1. Antioxidant Protection:
   • Protects cell membranes from oxidative damage, reducing the risk of chronic diseases like heart disease and cancer (Harvard Medical School).
2. Skin Health:
   • Promotes skin healing, reduces UV damage, and may improve conditions like eczema (Mayo Clinic).
3. Immune Support:
   • Enhances immune cell function, particularly in the elderly (BNF).
4. Eye Health:
   • Reduces the risk of age-related macular degeneration (AMD) (Lange).
5. Neurological Health:
   • May slow cognitive decline in Alzheimer’s disease (Lippincott).

1. Oils:
   • Wheat germ oil, sunflower oil, safflower oil.
2. Nuts and Seeds:
   • Almonds, hazelnuts, sunflower seeds.
3. Vegetables:
   • Spinach, broccoli, and avocados.
4. Fortified Foods:
   • Cereals, fruit juices, and margarine.

Deficiency is rare but may occur in individuals with fat malabsorption disorders (e.g., cystic fibrosis, Crohn’s disease). Symptoms include:

• Neurological Issues: Peripheral neuropathy, ataxia, muscle weakness.
• Immune Dysfunction: Increased susceptibility to infections.
• Vision Problems: Retinopathy and impaired vision.
• Anemia: Due to oxidative damage to red blood cells (Mayo Clinic).

Risk Factors:

• Premature infants, cystic fibrosis, chronic liver disease, and genetic disorders (e.g., abetalipoproteinemia).

• Normal: 5.5–17 mg/L (Mayo Clinic).
• Deficiency: <4 mg/L.
• Toxicity: >40 mg/L (rare, from excessive supplementation).

1. Alpha-Tocopherol:
   • Most common and biologically active form.
   • OTC Tablets: 100 IU, 200 IU, 400 IU, 1000 IU.
2. Mixed Tocopherols:
   • Contains alpha, beta, gamma, and delta-tocopherols for broader antioxidant effects.
3. Capsules and Softgels:
   • Often combined with other fat-soluble vitamins (e.g., A, D, K).

1. Deficiency Treatment:
   • Corrects low levels in malabsorption disorders (BNF).
2. Skin Health:
   • Used topically or orally for wound healing and UV protection (Harvard Medical School).
3. Antioxidant Therapy:
   • Reduces oxidative stress in chronic diseases like diabetes and cardiovascular disease (Lange).
4. Neurological Conditions:
   • Investigated for Alzheimer’s and Parkinson’s diseases (Lippincott).
5. Eye Health:
   • Slows progression of age-related macular degeneration (AMD) (Mayo Clinic).

Daily Requirements (RDA):

• Adults: 15 mg/day (22.4 IU).
• Pregnancy/Lactation: 15–19 mg/day.

Deficiency Treatment:

• Adults: 60–75 mg/day (90–112.5 IU) orally or via injection (BNF).

Administration Tips:

• Take with meals to enhance absorption (fat-soluble vitamin).
• Avoid excessive doses (>1,000 mg/day) to prevent toxicity.

Vitamin E is generally safe but may cause:

• Mild: Nausea, diarrhea, headache.
• Severe (High Doses): Increased bleeding risk, hemorrhagic stroke, and impaired immune function (Lippincott).

• Bleeding Disorders: High doses increase bleeding risk.
• Surgery: Discontinue 2 weeks before surgery to reduce bleeding risk.
• Pregnancy: Safe in recommended doses; avoid high doses (BNF Category: A).
• Interactions with Medications: Monitor with anticoagulants and chemotherapy drugs.

1. Anticoagulants (e.g., warfarin):
   • Increases bleeding risk (Mayo Clinic).
2. Chemotherapy Drugs:
   • May reduce efficacy of certain agents (e.g., cyclophosphamide).
3. Statins:
   • High doses may reduce statin efficacy (Lange).
4. Vitamin K:
   • High vitamin E doses may impair vitamin K activity, increasing bleeding risk (Lippincott).

• Alpha-Tocopherol: Most common form.
• Mixed Tocopherols: Contains multiple forms of vitamin E.
• D-Alpha-Tocopherol: Natural form.
• DL-Alpha-Tocopherol: Synthetic form.