The "Renaissance" of Vitamin E By Dr. William Haynes, May 1998 Author, "A physician's Witness to the Power of Shared Prayer" and "Minding the Whole Person. Cultivating a Healthy Lifestyle from Youth through the Senior Years"

Dr. William F. Haynes, Jr.

It seems that only 15 years ago we clinicians were saying, "vitamin E was a vitamin looking for a disease."

The story of vitamin E is now beginning to take on a new life and enhanced interest among scientists for a wider role in the prevention and treatment of a variety of acute and chronic diseases. This especially true for the field of cardiovascular disease and stroke prevention. A mention should first be made about the role that "free radicals" play in the overall picture.

By definition, a free radical is any atom, molecule, or molecular fragment that has only one electron instead of the usual two electrons; it is "unpaired," which makes it highly reactive and unstable. Free radicals can be envisioned as flying around in their orbits inside our bodies striking various organs in the search for another electron to "calm down." Free radicals can damage body cells and tissues including DNA, proteins, carbohydrates, and lipids. Low density lipoprotein, (LDL), when oxidized by the free radicals, results in enhanced deposition of cholesterol into the walls of the coronary arteries forming atheroma or plaques. This may be a major factor in causing coronary artery disease. The cholesterol, by depositing in the vessel walls, can result in the narrowing of the lumen of the artery which in turn leads to an eventual thrombosis or blockage of the vessel. This condition has been called a coronary thrombosis or heart attack.

There is mounting evidence that antioxidants are capable of scavenging free radicals, and if so, should play a major role in controlling these potentially harmful reactions. One worker characterized antioxidants as shields or bullet-proof vests that protect against the free radicals which are likened to the bullets. Because of this, it is not surprising that antioxidants are being increasingly studied for the prevention of not only coronary artery disease but also a host of other diseases. The three antioxidants that have been subjected to most study are vitamin E (alpha-tocopherol), vitamin C (ascorbic acid), and beta-carotene. These agents are remarkably free from toxicity except in most unusual circumstances. Of the three agents, it seems that Vitamin E is at the center of most interest.

The chemical composition of Vitamin E is made up of eight substances that are categorized into two groups: the tocopherols and the tocotrienols. The food sources for the vitamin E group are vegetable oil, wheat germ, leafy vegetables, egg yolk, margarine, legumes, bran and cereals. The vitamin is manufactured in both the synthetic and natural forms. I take 400 units a day; check with your own doctor first.

Animal studies suggest that high levels of vitamin E (natural and synthetic) can retard atheroma formation in coronary arteries. Studies in humans suggest a high intake of natural vitamin E may also have similar benefits. Prospective studies in humans with high risk factors for coronary disease are currently underway from a number of centers.

Although the majority of studies with vitamin E center around prevention of coronary disease and strokes, the vitamin has recently been found to be of potential use in neurological diseases, e.g., it may have a protective effect against Parkinson’s disease, peripheral neuropathy, and cerebellar ataxia (unsteady gait). Vitamin E creams have used to protect the skin, e.g., to treat burns from radiation therapy. Likewise, the vitamin has been used to treat inflammation of the mucous membranes of the mouth that may occur after chemotherapy. One bites a 1000 mg capsule and sloshes the contents inside of the mouth.

Other workers feel that vitamin E, being an antioxidant, and therefore a free radical scavenger, may have use in various chronic conditions that are impacted by free radicals, e.g., arthritis, senility, cancer, and normal aging. There is preliminary evidence that vitamin E may lower the toxicity to certain chemotherapy agents like adriamycin, a frequently used drug that can have some cardiac side effects. Some investigators report it is useful in diminishing leg cramps at night. Antioxidants may have some protective effect against cataracts and even enhance the immune system.

The little regarded vitamin E is under much study in recent years along with the other major antioxidants, vitamin C and beta carotene. It seems that E has gone from a reputation of minimal import to one of major interest. Much further research needs to be done, but it will be exciting to follow its future in the months to come.

Dr. Haynes is a Senior Attending in cardiology and internal medicine at the Medical Center at Princeton and Assistant Clinical Professor of Medicine at Robert Wood Johnson Medical School. He has been practicing medicine since 1960 and recently retired from office practice. He is a lecturer and the author of two books: