Vitamin E has long been considered nature's "master antioxidant." Recent research has confirmed its astounding power to protect the cells of the body from damage by free radicals, making it instrumental in preventing the diseases associated with aging and promoting vibrant health and longevity. Unfortunately, some recent negative reports on the effects of antioxidants and supplement use on health have appeared in the mass media, generating confusion and concern among health-conscious consumers. A number of experts in the fields of nutrition and nutraceuticals have pointed out that these reports tend to cite poorly designed studies, leave out vital, relevant information and appear in publications heavily laden with pharmaceutical advertising. Vitamin E has been the target of some such selective reporting, but the truth is this: intelligent use of antioxidants like vitamin E can revolutionize your health and add healthy years to your life.

Why Take Vitamin E?

Simply put, taking supplemental vitamin E can lower your risk for the diseases of aging-including heart disease, cancer and Alzheimer's. It does this by preventing harmful oxidative damage to every cell in the body. Vitamin E can stop chain-reactions of oxidative damage that can cause massive cell damage. It has this unique ability because it embeds in cell membranes where it acts as a shield. Because it supports such broad and basic functions, vitamin E protects virtually every part of our bodies-our blood vessels, heart, eyes, brain, nerves, kidneys, skin, immune cells. You name it, vitamin E protects it.

Using vitamin E wisely means using the right form, in the right amounts for you. In this Special Report, I'll help you navigate the intricacies of this amazing antioxidant.

People with high blood levels of vitamin E are:

• 18% less likely to die from any cause
• 19% less likely to die of cardiovascular disease
• 21% less likely to die of cancer
• 42% less likely to die of lung disease

Taking supplemental vitamin E:

• Reduces infection by 20%
• Cuts the risk for having a heart attack by 49% in women age 65 or older
• Cuts the risk for amyotrophic lateral sclerosis (ALS) by 60%

Meet the E Team

The term "vitamin E" actually refers to a family of eight fat-soluble antioxidant members, divided into two groups: tocopherols and tocotrienols.

Both of these groups contain four different forms: alpha, beta, gamma and delta.

Each form has its own unique biological effects, and all eight work together in various ways. For instance, gamma-tocopherol and gamma-tocotrienol help to regulate the body's fluid balance, which is important in blood pressure control. And tocotrienols affect the liver's production of cholesterol. Researchers have only recently realized how important it is to make sure you are getting all eight forms of vitamin E.

Not All Vitamin E Is the Same

The vitamin E found in most multi-vitamins and in fortified foods is not full-spectrum vitamin E, and should not be used if you want to reap the most of its health benefits. You should be especially careful to avoid synthetic vitamin E, which has little bioactivity and may actually interfere with the absorption of natural vitamin E.

You can tell what you're buying by carefully reading the label.

• Natural vitamin E is always listed as the "d-" form (d-alpha-tocopherol, d-beta-tocopherol, etc.)
• Synthetic vitamin E is listed as "dl-" forms
• Full-spectrum vitamin E is listed as mixed tocopherols and mixed tocotrienols.

Vitamin E's main function is as an antioxidant molecule, which means that it helps to protect cells from damage caused by free radicals-molecular particles that are produced constantly in the body as a byproduct of normal metabolism. Free radicals are also produced in response to stressors like cigarette smoke, air pollution, drugs and inflammation. Antioxidants have the power to "deactivate" these dangerous free radicals before they have the chance to harm cellular structures.

If free radicals are produced in excess of the body's ability to deactivate them, that's bad news-free radicals can damage cells in many ways. Free radicals and oxidative stress have been implicated in every major chronic disease and are thought to be an underlying cause of accelerated aging.

In addition to its role as a powerful antioxidant, vitamin E reduces the production of inflammatory compounds which increase the production of free radicals and play a major role in aging and disease.

Vitamin E Puts the Breaks on Aging

Growing old is inevitable, but just how and why we do so is open to debate. One theory is that years of free radical damage to cells eventually wreaks so much havoc within the body that its cells lose the ability to regenerate. We literally wear out. While that's not likely to be the only reason we grow old, it is certainly part of the reason. It's especially true for premature aging of the skin and eyes. Luckily, free radical damage is one part of the aging process over which we can have some control-with antioxidant nutrients.

Keeping Your Skin Healthy

Getting a healthy dose of vitamin E, for instance, can help your skin look younger and stay healthier. Research has shown that alpha-tocopherol plays the most important role of all the antioxidants in preventing sun damage to the skin. (Traber, M., et al. J Inv Derm. 1998. 110, 756-761; doi:10.1046/j.1523-1747.1998.00169.) Using vitamin E directly on your skin has special benefits. Its fat-soluble molecular structure allows for rapid absorption into the skin. Topical vitamin E can act as a sunscreen, protect the immune defenses of the skin, help protect against skin cancer, delay aging of the skin, and perhaps, even reverse some of the damage. Topical vitamin E can be especially helpful at reducing inflammation and scarring after cosmetic surgery or a skin injury. A recent study found that topically applied vitamin E may prevent inflammation associated with the free radical damage considered an early indicator of skin cancer. (Rahman S., et al. Chem Biol Interact. 2008 Apr 15;172(3):195-205. Epub 2008 Jan 4.)

For maximum skin protection, you've got to choose the right vitamin E product. The only kind that can penetrate into the deep layers of skin, where the cells that regenerate skin are located, is natural vitamin E, as mixed tocopherols and tocotrienols.

Keeping Your Mind Sharp

Neurological problems are a hallmark of vitamin E deficiency. That's because nerve cells are wrapped in a protective, fatty sheath, rich in vitamin E, which degenerates when vitamin E is low. Vitamin E shows promise against a number of diseases that affect nerves and the brain, including Alzheimer's, Parkinson's and amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease). These diseases all involve inflammation, free radical damage and problems with cells' energy-producing mitochondria.

A large study conducted at medical centers across the country found that Alzheimer's patients taking 2,000 IU a day of vitamin E delayed progression of the memory-robbing disease. (Sano M, et al. N Engl J Med. 1997: 336:1216-1222.) Research also shows that diets high in the various types of vitamin E can slow cognitive decline. (Morris MC, et al. Am J Clin Nutr. 2005 Feb;81(2):508-14.)

Supplemental vitamin E also improves lifespan in Alzheimer's patients, according to new research, which also found that taking vitamin E with a cholinesterase inhibitor such as Aricept may be more beneficial than taking either alone. (American Academy of Neurology 60th Anniversary Annual Meeting. April 2008, Poster Sessions III: Aging and Dementia: Clinical II [P03.076] Vitamin E Use Is Associated with Improved Survival in an AD Cohort.)

The risk for Lou Gehrig's disease was cut by 60% with supplemental vitamin E in a 2007 study. (Veldink, JH et al. J Neurol Neurosurg Psychiatry. 2007 Apr;78(4):367-71.) This confirms an earlier study in which regular long-term vitamin E users also cut their risk for ALS by about 60%. (Ascherio, A. et al. Ann Neurol. 2005 Jan;57(1):104-10.)

Vitamin E offers protection from the environmental toxins that contribute to Parkinson's disease, and can also minimize the side effects of the drugs used to treat it.

All in all, the arguments for preventing neurological problems with vitamin E are compelling and make good sense. Still, we need to remember that Alzheimer's, Parkinson's and other neurologic diseases develop very slowly, over decades, and that by the time symptoms are apparent, most of the damage is done. Vitamin E may slow the progress, but it can't cure these diseases. It's best to start taking full-spectrum vitamin E early in life to prevent these diseases. (See below for our recommendations.)

Fighting Infection

As we age, our immune system loses some of its punch, making us more likely to get very sick from colds or the flu, and making us more prone to pneumonia and cancer. But vitamin E can boost the immune system's response to invasive organisms. It does so, in part, by protecting immune cells from damage as they fight infection.

Studying healthy elderly people, researchers at Tufts University reported that vitamin E increased the power of disease-fighting T-cells, sophisticated immune cells that help maintain the "memory" that allows the immune system to gear up fast when it is re-exposed to a pathogen. This memory is what makes vaccines work.

In another study, a common, normally harmless virus ravaged the hearts of mice when they were low in vitamin E. And in people with HIV, supplemental vitamin E helps reduce the risk of opportunistic infections-the same sorts of bugs that can cause pneumonia, bladder infections or post-surgical complications in older folks.

Here again, it's important to take full-spectrum vitamin E, in conjunction with a healthy diet. (Note: Taking selenium has been shown to work synergistically with vitamin E for optimum immunity.)

Vitamin E Battles Cancer

Because it makes immune cells work better, vitamin E may protect against cancer, especially in older people, who often have weaker immune systems. It keeps cell membranes intact, reducing the risk for cancer-inducing genetic damage and slows down key enzymes that play a role in the rapid growth of cancer cells. Vitamin E neutralizes some chemicals that are known to promote cancer, such as nitrosamines found in cured meats like hot dogs, bacon and ham.

The strongest evidence of vitamin E's protective power comes from a study done in Finland that involved more than 29,000 older male smokers. Those taking 50 mg a day of vitamin E for six years, had 32% fewer diagnoses of prostate cancer and 41% fewer prostate cancer deaths than men who did not take vitamin E. There was also a 16% reduction in colon cancer, and a 10-15% reduction in lung cancer in those who took vitamin E for five years or longer. (Heinonen, OP et al., Cancer Causes Control 2000 Mar;11(3):197-205.)

Most of the early research on vitamin E and cancer was done with only alpha-tocopherol or its synthetic form. But new findings suggest that the other tocopherols and tocotrienols may do an even better job at stopping breast, prostate and colon cancers, leukemia and melanoma cells.

For instance, in one study, a supplement that contained all four tocotrienols plus alpha-tocopherol significantly reduced DNA damage to white blood cells, compared to people not getting the vitamin E mix. (Chin, SF, et al. Nutrition 2008 Jan;24(1):1-10.) Another found that men with the highest blood concentrations of gamma-tocopherol had a fivefold reduction in the risk of developing prostate cancer, compared to men with the lowest blood levels. (Helzlsouer, KJ et al. J Natl Cancer Inst. 2000 Dec 20;92(24):2018-23. Gamma-tocopherol is found in foods like unrefined soybean, corn and canola oil, but it's not added to most vitamin supplements.)

Antioxidants Can Support Cancer Treatment

Taking supplemental antioxidants like vitamin E during cancer chemotherapy may help increase survival rates, tumor response and the person's ability to tolerate chemotherapy, a new research review suggests. This comes in the midst of a long-running debate about the use of antioxidants during chemotherapy. A number of studies have shown that antioxidants can reduce the damage chemo drugs can cause to healthy cells. But some doctors are reluctant to encourage their patients to use them because they fear it might interfere with the effectiveness of the treatment-that it might protect cancer cells the same way it protects healthy cells.

This review study showed similar or better survival rates for the antioxidant group than the control group. None of the studies supported the theory that antioxidant supplements make chemotherapy less effective, and of the 17 trials that assessed chemotherapy toxicity, including diarrhea, weight loss, nerve damage and low blood counts, 15 found that the antioxidant group had similar or lower rates of these side effects than the control group.

The authors note that reducing side effects may help people undergoing cancer treatment avoid having to cut back on their chemotherapy dosage, interrupt scheduled treatments, or abandon treatment altogether, This, in turn, is likely to lead to a better treatment outcome. (Block, KI, et al. Cancer Treatment Rev (2007), doi:10.1016/ctrv.2007.01.005.) One important exception: smokers who continue smoking during radiation treatment for head or neck cancer saw an increase in recurrence if they took vitamin E. Obviously, the best thing these people can do is to stop smoking-whatever it takes.

Vitamin E Protects Your Heart

Natural, full-spectrum vitamin E can be useful for preventing heart disease. It has a number of heart-protecting properties. For instance, vitamin E:

• Helps prevent blood platelets from sticking together, a big factor in blood clotting.
• Stops oxidation of LDL cholesterol, a factor in hardening of the arteries.
• Lowers blood pressure by promoting production blood vessel-relaxing nitric oxide.
• Inhibits cholesterol production in the liver.

Studies show that people whose diets are high in vitamin E reduce their risk for heart disease by about 30 to 50% compared to people getting low amounts. And in the Women's Health Study, which looked at supplemental vitamin E and heart disease, women age 65 or older who took 600 IUs of vitamin E every other day for nearly a decade slashed their death rates by 49%. Women age 45 or older had a 24% drop in deaths from heart disease. (Lee, IM et al. JAMA. 2005 Jul 6;294(1):56-65.)

That means 208,250 women could be saved yearly by taking vitamin E, since about 500,000 American women die of heart disease every year, and 85%, or 425,000, are age 65 and over, says Maret Traber, Ph.D., a worldwide authority on vitamin E, a member of a National Academy of Sciences committee on vitamin safety and effectiveness, and a professor of nutrition at Oregon State University and the Linus Pauling Institute.

Also in the Women's Health Study, those who received vitamin E had a 21% reduction in incidence harmful blood clots in their veins. Women at high risk for blood clots because they'd had them before benefited even more, with a 44% reduction in risk. (Glynn, RJ, et la. JAMA. 2005 Jul 6;294(1):56-65.)

Another study showed that people with clogging of neck and brain arteries who took full-spectrum vitamin E experienced improvement in their conditions. One study showed that full spectrum vitamin E not only slowed down narrowing of neck arteries, but in 40% of the patients, appeared to reverse the condition. (Tomeo, A. C. et al. Lipids 1995;30:1179-1183.)

Diabetics are at high risk for heart disease, and new research shows just how much vitamin E can help. It found that taking 400 IUs a day of supplemental vitamin E cut the risk of heart attacks, strokes and related deaths in half in people with diabetes who carry a particular gene called haptoglobin (Hp) 2-2. People with this gene have less ability than normal to produce natural antioxidants that protect the iron-rich hemoglobin in their red blood cells from oxidative damage. About 40% of people with diabetes carry the Hp 2-2 gene. (Blum, S et al. Arterioscler Thromb Vasc Biol. 2008 Mar;28(3):e18-20.)

Bottom Line: As with cancer, prevention is the best policy when it comes to heart disease. Plaque is very difficult to remove once it has formed. Vitamin E works best as part of an overall program to reduce heart disease.

How Much Vitamin E Do You Need?

Much more than you're probably getting from food.

Population studies generally do show that high intake of vitamin E from foods provide some protective effects against cancer and heart disease. So people can get some benefits from eating vitamin-E rich foods such as unrefined vegetable oils, nuts, seeds, whole grains and dark leafy greens.

On the other hand, most people eating a typical American diet don't get anywhere near the RDA of vitamin E for adults, which is 5 mg, or 22.5 IUs. "Most people get 5-7 mg a day of vitamin E from foods, and 96% of women do not even get that much," Dr. Traber says. That means their diets likely aren't providing much in the way of protection.

And it's practically impossible to get the high amounts of vitamin E found helpful in intervention studies from eating foods alone. You'd have to consume 20 tablespoons of the best source of vitamin E, wheat germ oil, to get 400 IUs. Fresh nuts and seeds, along with unrefined, cold-pressed vegetable oils are your best food sources for full-spectrum vitamin E. Whole grains (germ included) and fresh dark leafy greens are also good sources.

So how much vitamin E do you need? In general, if you want to get vitamin E's full benefits and are age 50 or older, we recommend the high yet very safe combination of 400 IU of alpha-tocopherol and mixed tocopherols, along with 400 mg of mixed tocotrienols.

If your concern is preventing a particular health problem, because of a family history or several risk factors, see our chart below.

How much do you need?

Notes on how to use this chart:

• The number to the left of the slash equals d-alpha-tocopherol
• The number to the right of the slash equals of mixed tocopherols and tocotrienols

People with diabetes may need higher doses. If you are ill, we recommend finding a doctor to work with you. You may be taking drugs that interact with vitamin E, and may need adjustments in dosages.

Getting Vitamin E from Foods

Getting enough vitamin E from foods is hard. The best sources have lots of fat and calories. Here are some top sources.

The Vitamin E Controversy

Uncovering the truth behind the negative press

You're probably aware that supplemental vitamin E has gotten a mixed report card when it comes to large clinical trials for conditions like heart disease and cancer. In fact, two recent studies found a connection between vitamin E and increased risk for lung cancer. In one of those studies, people with lung cancer who smoked and took vitamin E during radiation treatment had an increased risk for recurrence of cancer. (Meyer, F, et al. Int J Cancer. 2008 122:1679-1683.) In another, people saw a slight increase for risk in lung cancer if they took supplemental vitamin E. The risk was highest in smokers. (Slatore, CG et al. Am J Resp Crit Care Med. 2008 177:524-530.)

Experts say there are a number of reasons for vitamin E's disappointing performance in recent studies, including unrealistic expectations that it would be a "magic bullet" for people who were quite ill, dosages that were too low or studies that were too short.

But the biggest reason these studies showed negative findings is that they weren't using the right kind of vitamin E! Many of them, including one of the lung cancer studies, used the synthetic form of vitamin E, dl-alpha-tocopherol, which doesn't have the protective power of natural vitamin E. The other studies used d-alpha- tocopherol, a natural form, true, but only one of the eight natural forms of vitamin E found in foods, and not as powerful as the full spectrum of vitamin E now being used in high-quality supplements. In fact, using d-alpha-tocopherol alone can interfere with the body's ability to use gamma-tocopherol, the dominant form in our diet and the most promising for some forms of cancer.

Get the Right Kind of Vitamin E

You need the full team.

Vitamin E is a team of nutrients that need to be taken together to be most effective. The research focus has shifted, from alpha-tocopherol alone to all the different forms of vitamin E and what they do in the body. Exciting new discoveries about vitamin E continue to emerge, revealing the complex ways it works as the "master antioxidant" to promote health and longevity. Understanding for yourself how vitamin E works to enhance and protect your health will enable you to take full advantage of the amazing benefits it can offer you. A personalized strategy to using vitamin E can revolutionize your health and add healthy, vibrant years to your life.

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