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Vitamin E is a vitamin that dissolves in fat. It is found in many foods including vegetable oils, cereals, meat, poultry, eggs, and fruits.

Vitamin E is an important vitamin required for the proper function of many organs in the body. It is also an antioxidant. Vitamin E that occurs naturally in foods (RRR-alpha-tocopherol) is different from man-made vitamin E that is in supplements (all-rac-alpha-tocopherol).

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. Vitamin E is also used for many other conditions, but there is no good scientific evidence to support many of these other uses.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
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When taken by mouth: Vitamin E is likely safe for most people when taken in doses lower than 1000 mg daily. This is the same as 1100 IU of synthetic vitamin E (all-rac-alpha-tocopherol) or 1500 IU of natural vitamin E (RRR-alpha-tocopherol). The risk of side effects increases with higher doses. Side effects can include nausea, fatigue, headache, and bleeding. Vitamin E is possibly unsafe when taken in doses greater than 1000 mg daily.

When applied to the skin: Vitamin E is likely safe for most people.

When inhaled: Vitamin E is possibly unsafe. Use of e-cigarettes and other vaping products containing vitamin E acetate has been linked to serious lung injury in some people.

Special Precautions & Warnings:

Pregnancy: When used in the recommended daily amount, vitamin E is possibly safe during pregnancy. Do not take vitamin E supplements during the first 8 weeks of pregnancy without speaking with your healthcare provider. It might be harmful to the baby. Later in pregnancy, the maximum recommended amount of vitamin E is 800 mg in those 14-18 years of age and 1000 mg in those older than 18 years of age.

Breast-feeding: Vitamin E is likely safe when taken by mouth in recommended daily amounts. The maximum recommended amount of vitamin E while breast-feeding is 800 mg in those 14-18 years of age and 1000 mg in those older than 18 years of age. Vitamin E is possibly unsafe when taken in doses greater than the maximum recommended amount.

Children: Vitamin E is likely safe when taken by mouth appropriately. But children should avoid taking doses of vitamin E higher than the daily upper limits. These limits are 300 IU in children 1-3 years of age, 450 IU in children 4-8 years of age, 900 IU in children 9-13 years of age, and 1200 IU in children 14-18 years of age.

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

Heart disease: Vitamin E might increase the risk for death in people with a history of heart disease. People with a history of heart disease should avoid taking doses of vitamin E greater than 400 IU daily.

Diabetes: Vitamin E might increase the risk for heart failure in people with diabetes. People with diabetes should avoid taking doses of vitamin E greater than 400 IU daily.

Head and neck cancer: Vitamin E might increase the chance that this cancer will return. Do not take vitamin E supplements in doses greater than 400 IU daily.

Weak and brittle bones (osteoporosis): Exercise is sometimes used by people with osteoporosis to improve bone strength. Exercising and taking high doses of vitamin E and vitamin C might lessen the benefits of exercise on bone strength.

Prostate cancer: Vitamin E might increase the chance of developing prostate cancer. The effect of vitamin E in people who currently have prostate cancer isn't clear, but it might worsen the condition.

An inherited eye condition that causes poor night vision and loss of side vision (retinitis pigmentosa): All-rac-alpha-tocopherol (synthetic vitamin E) 400 IU seems to speed vision loss in people with this condition. But much lower amounts (3 IU) don't seem to have this effect. If you have this condition, it is best to avoid vitamin E supplements.

Stroke: Vitamin E might increase the risk for death in some people with a history of stroke. People with a history of stroke should avoid taking doses of vitamin E greater than 400 IU daily.

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

Cyclosporine (Neoral, Sandimmune)

Interaction Rating=Moderate Be cautious with this combination.

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).

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)

Interaction Rating=Moderate Be cautious with this combination.

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.

Medications for cancer (Chemotherapy)

Interaction Rating=Moderate Be cautious with this combination.

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.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Interaction Rating=Moderate Be cautious with this combination.

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.

Medications used for lowering cholesterol (Statins)

Interaction Rating=Moderate Be cautious with this combination.

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).

Niacin

Interaction Rating=Moderate Be cautious with this combination.

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.

Warfarin (Coumadin)

Interaction Rating=Moderate Be cautious with this combination.

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.

Beta-carotene: Taking vitamin E 800 IU daily seems to reduce blood levels of beta-carotene. Higher doses of vitamin E may reduce beta-carotene even more.
Herbs and supplements that might slow blood clotting: Vitamin E might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.
Iron: Large doses of vitamin E might reduce how much iron is absorbed by the body in infants with low iron levels. Low doses of vitamin E do not seem to have this effect. Avoid high doses of vitamin E in infants. It isn't known whether this interaction occurs in adults.
Omega-6 fatty acids: Taking omega-6 fatty acids, especially in high doses, may increase the amount of vitamin E that the body needs.
Vitamin A: Vitamin E might change how much vitamin A is absorbed by the body. But this probably isn't a major concern for most people.
Vitamin K: Large doses of vitamin E can decrease the effects of vitamin K. This might increase the risk of bleeding in people taking warfarin or other medicines that slow blood clotting. People with low vitamin K levels might be at especially high risk.

There are no known interactions with foods.

Vitamin E is an important nutrient. Vegetable oils, cereals, meat, poultry, eggs, fruits, and wheat germ oil are good sources of vitamin E. The amount that should be consumed on a daily basis is called the recommended dietary allowance (RDA). The RDA for natural vitamin E (RRR-alpha-tocopherol) in adults is 15 mg (22 IU), 15 mg (22 IU) during pregnancy, and 19 mg (28 IU) when breastfeeding.

Keep in mind that the doses of natural vitamin E (RRR-alpha-tocopherol) and vitamin E that has been made in the lab (all-rac-alpha-tocopherol) are calculated differently. This can make supplement dosing confusing. The American Heart Association recommends obtaining vitamin E by eating a well-balanced diet rather than from supplements until more is known about the risks and benefits of these supplements.

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