Vitamin E toxicity is rare. Doses up to 400 IU per day are considered safe, and doses up to 3200 IU have not consistently caused ill effects. However, doses over 1000 IU per day have been associated with side effects like headache, fatigue, and nausea in some cases. At very high levels, vitamin E may interfere with the functions of other fat-soluble vitamins like vitamins A, D, and K by inhibiting their metabolism.

1. Vitamin E toxicity
Domina Petric, MD

2. Vitamin E toxicity
Vitamin E is one of the least toxic of the
vitamins.
Daily doses as high as 400 IU can be
considered harmless.
Large oral doses as great as 3200 IU have
not been found to have consistent ill effects.
April 11, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
2

3. Vitamin E toxicity
• At very high doses, however, vitamin E can
antagonize the functions of other fat-soluble
vitamins.
• This can be antagonised with increased dietary
supplements of the appropriate vitamins: vitamins D,
A and K.
• Isolated reports of negative effects in patients
consuming up to 1000 IU of vitamin E per day
included headache, fatigue, nausea, double vision,
muscular weakness, mild creatinuria and
gastrointestinal distress.
April 11, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
3

4. Fat soluble vitamins
April 11, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
4
Vitamin AVitamin E
Vitamin K
Vitamin D
Fat soluble
vitamins

5. Vitamin E toxicity
April 11, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
5
DOUBLE
VISION
HEADACHE
FATIGUE
NAUSEA
MUSCULAR
WEAKNESS
CREATINURIA
GASTROINTESTINAL
DISTRESS
Vitamin E
intoxication
The least
toxic of
vitamins
Individual
cases
Dose >1000
IU/day

6. Vitamin E toxicity
• Potentially deleterious metabolic effects of
high level vitamin E status include inhibitions
of retinyl ester hydrolase and vitamin K-
dependent carboxylations.
• Patients of normal coagulation status given
high doses of vitamin E (at least 1000 IU/day)
showed decreased γ-carboxylation and
decreased functionality of prothrombin.
April 11, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
6

7. Vitamin E toxicity
Tocopherylquinone has
structural similarities to
vitamin K and may act as
an inhibitor of vitamin K
metabolism.
April 11, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
7

8. Conclusion
Vitamin E is safe over a
wide range of intakes that
would extend to
approximately 1600 IU/day
for most healthy adults.
April 11, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
8

9. Literature
• Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
April 11, 2018 9