Vitamin E supplement use is high in the U.S. population (Hartz et al., 1988; Slesinski et al., 1996). Information from the Boston Nutritional Status Survey on use of supplemental vitamin E by a free-living population, 60 years of age and older, indicated that 38 percent of the men took a nutritional supplement and 68 percent of these users took a vitamin E supplement. Of the women, 49 percent used supplements with 73 percent of them taking a vitamin E supplement (Hartz et al., 1992). In the earlier 1986 National Health Interview Survey, 26 percent of all adults reported use of supplements containing vitamin E (Moss et al., 1989). Slesinski et al. (1996) examined supplement usage in over 11,000 adults who participated in the 1992 National Health Interview Survey Epidemiology Supplement and reported that diets of women utilizing supplements that contained vitamin E were higher in vitamin E compared with those of nonsupplement users. No differences in vitamin E intake were found in the men participating in the survey.
The Tolerable Upper Intake Level (UL) is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects in almost all individuals. Although members of the general population should be advised not to exceed the UL for vitamin E routinely, intake above the UL may be appropriate for investigation within well-controlled clinical trials. In light of evaluating possible benefits to health, clinical trials of doses above the UL should not be discouraged, as long as subjects participating in these trials have signed informed consent documents regarding possible toxicity, and as long as these trials employ appropriate safety monitoring of trial subjects. Also, the UL is not meant to apply to individuals who are receiving vitamin E under medical supervision.
There is no evidence of adverse effects from the consumption of vitamin E naturally occurring in foods. Therefore, this review is limited to evidence concerning intake of α-tocopherol as a supplement, food fortificant, or pharmacological agent. RRR-α-tocopheryl acetate (historically and incorrectly labeled d-α-tocopheryl acetate)