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Which Type of Vitamin E Is Best for My Liver?
When it comes to caring for your liver with Vitamin E, there is more involved than picking a Vitamin E supplement off the shelf.
Many people have heard of the antioxidant known as Vitamin E, but few realize that there are eight naturally occurring forms of this vitamin. Known to be helpful for those with liver health concerns, choosing the best Vitamin E variety for liver health can be confusing. By becoming familiar with Vitamin E’s primary forms, consumers will have a better understanding of this vitamin’s saga – and know more about ideal Vitamin E supplementation.
Admittedly, most of us like to think of vitamins as relatively straight-forward healthful pills that are taken with breakfast. When a particular vitamin is shown to defend against a chronic illness we are personally grappling with, it’s generally an easy transition to include in our routine. However, when the information about a vitamin is complex and filled with layers of instruction, most of us tend to shy away – preferring suggestions that come in simple, neat packages. Regrettably, the complexity of supplementing with Vitamin E encourages many to dismiss it. Dismissal is unfortunate for those who could really benefit (like those with chronic liver disease) – because – in this instance, Vitamin E is definitely worth the bother.
The Many Forms of Vitamin E
Vitamin E is a fat-soluble antioxidant that stops the production of reactive oxygen species (ROS). The result of cellular oxidation, ROS is a major contributor to most chronic diseases. Vitamin E is believed to prevent or delay chronic liver disease progression because it can infiltrate fatty tissue in the liver to exert its antioxidant properties.
Vitamin E is defined by chemists as eight naturally occurring forms which can be found in food; four tocopherols and four tocotrienols. The tocopherols are:
- d-alpha-tocopherol
- d-beta-tocopherol
- d-gamma-tocopherol
- d-delta-tocopherol
The four tocotrienols are:
- d-alpha-tocotrienol
- d-beta-tocotrienol
- d-gamma-tocotrienol
- d-delta-tocotrienol
Tocopherols
Although there are eight distinct forms (each with its own potential health benefits), d-alpha-tocopherol is the most common substance packaged as a Vitamin E supplement. Known to have the highest biological activity within the Vitamin E family, d-alpha-tocopherol is continually recycled by the liver – while the liver metabolizes and excretes the other Vitamin E forms. As such, blood and cellular concentrations of other forms of Vitamin E are lower and have been the subjects of less research.
The function of d-gamma-tocopherol in humans is not totally clear, with blood levels generally ten times lower than those of d-alpha-tocopherol. Very few studies have evaluated d-gamma-tocopherol in the body, but those that have suggest that it has the unique ability to scavenge reactive nitrogen species. Like ROS, reactive nitrogen species can also damage proteins, lipids and DNA. Most healthcare professionals suggest supplementing with a mixture of tocopherols – including both the alpha and gamma versions.
Tocotrienol
Most of the research involving Vitamin E has been conducted on tocopherols because of their abundance – both in the body and in nature. However, modern research is demonstrating tocotrienols to be particularly valuable to human health.
On a molecular level, tocopherols and tocotrienols differ because of their lipid-soluble tails. Tocopherol has a longer tail, enabling it to embed in cell membranes and be less mobile. On the other hand, tocotrienol has a shorter tail that increases its mobility in cell membranes. According to Dr. Barrie Tan, an international authority on the subject, tocotrienol’s increased mobility allows it to move faster and cover a larger area of the membrane. This speed helps tocotrienols hunt down free radicals across a large area. According to the work of University of California/Berkeley’s Dr. Lester Packer, tocotrienol is about 50 times more potent as an antioxidant than tocopherol.
Both tocotrienol and tocopherol are antioxidants, but tocotrienol also:
- Helps lowers cholesterol
- Helps maintain and reduce triglyceride levels
- Has anti-cancer properties
Tocotrienols are not as easy to isolate from Vitamin E-rich sources as tocopherols are. Consequently, the supportive science and availability of tocotrienols remains in its relative infancy.
With such potent health benefits of both tocotrienols and tocopherols, it is logical to seek a united Vitamin E supplement containing both of these forms. However, keen clinicians advise against this practice. This is because d-alpha-tocopherol interferes with tocotrienol’s benefits, virtually cancelling out the good intentions of taking these substances together.
Although not falling into the simplistic approach of relying on one supplement for your Vitamin E intake, experts in the field of antioxidant therapies recommend taking both supplements, separately. By taking tocopherols in the morning and tocotrienols in the evening, the body receives unparalleled oxidation-fighting power – giving their liver a true Vitamin E advantage.
http://lpi.oregonstate.edu/infocenter/vitamins/vitaminE/, Vitamin E, Retrieved October 16, 2011, Linus Pauling Institute, 2011.
http://naturalhealthperspective.com/supplements/vitaminestory.html, The Vitamin E Story, Retrieved October 16, 2011, John H. Gohde, 2011.
http://ods.od.nih.gov/factsheets/vitamine, Vitamin E, Retrieved October 16, 2011, US National Institutes of Health, 2011.
http://www.drpasswater.com/nutrition_library/tan_1.html, Health Benefits Beyond Vitamin E Activity: Solving the Tocotrienol Riddle - An Interview with Dr. Barrie Tan, Richard A. Passwater, PhD, Retrieved October 16, 2011, Whole Foods Magazine, 2008.
http://www.drweil.com/drw/u/ART02813/facts-about-vitamin-e, Facts About Vitamin E, Retrieved October 16, 2011, Weil Lifestyle LLC, 2011.
http://www.fujihealthscience.com/tocotrienol.html, About Tocotrienols, Retrieved October 16, 2011, Fuji Health Science, Inc., 2011.
http://www.vitamins-nutrition.org/vitamins/vitamin-e-form.html, What Form of Vitamin E is Best?, Dr. George Obikoya, Retrieved October 16, 2011, Seacra Enterprises, Inc., 2011.
About the Author
Nicole Cutler, L.Ac., MTCM is a long time advocate of integrating perspectives on health. With a Bachelor's degree in Neuroscience from the University of Rochester and a Master's degree in Traditional Chinese Medicine from Five Branches Institute, Nicole has been a licensed acupuncturist since 2000. She has gathered acupuncture licenses in the states of California and New York, is a certified specialist with the National Acupuncture Detoxification Association, has earned diplomat status with the National Commission of Chinese and Oriental Medicine in Acupuncture and Chinese Herbology and is a member of the Society for Integrative Oncology. In addition to her acupuncture practice that focuses on stress and pain relief, digestion, immunity and oncology, Nicole contributes to the integration of healthcare by writing articles for professional massage therapists and people living with liver disease.
Dear Nicole,
Thank you for this excellent article that provides important information to readers that vitamin E is more than alpha-tocopherol alone. When it comes to supporting our overall health, it is true that all vitamin E forms (tocopherols and tocotrienols) play important roles synergistically, just as nature intended.
Specifically for liver support, there have been in vitro and in vivo studies as well as several human clinical papers that showed the synergistic effect of alpha-tocopherol and tocotrienols in supporting liver health; and orally supplemented palm tocotrienol/tocopherol complex in a bioenhanced formulation improves liver health in non-alcoholic fatty liver disease, and end-stage liver disease patients.
Allow me to share the details:-
Japanese researchers have found through study of a rat model for steatohepatitis that supplementation of combined full spectrum d-mixed tocotrienols and alpha-tocopherol significantly reduce triglycerides accumulation in the liver; decreased level of lipid peroxides (TBARS); improved hepatic damage markers ALT and AST; as well as inhibiting liver fibrosis, compared to the standalone alpha-tocopherol group or standalone d-mixed tocotrienol group
The researchers concluded that tocotrienol and alpha-tocopherol exert a potent synergistic effect in improving NASH (J Clin Biochem Nutr. Mar 2013; 52(2): 146–153.“Effects of tocotrienol on tumor necrosis factor-alpha/D-galactosamine-induced steatohepatitis in ratsâ€).
Following are human clinical studies:-
1. J Nutr. 2012 Mar;142(3):513-9. “Oral Tocotrienols are Transported to Human Tissues and Delay the Progression of the Model for End-Stage Liver Disease Score in Patientsâ€
[Human clinical trial conducted at Ohio State University Wexner Medical Center]
Orally supplemented tocotrienols (Tocomin SupraBio® – bioenhanced and natural full spectrum palm tocotrienol/tocopherol complex) are well distributed to various tissues and vital organs and produced meaningful clinical benefits. In addition, a significant finding from this human clinical trial is that 50% of end stage liver disease patients given 12 weeks of oral supplementation of Tocomin SupraBio® at 400mg/day have reduced Model for End Stage Liver Disease (MELD) score, compared to just 20% for those on alpha-tocopherol alone (400mg/day).
2. “The Effect of Vitamin E (Mixed Tocotrienol) on the Liver Stiffness measurement Measured by Transient Elastography (FibroScan) among NAFLD Patientsâ€, presented at APASL Liver Week, Singapore, June 7th, 2013.
[Human study conducted at The Philippines]
Dr. Marilyn Arguillas shows that supplementation with Tocomin SupraBio® patented and bio-enhanced full spectrum palm tocotrienol/tocopherol complex at 100mg daily for 3 months significantly reduces liver stiffness in patients with NAFLD.
3. Nutr J. 2013 Dec 27;12(1):166. “Tocotrienols for normalisation of hepatic echogenic response in nonalcoholic fatty liver: a randomised placebo-controlled clinical trialâ€
[Human study conducted at University of Science, Malaysia]
This randomized, double blind, placebo controlled clinical study shows that oral supplementation with Tocomin SupraBio® patented and bio-enhanced full spectrum palm tocotrienol/tocopherol complex at 400mg daily for one year improves fatty liver in NAFLD patients.
A total of 64 subjects completed the study – 34 from control group and 30 from tocotrienols group. Liver ultrasound showed normalized echogenic response in 15 subjects out of 30 in the tocotrienols group (50%). In comparison, only 8 subjects out of 34 in the placebo group (23.5%) showed normalization. The normalization of hepatic echogenic response was significantly higher for the tocotrienols treated group compared to the placebo group.
As secondary objective, protocol assessment also showed significant rate of remission. Worsening of NAFLD grade was recorded in two patients in the placebo group, but none in the group treated with tocotrienols. No adverse events were reported for both groups.
As the above have shown, the liver protective actions of tocotrienol/tocopherol complex are supported by human studies. It is therefore, important to consider the vitamin E formula one is using to address liver health.
In your article, you highlighted that “d-alpha-tocopherol interferes with tocotrienol’s benefits, virtually cancelling out the good intentions of taking these substances together†– this is not substantiated and may be misleading. The scientific evidence provided above clearly showed presence of alpha-tocopherol does not affect tocotrienol’s benefit.
too much to go thru reading just to find the answer to the question . ugh. Not that I’m in a hurry or anything. 🙂