From the Guidelines
Vitamin E does not significantly help with cholesterol management. While some early research suggested potential benefits, more rigorous clinical studies have not shown consistent or meaningful effects of vitamin E supplementation on cholesterol levels 1. Vitamin E is an antioxidant that may have some cardiovascular benefits through other mechanisms, such as reducing oxidation of LDL cholesterol, but it doesn't directly lower total cholesterol, LDL ("bad") cholesterol, or raise HDL ("good") cholesterol in a clinically significant way. For managing cholesterol, proven approaches include medications like statins (such as atorvastatin or rosuvastatin), dietary changes (reducing saturated fats, increasing fiber), regular exercise, weight management, and avoiding tobacco. These interventions have substantial evidence supporting their effectiveness in improving cholesterol profiles 1. Vitamin E works primarily as an antioxidant in the body, protecting cells from damage, but this function doesn't translate to meaningful changes in blood lipid levels that would impact cardiovascular risk.
Some studies have suggested that vitamin E may have benefits in specific populations, such as older adults, but the evidence is not strong enough to support a recommendation for increased vitamin E intake for cholesterol management 1. The current dietary recommendations for vitamin E are based on the estimated average requirements for adults, and there is no evidence to suggest that older adults require more vitamin E for cholesterol management 1.
In terms of specific dietary recommendations, the American Heart Association suggests that adults aim to reduce their intake of saturated fats, trans fats, and cholesterol, and increase their intake of soluble fiber, plant stanols, and sterols 1. These dietary changes, combined with regular exercise, weight management, and avoidance of tobacco, can help to improve cholesterol profiles and reduce the risk of cardiovascular disease.
Overall, while vitamin E may have some antioxidant benefits, it is not a recommended treatment for cholesterol management. Instead, proven interventions like statins, dietary changes, and lifestyle modifications should be prioritized to improve cholesterol profiles and reduce cardiovascular risk.
From the Research
Vitamin E and Cholesterol
- The effect of vitamin E on cholesterol levels has been studied in several trials 2, 3, 4.
- A study published in 2007 found that vitamin E supplementation did not affect total or low-density-lipoprotein cholesterol levels in hypercholesterolemic patients receiving statins, but it did cause a small decrease in high-density-lipoprotein cholesterol levels 2.
- Another study from 1999 compared the efficacy of vitamin E with simvastatin or atorvastatin in preventing the progression of atherosclerosis in patients with homozygous familial hypercholesterolemia, and found that vitamin E therapy did not prevent the progression of atherosclerosis, whereas statin therapy did 3.
- A 1998 study found that combined simvastatin and vitamin E therapy improved endothelial function in hypercholesterolemic men, as measured by flow-mediated dilation of the brachial artery 4.
Statins and Cholesterol
- Statins are known to inhibit the de-novo synthesis of cholesterol, leading to a decrease in low-density-lipoprotein cholesterol levels and an increase in high-density-lipoprotein cholesterol levels 5.
- Statins have been shown to reduce the rate of cardiovascular events, and the degree of cardiovascular risk reduction is related to the extent of low-density-lipoprotein cholesterol lowering 5.
Interaction between Vitamin E and Statins
- A study published in 2010 found that atorvastatin increased the blood ratios of vitamin E/low-density-lipoprotein cholesterol and coenzyme Q10/low-density-lipoprotein cholesterol in hypercholesterolemic patients, suggesting that statins may affect the antioxidant status of patients 6.
- The same study found that atorvastatin had no significant effect on urinary levels of 8-hydroxy-2'-deoxyguanosine, a marker of oxidative stress, suggesting that statins may not increase oxidative stress in patients 6.