Substantiated Clinical Uses of Vitamin E


Beginning in the 1940's, Doctors Evan and Wilfrid Shute pioneered vitamin E's use in preventing and treating many types of heart and circulatory conditions. They soon discovered the vitamin dramatically benefited many other health conditions. The simple nutrient seemed too good to be true.

Convinced vitamin E would revolutionize the treatment of many types of diseases, the Shutes diligently endeavored to promote its recognition and use in the medical establishment. Because prominent medical journals would not print their articles, they published their own vitamin E medical journal, The Summary, and sent it complimentary to medical libraries worldwide, Finally in the late 1960's and early 1970's they turned to the public and wrote several books, such as The Heart and Vitamin E and Vitamin E for Ailing and Healthy Hearts, which became a #1 best-seller in the United States.

In 1976, a progressive physician, G. Edward Desaulniers, succeeded Evan Shute as medical director of the Shute Institute and Medical Clinic and continues in this capacity today. Evan and Wilfrid Shute lived, ate, and breathed vitamin E for nearly 40 years.

Using vitamin E, the Shute doctors and their medical colleagues treated over forty thousand patients with many different conditions including: coronary heart diseases (including hypertensive, rheumatic, and congenital heart diseases); angina pectoris; acute rheumatic fever; high blood pressure; arteriosclerosis; stroke; thrombosis; intermittent claudication; varicose veins; eczema; phlebitis; diabetes; gangrene; indolent leg ulcers; Buerger's disease; Milroy's disease; purpura; burns of all kinds; Dupuytren's contracture; cataracts; nephritis; peptic ulcer; miscarriage; prematurity; toxemia of pregnancy; sterility; menstrual pain; muscle cramps; fibrositis; leukoplakia; rheumatoid arthritis; and osteomyelitis.

Although most physicians and medical scientists rejected vitamin E's reported health benefits, Evan and Wilfrid Shute persisted in the clinical use of vitamin E with success, Today, research is substantiating what the Shute brothers had earlier reported. The medical community is finally beginning to accept vitamin E as a powerful ally in the battle for health.

Modern research is not only verifying vitamin E's therapeutic value but also discovering the biochemical principles behind it, for instance, vitamin E's antioxidant potential. Studies implicate free radical-mediated damage to body tissues as an important factor in a number of disease processes. Vitamin E has been identified as one of the body's main lipid-soluble antioxidants, and together with other cellular antioxidant defenses, provides protection against damaging free radical processes.

Ischemic Heart Disease

Low Blood Levels of Vitamin E Found to be the Main Risk Factor in Heart Disease Death

A World Health Organization study found low plasma vitamin E levels to be the main risk factor for death from ischemic heart disease. Blood pressure and the plasma status of vitamin A, C, and E, carotene, other major carotenoids, selenium, and cholesterol of middle-aged men representing 16 European study populations were statistically evaluated. Cholesterol and blood pressure, the traditional risk factors, were only moderately associated to risk of ischemic heart disease death. Vitamin E status alone predicted 62% of the deaths.

"The cross-cultural differences of ischemic heart disease mortality are primarily attributable to plasma status of vitamin E, which might have protective functions."

Gey K, et al. Inverse correlation between plasma vitamin E and mortality from ischemic heart disease in cross-cultural epidemiology. Am. J. Clin. Nutr. 1991; 53:3265-3345.

Angina Pectoris Low Plasma Vitamin E Levels Associated with Higher Risk of Angina Pectoris

A population case-control study examined the relation between the risk of angina pectoris and plasma levels of vitamins A, C, and E, and carotene in 110 cases of angina and 394 controls selected from a sample of men aged 35-54.

A significant inverse correlation was found between plasma levels of vitamins C and E and carotene and the risk of angina. After adjustment for smoking habits, age, blood pressure, weight, and blood lipid levels, only the inverse association between plasma vitamin E and angina risk remained significant. According to the researcher, the results suggest that populations with high coronary heart disease incidence may benefit from diets rich in antioxidants, especially vitamin E.

Riemersma RA, et al. Risk of angina pectoris and plasma concentrations of vitamins A, C, and E and carotene. Lancet 1991 ;337:1-5.

Thromboembolic Disease

Vitamin E Supplementation Significantly Decreases Risk of Abnormal Clotting in Blood Vessels

Statistical evaluation of 6 clinical studies totaling 3197 patients comparing vitamin E-treated groups (200-600IU daily) with control groups revealed that vitamin E significantly decreases the risk of thromboembolic disease.

Compared with vitamin E supplemented patients, those not supplemented had a 212% greater risk for peripheral venous thromboses, 596% greater risk for all pulmonary embolisms and 911% greater risk for fatal pulmonary embolisms.

Kanofskyk JD. Prevention of thromboembolic disease by vitamin E. N Eng J Med 1981; 305:173-17..

Cholesterol Profile

Vitamin E Increases 'Good' HDL Cholesterol Levels, While Keeping Total Cholesterol Levels the Same

Several lipoproteins transport cholesterol through the blood. Low levels of one of these lipoproteins, called high density lipoprotein (HDL), has been associated with greater risk of heart disease.

Five persons with average cholesterol distributions and 5 with low HDL levels were given 600 IU vitamin E. After 30 to 45 days, the group with normal cholesterol distributions experienced a 9%-179% increase in HDL cholesterol concentration. The group with initially low HDL levels experienced a 120%-383%increase in HDL concentration. In both groups, the total cholesterol concentration remained essentially the same as initial values.

The study suggests vitamin E may be of significant value in reversing Type IV hyperlipoproteinemia.

"D-Alpha-tocopherol appears to cause a significant redistribution of cholesterol among the lipoproteins, with elevation of the HDL fraction. Response to tocopherol probably requires less than 20 days, especially in persons with below-average HDL cholesterol levels."

Hermann WJ, et al. The effect of tocopherol on high-density lipoprotein cholesterol. Am J Clin Path 1979;72:848-852.

Heart Surgery Protection

Vitamin E Supplementation Significantly Controls Free Radical Damage Resulting from Heart Surgery

Increased free radical generation during cardiopulmonary bypass may overwhelm the body's antioxidant defense systems, resulting in peroxidation damage. A group of patients were pretreated with 2000 IU vitamin E, 12 hours before surgery. Free radical levels did not significantly increase during or after surgery, and blood vitamin E levels showed no significant change. In unsupplemented patients, free radical levels progressively increased during surgery, and blood vitamin E levels were significantly reduced. Vitamin E pretreatment maintained blood levels of vitamin E while effectively neutralizing free radicals generated during cardiopulmonary bypass.

Cavarocchi NE, et al. Superoxide generation during cardiopulmonary bypass: Is there a role for vitamin E? J Surg Res 1986; 40:519-527.

Intermittent Claudication

Vitamin E Relieves Pain Due to Restricted Arteries in the Legs

Those suffering from intermittent claudication experience pain and difficulty walking, due to restricted blood flow in the leg arteries. The underlying disorder is the body's inability to supply adequate arterial blood to contracting muscles, thus depriving the muscles of enough oxygen during exercise. The chronic suppression of blood flow may produce muscular degeneration, worsening the condition.

Vitamin E supplementation has helped patients with intermittent claudication. In a series of clinical studies, patients receiving 300 mg vitamin E per day and a standard exercise program for 4-6 months showed significantly greater improvement in performing a walking test compared to unsupplemented patients. After 12-18 months of supplementation, the vitamin E group showed significantly improved arterial blood flow.

Haeger K. Walking distance and arterial flow during long term treatment of intermittent claudication with d-alpha tocopherol. J for Vascular Diseases 1973; 2:280-287.

Haeger K. Long-time treatment of intermittent claudication with vitamin E. Am J Clin Nutr 1974; 27:1179-1181.

Physical Endurance

Vitamin E Effectively Quenches Exercise-Induced Free Radicals

Strenuous aerobic physical activities may benefit from vitamin E supplementation. In a study, high altitude mountain climbers were given 400 IU vitamin E daily to evaluate the effect on physical performance and cell damage.

After 4 weeks under conditions of chronic hypoxia, supplemented climbers experienced no significant decrease in anaerobic threshold, nor did their pentane breath exhalation, considered a reliable measure of lipid peroxidation, change significantly. However, unsupplemented climbers demonstrated a significant decrease in anaerobic threshold, and their pentane breath exhalation increased by 104%. Thus, high mountain climbers may be at considerable risk of free-radical induced cell damage, and vitamin E intake from the diet is insufficient for optimal oxygen utilization and cell protection.

"The results of this study show that vitamin E has a beneficial effect on physical performance and on cell protection...."

Simon-Schnass I, et al. Influence of vitamin E on physical performance. Internat J Vit Nutr Res 1988; 68:49-54.

In another study, supplementation of 1000 IU vitamin E per day for 10 days resulted in a significant decrease in breath pentane output in normal adults. "This observation confirms that vitamin E reduces breath pentane output and may, by inference, reduce lipid peroxidation."

Van Gossum A, et al. Decrease in lipid peroxidation measured by breath pentane output in normals after oral supplementation with vitamin E. Clin Nutr 1988; 7:53-57.

Rheumatoid Arthritis

Rheumatoid Arthritis Patients Exhibit Low Vitamin E Levels

Increased free radical generation can enhance lipid peroxidation and cause cartilage destruction. Sixty-one patients with rheumatoid arthritis and 35 healthy subjects were evaluated for serum vitamin A and E concentrations.

Rheumatoid arthritis patients had significantly lower serum vitamin A and vitamin E levels than controls. "Vitamins A and E inhibit the oxidation of arachidonic acid to prostacyclins and leukotrienes in vitro. The lack of these micronutrients in the sera of rheumatoid arthritis patients may thus further enhance the disease by allowing production of pro-inflammatory arachidonic acid metabolites, prostaglandins and leukotrienes in addition to oxygen radicals."

Honkanen V, et al. Vitamins A and E, retinol binding protein and zinc in rheumatoid arthritis. Clin Exper Rheumatol 1989; 7:465-469.


Vitamin E Supplementation Relieves Pain in Osteoarthritis

A study involved 30 osteoarthritis patients. Each subject was randomly assigned to the tocopherol group, which received 600 mg daily, or to the placebo group. In ten days, 52% of the tocopherol group reported a good analgesic effect, while only 4% of the placebo group reported a similar effect.

The researchers suggest tocopherol's analgesic effect may be due to the stabilizing influence on the membranes of cells which contain inflammatory precursors.

Machtey I, Ouaknine L. Tocopherol in osteoarthritis: A controlled pilot study. J Am Geriatric Society 1978; 7:328.


Vitamin E Reverses Nutritional Muscular Dystrophy

An early symptom of vitamin E deficiency in experimental animals is "nutritional muscular dystrophy." Levels of serum creatine phosphokinase (an enzyme increased in the blood during muscle degeneration) increase and neurological disorders usually become apparent.

A report from Children's Memorial Hospital, Chicago, Illinois, describes a 7 year-old boy with severe malabsorption since birth who showed pathological signs similar to those in vitamin E deficient animals. Treatment with 400 to 800 IU vitamin E daily for 16 months resulted in the gradual decrease of serum muscle enzyme levels. The change was in proportion to blood vitamin E levels.

The results suggest the chemical abnormality was reversible by supplementing vitamin E in the diet. The researchers noted that the patient's condition improved and that "previous inability to demonstrate the clinical syndrome of human vitamin E deficiency may be related to severity and duration of the deficiency."

Tomasi LG. Reversibility of human myopathy caused by vitamin E deficiency. Neurology 1979; 29:1182.

Muscle Cramps

Vitamin E Is More Effective and Safer than Traditional Drugs in Relieving Muscle Cramps

In orthopedic practice, idiopathic leg cramps and other types of muscle cramps are common complaints. A report described that 300 IU vitamin E daily is almost universally effective on idiopathic nocturnal leg cramps. In the researcher's opinion, vitamin E is "far more effective and safer to use than quinine or quinine-aminophylline combinations."

Cathcart RF. Leg cramps and vitamin E. JAMA 1972;219: 216-217.

Neuromuscular Diseases Caused by Vitamin E Deficiency

Vitamin E Aids Children and Adults with Neuromuscular Disorders Due to Vitamin E Deficiency

Cholestasis, the stoppage or suppression of bile flow, may lead to vitamin E deficiency, as bile may be required for absorption of vitamin E. Patients suffering from cholestasis often develop neuromuscular disorders.

Four children, ages 6-17 years, with chronic cholestasis had developed neuromuscular diseases characterized by ataxia, dysmetria, complete areflexia, loss of vibratory sensation and variable ophthalmolplegia. Serum vitamin E concentrations were low in all of them. Muscle biopsies revealed autofluorescent basophilic esterase and acid phosphatase-positive cytoplasmic inclusions and occasional necrotic fibers.

Vitamin E was administered for two years to normalize serum vitamin E values. After normalization of serum vitamin E concentrations for 6 to 14 months, all patients have shown definite improvement. One patient regained her ability to walk. The ophthalmolplegia in another was no longer present. Upper extremity deep tendon reflexes returned in all. RBC hemolysis was normalized. The younger patients experienced the greatest functional improvement.

Guggenheim MA, et al. Progressive neuromuscular disease in children with chronic cholestasis and vitamin E deficiency: diagnosis and treatment with alpha-tocopherol. J Pediatrics 1982; 100:51-58.

Vitamin E deficiency in children with chronic cholestasis. Nutr Rev 1984; 42:284-286.

In another case report, a 64 year-old man with chronic steatorrhea suffered from vitamin E deficiency. This leads to the development of ataxia and a visual field defect. Vitamin E was administered intramuscularly and then orally in a water miscible form. His vitamin E status eventually normalized. Progressive improvement in his vision and gait followed. After two years of supplementation, the patient felt back to normal.

Howard L, et al. Reversible neurological symptoms caused by vitamin E deficiency in a patient with short bowel syndrome. Am J Clin Nutr 1982; 36:1243-1249.

Patients with abetalipoproteinemia lack apoprotein B, essential for low-density and very-low-density lipoproteins and chylomicrons. This results in greatly reduced concentrations of lipids in the blood, which often leads to ataxic neuropathy and pigmentary retinopathy.

Eight patients with abetalipoproteinemia were treated with large amounts of vitamin E (100 mg/kg daily), required because of their reduced ability to absorb fats and fat-soluble nutrients. None of the 5 youngest patients have developed any retinal or neurological signs. One had absent deep tendon reflexes in the beginning, which subsequently returned and have remained normal. An older patient experienced significant improvement in neurological and visual functions, while the response in two others was less apparent.

"There is, therefore, evidence that large oral doses of vitamin E may prevent the development of neurological lesions in abetalipoproteinemia. Established lesions in abetalipoproteinemia and other conditions associated with chronic severe vitamin E deficiency may also be improved by vitamin E therapy."

Muller D, Lloyd J. Effect of large oral doses of vitamin E on the neurological sequelae of patients with abetalipoproteinemia. Ann New York Acad Sci 1982; 393:133-141.


Complete Remission of `Untreatable' Condition Using Vitamin E

Polymyositis is a chronic, progressive inflammatory disease of skeletal muscle characterized by symmetrical weakness of limb girdles, neck, and pharynx. No satisfactory treatment has been proven, although high doses of corticosteroids and other immunosuppressive drugs given over much time have induced remissions. Serious complications from this type of treatment often result.

A clinical report detailed the case of a 70 year-old woman with polymyositis. Treatment with high doses of the immunosuppressive drugs cyclophosphamide, azathioprine, and steroids failed to help her. After 3 months, her condition worsened and she became totally helpless.

She was taken off the immunosuppressive drugs and administered 400 IU of vitamin E twice daily, then after 10 days four times daily. Noticeable improvement was noted in a few weeks, and in 3 months, she was released from the hospital, having recovered enough to be able to take care of herself. She continued taking 1600 IU vitamin E daily.

Killeen R, et al. Polymyositis: response to vitamin E.

Southern Medical Journal 1976:69:1373-1374.

Restless Legs Syndrome

Substantial Relief of Deep Calf Pain by Vitamin E

This disorder is characterized by unpleasant deep discomfort inside the calves when sitting or lying down, especially before sleep, resulting in an irresistible urge to move the legs.

A clinical report detailed the response of 9 patients with restless legs syndrome. The response was completely controlled in 7, almost 75% controlled in one, and 50% controlled in one.

Ayres S, Mihan R. "Restless Legs" syndrome: response to vitamin E. J App Nutr 1973; 25:8-15.


Vitamin E Treatment Improves Seizure Control and Reduces Seizure Frequency, Duration, Damage and Intensity

As an antioxidant, vitamin E may reduce damaging effects of prolonged seizures on certain brain structures. Recent clinical trials suggest that vitamin E improved seizure control in some subjects with epilepsy treated with anticonvulsants.

Twelve study subjects and 14 controls (ages 5-18) were given 294 mg vitamin E or placebo along with traditional antiepileptic drug therapy. After 3 months, significant reduction of seizure frequency, duration, and intensity were experienced by 10 out of 12 on vitamin E. No change was detected in 13 of the 14 controls.

"The findings in this study would at least justify further large, longer trials independently or multicentrically to confirm that alpha-tocopherol supplements may have a place as an add-on therapy in seizure control. This maybe very important to the 10-20% of the epileptic population whose seizures are inadequately controlled on the best medical treatment presently available."

Ogunmekan AO, Hwang PA. Modified, randomized, double-blind placebo-controlled clinical trial of alpha-tocopherol (vitamin E) as add-on therapy for epilepsy in children. International Congress of Pediatrics, Honolulu, Hawaii, July 1986.

In a nine-month, double-blind study, epileptic patients received either 250 IU vitamin E daily or placebo. Two-thirds of the adult patients receiving vitamin E showed improvements in seizure control, ranging from 11% to over 50% reductions in seizures. One third of the children taking vitamin E reported improvements.

Sullivan C, et al. Seizures and natural vitamin E. Med J Aust 1990; 152:613-614.

Tardive Dyskinesia

Vitamin E Reduces Abnormal Involuntary Movements in Tardive Dyskinesia

The chronic use of certain antipsychotic drugs may result in a movement disorder known as tardive dyskinesia. Excess free radical generation may be involved in its development.

Since vitamin E was documented as being beneficial in certain neurological conditions, a double-blind, crossover study evaluated the effects of vitamin E on clinical signs of tardive dyskinesia in adult patients. After vitamin E supplementation, subjects reported a 43% average reduction in scores on the Abnormal Involuntary Movements Scale. Seven patients demonstrated an over 50% reduction in their dyskinesia.

Lohr JB, et al. Vitamin E in the treatment of tardive dyskinesia: The possible involvement of free radical mechanisms. Schizophrenia Bulletin 1988; 14:291-296.

A more recent study replicated Lohr's findings.

Elkashef AM, et al. Vitamin E in the treatment of tardive dyskinesia. Am J Psychiatry 1990; 147:505-506.

Parkinson's Disease

Long Term Vitamin E Use May Slow Parkinson's Disease Progression

Symptoms of Parkinson's disease include incapacitating tremors, rigidity and loss of balance. Parkinson's disease patients who were taking 400-3200 IU vitamin E daily for an average of 7 years showed significantly less severe symptoms than in age-matched, unsupplemented subjects. The reduced disease severity was reflected in the ability to carry out activities of daily living. The researchers suggest that vitamin E may slow the progression of Parkinson's disease.

Factor SA. Retrospective evaluation of vitamin E therapy in Parkinson's Disease. Vitamin E: Biochemistry and Health Implications, New York Academy of Sciences Meeting, November, 1988.

Huntington's Disease

A long-term clinical study is currently in progress to determine if high doses of vitamin E can delay the onset of symptoms of Huntington's disease.

Cystic Breast Disease

Complete and Moderate Regression of Cystic Breast Disease Resulting from Vitamin E Supplementation

Non-cancerous lumpy breast tissue affects almost 20% of American women. Some types of fibrocystic breast disease are thought to increase the risk of breast cancer development 2 to 8 times. Even those whose lumps remain benign often experience extreme discomfort.

In a study, 26 women with middle-stage mammary dysplasia were given a placebo for 4 weeks followed by 600 IU of vitamin E daily for 8 weeks. Ten patients experienced complete regression of lumps and tremendous clinical improvement. Twelve noticed moderate lump regression.

Gonzalez ER. Vitamin E relieves most cystic breast disease; may alter lipids, hormones. JAMA 1980; 244:1077.

In another study, 26 patients with confirmed mammary dysplasia and 5 age-matched controls were given 600 mg vitamin E daily. After three weeks, 85% of the patients showed objective and subjective remission from disease following therapy. Also, the higher serum cholesterol/ high density lipoprotein (HDL) cholesterol ratio observed in the patients was corrected by vitamin E therapy. Furthermore, HDL lipoproteins increased and ester cholesterol associated with low density lipoproteins decreased.

Sundaram GS. Alpha-tocopherol and serum lipoproteins. Lipids 1981; 16:223-227.

Vorherr H. Fibrocystic breast disease: Pathophysiology, pathomorphology, clinical picture, and management.

Am J Obstet Gynecol 1986; 154:161-179.

London RS, et al. The effect of vitamin E on mammary dysplasia: A double blind study. Obstet Gynecol 1985; 65:104-106.

Premenstrual Syndrome

Substantial Reduction of PMS Symptoms Enjoyed by Women Taking Vitamin E

To evaluate the effectiveness of daily vitamin E supplementation in improving PMS symptoms, a carefully screened population of women with PMS were given 400 IU natural source vitamin E or placebo in a randomized, double blind study. A standardized PMS questionnaire was administered to all subjects with 15 symptom categories.

In all 15 categories of symptoms, vitamin E supplemented women reported 27-42% reduction of severity. Placebo treatment was associated with moderate reduction in only 9 of 15 categories. The researchers concluded that vitamin E supplementation appears to be a rational approach to PMS management.

"The results of the present investigation are consistent with our previous observations that alpha tocopherol supplementation reduces symptoms of PMS with no demonstrable side effects."

London RS, et al. Efficacy of alpha tocopherol in the treatment of the premenstrual syndrome. J Reprod Med 1987; 32:400-404.

An earlier study involved 75 women. Those given vitamin E experienced improvement in 3 of the 4 classes of PMS symptoms on a standardized questionnaire. Controlling for age and pretreatment score, vitamin E had a significantly greater effect than placebo.

London RS, et al. The effect of alpha-tocopherol on premenstrual symptomatology: a double blind study. Journal of the American College of Nutrition 1983; 2:115-122.

Toxemia of Pregnancy

Plasma Vitamin E Level May Be an Accurate Risk Factor for Pre-Eclampsia.

A major cause of maternal and fetal complication and death is pre-eclampsia (toxemia of late pregnancy). Most researchers agree that free radicals play a major role in this disorder. Thus, the potential for antioxidant nutrients in treating pre-eclampsia may be great.

A study of healthy, pregnant women evaluated plasma vitamin E, beta-carotene and retinol levels in relation to subsequent risk of pre-eclampsia. In those who subsequently developed the signs and symptoms of pre-eclampsia, plasma vitamin E and retinol levels were significantly lower at 28 weeks gestation and remained significantly lower until delivery. The results reflect decreased free radical scavenging activity before onset of the signs and symptoms of pre-eclampsia.

"The pilot study indicates a possible predictor of pre-eclampsia concentrations of retinol and vitamin E in plasma which is relatively easy to measure at 28 weeks gestation."

Jendryczko A, Drozdz M. Zent bl Gynakol 1989; 111:1121-1123.

Periventricular Hemorrhage

Vitamin E Substantially Reduces Brain Lesions in Premature Infants

Forty percent of very premature infants develop brain lesions during the first three days of life, resulting in periventricular hemorrhage. A randomized control study was conducted to evaluate the role of intramuscular vitamin E injection during the first three days of life in prevention of periventricular hemorrhage in premature infants.

After adjusting for factors that might influence periventricular hemorrhage development, vitamin E demonstrated an independent protective effect. 69.6% of vitamin E-supplemented infants developed no brain hemorrhaging. In vitamin E supplemented infants who did develop hemorrhages, the majority of the hemorrhages were confined to a limited area (subependymal hemorrhage).

"These findings suggest that vitamin E protects by rapidly limiting the extent of subependymal hemorrhage within 24 hours of its occurrence and that early supplementation is important."

Sinha S, et al. Vitamin E supplementation reduces frequency of periventricular hemorrhage in very preterm babies. Lancet 1987; February 28, 1987, 446-470.

Chiswick M, et al. Vitamin E supplementation and periventricular hemorrhage in the newborn. Am J Clin Nutr 1991; 53:370S-372S.

Respiratory-Distress Syndrome

Vitamin E Completely Prevents Lung Tissue Damage in Preterm Infants

Premature infants with respiratory-distress syndrome often develop fetal lung tissue damage, which may lead to death. In a study, 9 neonates were treated with vitamin E, and 13 were chosen as controls. All required supplemental oxygen for more than 250 hours, treated with positive-pressure ventilation and endotracheal continuous distending airway pressure.

None of the 9 vitamin E-treated infants suffered changes characteristic of bronchopulmonary dysplasia and all survived. Six of the 13 controls had changes consistent with bronchopulmonary dysplasia and 4 died.

This report further substantiates vitamin E's role as an antioxidant in preventing oxygen-induced lung injury.

Ehrenkranz RA, et al. Amelioration of bronchopulmonary dysplasia after vitamin E administration. New Engl J Med 1978; 299:564.

Vitamin E in the prevention of chronic bronchopulmonary dysplasia in low birth weight infants. Nutr Rev 1979; 37:11-12.

Editor's Note: Case reports of toxicity caused by excessive vitamin E administration to neonates has led to recent litigation (1988) and pediatric cautions against its use in I.C.U.'s.


Phototherapy Plus Vitamin E Found to be the Most Effective Treatment of Excessive Blood Bilirubin levels in Neonates

A common phenomenon in neonates is increased levels of blood bilirubin, one of the bile pigments. This may be due to an increased rate of red blood cell destruction. Infants with bilirubinemia are usually exposed to special sources of light (phototherapy) until the level of bilirubin in the blood is normalized.

In a report from the Duke University Medical Center, 40 infants suffering from this disorder were administered vitamin E (50 mg/kg intramuscularly) during the first 3 days of life. The time required for phototherapy was effectively reduced from 107 hours to 48 hours.

Gross SJ. Vitamin E and neonatal bilirubinemia.

Pediatrics 1979; 64:321.

Retrolental Fibroplasia

Vitamin E Significantly Reduces Eye Damage in Premature Infants

An important cause of childhood blindness is retrolental fibroplasia, also known as retinopathy of prematurity. The disease begins when a neonate is introduced into an environment of highly concentrated oxygen, possibly leading to destructive free-radical processes in the eye.

A double-blind study in 101 preterm infants was conducted to evaluate the efficacy of oral vitamin E in preventing the development of retrolental fibroplasia. After accounting for variables in both control and treatment groups, the severity of retrolental fibroplasia was found to be significantly reduced in infants given 100 mg of vitamin E.

"Since there have been no detrimental side effects from oral treatment with the higher dose of the vitamin, and because severe visual loss maybe reduced markedly by its administration, the risk-benefit ratio strongly favors early high-dose vitamin E administration in the high-risk preterm infant."

Hittner HM, et al. Retrolental fibroplasia: Efficacy of vitamin E in a double-blind clinical study of preterm infants. N Eng J Med 1981; 305:1365-1371.


Low Blood Levels of Vitamin E .May Increase Risk of Cataract Development

Researchers believe cataracts are formed when excessive free radicals in the eye attack and precipitate proteins in the lens. A study that compared the self-reported intake of supplementary vitamins E and C in 175 cataract patients and 175 individually matched, cataract-free patients, found that those who were cataract-free took significantly more vitamins E and C. Overall, the cataract-free subjects had an overall risk reduction of at least 50%. The results of this study are similar to those epidemiological studies at the Tufts University/USDA Human Nutrition Research Center on Aging.

Trevithick JD. Vitamin E: Cataract risk and prevention.

Vitamin E Symposium, Henkel Corporation; June 12-15, 1989.

Sickle Cell Anemia

Vitamin E Reduces Percentage of Irreversibly Sickled Blood Cells

Sickle cell anemia patients have abnormally shaped red blood cells which regain their normal shape upon oxygenation. Some red cells retain the sickled shape even when oxygenated and are termed irreversibly sickled cells ( I S C). The percentage of ISC correlates with hemolysis observed in sickle cell anemia patients. Sickle cell anemics also have low vitamin E plasma levels.

Six sickle cell anemia patients were given 450 IU vitamin E daily for 6 to 35 weeks. The percentage of circulating ISC decreased from 25% before treatment to 11% after vitamin E supplementation. The percentage of ISC remained below pretreatment levels as long as vitamin E was administered.

The researchers noted that ISC formation may be related to faulty membrane synthesis. Vitamin E may have acted by structurally stabilizing the red cell membrane against oxidative damage.

The "profound decreases in the number of circulating ISC's" observed in this study strongly supports using vitamin E to benefit sickle cell anemia patients.

Natta CL. A decrease in irreversibly sickled in sickle cell anemia patients given vitamin E. Am J Clin Nutr 1980: 33:968-971.

Chronic Hemolysis

Long Term Vitamin E Treatment Improves RBC Life-Span and Increases Hemoglobin Concentration

Mediterranean-type glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic disorder of red blood cell metabolism, characterized by chronic hemolysis and severe episodic acute hemolysis. Since patients with G6PD deficiency demonstrate inadequate levels of important antioxidants (reduced nicotinamide adenine dinucleotide phosphate and glutathione), the hemolysis may be due to free radical oxidation and denaturization of hemoglobin and red blood cell structure. In the following study, vitamin E, as an effective lipid-soluble antioxidant, has been shown effective in reducing hemolysis.

Twenty-three patients with Mediterranean G-6PD deficiency were given vitamin E for three months. The results showed decreased chronic hemolysis as evidenced by improved red-cell life span, increased hemoglobin concentration and decreased reticulocytosis as compared to base line values.

"Evaluation after one year of vitamin E administration demonstrated sustained improvement in all these indices. Controlled clinical trials of vitamin E supplementation may be warranted to examine its efficacy in ameliorating acute hemolytic crises or in reducing morbidity from neonatal jaundice in this relatively common genetic disorder."

Corash L, et al. Reduced chronic hemolysis during high-dose vitamin E administration in Mediterranean-type Glucose-6-Phosphate Dehydrogenase Deficiency.

N Engl J Med 1980; 303:416.


Vitamin E Effectively Inhibits Platelet Aggregation in Diabetic Complications

In the early stage of diabetes, platelet aggregation has been observed to increase. This change may be a factor in the development of vascular complications and premature atherosclerosis.

In a randomized, double-blind study, the effects of vitamin E supplementation on platelet function were evaluated in 9 insulin-dependent (Type I) diabetic patients. The study was divided into 2 periods of 35 days with either 1000 mg vitamin E per day or a placebo.

Vitamin E supplementation resulted in a small but significant decrease in adenosine diphosphate-induced platelet aggregation. There were no significant changes observed in those taking the placebo.

"Results indicate that high doses of vitamin E diminish ADP-induced platelet aggregation in Type I diabetic patients and suggest that this effect is partly mediated through a diminution of the cyclooxygenase activity."

Colette C, et al. Platelet function in type I diabetes: Effects of supplementation with large doses of vitamin E.

Am J Clin Nutr 1988; 47:256-261.

Another study examined vitamin E levels in non-insulin dependent (Type II) diabetes. Plasma vitamin E levels were significantly inversely correlated with induced platelet aggregation rate and production of thromboxane B2, a metabolite of prostaglandin metabolism. Platelet vitamin E content was demonstrated to be closely related to both the activity of platelet prostaglandin metabolism and ADP-induced platelet aggregation rate.

Watanabe J, et al. Effect of vitamin E on platelet aggregation in diabetes mellitus. Thromb Haemostas (Stuttgart) 1984; 51:313-316.

Skin Conditions

Skin conditions which have benefited from oral and/or topical administration of vitamin E include: Raynaud's phenomenon; scleroderma; calcinosis cutis; keratosis follicularis (Darrier's disease); yellow nail syndrome; epidermolysis bullosa; pseudoxanthoma elasticum; morphea; lichen sclerosus et atrophicus; granuloma annulare; necrobiosis lipoidica; diabeticorum; discoid lupus erythematosus; vasculitis and related conditions; porphyria cutanea tarda; subcorneal pustular; dermatosis; benign chronic familial; post-herpes zoster; pemphigus; neuralgia; pityriasis rubra pilaris; dermolytic bullous dermatosis.

Ayres S, Mihan R. Vitamin E and dermatology. Cutis 1975; 16:1017-1021.

Ayres S, Mihan R. Lupus Erythematosus and vitamin E: An effective and nontoxic therapy. Cutis 1979; 23: 49-53.

Ayres S, Mihan R. Yellow nail syndrome. Arch Dermatol 1973;198:267-268.

Ayres S, Mihan R. Keratosis follicularis (Darrier's Disease). Arch Derm 1972;106:909-910.

Ayres S, et al. Raynaud's phenomenon, scleroderma and calcinosis cutis: Response to vitamin E. Cutis 1973; 1:54-62.

Ayres S, Mihan R. Post-herpes zoster neuralgia: Response to vitamin E therapy. Arch Dermatol 1973; 108-855-856.

Ayres S, Mihan, R. Pseudoxanthoma elasticum and epidermolysis bullous - Response to vitamin E. Cutis 1969; 5:287-294.

Ayres S, Mihan R. Epidermolysis bullosa. Arch Dermatol 1982; 118:372-3 73.

Ayres S, Mihan R.. Vitamin E treatment of dermolytic bullous dermatosis. Arch Dermatol 1974; 109.

Ayres S, Mihan R. Subcorneal pustular dermatosis controlled by vitamin E. Arch Dermatol 1974; 109:914.

Ayres S, Mihan R. Porphyria cutanea tarda: Response to vitamin E. Cutis 1978; 22:50-52.

Smith EB, et al. Vitamin E treatment of dermolytic bullous dermatosis. Arch Dermatol 1973; 108:254-256.

Acne Vulgaris

Vitamin E Clears Up Acne Without Need for Antibiotics

5000 IU vitamin A and 400 IU vitamin E were administered to acne patients two times daily. Excellent results were reported with no undesirable side-effects. Moreover, antibiotics were unnecessary.

The researchers suggest the vitamin E prevented lipid peroxidation from bacterial-induced leakage through follicles and sebaceous glands. Inflammation due to peroxide irritation was hence prevented.

Ayres S, Mihan R. Cutis 1981; 28:41.


Vitamin E Dramatically Reduces Fungal Growth on Skin

400 IU vitamin E was applied daily to the toenail of a patient with severe chronic thread fungus. Dramatic improvement of the condition was noted in two weeks. The researcher attributed this to inhibition of lipid peroxide formation and suggested vitamin E is effective for other keratotic skin disorders.

Goldsmith SJ. Am Acad Dermatol 1983; 8:910.

Venous Stasis Ulcer

Vitamin E Prevents Recurrent Skin Ulceration

Chronic venous insufficiency usually results from deep vein thrombosis. Free radical generation may increase due to an incomplete ischemic state, leading to tissue necrosis and skin ulceration.

Twenty patients with chronic venous stasis ulceration received debridement and split-thickness skin graft coverage and were divided into two equal groups. Group I received 400 IU vitamin E daily, while group II did not. Results of skin grafts at 18 months showed that in the vitamin E treated group, 9 out of 10 were stable, with one having a small, shallow ulcer recurrence. In the non-supplemented group, all skin grafts were unstable.

The researchers conclude that in chronic venous insufficiency, increased lipoperoxidation at the site of skin ulceration is evidenced, and vitamin E as an antioxidant prevents recurrent skin ulceration.

Ramasastry SS, et al. Biochemical evidence of lipoperoxidation in venous stasis ulcer. Vitamin E: Biochemistry and Health Implications 1989; 570:506-508.


Burn Patients' Plasma Vitamin E Levels are Drastically Reduced Due to Peroxidative Damage

Burn damage has been attributed to increased free radical generation. The damaged tissues of burned animals show high lipid peroxide levels. To further study the role of peroxidative damage in burns and implications for treating burns, a clinical study assessed lipid peroxidation rates, vitamin E concentrations, and glutathione peroxidase activities in serum and red blood cells of 12 adult patients during the first 15 days post-burn.

Compared to controls, the plasma of burn patients showed a significant increase in lipid peroxide levels and a significant decrease in vitamin E and glutathione peroxidase activities. Plasma lipid peroxide levels were inversely correlated with plasma vitamin E concentrations. The changes in plasma concentrations were most significant on the tenth post-burn day, and the degree of change was greater in subjects with severe burn injuries.

"The results show that the burn injuries and the extent of injuries were closely related with the lipid peroxidation damage initiated by free radicals. This provides a theoretical basis for the better treatment of burns. Our study shows that replenishment of vitamin E is requisite to the burn patients."

Yuan C, et al. Burns and damage by lipid peroxidation.

J Med Coll PLA 1988; 3:55-59.

Periodontal Disease

Vitamin E Reduces Gum Inflammation and Blisters

Periodontal inflammation involves prostaglandin processes, and treatments inhibiting prostaglandin biosynthesis were presumed beneficial in treating periodontal disease.

To evaluate vitamin E's role as a prostaglandin inhibitor in periodontal disease therapy, a double-blind study was conducted. Patients who were given 800mg vitamin E daily had significantly reduced fluidity of the sulcus fluid, which is typically increased in periodontal disease.

The positive effect appears to have resulted from inhibition of prostaglandin synthesis.

Goodson JM, Bowles D. IRDR Abs 1973; 633.

In another double-blind study, an ointment containing 2% vitamin E was compared to placebo in 244 periodontitis patients from 6 different facilities. The ointment was found effective in curing and improving local inflammatory symptoms such as flare and swelling.

Kimura Y, et al. J Japan Ass Periodont 1977; 19:413.

Another study reports that oils with high concentrations of vitamin E effectively treated primary herpes gingivostomatitis. Only 15 minutes after application, complete relief from pain occurred. After 10 days of application, patients reported complete recovery.

Starosoler S, Haber GS. NY State Dental J 1978; 44:382.


Vitamin E Levels Decrease with Age

Research has documented that blood levels of free peroxide radicals increase with age and are inversely related to blood levels of vitamin E and vitamin C. In a study, elderly women 60-100 years of age were given 200 mg vitamin E or 400 mg vitamin C for a two-year period.

In vitamin E supplemented subjects, the average blood peroxide levels decreased by 20% from their initial values, while vitamin C supplemented subjects experienced an average decrease of 11%.

"The obtained data suggest that vitamin C and vitamin E may beneficially influence some processes of aging."

Ziemlanski S, et al. The effect of two-year supplementation with ascorbic acid and alpha tocopherol on lipid, hematological and vitamin state in elderly women. I Metabolizm 1986; 13:7-14.

Wartanowicz M, et al. The effect of alpha-tocopherol and ascorbic acid on the serum peroxide level in elderly people. Ann. Nutr Metab 1984; 28:186-191.

Natural-Source Vitamin E is Superior

Natural-source vitamin E (d-alpha tocopherol) has long been known to be significantly more bioactive than synthetic vitamin E (dl-alpha tocopherol). More recent studies suggest that natural-source vitamin E is also incorporated better and retained longer in body tissues and cells than synthetic vitamin E. Indeed, many individuals find natural-source vitamin E to be much more effective in relieving symptoms than the synthetic version.

Cheng SC, Burton GW, et al. Chiral discrimination in the exchange of alpha-tocopherol stereoisomers between plasma and red blood cells. Lipids 1987; 22:469-473.


Research with vitamin E continues both in the laboratory and the clinic. Doctors Evan and Wilfrid Shute had tried to make clear that vitamin E is no panacea. However, the simple nutrient has already been proven a worthy gem in an incredibly broad spectrum of ailments. Thankfully, physicians and medical researchers are beginning to accept vitamin E as a legitimate health-promoting agent. The Shutes' work has not been in vain. The world just needs a little time to catch up.

Dr. Evan Shute summed it all up best: "We didn't make vitamin E so versatile. God did. Ignore its mercy at your peril."

Correspondence: David Lin 4504 Normandy Dr. Lisle, IL 60532


By David Lin

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