Vitamin E exists in eight different forms called isomers: alpha, beta, gamma and delta tocopherol; and alpha, beta, gamma and delta tocotrienol.

Alpha-tocopherol is the most active form in humans; dosing and daily allowance recommendations for vitamin E are often provided in Alpha-Tocopherol Equivalents (ATE) or International Units (IU).

In addition, it has indirect activity against HIV: Vitamin E belongs to a class of antivirals which, in the laboratory, inhibit a section of the virus called the Long Terminal Repeat (LTR) which is basically the viral “on/off switch.” Evidence shows it helps with Hepatitis C as well.

The Tolerable Upper Intake Limit (UL) for alpha-tocopherol is set at 1000 mg (1500 IU).

University of Miami researchers have shown that even in earlier HIV disease stages there is a vitamin E deficiency that correlates with elevation in the level of one of the inflammatory prostaglandins (IgE).

Research has shown that vitamin E deficiency appears to increase the risk of cervical dysplasia and cancer, and that high vitamin E intake is associated with significantly lower risk of cervical cancer. Since the tissue lining the anal area is similar to that lining the vagina, vitamin E may provide the same protective effect against anal dysplasia in both men and women, important since both men and women people with HIV appear to be at increased risk of developing anal cancer.

Vitamin E is particularly important if using AZT to reduce bone marrow toxicity. Laboratory research at Tulane University revealed that vitamin E may potentiate the effectiveness of AZT and reduce AZT’s toxicity.

In one study of 23 people living with hepatitis C, almost half of those given 800 IU of vitamin E daily saw significant improvement of liver enzymes. The enzyme levels increased again after the vitamin E was discontinued, indicating that the nutrient was not permanently stopping the process of inflammation in the liver, but rather was suppressing the inflammation while the nutrient was being taken. Other studies have shown that vitamin E may also slow the process of fibrosis by interrupting the biochemical pathway that leads to this liver scarring.

In 2004, a review of various studies was undertaken (called a meta analysis) which suggested a very slight increased risk of cancer in people taking more than 400 IU of vitamin E. First, this finding is uncertain at best, yet it has been trumpeted as an established risk by the mainstream media. However, as with giving beta carotene alone, it is not surprising that by adding just one antioxidant into a mix that requires balance, you throw off the rest of the system. And, as with beta carotene, Vitamin E is just one member of a class of substances (called tocopherols). Thus, it is probably prudent to use a mix of vitamins and minerals as one finds in a multivitamin rather than rely upon single agents like vitamin E, especially in the context of a chronic infection.

Vitamin E should be taken together with selenium.

People with hemophilia or low platelet counts should only supplement with vitamin E under the consultation of their healthcare provider.

Do not take extra vitamin E if using the protease inhibitor drug, amprenavir (Agenerase).

MedLine Plus (from the U.S. National Library of Medicine and the National Institutes of Health offer some detailed but skeptical information on vitamin E.

E-400 (Jarrow) Each bottle, 250 softgels. Each softgel, 400 IU of vitamin E (d-alpha tocopherol) along with selenium from yeast (100 mcg) and mixed tocopherols.