Quite a number of patients are visiting the pharmacy for vitamin E supplements. I personally recommend against stand-along supplementation of vitamin E. Reasons are below,
vitamin E is an antioxidant that was marketed towards general health and boosting immune function many years ago. The marketing was based on the theory that antioxidants decrease free radicals in the body thus preventing cellular damage. Evidence did not exist in full strength then on the safety of supplementation. Multiple studies looking at such concern was published around 2004-2005, suggesting that supplementing with vitamin E can possibly cause HARM with NO BENEFIT in cardiovascular protection. It is suggested that vitamin E supplementation if necessay must be kept under 400IU daily and an intake of 400IU or greater has been shown to increase risk of heart failure minimally in high risk patients and increase all-cause-mortality with dose >400IU/day.
In addition, vitamin E has been noted to increase bleeding tendency in patients taking NSAIDs, Warfarin, ASA or other blood thinning products. It is suggested to limit supplementation to 200IU if necessary or discontinue supplementation if vitamin E is not necessary.
Vitamin E:
sources: nuts, seeds, vegetable oils
daily requirement ~22.4IU from natural sources daily for general population (value may vary with references)
Usual commercially available products, 200IU and 400IU from natural or synthetic sources
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