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Vitamin E refers to a group of eight fat-soluble compounds that include both tocopherols and tocotrienols. Vitamin E has many biological functions, the antioxidant function being the most important and/or best known. Other functions include enzymatic activities, gene expression, and neurological function(s). The most important function of vitamin E has been suggested to be in cell signaling (and it may not have a significant role in antioxidant metabolism)
Numerous foods provide vitamin E. Nuts, seeds, and vegetable oils are among the best sources of alpha-tocopherol, and significant amounts are available in green leafy vegetables and fortified cereals.
Supplements of vitamin E typically provide only alpha-tocopherol, although "mixed" products containing other tocopherols and even tocotrienols are available. People need approximately 50% more IU of synthetic alpha tocopherol from dietary supplements and fortified foods to obtain the same amount of the nutrient as from the natural form (the natural form is proven to be better than the synthetic forms of vitamin E)
Vitamin E deficiency is rare. Because the digestive tract requires fat to absorb vitamin E, people with fat-malabsorption disorders are more likely to become deficient than people without such disorders. Deficiency symptoms include peripheral neuropathy, ataxia, skeletal myopathy, retinopathy, and impairment of the immune response. People with Crohn's disease, cystic fibrosis, or an inability to secrete bile from the liver into the digestive tract, for example, often pass greasy stools or have chronic diarrhea; as a result, they sometimes require water-soluble forms of vitamin E.
Some people with abetalipoproteinemia, a rare inherited disorder resulting in poor absorption of dietary fat, require enormous doses of supplemental vitamin E. People with AVED have such severe vitamin E deficiency that they develop nerve damage and lose the ability to walk unless they take large doses of supplemental vitamin E.
Many claims have been made about vitamin E's potential to promote health and prevent and treat disease. The mechanisms by which vitamin E might provide this protection include its function as an antioxidant and its roles in anti-inflammatory processes, inhibition of platelet aggregation, and immune enhancement. There are four diseases and disorders in which vitamin E might be involved: heart disease, cancer, eye disorders, and cognitive decline.
Coronary heart disease. Evidence that vitamin E could help prevent or delay coronary heart disease (CHD) comes from several sources. In vitro studies have found that the nutrient inhibits oxidation of low-density lipoprotein (LDL) cholesterol, thought to be a crucial initiating step for atherosclerosis. Vitamin E might also help prevent the formation of blood clots that could lead to a heart attack or venous thromboembolism. Several observational studies have associated lower rates of heart disease with higher vitamin E intakes.
The recycling of vitamin E in the body is intricately connected to four other nutrients: vitamin C, glutathione, selenium, and vitamin B3.
Vitamin C is required to keep vitamin E in its metabolically active form; glutathione (a very small protein molecule called a tripeptide and consisting of three amino acid building blocks) is required to keep vitamin C in its active form; and selenium (a micromineral) and vitamin B3 (in a special form called NADPH) are required to keep glutathione in its active form.
The fact that vitamin E is so heavily dependent on vitamin C, vitamin B3, selenium, and glutathione means that a diet high in vitamin E cannot have its optimal effect unless it is also rich in foods that provide these other nutrients.