, were carried out by Max Horwitt . Interestingly, Horwitt seriously criticized the approach in the calculation of the EAR . As early as 1963 Horwitt had stated that he had requested that no specific requirement for vitamin E be adopted on the basis of his studies. He emphasized that the experimental diets in the studies had contained large amounts of oxidized unsaturated fats not found in habitual diets . He also pointed out that millions of people have lived long lives while consuming much less that 10 mg/day of vitamin E. Thus, according to his opinion, increasing the assumed requirement’ to 15 mg/day benefits only the commercial interests involved in the sale of vitamin E. Horwitt was also concerned with setting the tolerable upper intake level to 1 g/day. He noted that millions of persons swallowed aspirin each day, and there was already at that time evidence that vitamin E could enhance the anticoagulant effects of aspirin . After Horwitt’s critique there has emerged much stronger evidence that vitamin E doses substantially lower than 1 g/day can cause significant harm in some population groups .
How Much Is Too Much
Because high doses of some supplements can have risks, how do you know when it’s OK to take more than the RDA or DV?
One way is to look for the UL of a nutrient. With many vitamins and minerals, you can safely take a dose much higher than the RDA or DV without coming close to the UL.
For instance, the average person can take more than 50 times the RDA of vitamin B6 without reaching the upper limit. But some people develop symptoms of nerve pain with these higher levels of B6. So you should always be cautious. Here are some things to keep in mind:
Some supplements are riskier than others. With some vitamins and minerals, the upper limit is pretty close to the RDA. So it’s easy to get too much. For example, a man who takes just over three times the RDA of vitamin A would get more than the upper limit. High doses of vitamin A — and other fat-soluble vitamins like E and K — can build up in the body and become toxic. Other risky supplements include the minerals iron and selenium.
Supplementsare designed to be additions to your diet. Popping pills is not the answer to good health. Experts say you should eat a well-balanced diet and take supplements to fill in any nutritional gaps. Some people take a multivitamin with minerals for nutritional insurance.
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What Type Of Vitamin E Supplement To Prefer
You better prefer vitamin E supplements that contain the natural form of alpha-tocopherol, as its twice as active compared to the synthetic form. We absorb it more easily.
Vitamin E supplements that contain the natural form are labeled as d. On the contrary, the synthetic form is labeled as dl. So, d-alpha-tocopherol supplements contain the natural form of vitamin E.
Moreover, most supplements contain much higher doses of vitamin E per capsule than the required or even the maximum safe dose. Hence, healthy people better prefer vitamin E supplements with the lowest amount of vitamin E.
Should I Take Vitamin E Supplements
Taking a single vitamin E supplement will increase the amount of that specific vitamin in your body but wont necessarily mean youre getting the nutrients, minerals, vitamins and dietary fibre that come with a balanced diet.
Eating whole foods is a healthier approach.
If you are on a restrictive diet, such as a vegan diet, or you have a health condition that impacts how you eat foods or how you absorb nutrients, you may need to take vitamin supplements to avoid deficiency and stay healthy.
Before taking any vitamin supplement and particularly if you are on a restrictive diet speak with your doctor or an accredited dietitian.
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Could Reduce Risk Of Developing Certain Cancers
Another controversial benefit of vitamin E is its effect on cancer. Vitamin E is a powerful antioxidant that prevents and fights free radical oxidation and damage to cells which may play a role in developing cancer and other health conditions.
Research on whether or not vitamin E prevents or promotes cancer is still emerging and is specific to the form of vitamin E and its bioavailability. Evidence suggests that lower vitamin E intake is associated with increased cancer risk.
Other reviews have examined the type of vitamin E on cancer risk. They have found that a gamma-tocopherol-rich mixture of vitamin E tocopherols is a promising anti-cancer agent and should be studied further.
On the other hand, some evidence does not support the supplementation of vitamin E for cancer prevention. One study examined the effect of vitamin E supplementation on the risk of prostate cancer and showed that vitamin E is not a good prevention method for cancer. This study also determined that vitamin E may increase the risk of prostate cancer.
More research is needed to determine whether vitamin E can help prevent cancer.
What To Look For
Supplement manufacturers are not required to put their products through vigorous testing and research. Because of this, there’s no way to be sure the label represents what is actually in the bottle.
To find products you can trust, opt for brands that voluntarily put their products through independent third-party testing by a certifying body like the U.S. Pharmacopeia , ConsumerLab, or NSF International.
Vitamin E is sensitive to heat and can quickly degrade if exposed to extreme heat or direct sunlight. Always store vitamin E in the original container in a cool, dry room. Remember to discard any gel caps that have reached their use-by or expiration date, are discolored, or have evidence of leakage.
Topical vitamin E oil is available in drugstores and health food markets. It’s intended for external use only.
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Combinations Of Vitamins E And C: The Evidence For Safety
Several large or long-term clinical trials have employed combinations of vitamins E and C, sometimes with additional agents, as already discussed. For example, the combination of vitamins E and C used in the Antioxidant Supplementation in Atherosclerosis Prevention Study, the Roche European American Cataract Trial, the Age-Related Eye Disease Study, and the Medical Research Centre/British Heart Foundation trials, as well as the simvastatin-niacin study of Brown et al were already described for their antioxidant treatments . These studies support the safety of vitamin E and C in combination.
The Recommended Dietary Allowance
The RDA for vitamin E was last revised by the Food and Nutrition Board of the US Institute of Medicine in 2000 . The RDA is based largely on the results of studies done in the 1950s in men fed vitamin E-deficient diets. In a test-tube analysis, vitamin E suppresses the breakdown of red blood cells induced by hydrogen peroxide. Because hemolysis has also been reported in children with severe vitamin E deficiency, the preventive effect of vitamin E against oxidative damage-induced hemolysis was considered to be a clinically relevant in vitro analysis to assess vitamin E status. Importantly, this means that the latest RDA for vitamin E continues to be based on the prevention of deficiency symptoms rather than on health promotion and prevention of chronic disease.
The forms of -tocopherol that meet the recommended intakes are RRR–tocopherol the only naturally occurring form of vitamin E and the three synthetic isomers, RRS-, RSR-, and RSS–tocopherol, which are found in nutritional supplements and fortified food.
Table 1 lists the RDA for -tocopherol expressed in both milligrams and international units .Table 1. Recommended Dietary Allowance for -Tocopherol*#
*These recommended intakes are limited to 2R-stereoisomeric forms of -tocopherol.#One mg of 2R–tocopherol is equivalent to 1.5 IU, and one IU is equivalent to 0.67 mg of 2R–tocopherol.
Do Supplements Exceed The Maximum Daily Safe Dose
Most vitamin E supplements dont exceed the upper safe dose. They contain between 180 and 670 mg of vitamin E per tablet. Hence, theyre considered pretty safe.
You can find a wide variety of vitamin E supplements on Amazon.
As a rule of thumb, prefer supplements containing low amounts of vitamin E, though. Also, prefer supplements with the natural form of vitamin E . Theyre more bioavailable.
Always consult your health care provider before taking any supplement.
Deficiency Of Vitamin E
There exists a subtle difference in definitions describing levels of vitamin intake . Whereas vitamin deficiency is caused by diseases, metabolic disorders , or impaired absorption of the vitamin. Vitamin undersupply is characterized as an intake issue and they can result from insufficient dietary intake, which does not achieve reference values . Because of an abundance of tocopherols in the human diet, its deficiency is rare except in individuals with pancreatic insufficiency or other conditions causing substantial fat malabsorption, or protein-energy malnutrition and may be caused by rare genetic defects affecting vitamin E metabolism or transport .
Vitamin E can be mobilized from adipose tissue for a relatively long time , so that the symptoms of slightly vitamin E deficiency may manifest following many years, even decades .
Nevertheless, a severe vitamin E deficiency may reveal itself almost immediately in acute symptoms such as neuro- and myopathy, as vitamin E is essential for an optimal development and condition of the central nervous system . Insufficient vitamin E saturation can occur in intestinal resection, in severe liver disease and in cystic fibrosis . In the absence of vitamin E, the accumulation of radicals with lipoperoxidation in humans leads to various defects in membrane function, muscle metabolism and the nervous system . These reactions should be considered if vitamin E is not absorbed or cannot be used.
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