Supplements › Vitamin

Vitamin E

A fat-soluble antioxidant from nuts, seeds and plant oils. Most studied for the heart, fatty liver disease and the eyes.

Strongest evidenceAntioxidantStrong, 296 studies
Median dose in studies200 mg a dayFrom 530 study groups
Daily need for adults15 mg a dayUS. In the EU, 13 mg for men and 11 mg for women.
Upper limit300 mg a dayEU, from all sources. The US limit for supplements is 1,000 mg.
Ask a doctor or pharmacist first

Ask a doctor or pharmacist first if you:

  • take a blood thinner such as warfarin, or a medicine against platelets such as aspirin: large doses of vitamin E can raise the risk of bleeding[1][2]
  • get chemotherapy or radiotherapy: cancer doctors often advise against antioxidant supplements during treatment[1]
  • take simvastatin with niacin: antioxidants that included vitamin E blunted the rise in HDL cholesterol from this treatment[1]
  • have heart disease or diabetes: in a large trial in these groups, 400 IU a day did not prevent heart attacks or strokes. It raised the risk of heart failure[3]
  • have a condition that makes it hard to absorb vitamin K: the EU upper limit does not apply to you[2]
  • are pregnant: in trials, vitamin E with other supplements did not prevent pre-eclampsia, preterm birth or stillbirth[4]

Overview

What is vitamin E?

Vitamin E is a fat-soluble vitamin and an antioxidant. The name covers 8 compounds: 4 tocopherols and 4 tocotrienols. Only one of them, alpha-tocopherol, meets human needs.[1]

The best food sources are nuts, seeds and plant oils, such as wheat germ oil, sunflower seeds and almonds.[1] Most supplements contain alpha-tocopherol, in its natural form (d-alpha-tocopherol) or its synthetic form (dl-alpha-tocopherol), often bound to acetate or succinate. Some also contain other tocopherols and tocotrienols.[1] By weight, the synthetic form is half as active as the natural form.[1]

What is vitamin E used for?

Vitamin E is most studied for the heart, the liver, the eyes and the brain. Large trials found that it does not prevent heart disease or cancer, and the US Preventive Services Task Force advises against it for that use.[5][6]

The best evidence for a benefit is in people who already have a disease of the liver or the eyes (organ function). In fatty liver disease, a 2024 Cochrane review of 16 trials found that vitamin E likely lowers the liver enzymes ALT and AST slightly.[7] In intermediate macular degeneration, the AREDS formula slowed progression to late disease. It combined vitamin E with vitamin C, beta-carotene and zinc.[8] Vitamin E alone did not prevent macular degeneration.[9]

For memory, a 2017 Cochrane review found no effect on thinking in people with mild cognitive impairment or Alzheimer's disease.[10] After exercise, a 2024 review of 20 trials in healthy people found no effect on muscle damage, soreness or strength.[11] An earlier 2022 review of 44 trials found lower levels of creatine kinase, a blood marker of muscle damage.[12] For period pain, 2 trials with 135 women found no effect.[13]

Is vitamin E safe?

Vitamin E from food is safe: no harm from large amounts in food has been found.[1] The risks come from high-dose supplements. The US upper limit for supplements is 1,000 mg a day for adults, and the EU limit from all sources is 300 mg a day. Both are set to avoid bleeding.[1][2]

A 2010 review of trials found 22% more hemorrhagic strokes, strokes caused by bleeding in the brain, with vitamin E.[14] A 2024 review found this only when vitamin E was taken with other antioxidants.[15] In healthy men, 400 IU a day raised the risk of prostate cancer by 17%.[16] Large doses can add to the effect of blood thinners.[1] In pregnancy, vitamin E with other supplements did not prevent pre-eclampsia, preterm birth or stillbirth.[4] People who take a blood thinner or other medicines every day should ask a doctor or pharmacist first.[1]

How it works

Vitamin E is the name of 8 fat-soluble compounds. Only one of them, alpha-tocopherol, meets human needs, and it is the form the body keeps.[1]

  1. Gut absorption

    The small intestine absorbs vitamin E, and it needs fat to do so.[1] In a trial with labelled vitamin E, healthy adults absorbed about 30% of a 15 mg dose, and adults with metabolic syndrome about 26%.[17] Many supplements contain an ester, such as tocopheryl acetate. The gut splits it and absorbs it as well as plain alpha-tocopherol.[1]

  2. Liver sorting

    All forms of vitamin E go to the liver. A liver protein, the alpha-tocopherol transfer protein, sends alpha-tocopherol back into the blood. The liver breaks down the other forms and removes them, so blood and cells have much less of them.[1]

  3. Antioxidant

    Vitamin E is an antioxidant that works in fats. It stops the production of reactive oxygen species, unstable molecules that form when fats react with oxygen and can damage cells.[1]

  4. Vessels and platelets

    In the cells that line blood vessels, vitamin E raises the release of prostacyclin. Prostacyclin widens blood vessels and makes platelets less likely to clump. Vitamin E also takes part in immune function.[1]

  5. Bleeding risk

    In large doses, vitamin E can slow platelet clumping and work against the clotting factors that need vitamin K. With a blood thinner, this can raise the risk of bleeding.[1]

Benefits and studies

Each row is one benefit. The square shows the grade and the number of studies. Open a row to see the most trusted studies.

StrongModerateWeakNo trials
BenefitMain effects in studiesStudiesPeople

Dose

Large trials gave 400 IU of vitamin E a day, or 400 to 600 IU every other day.[3][16][18][19] The US recommended amount for adults is 15 mg of alpha-tocopherol a day. The EU adequate intake is 13 mg for men and 11 mg for women.[1][20]

Usual dose

Heart and cancer trials gave 400 IU a day, or 400 to 600 IU every other day.[3][16][18][19] Trials in fatty liver disease gave 298 to 1,000 IU a day, and the largest US trial gave 800 IU.[7][21] In the AREDS eye trial, 400 IU of vitamin E was one part of a formula with vitamin C, beta-carotene, zinc and copper.[22] Trials of the immune system in older adults gave 200 IU a day, or 60 to 800 mg a day.[23][24]

Daily need

The US recommended amount is 15 mg a day from age 14, also in pregnancy, and 19 mg when breastfeeding. Children need 6 mg at 1 to 3 years, 7 mg at 4 to 8 years and 11 mg at 9 to 13 years.[1] The EU adequate intake is 13 mg for men and 11 mg for women, the same in pregnancy and when breastfeeding.[20] In the US, food gives people aged 2 and older an average of 9.8 mg a day for males and 8.5 mg for females.[1]

Form

Labels give vitamin E in mg or in IU. 1 IU of natural vitamin E (d-alpha-tocopherol) is 0.67 mg, and 1 IU of synthetic vitamin E (dl-alpha-tocopherol) is 0.45 mg. So 400 IU is 268 mg of the natural form or 180 mg of the synthetic form.[1] Most supplements with vitamin E alone give at least 67 mg, which is 100 IU of the natural form.[1]

When to take

With a meal that contains fat, because the gut needs fat to absorb vitamin E.[1] In a small study, a 400 IU capsule taken with a low-fat breakfast was poorly absorbed.[25]

How long

Trials in fatty liver disease lasted 2 to 24 months, and the 800 IU trial lasted 96 weeks.[7][21] Heart trials lasted about 7 to 10 years,[3][19] and AREDS lasted 6.3 years on average.[22]

Upper limit

The US upper limit is 1,000 mg a day of vitamin E from supplements for adults: 1,500 IU of the natural form or 1,100 IU of the synthetic form.[1] The EU upper limit is 300 mg a day from all sources, also in pregnancy.[2] Both limits are set to avoid bleeding.[1][2] The EU limit does not apply to people who take a blood thinner or aspirin. They should ask a doctor or pharmacist first.[2][1]

Doses in studies

Most studies gave 250 to 500 mg a day, for 1 to 3 months.

The counts are study groups. A study group is one set of people in a study who took the same dose. One study can have several groups. These are amounts from studies, not advice for you.

How much a day530 groups in 368 studies
  1. Up to 5 mg18 groups
  2. 5 to 10 mg13 groups
  3. 10 to 25 mg31 groups
  4. 25 to 50 mg90 groups
  5. 50 to 100 mg52 groups
  6. 100 to 250 mg92 groups
  7. 250 to 500 mg129 groups
  8. 500 to 1,000 mg83 groups
  9. 1,000 mg or more22 groups
For how long854 groups in 604 studies
  1. 1 week or less58 groups
  2. 1 to 4 weeks122 groups
  3. 1 to 3 months357 groups
  4. 3 to 6 months113 groups
  5. 6 to 12 months57 groups
  6. More than a year147 groups
Half of the groups took less than 200 mg a day. Half took more.Half of the groups took 50 to 400 mg a day. A quarter took less, a quarter took more.105 of 530 groups took 500 mg a day or more. Do not copy a study dose without a doctor.

Taken together

441 of 902 study groups took vitamin E with something else. This shows what studies gave together, not what works together.

  1. Vitamin C211 studies269
  2. Beta-Carotene90 studies114
  3. Selenium53 studies56
  4. Zinc49 studies56
  5. Omega-3 Fatty Acids36 studies37
  6. Vitamin A26 studies29
  7. Folic Acid16 studies22
  8. Copper12 studies16
  9. Iron12 studies16
  10. Vitamin B1212 studies16
Bars and numbers count study groups. A companion is shown only when at least 3 different studies gave it.

Questions

12 questions in 4 groups. Open one for the short answer; each has its own page with the full answer and sources.

Basics
Which foods contain vitamin E?

Nuts, seeds and plant oils are the best sources.[1] One tablespoon of wheat germ oil has 20.3 mg, more than the adult daily need of 15 mg. One ounce (about 28 g) of sunflower seeds has 7.4 mg, and the same amount of almonds 6.8 mg. One tablespoon of sunflower oil has 5.6 mg.[1]

Green leafy vegetables and fortified cereals also add some: half a cup of boiled spinach has 1.9 mg.[1] Most vitamin E in US diets is gamma-tocopherol from soybean, canola and corn oil. The body keeps much less of this form than of alpha-tocopherol.[1]

Open the answer with sources ›
Who is at risk of vitamin E deficiency?

Deficiency is rare. It has not been found in healthy people who eat little vitamin E.[1] It occurs mainly in:

  • preterm babies with a very low birth weight, under 1,500 g[1]
  • people who absorb fat poorly, for example with Crohn's disease or cystic fibrosis[1]
  • people with rare inherited diseases, such as abetalipoproteinemia or ataxia with vitamin E deficiency (AVED)[1]

Signs include anemia, nerve damage in the arms and legs, poor balance, muscle weakness, damage to the retina and a weaker immune response.[1] A blood level of alpha-tocopherol under 12 µmol/L is the usual cut-off for deficiency.[1]

Open the answer with sources ›
Benefits
Does vitamin E prevent heart disease?

No. Reviews of large trials found that vitamin E supplements do not lower the number of heart and blood vessel events or deaths.[5][26] The US Preventive Services Task Force recommends against vitamin E to prevent heart disease or cancer.[6] A 2010 review of trials also found more hemorrhagic strokes, strokes caused by bleeding in the brain, with vitamin E.[14]

Read the full answer ›
Does vitamin E help fatty liver disease?

In trials, vitamin E lowered liver enzymes in people with fatty liver disease, and in two trials it improved liver biopsies.[21][27] A 2024 Cochrane review of 16 trials found that it likely lowers the enzyme ALT slightly, by about 9 U/L. Whether this changes the course of the disease is unknown.[7] The trials gave 298 to 1,000 IU a day.[7]

Read the full answer ›
Does vitamin E help with macular degeneration?

Not on its own. A Cochrane review of 4 trials with 55,614 people found that vitamin E does not prevent age-related macular degeneration (AMD).[9] In people who already have AMD, the AREDS formula slowed progression to late AMD. It combined 400 IU of vitamin E with 500 mg of vitamin C, 15 mg of beta-carotene, 80 mg of zinc and 2 mg of copper.[22] A 2023 Cochrane review rated this effect as moderate certainty: about 78 fewer cases of late AMD for every 1,000 people with intermediate AMD.[8]

Beta-carotene in the formula raised the risk of lung cancer, mostly in former smokers.[8] The AREDS formula did not affect cataracts.[1]

Open the answer with sources ›
Does vitamin E help with memory and dementia?

Not for thinking and memory. A 2017 Cochrane review found that vitamin E did not improve thinking in people with Alzheimer's disease. In 516 people with mild cognitive impairment, it did not lower the chance of dementia over 36 months.[10] One trial found that it may slow the loss of daily skills in Alzheimer's disease.[10]

An earlier trial included 341 people with moderate Alzheimer's disease. For 2 years, one group took 2,000 IU of vitamin E a day, and the others took the medicine selegiline, both, or a placebo. Without adjustment, the groups did not differ. After the authors adjusted for differences at the start, people on vitamin E reached the main outcome later: a median of 670 days against 440 days with placebo. The main outcome was death, a move to a care home, loss of basic daily skills or severe dementia.[28] People who took vitamin E in that trial fell more often.[1] A trial in mostly healthy older women found no benefit for thinking.[1]

Open the answer with sources ›
Does vitamin E help the immune system?

In older adults, single trials found some effects on the immune system. In 88 healthy people aged 65 or older, 200 mg a day for 235 days raised a skin test of immune response by 65%, against 17% with placebo. It also raised the antibody response to a hepatitis B vaccine 6-fold, against 3-fold with placebo.[24] In 617 nursing home residents, 200 IU a day for 1 year did not change the number of respiratory infections. Fewer people caught at least one upper respiratory infection: 44% against 52%.[23]

These are single trials in older people. In the first trial, 800 mg a day raised the skin test by 49%, less than 200 mg did.[24]

Open the answer with sources ›
Does vitamin E oil help scars?

The evidence is weak. A 2016 review found 6 prospective studies of vitamin E put on the skin for scars. Three found that scars looked better: one used vitamin E alone in children, and two used it with other treatments in adults. The other three found no effect of vitamin E alone.[29] Two studies reported skin reactions: contact dermatitis, itching and rash.[29] The authors concluded that the evidence is not enough to support its wide use.[29]

Open the answer with sources ›
Safety
Can high doses of vitamin E be harmful?

Yes. High-dose supplements can raise the risk of bleeding, especially with blood thinners.[1] A 2010 review of trials found 22% more hemorrhagic strokes with vitamin E,[14] and in one trial 400 IU a day raised the risk of prostate cancer by 17%.[16] Reviews disagree on whether high doses raise the risk of death.[30][31]

Read the full answer ›
Can you take vitamin E with blood thinners?

Ask a doctor or pharmacist first. Vitamin E can slow platelet clumping and work against the clotting factors that need vitamin K. With warfarin or a medicine against platelets, large doses can raise the risk of bleeding, especially when vitamin K intake is low.[1] The amount that matters is not known, but it is probably more than 400 IU a day.[1]

The EU upper limit of 300 mg a day does not apply to people who take blood thinners or medicines against platelets such as aspirin.[2] In the Physicians' Health Study II, where most men also took aspirin, vitamin E raised the risk of hemorrhagic stroke.[1]

Open the answer with sources ›
Forms and timing
Is natural vitamin E better than synthetic?

Gram for gram, yes: natural vitamin E is about twice as active. Natural vitamin E (d-alpha-tocopherol) is one compound. Synthetic vitamin E (dl-alpha-tocopherol) is a mix of 8 forms, and the body keeps only 4 of them.[1] A dose in IU already counts this difference: 400 IU is 268 mg of the natural form or 180 mg of the synthetic form.[1]

Read the full answer ›
Should vitamin E be taken with food?

Yes, with a meal that contains some fat. The gut needs fat to absorb vitamin E.[1] In a small study of 5 people, a 400 IU capsule taken with a low-fat breakfast was poorly absorbed. The same dose added to a breakfast cereal gave 26 times as much vitamin E in the blood.[25]

How much fat is needed is less clear. In a trial of 20 adults, 15 mg of vitamin E taken with milk containing 0.2 to 7.9 g of fat was absorbed equally well. Healthy adults absorbed about 30% of the dose, and adults with metabolic syndrome about 26%.[17]

Open the answer with sources ›

References

  1. Vitamin E: Fact Sheet for Health Professionals. NIH Office of Dietary Supplements. ods.od.nih.gov
  2. Scientific opinion on the tolerable upper intake level for vitamin E. European Food Safety Authority (EFSA), 2024. efsa.onlinelibrary.wiley.com
  3. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. Lonn E, Bosch J, Yusuf S, Sheridan P, Pogue J, Arnold JM, et al. JAMA, 2005. PMID 15769967
  4. Vitamin E supplementation in pregnancy. Rumbold A, Ota E, Hori H, Miyazaki C, Crowther CA Cochrane Database Syst Rev, 2015. PMID 26343254
  5. Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. O'Connor EA, Evans CV, Ivlev I, Rushkin MC, Thomas RG, Martin A, et al. JAMA, 2022. PMID 35727272
  6. Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement. Mangione CM, Barry MJ, Nicholson WK, Cabana M, Chelmow D, Coker TR, et al. JAMA, 2022. PMID 35727271

Review history

  1. 10 Nov 2026CheckedReviewerChecked every claim against its source.
  2. 10 Nov 2026Page createdResearcherFirst edition, written from PubMed and public health sources.