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Information about Vitamin e
Vitamin E (alpha tocopherol) is a fat soluble vitamin and potent antioxidant that is believed to be important in protecting cells from oxidative stress, regulating immune function, maintaining endothelial cell integrity and balancing normal coagulation.
Liver safety of Vitamin e
There is no evidence that vitamin E, in physiologic or even super-physiologic, high doses, causes liver injury or jaundice.
Mechanism of action of Vitamin e
Vitamin E is a fat soluble vitamin known chemically as alpha-tocopherol (toe kof' er ol). Vitamin E is a potent antioxidant and is believed to be important is protecting cells from oxidative stress. Alpha tocopherol exists in 8 isomeric forms, but only one (R-R-R alpha tocopherol, “natural” vitamin E) has full antioxidant activity and is the predominant form found in nature in foods rich in vitamin E. Vitamin E is taken up my multiple cells and becomes embedded in the endoplasmic reticulum where it carries out antioxidant activity, maintaining the integrity of intracellular pathways and molecules than can be altered or inactivated by reactive oxygen radicals.
Deficiency of Vitamin e
Deficiency of vitamin E is rare, found largely in patients with severe fat malabsorption, with advanced liver disease or on total parenteral nutrition.
Sources of Vitamin e
Vitamin E is available in multiple forms, including tablets, capsules, oral solutions and syrups and solutions for intravenous administration (for parenteral nutrition).
RDA intake of Vitamin e
Most formulations are available over the counter, but many are mixed isomers of alpha tocopherol and the biologic activity of these products is unclear. The recommended daily allowance (RDA) for vitamin E is 15 mg (22 IU; 35 µmol) daily in adults and varies in children from 4 mg in neonates ages 0 to 6 months, 5 mg in infants ages 7 to 12 months, 6 mg for ages 1 to 3 years, 7 mg for ages 4 to 8 years, 11 mg for ages 9 to 13 years, to 15 mg for adolescents ages 14 years and above. Recent surveys suggest that the average American diet provides less than the RDA levels for vitamin E. An adequate blood level of vitamin E is considered 4 mg/mL.
Clinical use of Vitamin e
Vitamin E has been evaluated as therapy or means of prevention of many diseases including coronary artery disease, stroke, cognitive decline, macular degeneration and multiple forms of cancer, but has not been shown to have a significant effect on the incidence, morbidity or mortality of these diseases. Recently, small trials have suggested that vitamin E supplements can decrease steatosis, inflammation and cell injury in patients with nonalcoholic fatty liver disease. In doses below 1000 mg (1,500 IU; 2325 µmol) daily, vitamin E has been found to be safe and without adverse events. Patients on anticoagulant therapy may have an increase in bleeding episodes because of vitamin E’s effect on platelet aggregation.