VIT C OVERDOSING RAISING BLOOD SUGAR, AND OTHER RELATED TOXIC & DAMAGING ISSUES...

[MAMZELLE]

I am quite perplexed. Dr. Bernstein, one of the leading Diabetic and Low Carb Specialists doesn't seem very big on Vitamin/Mineral supplements above the FDA requirements if getting them in foods, and feels they can be quite toxic and create complications and inhibit other absorbsions.

He even considers ''enough'' as merely once or twice weekly of meat/protein and vegetable portions, which is quite low considering that most of us eat that on a daily basis..... vegetables and either fish, chicken or meat so that would indicate that we are getting much MORE than ''enough'', and not needing megadoses of vitamins, I would have to deduct.... or practically needing ANY vitamin/mineral suppliments at all as an overall conclusion with some rare exceptions. [pasted below]

Having been following Dr. Atkins all my life, I who have NO medical credentials.... have been in favor of megadosing... and that theory is also carried on and advocated in the recent "Diabetic Revolution".

Specifically of great concern to me is that when in my early teens, Dr. Atkins told me to take 3000 mg of vitamin C daily, to offset smoking because it depleats C.... and he also told me that I was hypoglycemic [even way back then, had blood sugar issues but as far as I can remember, the urgency wasn't impressed upon me and being so young, I
didn't have the savvy to understand the importance of it, he just introduced his diet and had me following it, in fact, I have only recently even remembered his statement that I was sugar imbalanced even then].

I have always taken two 2000 mg tablets daily, one morning and evening and the C in the rest of my vitamins filled in part of the balance of the 3000. Whenever strictly ON my vitamins, I have always gone by his [Atkins'] mega-dose recommendations of EVERYTHING there is that he had always advocated, and now with high sugar, even moreso.

"Bayer" told me that over 500 mg of C can affect the Keto Diastix reading [both sugar and ketones] but that didn't concern me, because continuing the C seemed more important and I just kept in mind that the readings were even more INaccurate, in my case, than I had previously always assumed anyway [but now also because of my large doses of C, along WITH 2-3 liters of water and other elements that also affect their readings.]

As can be seen below, Dr. Bernstein also says that mega doses of C, above 500, can also raise blood sugar and create NERVE DAMAGE/DYSFUNCTION! This was quite alarming to me and what I had never read anywhere before, but I wasn't studying it so I wouldn't have. I had total trust in Dr. Atkins. I am now wondering if my close to 3000 daily over DECADES could have actually triggered my diabetes along with my heritage on both sides of the family [mother and paternal grandmother who went blind and died from the disease, my mother faired well with it with no adverse effects after having it for about 40 years, luckily in a more modern medical world than my unfortunate grandmother on my father's side].

The vitamin C issue AND the two of the most reputable Doctor's differences of opinion in megadosing is my question, and why would one prominant expert in the field be so at opposite ends as another. I know you can't speak for Dr. Bernstein, but reading him, [page 161 in his book] I am suddenly really concerned about following Dr. Atkins megadosing suggestions.... especially the vitamin C and it's tendency to raise blood sugar and create nerve complications. Is this true in your opinion?

I will now, until I investigate this further through any venues that I may find... go down to the 500 mg per day just to be safe, and figured this is the best place to START my inquiries. But am also worried that without the 2000+, my C will be depleated from the smoking, [as per Dr. Atkins words] although I have been taking steps to figure out how to quit, it has not been accomplished yet after a lifetime of addiction... and don't know when I will be able to, so the C dosage is still a big issue until I do.

I have also attributed my never having any colds or any other ailments minor OR severe.... a single day in my life to possibly the C, and perhaps other high doses I've always taken, including the more obscure CO-Q10, Omega 3, L-Carnatine and all the other vitamins, minerals, herbs down the line] and also attributed my otherwise perfect health [other than the sugar imbalance] to all of that dosing as well, and have always agreed with Dr. Atkins on that.... but what do *I* know, when it really comes down to it....nor ANY non-medical laymen like myself and all of us out there.

I have never 'HAD' to see a doctor for anything but normal periodical 'checkups', which is quite rare, and always attributed that at least partially to my ongoing vitamin regimen, and don't want to start getting sick WITHOUT the mega C, but if such a high dosage has been effecting my blood sugar, and nerves, I need to know that and FAST, though it may be too late for the damage it might have already done over a lifetime?

Common sense and logic tells me that a Doctor such as Dr. Atkins wouldn't prescribe a dose to a hypoglycemic that would give them high sugar and Diabetes! But 3000 per day *WERE* his words back then. Can you help. I'm sure this information will be of use to others as well.

....and I extend a personal invitation to, and always welcome anyone else to feel free to join in with any useful and informative information that they also may have to offer, even on this particular 'Q&A' type page [and since my being the initiator of this specific one], because I am personally grateful for ANYONE'S help along with the respected professional experts.... and am of the belief that every amount of discussion contributes to the learning process. Thanks so much.....>

BERNSTEIN ON: VITAMIN AND MINERAL SUPPLEMENTS

It is common practice to prescribe supplementary
vitamins and minerals for diabetics. This is primarily
because most diabetics have chronically high blood
sugars and therefore urinate a lot. Excessive urination
causes a loss of water-soluble vitamins and minerals. If
you can keep your blood sugars low enough to avoid
spilling glucose into the urine (you can test it with
Clinistix/Diastix), and if you eat a variety of vegetables,
and red meat at least once or twice a week, you
should not require supplements. Note, however, that
major dietary sources of B-complex vitamins include
“fortified” or supplemented breads and grains in the
United States. If you’re following a low carbohydrate diet
and therefore exclude these from your meal plan, you
should eat some bean sprouts, spinach, broccoli,
brussels sprouts, or cauliflower each day. If you do not
like vegetables, you might take a B-complex capsule or a
multivitamin/mineral capsule each day. See page 175 for
a discussion of calcium supplementation for certain
people who follow high-fiber or high-protein diets or use
metformin.

Supplemental vitamins and minerals should not
ordinarily be used in excess of the FDA’s recommended
daily requirements. Large doses can inhibit the body’s
synthesis of some vitamins and intestinal absorption of
certain minerals. Large doses are also potentially toxic.
Doses of vitamin C in excess of 500 mg daily may
interfere with the chemical reaction on your blood sugar
strips. As a result, your blood sugar readings can appear
erroneously low. Large doses of vitamin C can actually
raise blood sugar and even impair nerve function (as can
doses of vitamin B-6 in excess of 200 mg daily). Vitamin
E has been shown to reduce one of the destructive
effects of high blood sugars (glycosylation of the body’s
proteins), in a dose-dependent fashion— up to 1,200 IU
(international units) per day. It has recently been shown
to lower insulin resistance. I therefore recommend
400–1,200 IU per day to a number of my patients. Be sure
to use the forms of vitamin E known as gamma
tocopherol or mixed tocopherols, not the common alpha
tocopherol, which can inhibit the absorption of essential
gamma tocopherol from foods

[pooticus]

MAMZELLE, i am a chronic reader of "books and articles". and i too have been concerned with the apparent contradictions in noted authors of some extensive repute! namely dr. a, dr. b, and dr's. eades, in addition to some of the late breaking "studies" on anti-oxidents.

dr. a and dr. b differ quite dramatically as u've noted in ur post regarding supplementation. the dr's. eades in protein power lifeplan tend to agree more with dr. b. especially with regards to vit c, vit e and additionally they have strong views about supplementation with vitamin d/k and also calcium/magnesium.

i have read very late breaking articles (i can't remember my sources ) that showed in the studies that if someone has heart disease, that high doses of e (and maybe c?) can actually harm the person by increasing the risk of cardiac death).

i don't know where the truth lies. i sometimes feel like i'm tiptoeing thru a minefield and if i succeed to the opposite end of the minefield without losing a limb i will be very lucky indeed! i wish i knew where the "truth" lies!

[MAMZELLE]

Sorry, hate to put something so long on here, [a lot of work to separate too] but when trying to do partially, there's too much information to choose from, so decided the whole thing was imperative. If going to google, mere 'vitamin e' will bring up many more articles like this. I'm really trying to get to the bottom of it. then Vitamin C, but won't post that here.

In atkins' 'diabetes revolution', [page 251-252] it says to take ''natural mixed T's plus selenium [which I'm assuming means BOTH Alpha AND Gamma]. So I don't know what to think. Alpha seems to be the most common, so WHY is it, if Bernstein claims it blocks the natural E from our foods!

The foremost thing from above regarding E [Bernstein] saying that not only is the Alpha pretty useless, but it also BLOCKS the NATURAL E from our foods from being absorbed .....is to me, QUITE a statement! That means that Alpha [the most commonly used form of E] is not only actually a waste of time and money & the equivelant of 'nothing', but is also damaging and detremental and harmful and blocking ALL forms of E from getting into our systems...even from our FOODS.

I finally had the nerve to check which type T's my bottles are [they're in the closet because I use those big round partitioned vitamin decanters for my so many vitamins where they all fit into two of those for convenience, and just keep refilling, so I've been dreading checking my stash of the actual bottles, kinda like an ostrich], I knew from long ago reading up on the differences of gamma and alpha that there WERE different kinds, but lately didn't focus on it again, and sure enough, as I suspected, they ARE alpha... wondering if everyone else's are too?].

Well, here goes [thought Linus Pauuling was the best source to start with. No, not putting any others on HERE about E, lol, and the Vitamin C 'overdosing' is MY personal delimma so I thought I'd do E, which applies to everyone], and really hope the nutritionist shows up with some assistance, as I saw they were around yesterday responding to 'other' threads] This has to be only 15,000 characters per post, and will be quite a job to calculate and separate, especially with my additional copy/paste dysfunctional problems I have to battle with, and the alignment will not be good. [read all the way down because it also covers diabetes and E as well. It IS really quite extensive and such a wealth of information, that I just couldn't resist, and hope administration doesn't mind it's length....


VITAMIN E

The term vitamin E describes a family of eight antioxidants,
four tocopherols, alpha-, beta-, gamma- and delta-, and four
tocotrienols (also alpha-, beta-, gamma- and delta-).
Alpha-tocopherol is the only form of vitamin E that is actively
maintained in the human body and is therefore, the form of
vitamin E found in the largest quantities in the blood and
tissue (1). Because alpha-tocopherol is the form of vitamin E
that appears to have the greatest nutritional significance, it
will be the primary topic of the following discussion. It is also
the only form that meets the latest Recommended Dietary
Allowance (RDA) for vitamin E.

FUNCTION

Alpha-tocopherol

The main function of alpha-tocopherol in humans appears to
be that of an antioxidant. Free radicals are formed primarily
in the body during normal metabolism and also upon exposure
to environmental factors such as cigarette smoke or
pollutants. Fats, which are an integral part of all cell
membranes, are vulnerable to destruction through oxidation
by free radicals. The fat-soluble vitamin, alpha-tocopherol, is
uniquely suited to intercepting free radicals and preventing a
chain reaction of lipid destruction. Aside from maintaining
the integrity of cell membranes throughout the body,
alpha-tocopherol also protects the fats in low density
lipoproteins (LDLs) from oxidation. Lipoproteins are particles
composed of lipids and proteins, which are able to transport
fats through the blood stream. LDL transport cholesterol from
the liver to the tissues of the body. Oxidized LDLs have been
implicated in the development of cardiovascular diseases
(See Disease Prevention). When a molecule of
alpha-tocopherol neutralizes a free radical, it is altered in
such a way that its antioxidant capacity is lost. However,
other antioxidants, such as vitamin C, are capable of
regenerating the antioxidant capacity of alpha-tocopherol (2).

Several other functions of alpha-tocopherol have been
identified, which likely are not related to its antioxidant
capacity. Alpha-tocopherol is known to inhibit the actvity of
protein kinase C, an important cell signaling molecule, as
well as to affect the expression and activity of immune and
inflammatory cells. Additionally, alpha-tocopherol has been
shown to inhibit platelet aggregation and to enhance
vasodilation (3,4).

Gamma-tocopherol

The function of gamma-tocopherol in humans is presently
unclear. Although the most common form of vitamin E in the
American diet is gamma-tocopherol (see Food Sources), blood
levels of gamma-tocopherol are generally ten times lower
than those of alpha-tocopherol. This phenomenon appears
due to the action of the alpha-tocopherol transfer protein
(a-TTP) in the liver, which preferentially incorporates
alpha-tocopherol into lipoproteins that are circulated in the
blood (1) and ultimately deliver alpha-tocopherol to different
tissues in the body. See the Linus Pauling Institute
Newsletter for more information about a-TTP and vitamin E
adequacy. Because gamma-tocopherol is initially absorbed in
the same manner as alpha-tocopherol, small amounts are
detectable in blood and tissue. Products of the metabolism of
tocopherols, known as metabolites, can be detected in the
urine. More gamma-tocopherol metabolites are excreted in
the urine than alpha-tocopherol metabolites, suggesting less
gamma-tocopherol is needed for use by the body (5). Limited
research in the test tube and in animals indicates that
gamma-tocopherol or its metabolites may play a role in the
protection of the body from damage by free radicals (6,7), but
these effects have not been convincingly demonstrated in
humans. Recently, concern has been raised regarding the fact
that taking alpha-tocopherol supplements lowers
gamma-tocopherol levels in the blood. However, no adverse
effects of moderate alpha-tocopherol supplementation have
been demonstrated, while many benefits have been
documented (see Disease Prevention and Disease Treatment).
In one recent prospective study, increased plasma
gamma-tocopherol levels were associated with a significantly
reduced risk of developing prostate cancer, while significant
protective associations for increased levels of plasma
alpha-tocopherol and toenail selenium were found only when
gamma-tocopherol levels were also high (8). These limited
findings, in addition to the fact that taking alpha-tocopherol
supplements lower gamma-tocopherol levels in the blood,
have led some scientists to call for additional research on the
effects of dietary and supplemental gamma-tocopherol on
health (9). For more information see the article, Which Form
of Vitamin E, Alpha- or Gamma-Tocopherol, is Better? in
the Linus Pauling Institute Research Report.

DEFICIENCY

Vitamin E deficiency has been observed in individuals with
severe malnutrition, genetic defects affecting the
alpha-tocopherol transfer protein, and fat malabsorption
syndromes. For example, children with cystic fibrosis or
cholestatic liver disease, who have an impaired capacity to
absorb dietary fat and therefore fat-soluble vitamins, may
develop symptomatic vitamin E deficiency. Severe vitamin E
deficiency results mainly in neurological symptoms, including
impaired balance and coordination (ataxia), injury to the
sensory nerves (peripheral neuropathy), muscle weakness
(myopathy), and damage to the retina of the eye (pigmented
retinopathy). For this reason, people who develop peripheral
neuropathy, ataxia or retinitis pigmentosa should be screened
for vitamin E deficiency (2). The developing nervous system
appears to be especially vulnerable to vitamin E deficiency
because children with severe vitamin E deficiency from birth,
who are not treated with vitamin E, develop neurological
symptoms rapidly. In contrast, individuals who develop
malabsorption of vitamin E in adulthood may not develop
neurological symptoms for 10-20 years. It should be noted
that symptomatic vitamin E deficiency in healthy individuals
who consume diets low in vitamin E has never been reported
(10).

Although true vitamin E deficiency is rare, suboptimal intake
of vitamin E is relatively common in the U.S. The National
Health and Nutrition Examination Survey III (NHANES III)
examined the dietary intake and blood levels of
alpha-tocopherol in 16,295 multi-ethnic adults over the age of
18. Twenty seven % of white participants, 41 % of African
Americans, 28% of Mexican Americans and 32% of the other
participants were found to have blood levels of
alpha-tocopherol less than 20 micromoles/liter, a value
chosen because the literature suggests an increased risk for
cardiovascular disease below this level (11).

The Recommended Dietary Allowance (RDA)

The RDA for vitamin E was previously 8 mg/day for women
and 10 mg/day for men. The RDA was revised by the Food and
Nutrition Board of the Institute of Medicine in 2000 (3). This
new recommendation was based largely on the results of
studies done in the 1950s in men fed vitamin E deficient
diets. In a test tube analysis, hydrogen peroxide was added to
blood samples and the breakdown of red blood cells, known
as hemolysis, was used to indicate vitamin E deficiency.
Because hemolysis has also been reported in children with
severe vitamin E deficiency, this analysis was considered to
be a clinically relevant test of vitamin E status. Importantly,
this means that the latest RDA for vitamin E continues to be
based on the prevention of deficiency symptoms rather than
on health promotion and the prevention of chronic disease.

DISEASE PREVENTION

Cardiovascular diseases (heart disease and stroke)

The results of at least five large observational studies
suggest that increased vitamin E consumption is associated
with decreased risk of myocardial infarction (heart attack) or
death from heart disease in both men and women. Each
study was a prospective study which measured vitamin E
consumption in presumably healthy people and followed them
for a number of years to determine how many of them were
diagnosed with, or died as a result of heart disease. In two of
the studies, those individuals who consumed more than 7 mg
of alpha-tocopherol in food were only approximately 35% as
likely to die from heart disease as those who consumed less
than 3-5 mg of alpha-tocopherol (12,13). Two other large
studies found a significant reduction in the risk of heart
disease only in those women and men who consumed
alpha-tocopherol supplements of at least 100 IU (67 mg of
RRR-alpha-tocopherol) daily (14,15). More recently, several
studies have observed plasma or red blood cell levels of
alpha-tocopherol to be inversely associated with the
presence or severity of carotid atherosclerosis detected
using ultrasonography (16-19). In contrast, intervention
studies with vitamin E supplements in patients with heart
disease have not shown vitamin E to be effective in
preventing heart attacks or death
CONTINUED.....

[MAMZELLE]

Cataracts

Cataracts appear to be formed by the oxidation of proteins in
the lens of the eye, which may be prevented by antioxidants
such as alpha-tocopherol. To date, ten observational studies
have examined the association between vitamin E
consumption and the incidence and severity of cataracts. Of
these studies, five found increased vitamin E intake to be
associated with protection from cataracts, while five reported
no association (20,21). A recent intervention trial of a daily
antioxidant supplement containing 500 mg of vitamin C, 400
IU of vitamin E, and 15 mg of beta-carotene in 4,629 men and
women found that the antioxidant supplement was no
different than a placebo in its effects on the development and
progression of age-related cataracts over a 7-year period (22).
Another intervention trial found that a daily supplement of 50
mg of synthetic alpha-tocopherol daily (equivalent to 25 mg of
RRR- alpha-tocopherol) did not alter the incidence of cataract
surgery in male smokers (23). Presently, the relationship
between vitamin E intake and the development of cataracts
requires further clarification before specific recommendations
can be made.

Immune Function

Alpha-tocopherol has been shown to enhance specific
aspects of the immune response that appear to decline as
people age. For example, 200 mg of synthetic
alpha-tocopherol (equivalent to 100 mg of
RRR-alpha-tocopherol) daily for several months increased the
formation of antibodies in response to hepatitis B vaccine and
tetanus vaccine in elderly adults (24). Whether
alpha-tocopherol associated enhancements in the immune
response actually translate to increased resistance to
infections such as the flu (influenza virus) in older adults
remains to be determined (25).

Cancer

Many types of cancer are thought to result from oxidative
damage to DNA caused by free radicals. The ability of
alpha-tocopherol to neutralize free radicals has made it the
subject of a number of cancer prevention studies. However,
several large prospective studies have failed to find
significant associations between alpha-tocopherol intake and
the incidence of lung cancer or breast cancer (3). A
placebo-controlled intervention study designed to look at the
effect of alpha-tocopherol supplementation on lung cancer in
smokers found a 34% reduction in the incidence of prostate
cancer in smokers given supplements of 50 mg of synthetic
alpha-tocopherol (equivalent to 25 mg of
RRR-alpha-tocopherol) daily (26). Because of these findings a
large randomized, placebo-controlled intervention study is
currently being conducted to examine the effect of
alpha-tocopherol supplementation on prostate cancer risk
(27).

DISEASE TREATMENT

Cardiovascular diseases

Observational studies have suggested that supplemental
alpha-tocopherol might have value in the treatment of
cardiovascular disease. For example, a small observational
study of men who had previously undergone a coronary artery
bypass surgery found a reduction in the progression of
coronary artery atherosclerosis by angiography in those men
who took at least 100 IU of alpha-tocopherol (67 mg of
RRR-alpha-tocopherol) daily (28). A randomized,
placebo-controlled intervention trial in Great Britain (the
CHAOS study) found that supplementing heart
diseasepatients with either 400 or 800 IU of synthetic
alpha-tocopherol (equivalent to 268 or 536 mg of
RRR-alpha-tocopherol) for an average of 18 months resulted in
a dramatic 77% reduction in nonfatal heart attacks. However,
total deaths from heart disease were not significantly
reduced (29). Chronic renal dialysis patients are at much
greater risk of dying from cardiovascular disease than the
general population, and there is evidence that they are also
under increased oxidative stress. Supplementation of renal
dialysis patients with 800 IU of natural alpha-tocopherol (536
mg of RRR-alpha-tocopherol) for an average of 1.4 years
resulted in a significantly reduced risk of heart attack
compared to placebo (30). In contrast, three other
intervention trials failed to find significant risk reductions
with alpha-tocopherol supplementation. One study, which
was designed mainly to examine cancer prevention, found
that 50 mg of synthetic alpha-tocopherol daily (equivalent to
25 mg of RRR-alpha-tocopherol) resulted in a non-significant
decrease in nonfatal heart attacks in those participants who
had had previous heart attacks (31) . However, two other
large trials found that daily supplements of 400 IU of natural
alpha-tocopherol (equivalent to 268 mg RRR-alpha-tocopherol)
and 300 mg of synthetic alpha-tocopherol (equivalent to 150
mg of RRR-alpha-tocopherol) in individuals with evidence of
cardiovascular disease (previous heart attack, stroke, or
evidence of vascular disease) did not significantly change the
risk of a subsequent heart attack or stroke (32,33). The
results of several other large intervention trials, which are
presently in progress may clarify the role of alpha-tocopherol
supplementation in the treatment of cardiovascular disease.

A more thorough discussion of the complex issues involved in
analyzing the results of recent trials of vitamin E in heart
disease can be found in the Fall/Winter 1999 issue of the
Linus Pauling Institute Newsletter: Fish Oil, Vitamin E,
Genes, Diet, and CHAOS. For a discussion of some of the
limitations of the HOPE study see the article, Vitamin E:
Hope or Hopeless, in the Spring/Summer 2000 issue of the
Linus Pauling Institute Newsletter.

Diabetes mellitus

Alpha-tocopherol supplementation of individuals with
diabetes has been proposed because diabetes appears to
increase oxidative stress and because cardiovascular
complications (heart attack and stroke) are among the
leading causes of death in diabetics. A recent study found a
biochemical marker of oxidative stress to be elevated in
diabetic individuals (34). Supplementation with 600 mg of
synthetic alpha-tocopherol daily (equivalent to 300 mg of
RRR-alpha-tocopherol) for 14 days resulted in a reduction in
the oxidative stress marker. Studies of the effect of
alpha-tocopherol supplementation on blood glucose control
have been contradictory. One study reported improved
control of blood glucose levels with supplementation of only
100 IU of synthetic alpha-tocopherol daily (equivalent to 45
mg RRR-alpha-tocopherol) (35), while studies using 900 to
1,600 IU of synthetic alpha-tocopherol daily (equivalent to 405
to 720 mg RRR-alpha-tocopherol) found either minimal or no
improvement, respectively (36,37). Although there is reason
to suspect that alpha-tocopherol supplementation may be
beneficial for individuals with diabetes, evidence from
well-controlled clinical trials is lacking.

Dementia (impaired cognitive function)

The brain is particularly vulnerable to oxidative stress, which
is thought to play a role in the pathology of neurodegenerative
diseases, such as Alzheimer's disease (38). In a large
placebo-controlled intervention trial, supplementation of
individuals who had moderate neurological impairment with
2,000 IU of synthetic alpha-tocopherol daily for two years
(equivalent to 900 mg/day of RRR-alpha-tocopherol) resulted
in a significant slowing of the progression of Alzheimer's
dementia (39). After Alzheimer's disease, vascular dementia
(dementia resulting from strokes) is the most common cause
of dementia in the U.S. A case-control study examining risk
factors for vascular dementia in elderly Japanese-American
men found that supplemental vitamin E and vitamin C intake
was associated with a significantly decreased risk of
vascular and other types of dementia, but not Alzheimer's
dementia (40). Among those without dementia, vitamin E
supplement use was associated with better scores on
cognitive tests. Although these findings are promising, further
studies are required to determine the role of alpha-tocopherol
supplementation in the treatment of Alzheimer's disease and
other types of dementia.

continued....

[MAMZELLE]

SOURCES

Food sources

Major sources of alpha-tocopherol in the American diet
include vegetable oils (olive, sunflower, safflower oils), nuts,
whole grains, and green leafy vegetables. All eight forms of
vitamin E (alpha-, beta, gamma-, and delta-tocopherols and
tocotrienols) occur naturally in foods, but in varying amounts.
If you wish to check foods you eat frequently for their nutrient
content, search the USDA food composition database.

Food
Serving
Alpha-tocopherol
(mg)
Gamma-tocopherol
(mg)
Olive oil
1
tablespoon
1.9
0.1
Soybean oil
1
tablespoon
1.2
10.8
Corn oil
1
tablespoon
1.9
8.2
Canola oil
1
tablespoon
2.4
4.2
Safflower
oil
1
tablespoon
4.6
0.1
Sunflower
oil
1
tablespoon
5.6
0.7
Almonds
1 ounce
7.3
0.3
Hazelnuts
1 ounce
4.3
0
Peanuts
1 ounce
2.4
2.4
Spinach
1/2 cup,
raw
chopped
1.8
0
Carrots
1/2 cup,
raw
chopped
0.4
0
Avocado
(California)
1 medium
3.4
0.6


Supplements

Alpha-tocopherol

The average intake of alpha-tocopherol from food in the U.S.
is approximately 9 mg daily for men and 6 mg daily for
women, well below the RDA of 15 mg/day of
RRR-alpha-tocopherol (3). Many scientists believe it is
difficult for an individual to consume more than 15 mg/day of
alpha-tocopherol from food alone, without also increasing fat
intake above recommended levels. All alpha-tocopherol in
food is the form of the isomer, RRR-alpha-tocopherol. The
same is not always true for supplements. Vitamin E
supplements generally contain from 100 IU to 1000 IU of
alpha-tocopherol. Supplements made from entirely natural
sources contain only RRR-alpha-tocopherol (also labeled
d-alpha-tocopherol). RRR-alpha-tocopherol is the isomer
preferred for use by the body, making it the most bioavailable
form of alpha-tocopherol. Synthetic alpha-tocopherol, which
is often found in food additives and nutritional supplements,
is usually labeled all-rac-alpha-tocopherol or
dl-alpha-tocopherol, meaning that all eight isomers of
alpha-tocopherol are present in the mixture. Because half of
the isomers of alpha-tocopherol present in
all-rac-alpha-tocopherol are not usable by the body, synthetic
alpha-tocopherol is less bioavailable and only half as potent.
To calculate the number of mg of bioavailable
alpha-tocopherol present in a supplement, use the following
formulas:

RRR-alpha-tocopherol (natural or d-alpha-tocopherol): IU x
0.67 = mg RRR-alpha-tocopherol.
Example: 100 IU = 67 mg

all-rac-alpha-tocopherol (synthetic or dl-alpha-tocopherol):
IU x 0.45 = mg RRR-alpha-tocopherol.
Example: 100 IU = 45 mg

For more information on the Biological Activity of Vitamin E,
see the article by Dr. Maret Traber in the Linus Pauling
Institute Newsletter.

Alpha-tocopheryl succinate and alpha-tocopheryl acetate
(alpha-tocopheryl esters)

Alpha-tocopherol supplements are available in the ester
forms, alpha-tocopheryl succinate and alpha-tocopheryl
acetate. Tocopherol esters are more resistant to oxidation
during storage than unesterified tocopherols. When taken
orally, the succinate or acetate moiety is removed from
alpha-tocopherol in the intestine. The bioavailability of
alpha-tocopherol from alpha-tocopheryl succinate and
alpha-tocopheryl acetate is equivalent to that of free
alpha-tocopherol. Because international units (IU) for
alpha-tocopherol esters are adjusted for molecular weight,
the conversion factors for determining the amount of
bioavailable alpha-tocopherol provided by alpha-tocopheryl
succinate and alpha-tocopheryl acetate are not different than
those used for alpha-tocopherol (see formulas) (3). The ester,
alpha-tocopheryl succinate, not alpha-tocopherol, is required
to effectively inhibit growth and induce death in cancer cells
grown in culture (see Disease Treatment: Cancer). However,
there is currently no evidence in humans that taking oral
alpha-tocopheryl succinate supplements delivers
alpha-tocopheryl succinate to tissues.


Gamma-tocopherol

Gamma-tocopherol supplements and mixed tocopherol
supplements are also commercially available (49). The
amounts of alpha- and gamma-tocopherol vary in mixed
tocopherol supplements, so it is important to read the label to
determine the amount of each tocopherol present in the
supplement.

SAFETY

Toxicity

Few side effects have been noted in adults taking
supplements of less than 2,000 mg of alpha-tocopherol daily
(RRR- or all-rac-alpha-tocopherol). However, most studies of
toxicity or side effects of alpha-tocopherol supplementation
have lasted only a few weeks to a few months, and side
effects occurring as a result of long-term alpha-tocopherol
supplementation have not been adequately studied. The most
worrisome possibility is that of impaired blood clotting
resulting in an increased likelihood of hemorrhage in some
individuals. In addition to setting the new RDA for
alpha-tocopherol in April of 2000, the Food and Nutrition
Board of the Institute of Medicine also set a UL (tolerable
upper intake level) for alpha-tocopherol supplements, citing
the avoidance of hemorrhage as the basis for the upper limit
(see table below). The Board felt that a UL of 1,000 mg daily
of alpha-tocopherol of any form (equivalent to1,500 IU of
RRR-alpha-tocopherol or 1,100 IU of all-rac-alpha-tocopherol)
would be the highest dose unlikely to result in hemorrhage in
almost all adults (3). Although only certain isomers of
alpha-tocopherol are retained in the circulation, all forms are
absorbed and the liver must break them down and eliminate
them. The rationale that any form of of alpha-tocopherol
(natural or synthetic) that can be absorbed potentially could
have adverse effects is the basis for a UL that refers to all
forms of alpha-tocopherol. Because hemorrhage is a
potentially life threatening condition, the Linus Pauling
Institute also recommends that individuals do not exceed
1,000 mg of alpha-tocopherol/day. Some physicians
recommend that high-dose vitamin E supplementation be
discontinued 1 month before elective surgery to decrease the
risk of hemorrhage. Premature infants appear to be especially
vulnerable to adverse effects of alpha-tocopherol
supplementation, which should be used only under controlled
supervision by a pediatrician (49). Supplementation with 400
IU/day of vitamin E has been found to accelerate the
progression of retinitis pigmentosa that is not associated
with vitamin E deficiency (50).



Tolerable Upper Intake Level (UL) for
Alpha-Tocopherol
Age Group
mg/day (IU/day
d-alpha-tocopherol)
Infants 0-12
months
Not Possible to Establish*
Children 1-3
years
200 mg (300 IU)
Children 4-8
years
300 mg (450 IU)
Children 9-13
years
600 mg (900 IU)
Adolescents
14-18 years
800 mg (1,200 IU)
Adults 19 and
older
1,000 mg (1,500 IU)


*Source of intake should be from foods or formula only.
CONTINUED......

[MAMZELLE]

Drug interactions

Individuals on anticoagulant therapy (blood thinners) or
individuals who are vitamin K deficient should not take
alpha-tocopherol supplements without close medical
supervision because of the increased risk of hemorrhage (3).
A number of medications may decrease the absorption of
vitamin E, including cholestyramine, colestipol, isoniazid,
mineral oil, orlistat, sucralfate, and the fat substitute, olestra.
Anticonvulsant drugs such as phenobarbitol, phenytoin, or
carbamazepine may decrease plasma levels of vitamin E (3,
49).

Antioxidants and HMG-CoA reductase inhibitors (statins)

A 3-year randomized controlled trial in 160 patients with
documented coronary heart disease (CHD) and low HDL levels
found that a combination of simvastatin (Zocor) and niacin
increased HDL2 levels, inhibited the progression of coronary
artery stenosis (narrowing), and decreased the frequency of
cardiovascular events, such as myocardial infarction and
stroke (51). Surprisingly, when an antioxidant combination
(1000 mg vitamin C, 800 IU alpha-tocopherol, 100 mcg of
selenium, and 25 mg beta-carotene daily) was taken with the
simvastatin-niacin combination, the protective effects were
diminished. However, in a much larger randomized controlled
trial of simvastatin and an antioxidant combination (600 mg
vitamin E, 250 mg vitamin C, and 20 mg beta-carotene daily)
in more than 20,000 men and women with coronary artery
disease or diabetes, the antioxidant combination did not
adversely affect the cardioprotective effects of simvastatin
therapy over a 5-year period (52). These contradictory
findings indicate that further research is needed on potential
interactions between antioxidant supplementation and
cholesterol-lowering agents, such as HMG-CoA reductase
inhibitors (statins).

THE LINUS PAULING INSTITUTE RECOMMENDATION

Scientists at the Linus Pauling Institute feel there exists
credible evidence that taking a supplement of 200 IU of
natural source d-alpha-tocopherol (RRR-alpha-tocopherol)
daily with a meal may help protect adults from chronic
diseases like heart disease, stroke, neurodegenerative
diseases, and some types of cancer. The amount of
alpha-tocopherol required for such beneficial effects appears
to be much greater than that which could be achieved through
diet alone (see Sources). Since supplements containing 200
IU of d-alpha-tocopherol are often as expensive as
supplements containing 400 IU of d-alpha-tocopherol, a less
expensive alternative may be to take 400 IU of
d-alpha-tocopherol every other day. Alpha-tocopherol
supplements are unlikely to be absorbed unless taken with
food.

Older adults (65 years and older)

The Linus Pauling Institute's recommendation of a
supplement providing 200 IU of natural source
d-alpha-tocopherol daily (or 400 IU of d-alpha-tocopherol every
other day) with a meal is also appropriate for generally
healthy older adults.

REFERENCES



Written by:
Jane Higdon, Ph.D.
Linus Pauling Institute
Oregon State University

Reviewed by:
Maret G. Traber, Ph.D.
Professor of Nutrition and Food Management
Principal Investigator, Linus Pauling Institute
Oregon State University

The Linus Pauling Institute

Note: Hmm, that's interesting under 'Linus Pailing Institute Recommendations' above... to take 400 IU every OTHER day. I've always taken 800 per day [splitting 400 IU mornin & night] and in the last month have gone down to only 400 after dinner because I was also taking the low grade 81mg aspirin, which also thins blood and is supposed to prevent heart attacks [which Diabetes is also privy to, along with strokes], then stopped the aspirin because they were BOTH blood thinners and also lowered the dosage to 400 because of reading that E can raise blood pressure. Didn't know a day can be skipped in-between and that 200 was enough. I've always heard that 400 is the daily normal dosage, but never knew a day could be skipped. The discrepancies of all this and other supplements are so frightening because it's our very lives we're playing with. I think I'll stick to the 400, because that's what I've always taken for decades... and i'm still around to talk about it :-( Though the more I read, the more barely, it seems... and still don't know which T to take.... gamma or alpha. I haven't had a chance to read it all yet, [thought I'd better throw it up here fast while my copy/paste was still working since the problem is intermittant] and have some other things to do first now.... but any opinions and 'conclusions' would be welcome.

END

[pooticus]

MAMZELLE here is one of the articles that i saw on the health board that i thought was so interesting about Vitamin E.

Antioxidant Supplements Don't Reduce Stroke Risk

and here is another one:

AHA: Get Antioxidants from Food, Not Supplements

this is good also:

Vitamin Recommendations

and the last one:

More Evidence Found of How Vitamins Prevent Cancer

jezzie is an awesome source of information. she always finds very interesting articles and posts them on the health/medical board.

[MAMZELLE]

all 4 are the same link, I don't see any difference in the URL characters. Does it give which T's are preferred? In mine, I read further and so interrupted all the time with phone & door that I even forgot what I read just before after I posted it but I DO remember that the jury is still out about which [gamma or alpha] for Diabetes and no conclusive evidence about alpha for that, [two things I remember is ''CONTRADICTORY evidence", "minimal or no improvement" and ''evedience lacking'' they seem to find it's inaffective as far as I can remember right now up there, my mind is so torn in different directions at the moment, and my DF keeps asking for me to finish the list for all the new supplement supplies that I haven't been able to finish because I can't come to terms about the E..... also, what is the dosage for Omega 3, the last bottle I have is EPA...360mg and DHA ...240mg. Or is there a better mixture? Now I see I have to question EVERYTHING! It's very hard when not being in the store myself but he gets everything at less than a THIRD of the price where he is! They charge him in one LUMP for everything at his little drug store.... it's miraculous. I have over 20 items on this current list to stock up on and am stalled with the E.... and also I don't understand about the C! EVERYONE megadoses on c.... at LEAST a 1000 if not 3000 like I was doing. I NEVER heard of anyone taking LESS than 1000 and that's in addition to more c that's added in all our other vitamins!

[pooticus]

they only look like they are the same link cuz u can't see the ending of each one. they are 4 different links. one giving supplement info the other 3 about vit e/antioxidant study findings

[MAMZELLE]

I went there and read those posts. [easy to find.... just type any subject on top of any browser and all sites on the internet come up on that subject.... just like google.]. We never got an answer if C raises blood pressure.