Talk:Vitamin E/Archive 1

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Vitamin?
Why is E a vitamin at all? Besides its unique antioxidant properties, it has no other valuable physiological function compared to the other vitamins. It is also abundant: its deficiency is rare and with no associated medical condition. Why is vitamin E a vitamin? — Preceding unsigned comment added by 41.238.133.55 (talk) 06:33, 23 July 2011 (UTC)

There is a genetically inherited disease called familial isolated vitamin E (FIVE) deficiency which provides proof of the essentiality of vitamin E for humans. Individuals with this disease have normal lipid absorption and gastrointestinal function as well as normal incorporation of vitamin E into chylomicrons and subsequent delivery to the liver. Nevertheless, they have low or undetectable levels of plasma vitamin E. They develop reduced tendon reflexes by 3-4 years of age and more disabling cerebrospinal symptoms such as unsteadiness of gait, loss of touch and pain sense, limb ataxia (lack of coordination), ptosis (a drooping of the upper eyelid), dysarthria (disorders of articulation, as stammering or stuttering), and impaired eye movements by early adolescence. The genetic defect involves a mutation in the gene for the alpha-tocopherol transfer protein, thus blocking the liver’s ability to incorporate alpha-tocopherol into VLDL. The clinical symptoms can be prevented by 1000 mg/day of oral all-rac-alpha-tocopherol. The therapy increases chylomicron vitamin E sufficiently to force enough vitamin E to be redistributed by direct transfer to other circulating lipoproteins from where it can be delivered to the tissues. — Preceding unsigned comment added by 82.139.117.231 (talk) 22:29, 24 November 2011 (UTC)

Vitamin e
Natural vitamin e produces cancer or is it a prevention??? —Preceding unsigned comment added by Kkrissy (talk • contribs) 03:25, 2 March 2009 (UTC) No, it does not cause cancer. I have taken natural Vitamin E supplements for almost half a century. Tpryan (talk) 12:04, 26 December 2011 (UTC)

The above statement is statistically illiterate. One individual not developing cancer proves exactly nothing, one way or another.

---

The following sentence in the article is meaninglss:

Studies on its role in age related macular degeneration are ongoing as, even though it is of a combination of dietary antioxidants used to treat the condition, it may increase the risk.

I don't know what language it's supposed to be in, but it sure isn't English. — Preceding unsigned comment added by 82.68.94.86 (talk) 09:34, 4 August 2012 (UTC)

Chart suggestion for vitamins and minerals.
Chart suggestion for vitamins and minerals.

Having been in business with a herbal department, there appears to be a need for a standardized presentation of vitamins and minerals to provide handy information to the general public.

Suggestion the following graph, if someone with this ability can present it as so.

Recommend a stardaized chart. Top lines, recommended daily allowance.

Then prioritized items that provide the element, together with amount of item in each serving and a percentage of the recommended daily allowance.

Why?

Well say vitamin C. One glass of orange juice. 100%

Vitamin D. One egg, 20. 3%

At the bottom of the chart important co ingredients required, and or negative factors to absorption.

Percentage of daily allowance supplied by a serving of food is high priority.

--Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 09:54, 18 March 2009 (UTC)

NY Times recent article
Just thought I'd mention here that the New York Times has a recent article on Vitamin E that you might want to use as a source. Cheers. -- ...but what do you think? ~B F izz (talk) 07:02, 25 March 2009 (UTC) I suggest that everyone look beyond what is reported in the media and read more authoritative sources for technical information. The SELECT study that is often quoted used Vitamin E in the form of alpha tocopherol only and it was synthetic Vitamin E. Alpha tocopherol alone can deplete important gamma tocopherol from the body and this is potentially dangerous, as has been reported in the scientific literature. Any study of Vitamin E should have it in the form of mixed tocopherols and it should be natural Vitamin E. Otherwise, the study design is flawed. I will be 67 in a few months and I have taken Vitamin E supplements for over 40 years. Don't be deceived by what you read in some sources; the importance of Vitamin E is well known and you will see this if you read articles and scientific study results in appropriate sources. Tpryan (talk) 11:59, 26 December 2011

External Review Comments
Hello, Vitamin E article writers and editors. This article currently a priority article for the Wikipedia talk:WikiProject Medicine/Google Project. The goal of this project to is provide a useful list of suggested revisions to help promote the expansion and improvement of this article.

BSW-RMH (talk) 23:12, 1 August 2010 (UTC)

Recommended organization
I recommend organizing this article into sections as follows:
 * Definition
 * Recommended daily intake
 * Dietary sources and supplements
 * Health benefits
 * Deficiency
 * Toxicity

Pictures
An example tocotrienol picture would be useful.
 * http://cropsoil.psu.edu/courses/agro518/images/IMG00028.GIF

BSW-RMH (talk) 23:12, 1 August 2010 (UTC)

Introduction
This is too technical as written. It should overview the subsections in a condensed summary style.

Definition
The definition would explain,a s is currently in the introduction, that the common naturally occurring forms of vitamin E are: four tocopherols (alpha, beta, gamma, delta) and four tocotrienols (alpha, beta, gamma, delta). (Columbo 2010). The current Tocotrienols and alpha-Tocopherol sections would become subsections of this Definition section.

BSW-RMH (talk) 23:12, 1 August 2010 (UTC)

Recommended daily intake
The Food and Nutrition Board at the Institute of Medicine report the following dietary reference intakes for vitamin E: Infants
 * 0 to 6 months: 4 mg/day
 * 7 to 12 months: 5 mg/day

Children
 * 1 to 3 years: 6 mg/day
 * 4 to 8 years: 7 mg/day
 * 9 to 13 years: 11 mg/day

Adolescents and Adults
 * 14 and older: 15 mg/day

See: Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000.

BSW-RMH (talk) 23:12, 1 August 2010 (UTC)

This section w/ information was added. BSW-RMH (talk) 04:33, 10 August 2010 (UTC)

And this section was removed, and replaced with text that puts RDAs in context with EARs, ULs and DVs. And provides a ref that links to the vitamin E chapter in the DRI book.David notMD (talk) 11:18, 7 May 2016 (UTC)

Dietary sources and supplementation
Based on the most current data from the USDA National Nutrient Database for Standard Reference, Release 22 Vitamin E Content of Selected Foods per Common Measure, I would reorganize this list as follows:
 * fortified cereals
 * seeds and seed oils, like sunflower and safflower
 * nuts and nut oils, like almonds and hazelnuts
 * green leafy vegetables, like spinach, turnip, beet, collard, and dandelion greens
 * tomato products
 * pumpkin
 * sweet potato
 * blue crab
 * canola oil
 * rockfish
 * mangoes
 * asparagus
 * broccoli
 * papayas

See: U.S. Department of Agriculture (2009) USDA National Nutrient Database for Standard Reference, Release 22: Content of Selected Foods per Common Measure, Vitamin E (alpha-tocopherol) mg sorted by nutrient content, http://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/SR22/nutrlist/sr22w323.pdf

Dietary sources were updated in the article. BSW-RMH (talk) 04:38, 10 August 2010 (UTC)

The NIH Office of Dietary supplements gives a good overview of Vitamin E supplementation:

” Supplements of vitamin E typically provide only alpha-tocopherol, although "mixed" products containing other tocopherols and even tocotrienols are available. Naturally occurring alpha-tocopherol exists in one stereoisomeric form. In contrast, synthetically produced alpha-tocopherol contains equal amounts of its eight possible stereoisomers; serum and tissues maintain only four of these stereoisomers [6]. A given amount of synthetic alpha-tocopherol (listed on labels as "DL" or "dl") is therefore only half as active as the same amount (by weight in mg) of the natural form (labeled as "D" or "d"). 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. Most vitamin-E-only supplements provide ≥100 IU of the nutrient. These amounts are substantially higher than the RDAs. The 1999-2000 National Health and Nutrition Examination Survey (NHANES) found that 11.3% of adults took vitamin E supplements containing at least 400 IU [8]. Alpha-tocopherol in dietary supplements and fortified foods is often esterified to prolong its shelf life while protecting its antioxidant properties. The body hydrolyzes and absorbs these esters (alpha-tocopheryl acetate and succinate) as efficiently as alpha-tocopherol [6].”

References:
 * National Institutes of Health Vitamin E Professional Fact Sheet (http://ods.od.nih.gov/factsheets/vitamine.asp#h3)
 * (6) Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000.
 * (8) Ford ES, Ajani UA, Mokdad AH. Brief communication: the prevalence of high intake of vitamin E from the use of supplements among U.S. adults. Ann Intern Med 2005;143:116-20. PMID: 16027453

BSW-RMH (talk) 23:12, 1 August 2010 (UTC)

I just noticed the list in the article, which is similar to the list above, does not seem to be ordered by decreasing % amounts of Vitamin E. For example, using Nutrient Data Laboratory, it seems that California Avocados have 1.97 mg Vitamin E per 100 grams, while tomatoes (Tomatoes, red, ripe, raw, year round average) have 0.54 mg per 100 grams: in the listing, tomatoes occur before avocados. Since wheat germ oil occurs at the top of the list, and it is reported by the same database to have 149.40 mg per 100 grams, one would presume the list should be in decreasing order. Just wanted to note this issue, I haven't checked every list item at this time. ... Okay, I checked more items, here's one article line from the list, which again is different from the list above, the parenthetical number is reported as mg/100g: "Green leafy vegetables, like lettuce (0.18, iceburg; 0.22, green leaf; 0.13, romaine; 0.15, red leaf; 0.18, butterhead), spinach (2.03 raw, 2.08 cooked), turnip (2.86 raw, 1.88 cooked), beet (1.50 raw, 1.81 cooked), collard (2.26 raw, 0.88 cooked), and dandelion greens (3.44 raw, 2.44 cooked).  From that, it appears that lettuce is an outlier, and should be separated to its own line and moved down. Avocado, mango, and kiwifruit should be moved upward some.  There is some variance in raw versus cooked reported values. Gzuufy (talk) 17:04, 3 December 2011 (UTC)


 * I resorted the article list, included milligram values from USDA Nutrient Data Laboratory, created a wiki table, and created the Notes section for miscellaneous notes. Gzuufy (talk) 16:51, 4 December 2011 (UTC)

Health benefits
The current section entitled ‘Health effects of dietary Vitamin E’ has the health benefits, deficiency effects, and side effects/toxicity of high does of vitamin E all together. I suggested these be divided into three separate sections to make it easier for readers to find what they are looking for.

The health benefits section should contain only those health benefits that are accepted in the medical community. It should also not be references with primary study articles because there is no way for readers to tell if these are anecdotal reports or representative of the medical community consensus.

The consensus in the medical community is that there is no good evidence to support health benefits from vitamin E supplementation, yet there is strong evidence that vitamin E overdose increases the risk of death. See ‘Toxicity’ below.

BSW-RMH (talk) 23:12, 1 August 2010 (UTC)

Toxicity
The consensus in the medical community is that there is no good evidence to support health benefits from vitamin E supplementation, yet there is strong evidence that vitamin E overdose increases the risk of death. Taking more than 400 IU per day increases the risk of death. Thus, the claimed health benefits in the original article have been removed because this information is seriously misleading and potentially harmful to the public.


 * Medline Plus Vitamin E (http://www.nlm.nih.gov/medlineplus/ency/article/002406.htm)
 * National Institutes of Health Vitamin E Professional Fact Sheet (http://ods.od.nih.gov/factsheets/vitamine.asp#h3)
 * Sesso HD, Buring JE, Christen WG, Kurth T, Belanger C, MacFadyen J, et al. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. JAMA 2008;300:2123-33. PMID: 18997197
 * Dotan Y, Lichtenberg D, Pinchuk I. No evidence supports vitamin E indiscriminate supplementation. Biofactors. 2009 Nov-Dec;35(6):469-73. PMID: 19866453

BSW-RMH (talk) 23:12, 1 August 2010 (UTC)

Changes made. BSW-RMH (talk) 04:40, 10 August 2010 (UTC)
 * It's unclear from the article if there's something specific about _supplements_ (i.e., taking it in pill form), or whether this is simply taking about excess amounts (beyond the RDA). So:
 * Clearly a lack of vitamin E is known to cause problems, so if taking vitamin E prevents this deficiency, then it's misleading to say there are no "health benefits". Unless this is actually saying that vitamin E taking in pill form has no effect at preventing vitamin E deficiency?
 * Does the risk of vitamin E overdose apply no matter what form it's taken in (in which case, there's no reason to specify supplments here, if it would also apply to someone eating twice as many broccoli, cereal etc per day) - unless again, it's actually that there's something bad only when taken in supplement form?
 * There's also the confusion of what "supplement" means here - some countries define it to be something in pill/powder/liquid form, where as others include foods, that are taken in addition to a normal diet. Can someone who knows more on this clarify what the research is saying? Mdwh (talk) 15:04, 26 September 2010 (UTC)
 * The best definitions I've heard of it were any sources of nutrients that were used to supplement the diet (which makes sense with where they got the name). By that definition, if you ate a banana specifically to get extra Potassium (as opposed to part of a meal or because of the taste), that would be a supplement, plus of course, any pills would be supplementing. I like that definition because it covers most everyone's description of supplementing (powders, pills, foods, etc). Burleigh2 (talk) 19:12, 20 October 2011 (UTC)

--- No. Etymology is not reliable evidence of meaning. Eating an extra banana is not an instance of a 'supplement' in the way the term is actually used, which is the only way to determine its meaning. A banana is just a banana, and it doesn't magically become a 'supplement' instead of food if you think about the potassium content while eating it instead of about the taste. Only extracted potassium which is then added to food can be a supplement. --- — Preceding unsigned comment added by 82.68.94.86 (talk) 09:43, 4 August 2012 (UTC)


 * The way the article read seems to me (having only read the VOA summary (http://www.voanews.com/english/news/health/Vitamin-E-Linked-to-Higher-Prostate-Cancer-Risk--131871838.html) of the medical article on the study with older men) that the article is too "neutral" on the danger: Apparently it is 17%:  why not give that number instead of the subjective word "slight"?Kdammers (talk) 07:56, 16 October 2011 (UTC)

The article stated that 150 IU supplementation is the optimum, while the cited source says different: 'For dosages less than 150 IU/d, all-cause mortality slightly but nonsignificantly decreased.' Meaning the 'optimum' could be anywhere from zero to 150 IU, but likely be lower than 150 IU. I made a correction, but it might be wise to further explain it. Speed57 (talk) 13:41, 26 January 2016 (UTC)
 * The large meta-analysis showed that 150 IU is the optimum in average. It can also be seen on the chart, where all cause mortality slightly increases at doses lower than 150 IU. 24.34.73.59 (talk) 17:03, 28 January 2016 (UTC)

Deficiency
“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 [6,12]. 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, such as tocopheryl polyethylene glycol-1000 succinate [1].

Some people with abetalipoproteinemia, a rare inherited disorder resulting in poor absorption of dietary fat, require enormous doses of supplemental vitamin E (approximately 100 mg/kg or 5-10 g/day) [1]. Vitamin E deficiency secondary to abetalipoproteinemia causes such problems as poor transmission of nerve impulses, muscle weakness, and retinal degeneration that leads to blindness [13]. Ataxia and vitamin E deficiency (AVED) is another rare, inherited disorder in which the liver’s alpha-tocopherol transfer protein is defective or absent. 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 [14].”


 * National Institutes of Health Vitamin E Professional Fact Sheet (http://ods.od.nih.gov/factsheets/vitamine.asp#h3)
 * (1) Traber MG. Vitamin E. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins R, eds. Modern Nutrition in Health and Disease. 10th ed. Baltimore, MD: Lippincott Williams & Wilkins, 2006;396-411.
 * (6) Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000.
 * (12) Kowdley KV, Mason JB, Meydani SN, Cornwall S, Grand RJ. Vitamin E deficiency and impaired cellular immunity related to intestinal fat malabsorption. Gastroenterology 1992;102:2139-42. PMID: 1587435
 * (13) Tanyel MC, Mancano LD. Neurologic findings in vitamin E deficiency. Am Fam Physician 1997;55:197-201. PMID: 9012278
 * (14) Cavalier L, Ouahchi K, Kayden H, Donato S, Reutenaucer L, Mandel JL, et al. Ataxia with isolated vitamin E deficiency: heterogeneity of mutations and phenotypic variability in a large number of families. Am J Hum Genet 1998;62:301-10. PMID: 9463307
 * Kayden HJ. The genetic basis of vitamin E deficiency in humans. Nutrition. 2001 Oct;17(10):797-8. PMID: 11684382
 * Gordon N. Hereditary vitamin-E deficiency. Dev Med Child Neurol. 2001 Feb;43(2):133-5. PMID: 11221903

BSW-RMH (talk) 23:12, 1 August 2010 (UTC)

Most of this information was added in list form, but the explanation should be expanded. BSW-RMH (talk) 04:48, 10 August 2010 (UTC)

What an extraordinary article
Never mind the typo 'foos' for 'foods'; it's just the way it says at the very end, such-and-such a quantity of Vitamin E 'increases risk of death' that had me laughing! —Preceding unsigned comment added by SwampOwl (talk • contribs) 01:08, 11 August 2010 (UTC)

@SwampOwl

Seriously - as well as this, the section entitled 'Health Effects' is extraordinarily amusing. It tells us everything that Vitamin E does NOT help with, or "may" help with, but lists none of the beneficial effects of Vitamin E. What wondrously classy editing has taken place here. . . --Krakaet (talk) 16:41, 13 December 2011 (UTC)
 * Feel free to pull up some review articles per WP:MEDRS and add there conclusions.-- Doc James (talk · contribs · email) 16:50, 13 December 2011 (UTC)

Complexity
For me, this article is far, far too technical. I'm well-educated and 'no spring chicken' but, if one is new to this topic, one is lost in the jargon. Please could people (a) downgrade the prose to suit a layman, and (b) remind us what the tag is to say that an article appears too full of jargon? (The latter on my talk page too, if you would - thanks.) Trafford09 (talk) 21:24, 7 March 2011 (UTC)
 * Well, the jargon parts should hopefully be kept till the technical sections are reached. But some of this is going to be technical, since it involves a lot of organic chem (stereochem at that) and biochem. It might help if you'd make a list of words that are "jargon" to you that you think are misplaced, and would like to see defined earlier, or else replaced. Otherwise, a general complaint like yours is hard to deal with, as we don't know now much you know. S  B Harris 18:53, 23 July 2011 (UTC)

Dietary only?
The whole article seems to be about only dietary vitamin E. Should it maybe mention something about common topical use like in lotion and shampoo? LieAfterLie (talk) 03:52, 30 December 2011 (UTC)
 * Sure dig up some review articles and add... -- Doc James (talk · contribs · email) 15:20, 30 December 2011 (UTC)
 * Added 2015 review - concludes there are no wound or scar healing benefits, based on two older reviews and two clinical trials; there are also two clinical trials not captured by the 2015 review that also concluded no benefits. Some of the evidence was that the vitamin E product had more adverse events, including contact dermatitis. David notMD (talk) 01:39, 1 April 2017 (UTC)

Some supplements may be harmful because they ONLY contain the most common form of vitamin E
Vitamin E was the subject in episode 347 of Security Now, 37 min 07 secs - 47 min 09 secs. Direct download link. --Mortense (talk) 19:35, 5 April 2012 (UTC)

What about the other six?
This article falls well short of normal Wikipedia standards. An article should either give, or link to, all available information of any significance on the topic it's dealing with. This article starts with "Vitamin E refers to a group of eight fat-soluble compounds", then tells us about two of them - the ones that most people familiar with vitamins know about. The article says nothing about the other six, other than hinting that they include tocopherols and tocotrienols, leaving the reader mystified. The article on tocopherols states that they are a class of chemical compounds of which "many" have vitamin E activity, suggesting some of them don't. I recommend the ambiguities in this article, and the tocopherol article, are ironed out. Either all the tocopherols and tocotrienols together constitute "Vitamin E", in which case this should be clearly stated, or they do not. Either way, one may as well list in this article precisely which individual compounds (if it is 8) count as Vitamin E. — Preceding unsigned comment added by 86.157.24.185 (talk) 06:53, 27 July 2012 (UTC)

German Article not linked
I just noticed that the German wikipedia page is not listed in the left column. Don't know how to add it but the correct article is http://de.wikipedia.org/wiki/Vitamin_E — Preceding unsigned comment added by 67.233.154.120 (talk) 14:10, 1 January 2014 (UTC)

Disagreement on conversion factor for synthetic form from IU to mg depending on the source?
In http://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/ (one of the references used in the article) they say "1 IU of alpha-tocopherol is equivalent to 0.67 mg of the natural form or 0.45 mg of the synthetic form."

but in http://dietarysupplementdatabase.usda.nih.gov/ingredient_calculator/equation.php they say "If the product label has DL-Alpha-tocopherol as the ingredient: From IU to mg: IU * 0.9 = mg"

So, which factor is the good one? 0.45 or 0.9? Thank you in advance. --Canyq (talk) 19:44, 20 January 2014 (UTC)

uh oh
http://news.yahoo.com/antioxidants-including-vitamin-e-promote-lung-cancer-study-190119863--finance.html — Preceding unsigned comment added by 76.176.108.8 (talk) 12:30, 30 January 2014 (UTC)

Chirality
There are a number of different forms of vitamin E. A great deal of what's tested is dl-alpha-tocopherol. Naturally occurring vitamin E doesn't include the "l" form. (d-alpha-tocopherol.)

It might be helpful to recognize which studies tested which forms of vitamin E when writing this page.

Currently, diet and supplementation seem to yeild different results. --Ryan W (talk) 01:53, 19 February 2014 (UTC)

Outdated and non-MEDRS sources
The section: Critical evaluation of current related literature, seems outdated and I'll be working to update this section. Any input or information regarding editing this section is most welcome and would only help in this effort to improve the article. Best Regards,
 *  Bfpage &#124;leave a message 23:49, 22 September 2015 (UTC)

Foo? ...not so much

 * https://www.ncbi.nlm.nih.gov/pubmed/25435896
 * https://www.ncbi.nlm.nih.gov/pubmed/24704972
 * https://www.ncbi.nlm.nih.gov/pubmed/25870713
 * https://www.ncbi.nlm.nih.gov/pubmed/26137487
 * https://www.ncbi.nlm.nih.gov/pubmed/23485439
 * https://www.ncbi.nlm.nih.gov/pubmed/22498300
 * https://www.ncbi.nlm.nih.gov/pubmed/21466429
 * https://www.ncbi.nlm.nih.gov/pubmed/22946849
 * https://www.ncbi.nlm.nih.gov/pubmed/21774782
 * https://www.ncbi.nlm.nih.gov/pubmed/23919929
 * https://www.ncbi.nlm.nih.gov/pubmed/25466495
 * https://www.ncbi.nlm.nih.gov/pubmed/24631865
 * https://www.ncbi.nlm.nih.gov/pubmed/23316695
 * https://www.ncbi.nlm.nih.gov/pubmed/22960308
 *  Bfpage &#124;leave a message 11:49, 23 September 2015 (UTC)

Dietary Reference Intakes
I am creating the same format for DRIs for all vitamins. This is a U.S.- based system that identifies Estimated Average Requirements (EARs), Recommended Dietary Allowances (RDAs), Adequate Intakes (AIs) if there is not enough information to establish EARs and RDAs, and Tolerable Upper Intake Levels (ULs). Another major regulatory agency that has established ULs is the European Food Safety Authority (EFSA). ULs for both are provided, as they often differ. If there is a UL (for some vitamins none has been determined) then rationale is covered in a Toxicity section. In addition to DRIs, the U.S. also established Daily Value, using it on food and dietary supplement labels as % DV. DVs were based on old RDAs but were revised in 2016 to reflect the newer DRIs. What I have written can be improved. It lacks EFSA or other major country RDAs. It lacks an estimate of what percentages of people are deficient - although that is often covered in a separate section on deficiency and consequences of deficiency. I am creating this Subject in all of the Talk pages of the vitamin entries I have edited. Comments and improvements are welcome.David notMD (talk) 18:21, 9 July 2016 (UTC)
 * Changed section title to Dietary recommendations because Dietary Reference Intakes is used only in U.S. and Canada; added European information, with citations.David notMD (talk) 00:35, 3 September 2017 (UTC)

Vitamin E loss in freezing and cooking
Some info on how much vitamin E is lost in freezing would be helpful. I can't find any solid info with a quick Google search. I would like info on how much is lost in seeds and nuts. Does the length of time frozen matter? Do frozen nut butters lose more Vitamin E due to being ground up? Nuts and seeds contain a relatively high amount of Vitamin E. So it would be good to know this info.

How much Vitamin E is lost in lower-value foods? Such as when bread is frozen? Since many people eat a large percentage of frozen food, it would be good to know how much Vitamin E is lost. Are people Vitamin E deficient because of this large percentage of frozen food eaten?

Here is a study:
 * http://www.ncbi.nlm.nih.gov/pubmed/23027652 - J Sci Food Agric. 2013 Apr;93(6):1326-30. doi: 10.1002/jsfa.5893. Epub 2012 Oct 2. Tocopherol retention and vitamin E activity in frozen and canned immature seeds of five cultivars of common bean. Słupski J1, Lisiewska Z.

I haven't read beyond the abstract. So I don't know how much vitamin E is lost in freezing alone. Not sure if this study even measures that since it is studying beans undergoing multiple processes: "These comprised frozen products obtained using the traditional method (blanching-freezing-frozen storage-boiling) and a modified method (boiling-freezing-frozen storage-defrosting and heating in a microwave oven), and canned products." --72.49.58.100 (talk) 19:24, 7 August 2016 (UTC)

Link to preventing alzheimers recently debunked
I'm not sure how to edit wikipedia properly, but I think this article would do well to be mentioned here as it is the only long term longitudinal study of vitamin e supplementation and its presumed role in preventing dementia. http://jamanetwork.com/journals/jamaneurology/article-abstract/2612477 I hope someone will include this. thanks. — Preceding unsigned comment added by 2601:602:200:E1C6:B997:B579:B692:58A3 (talk) 03:53, 23 June 2017 (UTC)
 * For medical topics, Wikipedia prefers meta-analyses, systemic reviews and reviews to individual clinical trials, no matter how large. There is a Cochrane Review on the topic of vitamin E and dementia, but it was published before the latest clin trial you cited. I recommend no content be added for or against vitamin E for dementia until a new review (Cochrane or other) is published. David notMD (talk) 10:27, 15 July 2017 (UTC)

Farina N, Llewellyn D, Isaac MGEKN, Tabet N. Vitamin E for Alzheimer's dementia and mild cognitive impairment. Cochrane Database Syst Rev. 2017 Apr 18;4:CD002854. doi: 10.1002/14651858.CD002854.pub5. Review. PubMed PMID: 28418065.

D-alpha vitamin E is found in nature. Dl-alpha is not found in nature
Natural vs. Synthetic Vitamin E. --Timeshifter (talk) 05:04, 3 August 2017 (UTC)
 * Yes, we know that. We all know that. Synthetic E (dl-alpha tocopherol) is known to be less effective in raising plasma and tissue E. There is evidence that it is only 50% or 75% as effective. Supplement companies 'solve' this problem by using amount of synthetic E well in excess of the RDA. David notMD (talk) 21:09, 24 August 2017 (UTC)
 * That is original research on your part as to what percentage of readers have knowledge of this. Unless you have references. All of the other info you wrote about needs to be in the article. Maybe someone can put it in the article, along with references.


 * My understanding (from memory) is that synthetic E can contain either or both d-alpha and dl-alpha. Many "natural" vitamin supplements use only the d-alpha version of Vitamin E. Whether the source is synthetic, or natural extraction.


 * Biosimilar chemicals like dl-alpha are not bioidentical to d-alpha. It could explain the harmful effects of Vitamin E in some studies. Same as with hormone replacement therapy with biosimilar hormones. Versus bioidentical.


 * In any case the dl-alpha info is significant info, and should not be censored from the article. That would be a violation of WP:NPOV. I don't have the time to add the info, and find the references. So I am discussing it here. --Timeshifter (talk) 16:24, 4 September 2017 (UTC)


 * The tocopherol article covers this info much more than this article.
 * To the larger point about varying toxicity see also:
 * Chirality (chemistry).
 * Chiral Toxicology: It's the Same Thing…Only Different. By Silas W. Smith. Toxicological Sciences, Volume 110, Issue 1, 1 July 2009, Pages 4–30, https://doi.org/10.1093/toxsci/kfp097 - Published: 04 May 2009.
 * --Timeshifter (talk) 02:38, 11 November 2017 (UTC)

Working on the Chemistry section to clarify comparative potency, and perhaps safety, of d-alpha-tocopherol (plant sourced) versus dl-alpha-tocopherol (synthetic). A good reference on the topic, now cited in the article, is Manolescu 2008 (PMID 20108516). David notMD (talk) 20:05, 29 August 2018 (UTC)

Improving this article as prep for GA nomination
Of the articles on fat-soluble vitamins (A,D,E,K) this one is the shortest by far and has the fewest citations. It is missing entire sections. Given that it gets between 40,000 and 50,000 views a month, it deserves to be be improved. A major issue is reducing duplication of content between the vitamin E and tocopherol articles (and the tocotrienol article) while still giving each its due space. David notMD (talk) 12:00, 22 February 2018 (UTC)
 * History section rewritten. David notMD (talk) 13:41, 1 March 2018 (UTC)
 * Sources list replaced and history added to Lead. David notMD (talk) 17:18, 3 March 2018 (UTC)
 * Side effects/Drug interactions content copied from Tocopherol into Vitamin E. David notMD (talk) 20:13, 3 April 2018 (UTC)
 * Uses section now supported by secondary references, primarily meta-analyses, but there are still a few primary references of very large clinical trials (HOPE, SELECT, WHS) as examples. Thus, not meeting WP:MEDRS. David notMD (talk) 00:27, 6 April 2018 (UTC)
 * Added Synthesis section covering plants and industrial. David notMD (talk) 10:41, 9 April 2018 (UTC)

Nominated article on June 5, 2018. Will be working on article while waiting for a reviewer. David notMD (talk) 20:03, 5 June 2018 (UTC)
 * Ongoing reference repair, using cite. Not completed. David notMD (talk) 00:38, 19 August 2018 (UTC)
 * Working on Chemistry section, which needs to incorporate functions of alpha-tocopherol transfer protein (α-TPP) and the initial step of metabolic modification and excretion managed by cytochrome P4504F2. David notMD (talk) 20:10, 29 August 2018 (UTC)
 * The Anti-oxidant section was weak, and as written, deletion-worthy. Can it be replaced by better text and references? Or is the anti-oxidant age truly over? And what would that leave as vitamin E mechanism(s)? David notMD (talk) 15:50, 30 August 2018 (UTC)

The Good Article Nomination (June 5) has been withdrawn because the article is undergoing multiple changes by nominator and other editors. David notMD (talk) 21:50, 30 August 2018 (UTC)

Changed from C-class to B-class, based on many edits. David notMD (talk) 02:27, 12 October 2018 (UTC)

Minimizing duplication between Tocopherol and Vitamin E
Proposed: That the two articles, Tocopherol and Vitamin E, complement each other without large amounts of duplication, with the molecular structure and consequent bioactivity in Tocopherol, and Uses in Vitamin E. In each article, there will be a summary of the content that is expanded upon in the other article. The intended model here is how mineral articles have a link to the same minerals' roles in biology. Another model might be the relationship between articles Vitamin A and Retinol. At present there is extensive Health topics content in the Tocopherol article, so this will require a transplant. Before I do this, anyone want to disagree? My plan is to clean up uses (at Tocopherol) in March and do the transplant in April. David notMD (talk) 11:05, 20 March 2018 (UTC)
 * Uses content copied from Tocopherol to Vitamin E on 5 April 2018. Shortened version left behind. Edit summary for the copying did not include attribution because I was the editor who created the content in Tocopherol. David notMD (talk) 10:30, 6 April 2018 (UTC)

What is it?
The intro seems to assume as a given that vitamin E exists as a category, and says things about that category. There is a tension with the statement that there are many different forms of vitamin E which could easily be construed as saying that there are VERY different forms of it. There is a need to explain clearly and early why these different forms are considered one distinct category and what criteria defines it. Does this category include ALL fat soluble antioxidants? I am asking, not proposing this. But fat soluble antioxidant is the only hint that I find in the intro. --Ettrig (talk) 05:34, 15 June 2018 (UTC)
 * A valid point, that the lede assumes some knowledge on the part of the reader. The tocopherol and tocotrienol articles provide more detail on the related chemical structures. Perhaps some of that information needs to be copied into vitamin E. David notMD (talk) 10:52, 15 June 2018 (UTC)
 * It is worse. The article does not define its subject. Those two articles do not help with this. To be a good article, it needs to define the subject. What are the principles used when it is determined that a substance is to be included in the group that is called Vitamin E? This question is not answered. It should be the first to be answered. --Ettrig (talk) 18:49, 15 June 2018 (UTC)
 * Lede now has more description. Figures are in the Chemistry section. David notMD (talk) 22:36, 15 June 2018 (UTC)
 * Thank you. I think this is a very valuable improvement. So vitamin E is a group of 8 molecules that are antioxidants and fat soluble. I am after the concept of vitamin E. Reading the history section, I realize this is a much more difficult problem than I thought. Would it be correct to say that these 8 substances are grouped together because of both structural similarities and similarities in chemical activity? Is vitamin E exactly these 8 substances forever? Or is the concept (in theory) open for a variant (epsilon ?) that fulfills the criteria? In the latter case, what are those criteria? (Sorry for the repetition.) Put another way: What is the reason that these 8 substances are seen as ONE vitamin? Can there be hitherto unknown substances that belong to the same group? Regardless of the answer to this question: What is the motivation for the answer? I suspect that the answer is that criteria for being a vitamin E is structural similarity to the existing vitamin Es, antioxidant effect and fat solubility. --Ettrig (talk) 10:42, 16 June 2018 (UTC)
 * Confirming that the chemical/structural similarity clusters these compounds as all being 'vitamin E.' However, anti-oxidant activity and any evidence for biological function are very different - surprising given the subtle structural differences - so that while gamma is predominant dietary compound, alpha has a transporter protein, higher plasma and tissue concentrations, and considered much more biologically functional (included antioxidant and other mechanisms) than the other seven. There is no evidence for compounds other than these eight which could be lumped into vitamin E. As an indicator of biological relevance, a PubMed search on alpha-tocopherol yields ~16,400 citations, versus beta 3,500, gamma 3,600 and delta 400. David notMD (talk) 16:33, 16 June 2018 (UTC)
 * A leading textbook ends its section on vitamin E with a question, what good is it? (Paraphrase.) I don't believe it is Wikipedia's place to advance (and retract) theories in the lead. We've been looking for a hundred years and haven't found a use for it yet. There's nothing wrong with that. -SusanLesch (talk) 12:43, 3 September 2018 (UTC)

Improving the Info Box
Compared to what is at Vitamin C or Vitamin B12, the Info box for Vitamin E is skimpy. Expanding it is outside my skill set. Anyone else want to dive in? David notMD (talk) 14:52, 30 June 2018 (UTC)

Note
User:David notMD, thanks as always for your work on this page and other DS pages. This article doesn't clearly state the essential role played by vitamin E in normal physiology (the activity that makes it a "vitamin"), other than this broad notion of antioxidant activity. Do we not know more? (what tissues, where in a given cell (membrane, mitochondria?); something about the metabolism and distribution when one eat foods with Vitamin E? I started looking  for this information a while back and got distracted... Jytdog (talk) 22:11, 24 August 2018 (UTC)
 * Working on it. Short answer is absorbed as chylomicrons, taken up by liver, incorporated into lipiproteins, primarily VLDL; HDL may serve as reverse transport back to liver. Key to why alpha-tocopherol, and of that preferentially only some of the stereoisomers, is transport by alpha-tocopherol transfer protein (α-TTP) and first step of metabolism by CYP4F2. Of greater mystery, if not anti-oxidant, what? Control of gene expression and signal transduction promising. Looking into that, but first addressing chemistry. David notMD (talk) 20:17, 29 August 2018 (UTC)


 * lipIproteins ==> lipOproteins ?  This line inserted by Ettrig (talk)


 * Interesting that for the rare instances of human vitamin E deficiency as a result of defective alpha-TTP gene or fat absorption disorders, the symptoms are NOT for diseases associated with the anti-oxidant hypothesis. David notMD (talk) 03:10, 31 August 2018 (UTC)

Function section
This section has rested on weak and somewhat outdated referencing that recognized only antioxidant activity as a plausible function. Needs more work. And Chemistry section needs explanation of role of alpha-tocopherol transfer protein, and why alpha-TTP favors RRR-alpha-tocopherol over other tocopherols, tocotrienols, and stereoisomers. David notMD (talk) 20:38, 30 August 2018 (UTC)
 * Second part addressed. Article still needs Function(s). David notMD (talk) 02:41, 2 September 2018 (UTC)

"most are the synthetic because it is cheaper"
User David notMD made an edit summary in which he stated that commercial supplements use tocopheryl acetate rather than natural vitamin E "because it is cheaper". But tocopheryl acetate is produced by taking highly refined vitamin E from natural sources, adding a precise amount of acetic acid and heating the mixture until esterification is complete. All these steps mean that the synthetic is more expensive than the natural vitamin E was in the first place. User David notMD seems to regard my good-faith edits to the article as an invitation to make Wikipedia a battleground, but cannot even be bothered to do the research to check if my edits have any value. Abductive (reasoning) 08:09, 7 September 2019 (UTC)
 * Stating that manufacturers of fortified foods and dietary supplements prefer synthetic vitamin E because natural becomes rancid is a non-neutral claim. I did not see any support for that in the Linus Pauling Institute reference. I could not view the second ref, but suspect that a 2006 book is not sufficiently recent or strong enough ref to support the statement. Per good manufacturing practices, dietary supplement companies have a stated shelf life for products, confirming that the label potency is met at the end of shelf life. If synthetic is more stable then less of an overage may be used at manufacturing time, but that does not confirm what happens to the natural ingredient is rancidity. And by cheaper, I meant customer cost, not manufacturing cost. Prices per capsule for synthetic E are in range of 3-10 cents; for natural 10-25 cents. David notMD (talk) 15:26, 7 September 2019 (UTC)

The debatable sentence: "Most commercially available vitamin E supplements are the synthetic tocopheryl acetate because it prevents formulations from going rancid as quickly." Natural alpha-tocopherol and synthetic alpha-tocopherol can both be stabilized by creating the acetate form. As written, the sentence can be read to imply that synthetic tocopherol does not go rancid as quickly. I suggest the removal of the word "synthetic" from the sentence, and a revision to "Most commercially available vitamin E supplements are esterified as tocopheryl acetate because esters are more resistant to oxidative degradation during storage." David notMD (talk) 16:01, 7 September 2019 (UTC)
 * You are correct; the issue is when something becomes "synthetic". If something is chemically identical to the natural chemical, I (and I assume some other people) would not view it as synthetic. But when a chemical change is made that created something not found in nature, such as tocopheryl acetate, I (and I assume some other people) would call it synthetic. So it is better to use neutral language as you have proposed. Abductive  (reasoning) 19:13, 7 September 2019 (UTC)
 * Revised sentence in lead to make clear that the commonly understood meaning of "synthetic" for vitamin E is not the same as combining tocopherol with an ester: "Both natural and synthetic tocopherol are subject to oxidation, and so in dietary supplements are combined with an ester, example tocopheryl acetate for stability purposes." Retained references. David notMD (talk) 21:29, 7 September 2019 (UTC)
 * Grammatically, esterification is the not same as "combined with an ester". Abductive  (reasoning) 20:55, 11 September 2019 (UTC)

Vaping-associated lung injuries can be attributed to vitamin E acetate, CDC says
See also the section higher up:.

I am just getting things started. I don't have the time to dig up the best sources, etc.. Including WP:MEDRS, etc..


 * Vaping-associated lung injuries can be attributed to vitamin E acetate, CDC says. By Nicole Wetsman. Dec 20, 2019. The Verge. "She stressed, though, that there may be more than one chemical causing these injuries. Not every patient with EVALI reported using THC-containing products, and not every tested product associated with an injury contained vitamin E acetate."


 * Template:Electronic cigarettes - see the many subarticles. Together they discuss the many chemicals added to e-cigs, and the toxic effects of many of them. That show/hide template should be at the top of all the e-cig subarticles. Or as a sidebar box.

By the way, Vitamin E acetate is not found in nature. As always, one needs to dig down to the references used in the articles below.


 * Ingredient Watch List: Tocopheryl Acetate, the Potentially Irritating Form of Vitamin E.

"This ingredient is basically a form of vitamin E created in the laboratory. Manufacturers take natural vitamin E and add acetic acid to it."

Various concerns and side effects are listed in the article.

Chemical of the Day - Q&A - Tocopherol vs. Tocopheryl Acetate. 26 April 2011. From the article (emphasis added):

See the "depigmentation" section of the hydroquinone article for its toxic effects. -- Timeshifter (talk) 11:56, 21 December 2019 (UTC)

Cardiovascular Effects Meta-Analysis Reported In Strange Way
From the article:

There is some supporting evidence from randomized clinical trials (RCTs). A meta-analysis on the effects of alpha-tocopherol supplementation in RCTs on aspects of cardiovascular health reported that when consumed without any other antioxidant nutrient, the relative risk of heart attack was reduced by 18%.[104] '''The results were not consistent for all of the individual trials incorporated into the meta-analysis. For example, the Physicians' Health Study II did not show any benefit after 400 IU every other day for eight years, for heart attack, stroke, coronary mortality or all-cause mortality.[105] The HOPE/HOPE-TOO trial, which enrolled people with pre-existing vascular disease or diabetes into a multi-year trial of 400 IU/day, reported a higher risk of heart failure in the alpha-tocopherol group.[106]'''

I find this kind of reporting misleading. Meta-analyses rarely are comprised of only studies that show an effect or don't show an effect, if they did I'd be concerned about whether or not their was a publication bias effect at work. Further, if we are going to start talking about specific studies from within the meta-analysis that ran contrary to the results, we really should look at the proportion of studies that were positive versus negative. Otherwise we may send the impression that the bulk of studies are not clearly demonstrating a pattern in favor or against the reported effect.

Pulling out a few negative studies from a meta-analysis to undercut the meta-analysis's results seems like cherry picking to me.

ScientificAnalyst (talk) 20:53, 9 June 2021 (UTC)
 * I agree. If Wikipedia lives and dies by WP:MEDRS, then individual trials, no matter how large, should not be presented separately as a means of contradicting the conclusions of the meta-analysis. The next step would be to delete the three sentences and two refs. David notMD (talk) 02:24, 10 June 2021 (UTC)
 * In case you are wondering, the person who wrote that content back in 2018 was me. You have my blessing to improve it. David notMD (talk) 12:47, 11 June 2021 (UTC)

Revert, poss heading toward edit war
I have now twice reverted an addition that is about a synthetic tocopherol compound, with only evidence for putative effect, in vitro experiments. David notMD (talk) 14:19, 25 October 2021 (UTC)

Preparing article for GA nomination
Revamping article in prepartion for GA nomination. Modeling after nine other vitamin articles that are GA. David notMD (talk) 16:04, 9 February 2022 (UTC)