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Vitamin E, Tocopherol, Alpha-Tocopherol


Tocopherol

Chemistry
natural forms include alpha, beta, gamma and delta tocopherol
DL-alpha tocopherol is the synthetic form

Metabolism
vitamin E requires the presence of bile for absorption
vitamin E is stored in the pituitary and aderenal glands
there is no correlation between serum levels and vitamin E stores

Functions
antioxidant, anti-fibrotic
protects cell membranes, fatty acids, nerves and muscle
anti-inflammatory - inhibits lypoxygenase (leukotriene synthesis)
anti-platelet effects - increases prostaglandin I2 production
increases HDL, decreases vascular fragility

Requirements
RDA - 15 iu qd, Optimal 600 iu
requirement proportional to intake of essential fatty acids

Sources
wheat germ oil, sunflower seeds

Toxicity
1800 iu qd can cause prolonged blood clotting time
nausea, flatulence, and diarrea may occur
may cause flushing when used in excess (2000 to 4000 mg rather than 5-20 mg)


Drug Interactions
AZT - vitamin E may decrease bone marrow toxicity
Coumadin - use caution (controversial)
Phenothiazine - large doses may reduce tardive dyskinesia

Interactions
iron binds with vitamin E and inactivates it
vitamin E is synergistic with selenium
vitamin A prevents oxidation of vitamin E
large doses of vitamin E may inhibit absorption of vitamin K

Deficiency
Deficiency is rare in humans
deficiency causes:
degeneration of the posterior columns of the spinal cord
selective loss of large-caliber, myelinated axons in peripheral nerves
appearance of spheroids in the gracile and cuneate nuclei of the brain.
EENT
cataracts, paresis of gaze
Respiratory
cystic fibrosis
Musculoskeletal
areflexia, gait disturbance
Osgood-Schlatter disease
Neurology
decreased proprioceptive and vibratory sensation
Dermatology
dry skin, eczema, psoriasis
Hematology
easy bruising, decreased clotting time
anemia, sickle cell anemia, beta thalassemia
Gynecology
PMS, hot flashes, fibrocystic disease
Andrology
BPH


Therapeutics

Cardiology
atherosclerosis - anti-platelet effects, increases HDL

Vascular
Raynaud's syndrome

Respiratory
cystic fibrosis - anti-fibrotic

Gynecology
dysmenorrhea, menopause, PMS
fibrocystic breast disease

Musculoskeletal
nocturnal cramping, restless leg syndrome
intermittent claudication - decreases vascular fragility
Osgood-Schlatter's disease - vit E and selenium work well
osteoarthritis

Neurology
muscular dystrophy - protects nerves and muscle

Immunology
scleroderma

Dermatology
herpetic lesions, psoriasis, allergies, inflammatory thrombophlebitis

Hematology
anemia

Obstetrics
SIDS, premature infants, Down's syndrome, spontaneous abortions

 

 

 

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