Quick: name a functional role for vitamin E.

Cardiovascular health antioxidant properties vision support and maybe even fertility may come to mind right away. Yet skin health and wound healing should also be pretty high up on that list.

Walk into any drugstore and you’ll find topical creams and ointments—particularly for burns—that contain this nutrient. And for good reason: the scientific literature does support a role for this fat-soluble vitamin in improving healing and reducing scar formation as well as boosting the efficacy of sunscreens.

Animal studies show vitamin E improves the action of sunscreen particularly when combined with vitamin C with researchers crediting vitamin E for enhancing protection against UVB-induced sunburn and vitamin C for boosting the UVA protection. (Other antioxidant compounds such as grape seed extract and ubiquinone also work synergistically with vitamin E for protecting skin from photoaging.) Burn patients show substantially increased plasma levels of lipid peroxidation products and reduced levels of vitamin E. (Compared to healthy non-injured controls with plasma vitamin E levels of 841.1 +/- 22.7 mcg/dl burn patients’ vitamin E levels were a mere 196.2 +/- 12.6 mcg/dl). Vitamin E supplementation could be especially helpful in these cases where demand for powerful antioxidants is increased. Beyond photoaging sunburns and burn injury topical application and oral supplementation with vitamin E-rich soybean and avocado extracts showed remarkable benefit for improvement of vulvar lichen sclerosus.

Vitamin E occurs naturally as a mixture of 8 distinct compounds: α- β- γ- and δ-tocopherol and α- β- γ- and δ-tocotrienol each having specific properties of its own. Regarding healthy skin the predominant form of vitamin E in the skin is α-tocopherol but skin also contains measurable amounts of γ-tocopherol. And when it comes to vitamin E and the skin both α- and γ-tocopherol (as well as γ-tocotrienol) applied topically have been shown to reduce synthesis of inflammatory prostaglandins. So in addition to its undisputed antioxidant function vitamin E is also a potent anti-inflammatory agent with efficacy demonstrated for reducing UV-induced skin swelling skin thickness erythema and edema.

On a scale of relative biologic activity α- β- γ- and δ-tocopherol weigh in at 100 50 10-30 and 1 respectively. This could be important in terms of choosing foods and supplements; for example soybean oil has a higher total tocopherol content than sunflower oil but soy oil is predominantly γ-tocopherol whereas sunflower oil is mostly α-tocopherol with a greater level of vitamin E activity. Additionally the naturally occurring isomer D-α-tocopherol has significantly greater bioavailability and activity in the body compared to synthetically produced vitamin E in the form of DL-α-tocopherol.

Good sources of vitamin E include sunflower oil and seeds almonds hazelnuts and other nuts & seeds avocado grapeseed oil safflower oil and there are small amounts in leafy green vegetables such as broccoli spinach chard and asparagus. Shrimp rainbow trout and select other seafoods are also good sources.

The dietary reference intake (DRI) for vitamin E for adult men and women was set at a daily estimated average requirement (EAR) of 12 mg α-tocopherol with a recommended daily allowance (RDA) of 15 mg. No increase is suggested for pregnancy but during lactation the RDA is 19 mg/d. The upper limit of tolerable intakes (UL) is 1000 mg/day equivalent to 1500 IU natural vitamin E. Overt deficiency is rare but may result from fat malabsorption or genetic defects in the hepatic α-tocopherol transfer protein (α-TTP) which “facilitates the selective incorporation of α-tocopherol into circulating lipoproteins that distribute the vitamin to nonhepatic tissues” and “is therefore considered to be the major regulator of vitamin E status in humans.” 

Vitamin E has anticoagulant properties and is a natural blood thinner although it will not lead to dangerous bleeding in healthy individuals. Owing to vitamin E’s antithrombotic effects and influence on decreasing levels of vitamin K-dependent clotting factors those taking anticoagulant medications should be cautious with high doses of vitamin E.