Vitamin E

Vitamin E is the name given to a family of eight related fat-soluble compounds. Alpha-tocopherol is the form the body holds and uses preferentially, and it is what most UK food values report. It is an antioxidant: it sits in the lipid layers of cell membranes and inactivates free radicals, the unstable molecules produced as a normal by-product of using oxygen for energy. Without enough vitamin E, cell membranes become more vulnerable to damage; red blood cell membranes are particularly sensitive.

Vitamin E also has a role in immune function and works with selenium and vitamin C as part of the body's antioxidant defence. The UK reference is set as a safe intake rather than a strict RNI, partly because vitamin E requirement is influenced by the polyunsaturated fat content of the diet (more PUFA, slightly more vitamin E needed) and individual needs vary.

Diet patterns: a diet that includes nuts, seeds, and plant oils tends to be sound on vitamin E without thinking about it. Diets that are very low in fat, or that rely on a narrow range of foods, can come up short.

Vitamin E is concentrated in fats and oils of plant origin and in nuts and seeds. Values per 100g come from USDA SR Legacy and McCance and Widdowson 7th edition; the site's food entries currently store macros only.

Practical: a daily small handful of mixed nuts and seeds covers the safe intake comfortably. A tablespoon of plant oil used in cooking adds more. For people on very low-fat diets, hitting the 4mg target needs a bit more attention.

Wheatgerm is one of the densest natural vitamin E sources by weight (about 15mg per 100g) and is sold in UK health-food shops; it is not currently in the site's food encyclopedia. A tablespoon over porridge is a useful contribution.

The UK position on vitamin E is a "safe intake" rather than a fixed RNI, set by SACN (1991 Dietary Reference Values). The values below are reproduced from NHS guidance.

SACN did not set a strict RNI for vitamin E because requirement varies with PUFA intake. The values above are the safe-intake figures the NHS reproduces for everyday guidance.

Vitamin E deficiency from dietary causes is rare in healthy UK adults. The condition does occur, but it is usually a consequence of fat malabsorption rather than dietary shortfall.

Signs of deficiency:

• Nerve and muscle problems: muscle weakness, loss of coordination, reduced reflexes
• Vision problems (retinopathy) in long-running deficiency
• Anaemia (red blood cells more fragile)
• Weakened immune response

Who is at higher risk in the UK

• People with cystic fibrosis and other conditions that impair fat digestion or absorption.
• People with cholestatic liver disease (impaired bile flow).
• People with rare inherited disorders of vitamin E metabolism: abetalipoproteinaemia, ataxia with vitamin E deficiency.
• People after some bariatric surgery.
• People on very low-fat diets over long periods, particularly if also low in nuts, seeds, and plant oils.

If symptoms or a known risk factor are present, a GP can arrange a blood test. Vitamin E status is rarely tested speculatively.

Vitamin E from food is not a realistic risk. The risk is from very high-dose supplements taken over years.

NHS supplement guidance: taking 540mg or less of vitamin E supplements a day is unlikely to cause harm.

High-dose vitamin E supplements (typically 300mg+ daily) can:

• Increase the risk of bleeding, particularly in people taking blood-thinning medicines such as warfarin or other anticoagulants. Speak to a GP before starting a high-dose vitamin E supplement if you are on these medicines.
• Cause nausea, tiredness, headache, or rash in some people at high doses.

The very high-dose vitamin E products sometimes promoted in popular wellness writing (often 400 to 800 IU) have not been shown to produce general health benefits in healthy adults and may cause harm at the highest end. Stick to a reasonable dose if supplementing at all.

Vitamin E supplementation is not routinely needed for healthy UK adults eating any mix of nuts, seeds, and plant oils.

When a supplement may be indicated (under medical advice):

• Cystic fibrosis or other fat-malabsorption conditions, as part of routine care.
• Confirmed deficiency on blood test.
• Rare inherited disorders of vitamin E metabolism.

If supplementing for any reason: choose a product with around 10 to 30mg per day; that level is well within the safe range and meets a generous proportion of needs. Stay below 540mg per day from supplements unless directed by a clinician.

If you take warfarin or other anticoagulants: speak to a GP before starting a vitamin E supplement, particularly at higher doses. Vitamin E can increase bleeding risk in this group.

• Vitamin E as a food antioxidant: E307 alpha-tocopherol is used to keep fats in food from going rancid.
• Fat-soluble vitamins together: Vitamin A, Vitamin D, Vitamin K.
• Best food sources: Sunflower oil, Olive oil, Peanuts, Avocado, Spinach.

• NHS. Vitamins and minerals: Vitamin E. nhs.uk/conditions/vitamins-and-minerals/vitamin-e. Adult safe intake, food sources, supplement upper.
• SACN. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Department of Health Report 41 (1991). Source of the safe-intake values.
• Public Health England. McCance and Widdowson's The Composition of Foods, 7th summary edition (2015).
• USDA Agricultural Research Service. FoodData Central, SR Legacy release. fdc.nal.usda.gov.

This page is reference information for UK shoppers. It is not medical advice. People on warfarin or other anticoagulants should discuss vitamin E supplements with a GP before starting.