Vitamin E

Vitamin E is a vitamin that liquifies in fat. It is found in numerous foods including veggie oils, cereals, meat, poultry, eggs, and fruits.

Vitamin E is an important vitamin required for the correct function of numerous organs in the body. It is likewise an antioxidant. Vitamin E that takes place naturally in foods (rrr-alpha-tocopherol) is different from man-made vitamin E that is in supplements (all-rac-alpha-tocopherol).

Vitamin E is utilized for dealing with vitamin E shortage, which is uncommon, but can take place in individuals with specific congenital diseases and in very low-weight premature infants. Vitamin E is likewise used for many other conditions, but there is no good scientific proof to support a number of these other uses. (2 ).

History

Vitamin E (α-tocopherol) was found nearly 100 years earlier because it was required to prevent fetal resorption in pregnant, vitamin E-deficient rats fed lard-containing diets that were quickly oxidizable. The human diet consists of 8 various vitamin E-related molecules synthesized by plants; despite the fact that all of these particles are peroxyl extreme scavengers, the body chooses α-tocopherol. The biological activity of vitamin E is extremely reliant upon regulatory systems that serve to maintain α-tocopherol and excrete the non-α-tocopherol kinds. This preference depends on the mix of the function of α-tocopherol transfer protein (α-ttp) to improve the plasma with α-tocopherol and the metabolism of non-α-tocopherols. Α-ttp is important for human health due to the fact that mutations in this protein result in extreme vitamin E deficiency defined by neurologic problems, particularly ataxia and eventually death if vitamin E is not provided in big quantities to conquer the lack of α-ttp. Α-tocopherol acts as a peroxyl radical scavenger that secures polyunsaturated fatty acids in membranes and lipoproteins. Although particular paths and particular molecular targets have been sought in a variety of research studies, the most likely explanation as to why human beings require vitamin E is that it is a fat-soluble anti-oxidant. (3 ).

Synthesis

Biosynthesis

Photosynthesizing plants, algae and cyanobacteria manufacture tocochromanols, the chemical family of compounds made up of four tocopherols and four tocotrienols; in a nutrition context this family is referred to as vitamin E. Biosynthesis starts with development of the closed-ring part of the molecule as homogentisic acid (hga). The side chain is attached (filled for tocopherols, polyunsaturated for tocotrienols). The path for both is the same, so that gamma- is created and from that alpha-, or delta- is created and from that the beta- compounds. Biosynthesis happens in the plastids.

As to why plants synthesize tocochromanols, the major reason appears to be for antioxidant activity. Different parts of plants, and different types, are controlled by different tocochromanols. The predominant kind in leaves, and thus leafy green vegetables is α-tocopherol. Place is in chloroplast membranes, in close proximity to the photosynthetic procedure. The function is to safeguard versus damage from the ultraviolet radiation of sunshine. Under regular growing conditions the presence of α-tocopherol does not appear to be important, as there are other photo-protective compounds, and plants that through mutations have actually lost the ability to synthesize α-tocopherol demonstrate regular development. However, under stressed out growing conditions such as drought, elevated temperature or salt-induced oxidative stress, the plants’ physiological status is superior if it has the typical synthesis capacity.

Seeds are lipid-rich, to offer energy for germination and early growth. Tocochromanols secure the seed lipids from oxidizing and becoming rancid. The presence of tocochromanols extends seed durability, and promotes effective germination and seedling growth. Gamma-tocopherol dominates in seeds of many plant species, but there are exceptions. For canola, corn and soy bean oils, there is more γ-tocopherol than α-tocopherol, but for safflower, sunflower and olive oils the reverse holds true. Of the typically utilized food oils, palm oil is unique in that tocotrienol content is higher than tocopherol material. Seed tocochromanols material is likewise depending on ecological stressors. In almonds, for example, drought or elevated temperature boost α-tocopherol and γ-tocopherol content of the nuts. The exact same article discusses that dry spell increases the tocopherol material of olives, and heat also for soybeans.

Industrial synthesis

Naturally sourced d-alpha-tocopherol can be drawn out and cleansed from seed oils, or gamma-tocopherol can be drawn out, cleansed, and methylated to produce d-alpha-tocopherol. In contrast to alpha-tocopherol extracted from plants, which is likewise called d-alpha-tocopherol, industrial synthesis creates dl-alpha-tocopherol. “it is synthesized from a mix of toluene and 2,3,5-trimethyl-hydroquinone that reacts with isophytol to all-rac-alpha-tocopherol, utilizing iron in the presence of hydrogen chloride gas as catalyst. The response mixture obtained is filtered and extracted with aqueous caustic soda. Toluene is gotten rid of by evaporation and the residue (all rac-alpha-tocopherol) is purified by vacuum distillation.” requirements for the component is >> 97% pure. This artificial dl-alpha-tocopherol has approximately 50% of the strength of d-alpha-tocopherol. Manufacturers of dietary supplements and strengthened foods for people or domesticated animals transform the phenol type of the vitamin to an ester utilizing either acetic acid or succinic acid due to the fact that the esters are more chemically steady, providing for a longer shelf-life. The ester kinds are de-esterified in the gut and absorbed as free alpha-tocopherol. (4 ).

Function

Vitamin E has the following functions:.

1. It is an anti-oxidant. This means it secures body tissue from damage brought on by substances called complimentary radicals. Free radicals can harm cells, tissues, and organs. They are thought to contribute in certain conditions associated with aging.
2. It helps keep the body immune system strong versus viruses and bacteria.
3. It assists form red blood cells and broaden blood vessels to keep blood from clotting inside them.
4. It assists the body usage vitamin k.
5. Cells likewise use vitamin E to connect with each other. It helps them perform numerous crucial functions.

Whether vitamin E can avoid cancer, cardiovascular disease, dementia, liver disease, and stroke still requires additional research study. (5 ).

Food sources

Vitamin E is found in plant-based oils, nuts, seeds, fruits, and veggies.

• Wheat germ oil
• Sunflower, safflower, and soybean oil
• Sunflower seeds
• Almonds
• Peanuts, peanut butter
• Beet greens, collard greens, spinach
• Pumpkin
• Red bell pepper
• Asparagus
• Mango
• Avocado (6 )

System of action

The mechanism of action for most of vitamin E’s results are still unknown. Vitamin E is an antioxidant, avoiding totally free extreme reactions with cell membranes. Though sometimes vitamin E has actually been shown to have pro-oxidant activity.

One system of vitamin E’s antioxidant effect remains in the termination of lipid peroxidation. Vitamin E responds with unstable lipid radicals, producing stable lipids and a reasonably stable vitamin E radical. The vitamin E radical is then lowered back to stable vitamin E by response with ascorbate or glutathione. (7 ).

Advantages of vitamin E

Though vitamin E is often considered a single compound, it’s actually a group of 8 fat-soluble substances with powerful antioxidant results.

Of these 8 chemical forms, alpha-tocopherol finest satisfies the dietary requirements of human beings.

Vitamin E exists naturally in particular foods, consisting of seeds, nuts, some veggies, and some fortified items. You can also take it as a dietary supplement.

It plays numerous functions in your body. It’s possibly best understood for its antioxidant results, securing your cells from oxidative damage by reducing the effects of hazardous particles called complimentary radicals. In addition, it’s needed for appropriate immune function and cellular signaling.

That’s why it’s not unexpected that research suggests taking vitamin E supplements might benefit your health in a number of methods.

This short article covers 8 possible advantages of vitamin E.

May decrease markers of oxidative tension and enhance antioxidant defenses

Oxidative tension is a condition that occurs when there’s an imbalance between your body’s antioxidant defenses and the production and build-up of compounds called reactive oxygen species (ros). This can cause cellular damage and increased illness risk.

Due to the fact that vitamin E acts as a powerful anti-oxidant in the body, research studies have revealed that supplementing with high dosages of it can lower markers of oxidative tension and increase antioxidant defenses in some populations.

For example, a 2018 research study in 54 people with diabetic nephropathy– kidney damage caused by high blood glucose– discovered that supplementing with 800 iu of vitamin E per day for 12 weeks considerably increased levels of glutathione peroxidase (gpx) compared to a placebo.

Gpx is a group of antioxidant enzymes that safeguard your cells from oxidative damage.

A 2021 research study also revealed that supplementing with a mix of vitamin E and vitamin c daily for 8 weeks minimized markers of oxidative tension, such as malondialdehyde and ros, in females with endometriosis.

May lower heart problem danger aspects

Having high blood pressure and high levels of blood lipids such as ldl (bad) cholesterol and triglycerides might increase your risk of developing heart problem.

Promisingly, research recommends that vitamin E supplements might help reduce heart disease danger factors such as these in some individuals.

A 2019 review of 18 research studies discovered that, compared with placebo treatments, vitamin E supplements considerably lowered systolic however not diastolic blood pressure– the top and bottom varieties of high blood pressure readings, respectively.

Some studies likewise show that taking vitamin E with omega-3 supplements might minimize ldl and triglyceride levels in individuals with metabolic syndrome– a cluster of conditions, consisting of high blood fat levels, that increases the threat of heart problem and other health conditions.

May benefit those with nonalcoholic fatty liver illness (nafld)

Nafld consists of a number of conditions that cause a build-up of fat in the liver in people who consume little or no alcohol.

According to research findings, vitamin E supplements might improve some elements of health in people with nafld.

A 2021 review of eight studies discovered that supplementing with vitamin E minimized levels of the liver enzymes alanine aminotransferase (alt) and aspartate aminotransferase (ast), decreased blood lipid levels, and improved liver health in people with nafld.

Raised ast and alt levels can suggest liver inflammation and damage in individuals with nafld, so lower levels are favorable.

May help manage dysmenorrhea

Dysmenorrhea is a condition identified by severe and frequent menstrual discomfort, such as cramps and pelvic pain.

Promisingly, research study suggests vitamin E supplements might minimize discomfort in females with this condition.

In a 2018 study in 100 ladies with dysmenorrhea, taking 200 iu of vitamin E everyday relieved menstrual pain more than a placebo. The results were even better when the vitamin was combined with an omega-3 supplement including 180 mg of epa and 120 mg of dha.

Additionally, a 2021 research study showed that supplementing with a combination of vitamin E and vitamin c daily for 8 weeks helped reduce the seriousness of pelvic discomfort and dysmenorrhea in ladies with endometriosis.

Other possible health benefits

Vitamin E supplements have actually also been connected to several other health advantages:.

May benefit skin health. Vitamin E supplements might be helpful for those with certain skin conditions, such as eczema. However, research is currently restricted, and more studies are required to learn more about this potential benefit.

May benefit cognitive health. Maintaining optimum vitamin E levels and taking supplements might help protect versus cognitive decline. But it’s still uncertain whether the supplements benefit people with cognitive conditions like alzheimer’s disease.

May benefit older grownups. Since vitamin E plays important functions in health, such as lowering inflammation and improving immune function, supplements may benefit individuals who have actually increased needs or don’t get enough in their diets, such as some older adults.

May enhance lung function. Research studies have revealed that vitamin E supplements could improve lung function and particular signs of asthma in kids and grownups. (8 ).

Function of vitamin E in pregnancy

Vitamins play essential roles in female health. They are necessary for many functions, consisting of menstruation and ovulation, oocyte (egg) quality and maturation. Vitamin E was first discovered in 1922 as a substance necessary for recreation. It has actually become extensively called a powerful lipid-soluble anti-oxidant. There are various reports on the benefits of vitamin E on health in general. Vitamin E helps your body produce and keep red cell, healthy skin, eyes and enhances your natural immune system. However, despite it being initially found as a vitamin required for reproduction, to date studies connecting to its impacts in this area are lacking. Vitamin E supplementation may help in reducing the threat of pregnancy issues involving oxidative stress, such as pre-eclampsia. This chapter is written to offer a review of the known functions of vitamin E in pregnancy. (9 ).

Skin health advantages of vitamin E for males

While it may be unusual for males to have a vitamin E shortage, this hasn’t stopped many of them from scooping up skin care products containing it (including our effective firming serum). Here is why a growing variety of guys are including vitamin E into their day-to-day skin care routine.

Anti-aging

Are you starting to show indications of crow’s feet? Vitamin E secures skin cells from complimentary radicals, which helps slow down indications of aging. This holds true whether you take in foods abundant in vitamin E or use it topically.

In fact, vitamin E is typically used in sunscreens and everyday moisturizers for males due to its photoprotective properties. Research reveals that alpha-tocopherol, the primary naturally occurring isomer in vitamin E, can potentially avoid dna cell damage from uv rays (see claim: “topical application of alpha-tocopherol (alphath), the most popular naturally happening type of vitamin E, prevents ultraviolet (uv) b-induced photocarcinogenesis and dna photodamage in c3h mice in vivo”.).

Wound healing

There has been a significant quantity of anecdotal evidence that vitamin E can speed up injury recovery and possibly lower acne scars. While there isn’t much in the method of medical proof on vitamin E’s role in injury recovery, research does recommend that keeping skin hydrated is essential to lowering the look of scars (see claim: “the discovery that a damp environment actively supports the healing reaction when compared with a dry environment highlights the importance of water and excellent hydration levels for optimal recovery.”).

Male who slather on cream including vitamin E may be seeing a reduction in scarring simply because they are hydrating their skin routinely. Using a day-to-day men’s moisturizer can help you attain similar skin care benefits by raveling flaws and safeguarding your face from sun damage.

Battles acne

Male tend to have oilier skin compared to women, which can cause extreme acne breakouts. If you’re wondering whether vitamin E can assist you control your breakouts, the answer is perhaps.

There are some research studies which recommend that a diet plan rich in vitamin E (in addition to vitamin a and zinc) can help reduce acne symptoms. Nevertheless, studies on how vitamin E can benefit acne victims are restricted and undetermined.

With research studies being so restricted, vitamin E isn’t advised as a standalone service to acne. Instead, men are much better off utilizing an acne treatment system developed for their skin. (10 ).

What can vitamin E do for hair?

Vitamin E has natural antioxidant impacts that might help to keep hair development.

People have claimed that vitamin E provides numerous benefits for hair health, however a number of these claims do not have extensive scientific evidence to back them up.

The majority of the claims about vitamin E’s role in hair health relate to its antioxidant residential or commercial properties. These focus on the idea that it can minimize cell damage and enhance hair development.

We examine a few of the most common claims listed below.

Could help support a healthy scalp

Vitamin E may help support a healthy scalp and hair as it has natural antioxidant impacts that might assist with preserving hair development.

The vitamin’s antioxidant residential or commercial properties might help in reducing the quantity of oxidative stress and complimentary radicals that trigger the hair roots cells in a person’s scalp to break down.

Help avoid hair loss

There is some restricted proof to support the claim that vitamin E can help avoid loss of hair.

A little research study using a total of 38 volunteers experiencing loss of hair examined the function that vitamin E played in preventing this loss. The study found that a person of the elements of vitamin E did enhance the hair growth of the volunteers compared with a placebo.

More research is still necessary to identify how vitamin E impacts loss of hair.

Increased shine

According to some people, vitamin E can help renew shine that the hair loses as a result of damage. Chemicals, heat, and other styling products can all harm the hair.

A person can restore shine using oils, which offer an additional layer of security to the skin and hair. Many manufacturers will add vitamin E to their items to assist bring back shine.

There is restricted research study on how reliable vitamin E is at making the hair shinier again. (11 )

Eye benefits of vitamin

Almonds and other nuts are excellent sources of natural vitamin E.

Research recommends vitamin E may help reduce the worsening of age-related macular degeneration (amd) amongst individuals who reveal early indications of the eye illness.

In the age-related eye disease research study (areds) including nearly 5,000 people, participants with early amd had a 25 percent lower risk of establishing advanced phases of the disease when taking a daily dietary supplement containing vitamin E. The areds supplement consisted of 400 worldwide systems (iu) of vitamin E, along with high levels of vitamin a (as beta-carotene), vitamin c and zinc.

Based upon areds and other nutritional research studies, numerous optometrist recommend that their clients supplement their diet with a day-to-day multivitamin which contains up to 400 iu of vitamin E in mix with other anti-oxidants as part of their preventative eye care.

Some research studies suggest vitamin E likewise might play a role in avoiding cataracts:.

In a big, long-lasting study of more than 3,000 grownups (ages 43 to 86) in wisconsin, five-year threat for cataracts was 60 percent lower among people who reported utilizing multivitamins or any supplement containing vitamin E or vitamin c for more than ten years, compared with nonusers.

In a 2008 research study that assessed the dietary intake of more than 35,000 female health specialists, women whose diet plans (including supplements) had the highest levels of lutein and vitamin E had a lower relative threat of cataracts than females whose diets remained in the lowest 20 percent for levels of these nutrients.

However, a recent research study of obviously healthy older guys in the united states stopped working to reveal any benefit of vitamin E supplements in the prevention of cataracts.

More than 11,000 males ages 50 and older (african-american participants) or 55 and older (all other participants) took a day-to-day vitamin E supplement (400 iu of dl-alpha-tocopherol) or a placebo tablet for roughly 5 and a half years. At the end of the research study duration, there was no substantial distinction in the number of cataract diagnoses or cataract surgical treatments carried out among individuals of the two groups.

It appears more research study is needed to totally understand the potential eye advantages of vitamin E– particularly in regards to whether vitamin E supplements can lower the danger of cataracts. (12 ).

Vitamin E shortage

Vitamin E shortage caused by a diet plan low in vitamin E is common in establishing nations. In industrialized countries, the cause is usually an absorption disorder. Some babies are born with vitamin E deficiency, which generally enhances with supplements.

• Vitamin E deficiency may trigger impaired reflexes and coordination, difficulty walking, and weak muscles.
• Premature infants with the deficiency may develop a serious kind of anemia.
• The diagnosis is based upon symptoms and outcomes of a physical exam.
• Taking vitamin E supplements corrects the deficiency.

Vitamin E (tocopherol) is an antioxidant: it safeguards cells against damage by totally free radicals, which are by-products of normal cell activity and which take part in chemical reactions within cells. Some of these responses can be damaging.

Vitamin E, like vitamins a, d, and k, is a fat-soluble vitamin, which dissolves in fat and is finest absorbed when consumed with some fat. Great sources of vitamin E include veggie oils, nuts, seeds, green leafy vegetables, and wheat bacterium.

Babies have a reasonably low reserve of vitamin E since only percentages of vitamin E cross the placenta. Therefore, babies, particularly early babies, are at increased threat of vitamin E deficiency. Nevertheless, with age, risk decreases since babies typically get enough vitamin E in breast milk or in business formulas. Adults can keep big amounts of vitamin E in fat tissue, making the shortage less most likely.

Causes of vitamin E shortage

A very low fat diet does not have vitamin E, due to the fact that vegetable oils are the primary source of this vitamin and because vitamin E is best absorbed when consumed with some fat. Disorders that hinder fat absorption (such as certain liver disorders, gallbladder conditions, pancreatitis, and cystic fibrosis) can also minimize the absorption of vitamin E and increase the threat of vitamin E shortage.

In the united states and other industrialized nations, vitamin E deficiency is rare amongst older kids and adults and is typically due to.

• A condition that impairs fat absorption (malabsorption disorder)
• In establishing nations, the most common cause of vitamin E shortage is
• Inadequate intake of vitamin E

Signs of vitamin E deficiency

In children, signs may include slow reflexes, difficulty strolling, loss of coordination, loss of position sense (understanding where the limbs are without taking a look at them), and muscle weakness.

In grownups with vitamin E shortage due to a malabsorption condition, these symptoms seldom establish due to the fact that adults keep large amounts of vitamin E in fat (adipose) tissue.

Vitamin E deficiency can trigger a kind of anemia in which red cell rupture (hemolytic anemia). Premature infants who have a vitamin E deficiency are at risk of this serious disorder.

In premature infants, bleeding (hemorrhage) may occur within the brain, and capillary in the eyes might grow unusually (a condition called retinopathy of prematurity). Impacted newborns also have weak muscles. (13 ).

Vitamin E side effects

Get emergency situation medical help if you have any of these indications of an allergic reaction to vitamin E: hives; tough breathing; swelling of your face, lips, tongue, or throat.

Stop taking vitamin E and call your physician simultaneously if you have:.

• Headache, lightheadedness, vision modifications;
• A light-headed sensation, like you might pass out;
• Uncommon weakness or exhausted sensation;
• Diarrhea, stomach cramps; or
• Easy bruising or bleeding (nosebleeds, bleeding gums).

Typical vitamin E adverse effects might include:.

• Queasiness;
• Worn out sensation
• Headache; or
• Moderate rash. (14 )

Dose and preparation

The suggested dietary allowance (rda) for vitamin E is 15 mg. The majority of vitamin E supplements provide around 67 mg of the nutrient, which is much greater than the rda. Those requiring a vitamin E supplement likely have an identified vitamin E deficiency, which is far more appropriate for the 60 to 75 mg each day dosage offered in a supplement. Big dose vitamin E supplements ought to be approached with caution and talked about with your physician ahead of time.

Vitamin E supplements are offered in 2 forms: artificial and natural. The natural type of vitamin E is alpha-tocopherol while the synthetic form is di-alpha-tocopherol. Both work well, however, a bigger dosage of the artificial kind is required to attain comparable outcomes. You can also discover vitamin E supplements containing both forms of alpha-tocopherol, called mixed tocopherols. (15 ).

Interactions

Use of some drugs can affect your vitamin E levels. Possible interactions consist of:.

Alkylating agents and anti-tumor antibiotics. There’s concern that high doses of vitamin E might impact the use of these chemotherapy drugs.

Anticoagulants and anti-platelet drugs, herbs and supplements. Use of vitamin E with these drugs, herbs and supplements to reduce blood clotting may increase the danger of bleeding.

Cytochrome p450 3a4 (cyp3a4) substrates. Use caution when taking vitamin E and other drugs impacted by these enzymes, such as omeprazole (prilosec, zegerid).

Statins and niacin. Taking vitamin E with statins or niacin, which may benefit individuals with high cholesterol, might decrease niacin’s result.

Vitamin k. Taking vitamin E with vitamin k might reduce the effects of vitamin k. (16 ).

What are cautions and preventative measures for vitamin E?

Warnings

This medication includes vitamin E. Do not take aquasol e, alpha-tocopherol, or tocopherol if you dislike vitamin E or any components included in this drug.

Stay out of reach of kids. In case of overdose, get medical help or get in touch with a poison nerve center right away. (17 ).

Conclusion

Vitamin E was first used as a supplement in canada by the physicians shute and shute; based upon the positive results it achieved, they started utilizing it routinely in their practices. Ever since, well-designed speculative and medical research studies have progressed steadily and increased our knowledge of vitamin E. The antioxidative properties of vitamin E have actually been discovered to play an important function in the battle versus various illness such as atherosclerosis, oxidative stress, cancer, cataract and ad, to name a few.

This evaluation focused on the important functions of vitamin E in some diseases; in addition to these, this vitamin has been discovered to be effective against asthma, allergic reactions and diabetes, to name a few. Discussion of the dietary sources, rda and the interaction of vitamin E supplements with other dietary aspects, has demonstrated the need for and significance of vitamin E in the human context. Therefore, raising public awareness of the function of dietary anti-oxidants in keeping much better health would benefit a variety of lives.

Apart from the enormous advantages reported, there has actually always been argument about the exact function of vitamin E and its function in different illness. There are numerous clashing reports of favorable and unfavorable outcomes on the same biological activities in the literature. The primary obstacle in figuring out the roles of vitamin E in human health is the absence of validated biomarkers for vitamin E intake and status, which would help to relate consumption to possible clinical outcomes. In conclusion, although the data surrounding vitamin E is contradictory, the current literature appears to support the view that the benefits outweigh the side-effects. (18 ).

Recommendations

1. Https://www.cancer.gov/publications/dictionaries/cancer-terms/def/vitamin-e
2. Https://www.webmd.com/vitamins/ai/ingredientmono-954/vitamin-e
3. Https://www.karger.com/article/abstract/343106
4. Https://en.wikipedia.org/wiki/vitamin_e
5. Https://medlineplus.gov/ency/article/002406.htm
6. Https://www.hsph.harvard.edu/nutritionsource/vitamin-e/
7. Https://go.drugbank.com/drugs/db00163
8. Https://www.healthline.com/health/all-about-vitamin-e#58.-other-potential-health-benefits
9. Https://www.intechopen.com/chapters/76117
10. Https://www.tiege.com/blogs/news/what-are-the-benefits-of-vitamin-e-for-men
11. Https://www.medicalnewstoday.com/articles/322836
12. Https://sinchewoptics.com.sg/blogs/news/vitamin-e-benefits-for-your-eyes-and-vision
13. Https://www.msdmanuals.com/home/disorders-of-nutrition/vitamins/vitamin-e-deficiency
14. Https://www.drugs.com/vitamin_e.html
15. Https://www.verywellfit.com/vitamin-e-supplements-what-you-need-to-know-90042
16. Https://www.mayoclinic.org/drugs-supplements-vitamin-e/art-20364144
17. Https://www.rxlist.com/consumer_vitamin_e_aquasol_e_tocopherol/drugs-condition.htm
18. Https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3997530/