Vitamin E deficiency is common - and supplements differ in quality

Lack of vitamin E increases your risk of fertility problems, atherosclerosis, blood clots, and Alzheimer's disease. The diet contains eight different forms of vitamin E. The vitamin is also available in supplement form, either as natural or synthetic vitamin E, and there are huge differences in terms of their effect.

Vitamin E, a lipid-soluble antioxidant, and selenium protect the lipid-containing cell surfaces and other lipids against free radicals, which are extremely harmful. Vitamin E also plays a role in cellular functioning, the cardiovascular system, and the immune defense. However, according to a study that was presented at the World Congress of Public Health Nutrition, more than 90 percent of the American population fails to meet the daily requirement for vitamin E. The same is believed to be the case with Europeans.

Big difference in actual intake, recommended intake, and optimal intake

Earlier studies suggest that most Americans only get roughly half the recommended amount of vitamin E. According to the most recent human studies of vitamin E, blood levels of the nutrient should be around 30 micromoles per liter of blood (µmol/L), a level that would require a daily vitamin E intake of around 33 mg.

Why is vitamin E deficiency so common?

Many people consume a diet consisting of raw materials that have been refined and processed to the point where their content of vitamin E and other nutrients has been undermined. As vitamin E is a lipid-soluble vitamin, eating a low-fat diet also contributes to the deficit. Furthermore, studies have shown that the body only absorbs around 10 percent of the vitamin E content in supplements, unless you take them with some kind of fat. It is also worth mentioning that a low-fat diet is not as filling and does not taste as good as a diet with plenty of fat.

The health effects and symptoms of getting too little vitamin E

According to the health authorities, deficiency symptoms are not seen in healthy individuals. The question is whether the widespread vitamin E deficiency may contribute to the development of atherosclerosis and other chronic diseases in the long run.
Another problem is that many overweight people with metabolic syndrome, an early stage of type-2 diabetes, have an increased need for vitamin E and other antioxidants because they are exposed to more oxidative stress caused by free radicals.

In any case, severe vitamin E deficiency may lead to:

• an increased risk of cancer and cardiovascular disease
• muscle weakness and unsteady walk
• balance and vision disturbances
• dementia and increased risk of Alzheimer's disease
• liver and kidney problems
• increased risk of miscarriage (pregnant women)
• problems with vision and immune defense (babies)

There are different forms of vitamin E that require the right balance

There are eight different types of vitamin E, four tocopherols and four tocotrienols. Alpha-tocopherol is considered to be the most effective antioxidant, but science has also increased its focus on gamma-tocopherols in terms of preventing blood clots. Researchers have not been all that interested in tocotrienols. Nonetheless, there is evidence pointing to tocotrienols as having the potential to protect against free radicals. Also, they appear to work together with tocopherols in protecting the brain against premature ageing processes and dementia.
It is assumed that healthy, fat-containing foods are the best sources of vitamin E, as they contain the different kinds of tocopherols and tocotrienols. If you consume such a diet you are also likely to benefit more from supplements that typically only contain alpha-tocopherol.

Foods with vitamin E

Because vitamin E is lipid-soluble it is found in dietary fats, mainly in vegetable sources like plant oils, nuts, kernels, seeds, whole-grain, avocado, and green vegetables like broccoli and Brussels sprouts. Vitamin E is also found in cod liver oil, cod roe, eggs, oily fish, and high-fat dairy products.

Natural or synthetic vitamin E?

There is a big difference between natural and synthetic vitamin E. Synthetic vitamin E, which is derived by the petrochemical industry, has toxic effects if consumed in large quantities for prolonged periods of time. What is more, synthetic vitamin E has not been shown to have any positive effects on health, on the contrary.
Synthetic vitamin E typically goes by the name dl- alpha-tocopherol and is only around 30-50 percent as bioavailable as natural vitamin E. The most common form of natural vitamin E is d-alpha-tocopherol and is the form which most experts recommend for supplementation.

Supplements

Excess vitamin E gets excreted in the bile, and overdose symptoms are rarely seen. Long-term consumption of high doses of vitamin E (typically 250-500 mg) is associated with dizziness, headache, fatigue, and blurry vision. Supplements should always be taken with food that contains fat to ensure optimal absorption in the digestive system.

References

http://preventdisease.com/news/16/072616_6-Billion-Do-Not-Meet-Vitamin-E-Levels.shtml

https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/

https://www.sciencedaily.com/releases/2015/10/151007144838.htm

https://www.sciencedaily.com/releases/2015/11/151102163718.htm

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1790869/

Traber MG. Mechanisms for the Prevention of Vitamin E Excess. J Lipid Res 2013. E-pub ahead of print.