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One of the nutrients most frequently overlooked by people at risk of osteoporosis is vitamin E. Here are seven reasons getting enough vitamin E is essential for healthy bones.

Vitamin E is one of the forgotten nutrients for warding off osteoporosis. There are some women for whom vitamin E can eliminate the effects of some risk factors for brittle bones. Here are 10 important facts about the role of vitamin E in bone health and fracture prevention.

1. Smokers get protection from fractures when they get enough vitamin E

Women who smoke have a three-times greater risk of fractures of the hip after they pass menopause. Taking vitamin E reduces their increased risk from 300 percent to 10 percent. No other antioxidant produces similarly drastic reductions in the risk of bone loss. Former smokers also benefit from taking vitamin E. Research has not reached a conclusion about whether the benefits of vitamin E for bone health apply equally to women who smoke and men who smoke.

Smokers should take a combination of antioxidant vitamins or make sure they get daily servings of fruits and vegetables. Berries are especially helpful, as are vegetables in the crucifer family, such as wasabi, watercress, broccoli, cauliflower, and cabbage. Taking just vitamin E or just vitamins E and C without getting vegetables and fruit in the diet elevates some other health risks. Making sure intakes of antioxidants are balanced ensures that the net effects of nutritional supplementation are positive.

2. Overdosing one form of vitamin E, however, can lower bone mineral density.

Vitamin E comes in eight different chemical forms. Four of these forms of vitamin E are known as tocopherols. The other four are known as tocotrienols. Most vitamin E supplements offer just one form of the vitamin, alpha-tocopherol. While low-dose alpha-tocopherol increases bone mineral density, especially in women after menopause and in women who smoke, high-dose alpha-tocopherol may reduce bone mineral density in healthy people. The reason too much alpha-tocopherol is harmful is that it interferes with the action of vitamin K2, and it stops the entry of other useful forms of vitamin E from entering bone. Taking more than 100 mg (150 IU) of alpha-tocopherol per day is not necessary and may be excessive.

If you have overdosed alpha-tocopherol in the past don't panic. It has the paradoxical effect of taking mineral out of bone under low-stress conditions and keeping mineral in bone in high-stress conditions. Maybe you were sufficiently "stressed out" metabolically that overdoing alpha-tocopherol didn't hurt. Just focus on better balance in the future.

3. You don't have to get your vitamin E just from supplements

Vitamin E is found in nuts (especially almonds), seeds, cold-pressed seed oils, apricots, asparagus, avocados,broccoli, cold-water fish cooked by methods other than frying, cranberry sauce, tomato sauce, spinach, and Swiss chard (silverbeet). You need about five servings of these foods every day to get your vitamin E naturally. Work cereals, rice bran, and unprocessed palm oil into your diet to get the specific form of vitamin E most helpful to your bones, gamma-tocotrienol (more about that below). If you can't work daily servings of high-vitamin E foods into your meal plan, then take a low-dose supplement.  

4. But if you do use a vitamin E supplement, choose one that contains gamma-tocotrienol

Of the eight chemical forms of vitamin E, gamma-tocotrienol (also known as gamma-T3)  is the isomer that does the most to activate the hormonal messengers that slow down the recycling of bone so that it does not get ahead of the formation of replacement bone.  It helps bones manufacture the collagen that they use to make a scaffold to organize mineral crystals. It helps bone-creating osteoblasts live longer. 

5. If you take calcium supplements, you probably also need vitamin E

Vitamin D helps your body absorb calcium from food. Vitamin K2 helps your bones absorb calcium from your bloodstream. But some of the chemical variations of vitamin E, especially gamma-tocotrienol, help to regulate vitamin K2. You need all of these vitamins to help your body use the calcium you get from food and supplements.

6. If you take bisphosphonates, you need vitamin E

One of the problems with bisphosphonate medications (for example, Fosamax and Reclast) is that they encourage the retention of minerals in bone but they don't encourage the formation of cross-links in bone that hold those minerals together. Certain forms of vitamin E, especially the tocotrienols, encourage the formation of trabecular bone, the "struts" that keep strands of crystals in place. The longer you take bisphosphonates, the more important it is that you get at least a minimum of tocotrienols (10 mg makes a difference), and you avoid excessive use of alpha-tocopherol. This means that you need to read the label of any vitamin E supplement you take to make sure it doesn't provide more than 100 IU of alpha-tocopherol per day and it provides at least a few IU of gamma-tocotrienol.

7. Vitamin E can be helpful in preventing osteoporosis in men, too

Laboratory studies have found that the form of vitamin E known as tocotrienol (not the alpha-tocopherol found in most vitamin E supplements) increases bone mineral formation when testosterone levels are too low. Older men also achieve greater bone mineral density when they get enough vitamin C.

  • Chin KY, Ima-Nirwana S. The effects of α-tocopherol on bone: a double-edged sword? Nutrients. 2014 Apr 10.6(4):1424-41. doi: 10.3390/nu6041424. Review. PMID: 24727433.
  • Chin KY, Abdul-Majeed S, Fozi NF, Ima-Nirwana S. Annatto tocotrienol improves indices of bone static histomorphometry in osteoporosis due to testosterone deficiency in rats. Nutrients. 2014 Nov 10.6(11):4974-83. doi: 10.3390/nu6114974. PMID: 25389899.
  • Melhus H, Michaëlsson K, Holmberg L, Wolk A, Ljunghall S. Smoking, antioxidant vitamins, and the risk of hip fracture. J Bone Miner Res. 1999 Jan.14(1):129-35. PMID: 9893075
  • Photo courtesy of SteadyHealth

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