Vitamin E

Also known by these names

  • Tocopherol (alpha, beta, gamma and delta)
  • Tocotrienol (alpha, beta, delta and gamma)
  • RRR-alpha-tocopherol (synthetic)

Vitamin E is a natural antioxidant found in the following foods:

  • Eggs
  • Nuts
  • Green leafy vegetables
  • Wheat germ
  • Whole grains
  • Plant oils, especially from rice bran, sunflower, safflower, cottonseed and palm

Key Points

  • Vitamin E is a generic term for multiple natural and synthetic compounds, all of which are antioxidants.
  • BCCT is interested in vitamin E because some forms may have anticancer properties.
  • Vitamin E may reduce side effects of some conventional cancer therapies.
  • Vitamin E is included in a number of integrative care cancer protocols.
  • No published clinical trials to date describe using vitamin E alone as an anticancer therapy.
  • Vitamin E has low toxicity and is usually well tolerated in low doses.
  • Vitamin E can cause side effects as well as react with some prescription drugs. Vitamin E is contraindicated in some medical conditions. Caution and medical supervision are advised.

Vitamin E is also available in supplement form.

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Treating the Cancer

Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action

No reported clinical trials have used vitamin E as a stand-alone  anticancer treatment. Most of the studies in humans look at its use in combination with drugs or in combination with conventional chemotherapy or radiotherapy.

Lab and Animal Evidence

In lab and animal studies, vitamin E has reportedly inhibited protein kinase C activity, which affects cell proliferation (growth) and differentiation. Studies of the tocotrienol forms of vitamin E suggest they may be effective against a number of cancers, including breast, pancreatic, prostate and skin cancer.3

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Managing Side Effects and Promoting Wellness

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

Clinical Evidence

Use in combination with drugs or in combination with conventional chemotherapy or radiotherapy shows that vitamin E may reduce side effects such as oral mucositis and peripheral neuropathy, as shown in several small studies.7 Some evidence shows reduced hot flashes during breast cancer treatment.8

Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

Results published in 2014 of a large-scale randomized trial in men showed vitamin E and C supplementation had no immediate or long-term effects on the risk of total cancers, prostate cancer, or other site-specific cancers.9 Other findings with prostate cancer:

  • Inconsistent evidence of increased risk or no effect10
  • Evidence of reduced risk for both prostate cancer and advanced cancer with alpha-tocopherol in a pooled analysis,11 but increased risk in another12
  • Analyses of data propose that risks associated with vitamin E may vary by genotype of patients or by the specific form of vitamin E (alpha-tocopherol versus gamma-tocopherol, for instance)13
  • Natural vitamin E contains eight tocopherols and tocotrienols, found in different combinations across sources. Most vitamin E supplements contain only alpha-tocopherol. Dr. Keith Block cautions against giving alpha-tocopherol alone, as this may deplete the body of other important components of vitamin E.14
  • Recommendation against use by Abrams15
  • Used in these plans and protocols:
  • Select tocopherols are used in these plans and protocols:

Cautions

Low doses of vitamin E are considered relatively nontoxic. However, vitamin E can cause side effects and drug interactions, some of which can be serious. Daily levels at or above 400 IU are not recommended. Higher levels have been associated with increased mortality:

  • Doses greater than 400 IU/day increased all-cause mortality, mostly in patients with chronic diseases. Higher levels of supplements were associated with greater mortality.20
  • No increase in mortality at doses up to 800 IU/day was seen in apparently healthy people.21
  • Increased mortality was found in mixed studies of healthy individuals and those with diseases.22

Some express concerns about vitamin E's interfering with chemotherapy and radiation therapy.23

Consult with your pharmacist for interactions, and discuss using vitamin E with your doctor. See the following sources for more information on specific side effects, cautions and contraindications:

Access

Vitamin E is widely available in food sources and in supplements.

Dosing

BCCT does not recommend therapies or doses, but only provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated.

As noted above, levels of active ingredients of natural products can vary widely between and even within products. See Quality and Sources of Herbs, Supplements and Other Natural Products.

Although no optimal vitamin E dose during or after cancer treatment has been established, suggested dosages are listed in these sources:

Integrative Programs, Protocols and Medical Systems

For more information about programs and protocols, see our Integrative Programs and Protocols page.

Integrative oncology clinicians such as Keith Block, Dwight McKee and Lise Alschuler incorporate vitamin E supplementation into care either during active cancer treatment or after treatment care (or both) to prevent recurrence or secondary cancers.

  • Programs and protocols
    • Alschuler & Gazella complementary approaches24
      • Breast cancer
      • Cervical cancer
      • Colon cancer
      • Esophageal cancer
      • Gastric cancer
      • Head and neck cancer
      • Kidney cancer
      • Ovarian cancer
      • Thyroid cancer protocol
      • Guidance for support during conventional treatment and for treatment recovery
    • Bastyr University Integrative Oncology Research Center protocol for stage IV breast cancer25
    • Block program26
      • Chemopreventive nutraceutical in remission maintenance program:
        • Brain cancer
        • Breast cancer
        • Colon cancer
        • Leukemia case
        • Prostate cancer
      • Core diet plan
      • Combination antioxidant support formula and terrain modification
      • Anti-inflammatory support
      • Immune surveillance booster
      • Circulatory support supplement
      • Remission maintenance program
    • Lemole, Mehta & McKee protocols27
      • Bladder cancer
      • Breast cancer
      • Lung cancer
      • Prostate cancer
    • McKinney protocols28
      • General cancer
      • Bladder cancer
      • Brain/nerve cancer
      • Breast cancer
      • Carcinoid/neuroendocrine cancer
      • Cervical cancer
      • Colorectal cancer
      • Esophageal cancer
      • Head and neck cancer
      • Kidney cancer
      • Leukemia
      • Lymphoma
      • Multiple myeloma
      • Myelodysplastic syndrome
      • Prostate cancer
      • Skin cancer
      • Stomach cancer
      • Thyroid cancer
      • Uterine cancer

Commentary

According to Raymond Chang, MD, tocotrienols are much more potent than the tocopherol form of E vitamins, especially against cancer (especially gamma tocotrienol).29

Keith Block, MD: “Avoid high doses of single antioxidant supplements . . . Labile antioxidants--which include vitamins A, C and E, selenium and beta-carotene--can change into pro-oxidants . . . Thus they can increase the oxidative stress of your terrain and, if used without proper supervision, enhance the growth and spread of cancer cells. Used in the right dosages and combinations, however, they can help control malignancy.”30 Dr. Block advises using antioxidants like vitamin E in a mix of diverse antioxidants to promote a synergistic effect.31

Non-cancer Uses of Vitamin E

BCCT has not reviewed the effectiveness of this therapy for non-cancer uses.

  • Preventing progression of Alzheimer’s disease
  • Treating arthritis
  • Preventing cardiovascular complications of diabetes
  • Treating fatty liver diseases
  • Reducing hot flashes

Written by Laura Pole, RN, MSN, OCNS, and reviewed by Nancy Hepp, MS; most recent update April 18, 2019. Note: BCCT has not conducted an independent review of research of vitamin E. This summary draws primarily from CAM-Cancer’s Summaries and the Memorial Sloan Kettering Cancer Center’s About Herbs.

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