Compound or practice · Supplement
Vitamin E
A fat-soluble antioxidant that fixes a rare deficiency and, at high doses, disappointed almost every disease-prevention trial it entered.
- Overall grade
- Grade C
- Last revised
- 3
- graded outcomes
- 0
- references listed
A structured monograph in Prometheus's bundled library. Its grades are the monograph's own reading of the evidence, not a peer-reviewed review.
1 at grade B · 1 at grade C · 1 at grade D — 3 graded rows
What is known
Each outcome with its grade (how strong the evidence is, A to D), the size of the effect where the entry records one, and how often studies agree.
- NAFLD/NASH histologyEvidence grade B
Niche benefit in trials
Moderatemixed
- All-cause mortality (high dose)Evidence grade C
Meta-analysis suggests slight increase ≥400 IU
Smallmixed
- CVD / cancer preventionEvidence grade D
Large trials null
Trivialhigh
What is uncertain
Read off the same rows as above. Nothing here is added that the entry does not itself record.
- Thin evidence: All-cause mortality (high dose) (grade C); CVD / cancer prevention (grade D).
- Studies disagree: NAFLD/NASH histology (mixed agreement).
- Caution with Anticoagulants (warfarin): High-dose E adds bleeding risk on anticoagulants.
Interactions
Documented pairings with supplements and medicines. A medicine on this list is a conversation for whoever prescribes it.
Anticoagulants (warfarin)Caution
High-dose E adds bleeding risk on anticoagulants.
The evidence in words
What it is
Vitamin E is a family of fat-soluble antioxidants (tocopherols and tocotrienols); alpha-tocopherol is the main circulating form. Dietary deficiency is rare outside fat-malabsorption disorders.
How it works
It sits in cell membranes and quenches lipid peroxidation, protecting polyunsaturated fats from oxidative chain reactions. The theory that this should prevent chronic disease drove decades of trials.
What the evidence shows
The 'antioxidant prevents everything' hypothesis failed here as clearly as anywhere: large trials found no cardiovascular or cancer benefit, and high-dose alpha-tocopherol was associated with a small increase in all-cause mortality and hemorrhagic stroke in meta-analysis. There is niche evidence in specific conditions (e.g., some benefit in NAFLD/NASH). For general health, food-level intake is the sensible target.
How to use it
Get it from nuts, seeds, and vegetable oils. Avoid routine high-dose (≥400 IU) supplements; niche therapeutic use belongs under medical supervision.
Safety & interactions
High doses thin the blood and raise bleeding risk, compounding anticoagulants and antiplatelets; meta-analyses link ≥400 IU/day to slightly higher mortality. warfarin — High-dose E adds bleeding risk on anticoagulants.
Bottom line
Skip the high-dose antioxidant capsules. Eat nuts and seeds. Reserve therapeutic doses for specific medical indications under care.
How it is used
As the entry records it, from the studies it summarises. Not a recommendation for you — doses that suit a trial population may not suit you.
- Food-first
- Nuts, seeds, oils; avoid routine ≥400 IU capsules.
Related reading
Entries that share this one's tags or conditions.
- CholineAn essential nutrient most people under-eat — critical in pregnancy for fetal brain development.Evidence grade B
- GlutathioneThe master antioxidant — better raised by making it (NAC, glycine) than by swallowing it, though liposomal forms help.Evidence grade C
- Glutathione for Fatty liver markersEvidence grade C — ModestEvidence grade C
- Glutathione for Oxidative stress markersEvidence grade C — Raised storesEvidence grade C
Sources
This entry lists no references of its own.
Last revised . A grade is this entry's reading of the evidence, not medical advice.