Vitamin E

• Overview
• Uses
• Side Effects
• Interactions
• Dosing

Vitamin E is a vitamin that dissolves in fat. It is found in many foods including vegetable oils, cereals, meat, poultry, eggs, fruits, vegetables, and wheat germ oil. It is also available as a supplement.

Vitamin E is used for treating vitamin E deficiency, which is rare, but can occur in people with certain genetic disorders and in very low-weight premature infants.

Some people use vitamin E for treating and preventing diseases of the heart and blood vessels including hardening of the arteries, heart attack, chest pain, stroke, irregular heart beat (atrial fibrillation), heart failure, leg pain due to blocked arteries, and high blood pressure.

Vitamin E is also used for treating diabetes and its complications, liver disease, kidney disease, Peyronie's disease (painful erection in men), and enlarged prostate (BPH). It is used for preventing cancer, particularly lung and oral cancer in smokers; colorectal cancer and polyps; and gastric, skin, bladder, breast, head and neck, prostate, and pancreatic cancers. Vitamin E is also used decrease side effects of chemotherapy.

Some people use vitamin E for diseases of the brain and nervous system including Alzheimer's disease and other dementias, Parkinson's disease, night cramps, restless leg syndrome, and for epilepsy, along with other medications. Vitamin E is also used for Huntington's chorea, and other disorders involving nerves and muscles.

Women use vitamin E for preventing complications in late pregnancy due to high blood pressure (pre-eclampsia), for preventing preterm labor, premenstrual syndrome (PMS), benign breast disease, weak bones (osteoporosis), painful periods, menopausal syndrome, hot flashes associated with breast cancer, and breast cysts.

Sometimes vitamin E is used to lessen the harmful effects of medical treatments such as dialysis and radiation. It is also used to reduce unwanted side effects of drugs such as hair loss in people taking doxorubicin and lung damage in people taking amiodarone.

Vitamin E is sometimes used for improving physical endurance, increasing energy, reducing muscle damage after exercise, and improving muscle strength.

Vitamin E is also used for cataracts, age-related vision loss (age-related macular degeneration), asthma, respiratory infections, skin disorders, aging skin, sunburns, cystic fibrosis, infertility, impotence, chronic fatigue syndrome (CFS), neurodegenerative disease called Lou Gherig's disease (ALS), leg cramps, peptic ulcers, H pylori, swelling in the middle layer of the eye (uveitis), mouth sores (oral mucosal lesions), movement and coordination disorder called dyspraxia, kidney problems in children (glomerulosclerosis), movement disorder (ataxia) associated with vitamin E deficiency (AVED), rheumatoid arthritis, for certain inherited diseases and to prevent allergies. Finally, vitamin E is used for preventing death.

Some people apply vitamin E to their skin to keep it from aging, sunburn, scarring, lice, stretch marks, and to protect against the skin effects of chemicals used for cancer therapy (chemotherapy).

The American Heart Association recommends obtaining antioxidants, including vitamin E, by eating a well-balanced diet high in fruits, vegetables, and whole grains rather than from supplements until more is known about the risks and benefits of taking supplements.

How does it work?

Vitamin E is an important vitamin required for the proper function of many organs in the body. It is also an antioxidant. This means it helps to slow down processes that damage cells.

Effective for...

• Movement disorder (ataxia) associated with vitamin E deficiency. The genetic movement disorder called ataxia causes severe vitamin E deficiency. Vitamin E supplements are used as part of the treatment for ataxia.
• Vitamin E deficiency. Taking vitamin E by mouth is effective for preventing and treating vitamin E deficiency.

Possibly Effective for...

• Alzheimer's disease. Some early research suggests that dietary intake of vitamin E is linked to a lower chance of developing Alzheimer's disease. But not all research agrees. Taking vitamin E supplements doesn't seem to prevent Alzheimer's disease from developing. In people who already have Alzheimer's disease, taking vitamin E along with some anti-Alzheimer's medicines might slow down the worsening of memory loss. Vitamin E might also delay the loss of independence and the need for caregiver assistance in people with mild-to-moderate Alzheimer's disease.
• Anemia. Some research shows that that taking vitamin E improves the response to the drug erythropoietin, which affects red blood cell production, in adults and children on hemodialysis.
• Blood disorder (beta-thalassemia). Taking vitamin E by mouth seems to benefit children with the blood disorder called beta-thalessemia and vitamin E deficiency.
• Leakage of chemotherapy drug into surrounding tissue. Applying vitamin E to the skin together with dimethylsulfoxide (DMSO) seems to be effective for treating leakage of chemotherapy into surrounding tissues.
• Chemotherapy-related nerve damage. Taking vitamin E (alpha-tocopherol) before and after treatment with cisplatin chemotherapy might reduce the risk of nerve damage.
• Painful menstruation (dysmenorrhea). Taking vitamin E for 2 days before and for 3 days after bleeding begins seems to decrease pain severity and duration, and reduce menstrual blood loss.
• Movement and coordination disorder called dyspraxia. Taking vitamin E by mouth together with evening primrose oil, thyme oil, and fish oils seems to improve movement disorders in children with dyspraxia.
• Kidney problems in children (glomerulosclerosis). There is some evidence that taking vitamin E by mouth might improve kidney function in children with glomerulosclerosis.
• An inherited disorder called G6PD deficiency. Some research shows that taking vitamin E by mouth, alone or together with selenium, might benefit people with an inherited disorder called G6PD deficiency.
• Healing a type of skin sore called granuloma annulare. Applying vitamin E to the skin seems to clear up skin sores called granuloma annulare.
• Huntington's disease. Natural vitamin E (RRR-alpha-tocopherol) can improve symptoms in people with early Huntington's disease. However, it does not seem to help people with more advanced disease.
• Male infertility. Taking vitamin E by mouth improves pregnancy rates for men with fertility problems. Taking high doses of vitamin E together with vitamin C does not seem to provide the same benefits.
• Bleeding within the skull. Taking vitamin E by mouth seems to be effective for treating bleeding in the skull in premature infants.
• Bleeding within the ventricular system of the brain. Taking vitamin E by mouth seems to be effective for treating bleeding within the ventricular system of the brain in premature infants.
• Liver disease (nonalcoholic steatohepatitis, NASH). Taking vitamin E daily seems to improve inflammation and liver markers of this form of liver disease in adults and children.
• Nitrate tolerance. There is some evidence that taking vitamin E daily can help prevent nitrate tolerance.
• Parkinson's disease. Early evidence suggests that vitamin E intake in the diet might be linked with a decreased risk of Parkinson's disease. However, taking all-rac-alpha-tocopherol (synthetic vitamin E) does not seem to have any benefit for people with Parkinson's disease.
• Laser eye surgery (photoreactive keratectomy). Taking high doses of vitamin A along with vitamin E (alpha-tocopheryl nicotinate) daily seems to improve healing and vision in people undergoing laser eye surgery.
• Premenstrual syndrome (PMS). Taking vitamin E by mouth seems to reduce anxiety, craving, and depression in some women with PMS.
• Physical performance. Research suggests that increasing vitamin E intake in the diet is linked with improved physical performance and muscle strength in older people.
• Fibrosis caused by radiation. Taking vitamin E by mouth with the drug pentoxifylline seems to treat fibrosis caused by radiation. However, taking vitamin E alone does not seem to be effective.
• An eye disease in newborns called retinopathy of prematurity. Taking vitamin E by mouth seems to be effective for treating an eye disease cause retinopathy of prematurity in newborns.
• Rheumatoid arthritis (RA). Vitamin E taken along with standard treatment is better than standard treatment alone for reducing pain in people with RA. However, this combination does not reduce swelling.
• Sunburn. Taking high doses of vitamin E (RRR-alpha-tocopherol) by mouth together with vitamin C protects against skin inflammation after exposure to UV radiation. However, vitamin E alone does not provide the same benefit. Applying vitamin E to the skin, together with vitamin C and melatonin, provides some protection when used before UV exposure.
• Movement disorder (tardive dyskinesia). Taking vitamin E by mouth seems to improve symptoms associated with the movement disorder called tardive dyskinesia. However, some other research suggests that it does not improve symptoms, but may prevent symptoms from worsening.
• Swelling in the middle layer of the eye (uveitis). Taking vitamin E with vitamin C by mouth seems to improve vision, but does not reduce swelling, in people with uveitis.

Possibly Ineffective for...

• Age-related vision loss (age-related macular degeneration). The majority of research suggests that taking vitamin E, alone or along with other antioxidants, is not effective for preventing or treating age-related vision loss.
• Neurodegenerative disease called Lou Gherig's disease (ALS). Research suggests that taking vitamin E (alpha-tocopherol) along with conventional medication does not affect function or increase survival rates compared to conventional medication alone in people with Lou Gherig's disease.
• Chest pain (angina). Taking vitamin E by mouth might have some effect on the functioning of blood vessels, but does not appear to reduce chest pain.
• Hardening of the arteries (atherosclerosis). Taking vitamin E (RRR-alpha-tocopherol) by mouth does not appear to prevent the progression of atherosclerosis. However, there is some early evidence that taking vitamin E and vitamin C might help prevent the progression of atherosclerosis in men.
• Cataracts. Most evidence shows that taking vitamin E does not prevent cataracts.
• Red and itchy skin (eczema). Research suggests that taking vitamin E, alone or along with selenium, does not improve symptoms of eczema.
• Hot flashes related to breast cancer. Taking vitamin E by mouth does not seem to reduce hot flashes in women who have had breast cancer.
• Lung condition in infants (bronchopulmonary dysplasia). Research shows that taking vitamin E by mouth does not benefit newborn infants with a lung condition called bronchopulmonary dysplasia.
• Cancer. Taking a combination of vitamin E, vitamin C, beta carotene, selenium, and zinc does not seem to lower overall cancer risk. However, it might reduce the risk of cancer in men, although evidence is conflicting.
• Colorectal cancer. Most evidence suggests that taking vitamin E does not prevent the occurrence of colorectal cancer or the development of non-cancerous colorectal tumors, which are considered precursors to colon cancer.
• Heart failure. Taking vitamin E by mouth for 12 weeks does not seem to improve heart function in people with heart failure and does not decrease the risk of developing heart failure.
• Muscle disease called Duchenne muscular dystrophy. Research shows that taking vitamin E with the drug penicillamine does not slow the progression of the muscle disease called Duchene muscular dystrophy.
• Head and neck cancer. Taking vitamin E (all-rac-alpha-tocopherol) daily during radiation therapy and for 3 years after the end of therapy does not seem to reduce the risk of head and neck cancer recurrence. There is some concern that taking vitamin E might actually increase the risk of tumor recurrence. People with head and neck cancer should avoid daily vitamin E supplements in doses over 400 IU daily.
• Abnormal breakdown of red blood cells (hemolytic anemia). Giving vitamin E to premature infants does not have a beneficial effect on the abnormal breakdown of red blood cells.
• High blood pressure. Taking vitamin E by mouth does not seem to lower blood pressure in people already taking blood pressure medications.
• Liver disease. Taking vitamin E does not reduce the risk of death in people with liver disease.
• An inherited muscle disorder called myotonic dystrophy. Taking vitamin E and selenium by mouth does not slow the progression of an inherited muscle disorder called myotonic dystrophy.
• Mouth sores (oral mucosal lesions). Most research shows that taking vitamin E (all-rac-alpha-tocopherol) for up to 7 years does not reduce the risk for mouth sores in men who smoke.
• Osteoarthritis. Taking vitamin E does not seem to decrease pain or stiffness in people with osteoarthritis. Vitamin E also does not seem to prevent the condition from becoming worse.
• Pancreatic cancer. Taking vitamin E, alone or together with other antioxidants such as beta-carotene and vitamin C, does not seem to reduce the risk of developing pancreatic cancer.
• Pharyngeal cancer. Research shows that people with diabetes who take vitamin E (RRR-alpha-tocopherol) by mouth do not have a reduce risk of developing mouth or pharyngeal cancer.
• High blood pressure during pregnancy (pre-eclampsia). Most evidence suggests that taking a combination of vitamins E and C does not reduce the risk of high blood pressure during pregnancy. However, some research suggests that taking a combination of vitamins E and C daily reduces the risk of high blood pressure in high risk women when started in weeks 16 to 22 of pregnancy.
• Prostate cancer. Research on the effects of vitamin E on prostate cancer risk has been inconsistent. Overall, research suggests that taking vitamin E supplements does not reduce the risk of developing prostate cancer, and might actually increase the risk.
• Respiratory tract infections. Taking vitamin E by mouth, alone or as a multivitamin, does not appear to decrease the risk of respiratory tract infections or the severity of symptoms once an infection develops.
• An eye condition called retinitis pigmentosa. Taking vitamin E (all-rac-alpha-tocopherol) by mouth does not appear to slow vision loss, and might actually increase vision loss, in people with a condition called retinitis pigmentosa.
• Scarring. Some research shows that applying vitamin E to the skin does not reduce scarring after surgery.

Likely Ineffective for...

• Benign breast disease. Taking vitamin E supplements does not seem to be effective for treating benign breast disease.
• Breast cancer. Although having higher blood levels of vitamin E might be linked with a reduced risk of breast cancer, increasing vitamin E intake from the diet or supplements does not reduce the risk of developing breast cancer.
• Heart disease. Most research suggests that taking vitamin E supplements does not prevent heart disease. However, some evidence suggests that increasing vitamin E intake in the diet might be beneficial.
• Early infant death. Vitamin E given to preterm infants does not seem to reduce the risk death in the infant.
• Lung cancer. Taking all-rac-alpha-tocopherol (synthetic vitamin E) for up to 8 years does not reduce the risk of developing lung cancer in men who smoke. Also, taking vitamin E (alpha-tocopherol) for up to 10 years does not prevent lung cancer or reduce the risk of death from lung cancer.
• Death from any cause. Research suggests that taking vitamin E for at least 1 year does not reduce the risk of death from any cause.

Insufficient Evidence to Rate Effectiveness for...

• Allergies. Taking vitamin E supplements during pregnancy does not seem to decrease the chance of infants having eczema, food allergy, wheeze, or any allergic disease later in life.
• Asthma. The role of vitamin E in asthma is unclear. While some research suggests that vitamin E prevents the risk of asthma and improves breathing in children, other research does not show this effect.
• Irregular heart beat (atrial fibrillation). Some research suggests that taking omega-3 fatty acids, vitamin C, and vitamin E decreases the risk of irregular heartbeat after surgery. The effect of vitamin E alone is unclear.
• Bladder cancer. Effectiveness of vitamin E for bladder cancer is unclear. Taking 200 IU of vitamin E by mouth for more than 10 years seems to help prevent death from bladder cancer. However, other research suggests that taking vitamin E has no effect on incidence of bladder cancer in men.
• Infections related to chemotherapy. Research suggests that higher intake of vitamin E in the diet might reduce the risk of infection in children undergoing chemotherapy.
• To prevent kidney damage from dyes injected into the vein. Some research shows that vitamin E injected into the vein does not decrease risk of kidney damage caused by injected dyes. However, other research shows that taking vitamin E by mouth decreases the risk of kidney damage from the same dyes.
• Dementia. Some research suggests that men who consume vitamin E and vitamin C have a decreased risk of developing some types of dementia. But taking vitamin E supplements does not seem to prevent dementia.
• Diabetes. Vitamin E might be beneficial for people with diabetes. Taking vitamin E may not improve blood sugar control in most people with diabetes. However it may help in people with low blood levels of vitamin E. Additionally, vitamin E may help improve blood sugar control in people with type 1 diabetes.
• Diabetic nerve pain. Early research suggests that vitamin E may help relieve diabetic nerve pain.
• Stomach cancer. Taking vitamin E plus beta-carotene and/or vitamin C does not seem to prevent stomach cancer. However, there is some evidence that consuming more vitamin E from the diet might decrease the risk slow the progression of stomach cancer.
• An infection in the stomach by the bacteria H pylori. Early research suggests that taking vitamin C and vitamin E in addition to standard therapy increases chances of cure for people with dyspepsia due to H. pylori infection.
• Kidney disease (IgA nephropathy). Early research suggests that taking vitamin E can improve kidney function in children with a kidney disease called IgA nephropathy.
• Difficulty walking due to poor blood flow in the legs (intermittent claudication). Taking all-rac-alpha-tocopherol (synthetic vitamin E) alone or together with beta-carotene by mouth does not appear to improve poor blood flow in the legs. However, other research suggests that taking vitamin E daily for 18 months reduces symptoms of intermittent claudication.
• Tissue damage after a blood clot (ischemic reperfusion injury). Taking vitamin E by mouth with vitamin C and conventional medication two days before bypass surgery and one day after surgery appears to reduce complications. However, vitamin E does not appear to be beneficial when taken alone.
• Stroke caused by a clot (ischemic stroke). There is some evidence that all-rac-alpha-tocopherol (synthetic vitamin E) might help prevent stroke in male smokers who have high blood pressure and diabetes. However, other research suggests that it might not reduce the risk of stroke.
• Lice. Early research suggests that using vitamin E spray (LiceKO) is more effective for removing head lice compared to permethrin rinse (Lyclear creme rinse).
• Liver transplant. Taking vitamin E (tocopheryl succinate polyethylene glycol) might reduce the dose of immunosuppressant needed after a liver transplant.
• Skin cancer (melanoma). Some evidence suggests that taking vitamin E (RR-alpha-tocopherol) daily does not reduce the risk of developing skin cancer.
• Nighttime leg cramps. Early evidence suggests that vitamin E might reduce nighttime leg cramps. However, other evidence suggests otherwise.
• A liver disease called nonalcoholic fatty liver disease (NAFLD). Some research shows that taking as specific supplement (Realsil) containing silybin, phosphatidylcholine, and vitamin E improves liver markers but does not improve life quality in people with NAFLD.
• Mouth sores caused by chemotherapy (oral mucositis). Some drugs used to treat cancer can cause painful mouth sores. Early research shows that applying vitamin E to the inside of the mouth helps heal these sores and reduce pain in children.
• Weak bones (osteoporosis). Early research suggests that consumnig vitamin E in the diet leads to a lower chance of hip and other fractures in adults over 40 years old.
• Peyronie's disease (painful erection in men). Early research shows that adding vitamin E to regular treatment does not improve pain but may reduce plaque in people with Peyronie's disease.
• Preterm labor. Early research suggests that taking vitamin C and vitamin E increases time until delivery by 5 days in pregnant women at risk for early labor.
• Restless legs syndrome. Early research suggests that taking vitamin E, vitamin C, separately or together, reduces severity of restless leg syndrome compared to placebo in people on hemodialysis.
• Sickle cell disease. Early research suggests that taking vitamin E with aged garlic extract and vitamin C might be useful for sickle cell anemia.
• Stretch marks (striae gravidarum). Some research shows that using a moisturizer containing vitamin E, rosehip oil, hydroxyprolisilane C, and Centella asiatica triterpenes does not prevent new stretch marks but does appear to decrease their severity.
• Allergies.
• Chronic fatigue syndrome (CFS).
• Common cold.
• Epilepsy.
• Skin disorders.
• Other conditions.

More evidence is needed to rate vitamin E for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Vitamin E is LIKELY SAFE for most healthy people when taken by mouth or applied to the skin. Most people do not experience any side effects when taking the recommended daily dose, which is 22.4 IU.

Vitamin E is POSSIBLY UNSAFE if taken by mouth in high doses. If you have a condition such as heart disease or diabetes, do not take doses of 400 IU/day or more. Some research suggests that high doses might increase the chance of death and possibly cause other serious side effects. The higher the dose, the greater the risk of serious side effects.

There is some concern that vitamin E might increase the chance of having a serious stroke called hemorrhagic stroke, which is bleeding into the brain. Some research shows that taking vitamin E in doses of 300-800 IU each day might increase the chance of this kind of stroke by 22%. However, in contrast, vitamin E might decrease the chance of having a less severe stroke called an ischemic stroke.

There is contradictory information about the effect of vitamin E on the chance of developing prostate cancer. Some research suggests that taking large amounts of a multivitamin plus a separate vitamin E supplement might actually increase the chance of developing prostate cancer in some men.

High doses can also cause nausea, diarrhea, stomach cramps, fatigue, weakness, headache, blurred vision, rash, and bruising and bleeding.

Special Precautions & Warnings:

Pregnancy: When used in the recommended daily amount, vitamin E is POSSIBLY SAFE for pregnant women. There has been some concern that taking vitamin E supplements might be harmful to the fetus when taken in early pregnancy. However, it is too soon to know if this is an important concern. Until more is known, do not take vitamin E supplements during early pregnancy without talking with your healthcare provider.

Breast-feeding: Vitamin E is LIKELY SAFE when taken by mouth in recommended daily amounts during breast-feeding.

Infants and children: Vitamin E is LIKELY SAFE when taken by mouth appropriately. The maximum amounts of vitamin E that are considered safe for children are based on age. Less than 298 IU daily is safe for children 1 to 3 years old. Less than 447 IU daily is safe for children 4 to 8 years old. Less than 894 IU daily is safe for children 9 to 13 years old. Less than 1192 IU daily is safe for children ages 14 to 18 years old. Vitamin E (alpha-tocopherol) is POSSIBLY UNSAFE when given intravenously (by IV) to premature infants in high doses.

Angioplasty, a heart procedure: Avoid taking supplements containing vitamin E or other antioxidant vitamins (beta-carotene, vitamin C) immediately before and following angioplasty without the supervision of a health care professional. These vitamins seem to interfere with proper healing.

Diabetes: Vitamin E might increase the risk for heart failure in people with diabetes. People with diabetes should avoid high doses of vitamin E.

Heart attack: Vitamin E might increase the risk for death in people with a history of heart attack. People with a history of heart attack should avoid high doses of vitamin E.

Low levels of vitamin K (vitamin K deficiency): Vitamin E might worsen clotting problems in people whose levels of vitamin K are too low.

An eye condition called retinitis pigmentosa: All-rac-alpha-tocopherol (synthetic vitamin E) 400 IU seems to speed vision loss in people with retinitis pigmentosa. However, much lower amounts (3 IU) do not seem to produce this effect. If you have this condition, it is best to avoid vitamin E.

Bleeding disorders: Vitamin E might make bleeding disorders worse. If you have a bleeding disorder, avoid taking vitamin E supplements.

Head and neck cancer: Do not take vitamin E supplements in doses of 400 IU/day or more. Vitamin E might increase the chance that cancer will return.

Prostate cancer: There is concern that taking vitamin E might increase the chance of developing prostate cancer. The effect of vitamin E in men who currently have prostate cancer is not clear. However, in theory, taking vitamin E supplements might worsen prostate cancer in men who already have it.

Stroke: Vitamin E might increase the risk for death in people with a history of stroke. People with a history of stroke should avoid high doses of vitamin E.

Surgery: Vitamin E might increase the risk of bleeding during and after surgery. Stop using vitamin E at least 2 weeks before a scheduled surgery.

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Antibiotics for Cancer (Antitumor Antibiotics)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Vitamin E is an antioxidant. There is some concern that antioxidants might decrease the effectiveness of antibiotic medication used for cancer. But it is too soon to know if the interaction occurs. Some antibiotics used for cancer include doxorubicin (Adriamycin), daunorubicin (DaunoXome), epirubicin (Ellence), mitomycin (Mutamycin), bleomycin (Blenoxane), and others.

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Cyclosporine (Neoral, Sandimmune)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking large amounts of vitamin E along with cyclosporine (Neoral, Sandimmune) might increase how much cyclosporine (Neoral, Sandimmune) the body absorbs. By increasing how much cyclosporine the body absorbs, vitamin E might increase the effects and side effects of cyclosporine (Neoral, Sandimmune).

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Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. Vitamin E might increase how quickly the liver breaks down some medications. Taking vitamin E along with some medications that are broken down by the liver can decrease the effectiveness of some medications. Before taking vitamin E, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

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Medications for cancer (Alkylating agents)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Vitamin E is an antioxidant. There is some concern that antioxidants might decrease the effectiveness of some medications used for cancers. But it is too soon to know if the interaction occurs.

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Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Vitamin E might slow blood clotting. Taking vitamin E along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

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Medications used for lowering cholesterol (Statins)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking vitamin E, beta-carotene, vitamin C, and selenium together might decrease the effectiveness of some medications used for lowering cholesterol. It is not known if taking vitamin E alone decreases the effectiveness of some medications used for lowering cholesterol.

Some medications used for lowering cholesterol include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), and pravastatin (Pravachol).

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NiacinInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking vitamin E along with beta-carotene, vitamin C, and selenium might decrease some of the beneficial effects of niacin. Niacin can increase the good cholesterol. Taking vitamin E along with these other vitamins might decrease the good cholesterol.

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Warfarin (Coumadin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Warfarin (Coumadin) is used to slow blood clotting. Vitamin E can also slow blood clotting. Taking vitamin E along with warfarin (Coumadin) can increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

The following doses have been studied in scientific research:

BY MOUTH:

• For vitamin E deficiency: a typical dose in adults is RRR-alpha tocopherol (natural vitamin E) 60-75 IU per day.
• For a movement disorder (ataxia) associated with vitamin E deficiency.
• For anemia: vitamin E 447-745 IU daily with erythropoietin 93-74 U/kg/week.
• For the movement disorder called tardive dyskinesia: RRR-alpha-tocopherol (natural vitamin E) 1600 IU daily.
• For the movement and coordination disorder called dyspraxia in children: vitamin E (dl-alpha tocopheryl acetate) in combination with fish oil, evening primrose oil, and thyme oil (Efalex, Efamol Ltd) daily.
• For improving male fertility: vitamin E 298-894 IU daily.
• For Alzheimer's disease: up to 2000 IU daily. Combination therapy of donepezil (Aricept) 5 mg and vitamin E 1000 IU per day has been used for slowing memory decline in people with Alzheimer's disease.
• For liver disease called non-alcoholic steatohepatitis: 800 IU daily in adults has been used; 400-1200 IU daily has been used in children.
• For early Huntington's chorea: RRR-alpha-tocopherol (natural vitamin E) 3000 IU.
• For rheumatoid arthritis pain: vitamin E 600 IU twice daily.
• For preventing nerve damage caused by cisplatin: vitamin E (alpha-tocopherol) 447 IU daily with each chemotherapy treatment and for up to 3 months after stopping cisplatin therapy.
• For improving effectiveness of nitrates used for heart disease: vitamin E 298 IU three times daily.
• To reduce protein in the urine of children with a kidney disease called focal segmental glomerulosclerosis: vitamin E 200 IU.
• For G6PD deficiency: vitamin E 800 IU daily.
• For premenstrual syndrome (PMS): RRR-alpha-tocopherol (natural vitamin E) 400 IU daily.
• For painful menstrual periods: vitamin E 200 IU twice or 500 IU daily starting 2 days before the menstrual period and continuing through the first 3 days of bleeding.
• For healing the eyes after a surgery called keratectomy: 343 IU vitamin E (alpha-tocopheryl nicotinate) and vitamin A (retinol palmitate) 25,000 units have been used 3 times daily for 30 days, followed by twice daily for 2 months.
• For fibrosis caused by radiation: vitamin E 1000 IU daily in combination with pentoxifylline 800 mg.
• For beta-thalassemia: vitamin E 750 IU daily.
• For swelling in the middle layer of the eye (uveitis): vitamin E (unspecified forms) 149 IU in combination with vitamin C 500 mg twice daily.
• For preventing sunburn: RRR-alpha-tocopherol (natural vitamin E) 1000 IU in combination with 2 grams of ascorbic acid.

For the most benefit, it's best to take vitamin E that has been made in a lab (all-rac-alpha-tocopherol) with food.

Dosing for vitamin E can be confusing. Current guidelines show recommended dietary allowance (RDA) and upper tolerable limits (UTL) for vitamin E in milligrams. However, most products are still labeled in International Units (IUs).