Vitamin E by Vital Nutrients

This is a high-dose vitamin E, best suited to people with a specific reason to take it: a low Vitamin E (Alpha-Tocopherol) level, a condition that impairs fat absorption, such as after bariatric surgery or with chronic liver, pancreatic or bowel disease, or a clinician's recommendation. It is not a general wellness supplement for most adults. Nuts, seeds and vegetable oils cover the daily need, and long trials of high-dose vitamin E in healthy people have not shown the benefits once hoped for.

Vitamin E is the body's main fat-soluble antioxidant. It sits in cell membranes and protects their fats from oxidation, and it supports normal immune function. This product uses d-alpha tocopherol, the natural form that the body retains better than synthetic dl-alpha tocopherol. It also includes d-gamma, d-delta and d-beta tocopherols. Alpha-tocopherol taken alone at high doses lowers blood levels of gamma-tocopherol, the main form in food, and the added mixed tocopherols are there to offset that.

Each softgel provides 268 mg of vitamin E as d-alpha tocopherol plus 67 mg of mixed tocopherols. The label directs 1 softgel daily. Take it with a meal that contains fat, which vitamin E needs for absorption. Do not take more than 1 unless your clinician has set a higher dose, and count the vitamin E in your multivitamin toward your total. The softgel is gelatin and the product contains soy.

The main risk is bleeding. High-dose vitamin E reduces platelet stickiness and works against vitamin K, so it can add to warfarin, aspirin, clopidogrel and other blood thinners; ask your prescriber first, and stop it 2 weeks before planned surgery. Pooled trial data link long-term high-dose vitamin E to a small rise in bleeding strokes, and one large trial in men found slightly more prostate cancer at a similar dose. If you are pregnant, nursing or having chemotherapy or radiation, check with your clinician before use.

If your level was low, Vitamin E (Alpha-Tocopherol) rises within a few weeks; retest after 2 to 3 months and step down once you are in range. You should not expect to feel a difference. For people without a deficiency, the amount of vitamin E in a multivitamin or in food is the more cautious choice, and large trials have not found that high doses lower the risk of heart disease or cancer.