Vitamin E and Heart Disease Reduction -Why Some Forms of Vitamin E Don't Work

There is a long history of controversy surrounding the use of vitamin E as a tool for preventing heart disease. In the 1990's, we were told it was a must. About 2000, we were told it didn't work. And now experts are beginning to recommend it once again.

The simple fact is, not all forms of vitamin E work equally well for preventing heart disease. And the study that found that taking vitamin E did not protect your heart used the wrong kind of vitamin E!

A famous study that used the "wrong" form of vitamin E. On 20 January 2024 the prestigious New England Journal of Medicine published the study that concluded that taking 400 IU of d-tocopheryl-acetate every day did not help reduce the risk of heart disease. The kind of vitamin E used here is important. It's made by combining natural alpha-tocopherol with acetic acid to make a kind of vitamin E that is stable when you mix it with soybean oil. The vitamin E acetate and the soybean oil are then put into capsules.

A form of vitamin E your body can't absorb when you are on a low-fat diet. This is the kind of chemically modified vitamin E that delivers the most vitamin E once it gets into your system, but it has a very hard time getting into your system. If you are on a low-fat diet, and most of the participants in the study were, then you don't get but about half the vitamin E from the capsule into your body. And if you take the vitamin E capsule on an empty stomach, you might not get very much vitamin E into bloodstream circulation at all.

The right form of vitamin E for heart health. People who know their vitamin E take a different supplement called d-tocopheryl succinate. This form of vitamin E is shelf-stable, maintaining its potency for several years. But because it is a dry powder, it's much easier for the body to absorb. Had the participants in the study published in the New England Journal of Medicine used this form of vitamin E, the results likely would have been quite different. But how could we know for sure?

There is more than one kind of vitamin E, and you need all of them. The simple fact is, there is more than one kind of vitamin E. Ninety-nine per cent of research studies focus on alpha-tocopherol, but the body also uses beta-tocopherol, gamma-tocopherol, delta-tocopherol, alpha-tocotrienol, beta-tocotrienol, gamma-tocotrienol, and delta-tocotrienol.

Over the 10 years since the famous study, further research has found that different kinds of vitamin E play different roles in heart health:

• The relatively well-known alpha-tocopherol keeps white blood cells from sticking to cholesterol deposits in the lining of arteries (it's actually white blood cells that cause calcification) and keeps blood platelets from sticking together to form clots.
• The more abundant gamma-tocopherol helps the kidneys regulate sodium and lower blood pressure, reducing physical stress on the arteries.
• The four tocotrienols, but not the four tocopherols, lower cholesterol.
• Delta-tocotrienol stimulates the body's production of coenzyme Q10.
• Gamma-tocotrienol keeps coenzyme Q10 from breaking down.
• Alpha-tocotrienol, but not alpha-tocopherol, protects brain and nerve tissue from damage when oxygen levels are low.

Science tells us that we need more than just the alpha-tocopherol form of vitamin E. Manufacturers sometimes simply add rice bran oil to the their alpha-tocopherol in soybean oil. Rice bran oil is a good source of gamma-tocotrienol but not the other three tocotrienols.

Natural palm oil, on the other hand, is a good source of all eight forms of vitamin E, but especially the tocotrienols that most nutritional supplements leave out.

For your heart health, you need all eight of the forms of vitamin E. You can't consume enough vitamin E from food to make a difference in supporting your recovery from heart disease-you would have to 100 to 200 grams of palm oil (containing 1000 to 2000 calories of energy) or 2 to 4 kilos (4 to 9 pounds) of wheat germ every day just to get your E's.

Supplements, however, are a sensible way to get your vitamin E. Your best bet is to use products formulated with the palm oil known as Tocomin®. Products made with rice bran oil probably don't deliver all the vitamins you need.

Selected References:

Sen CK, Khanna S, Roy S, Packer L. Molecular basis of vitamin E action. Tocotrienol potently inhibits glutamate-induced pp60(c-Src) kinase activation and death of HT4 neuronal cells.Journal of Biological Chemistry. 2000;275(17):13049-55.

Suzuki YJ, Tsuchiya M, Wassall SR, Choo YM, Govil G, Kagan VE, Packer L. Structural and dynamic membrane properties of alpha-tocopherol and alpha-tocotrienol: implication to the molecular mechanism of their antioxidant potency. Biochemistry. 1993;32(40):10692-9.

Yap SP, Yuen KH, Wong JW. Pharmacokinetics and bioavailability of alpha-, gamma- and delta-tocotrienols under different food status. J Pharm Pharmacol. 2001;53(1):67-71.

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