PT on the Net Research

Vitamins C & E and Heart Disease


One of my clients came to me with a question about vitamins E and C. His doctor told him he had high cholesterol and that the combination of vitamin C and vitamin E can help lower it. What kind of vitamin E is the most effective for this?


First, let me clear up a misunderstanding. Vitamin C and vitamin E do not lower cholesterol levels. The doctor’s recommendation to take these nutrients is an excellent idea because they are two powerful antioxidants that work well together to protect the patient from arterial blockage due to his elevated cholesterol levels. But they will not lower his cholesterol. A combination of dietary changes and exercise, and possibly prescription drugs, will be needed to actually lower the blood cholesterol levels.

High cholesterol levels are a known risk factor for heart disease. This is especially true if the major component in the cholesterol breakdown is the LDL, or bad cholesterol. Researchers are fairly certain that the oxidative modification of LDL cholesterol promotes blockage in coronary arteries, which leads to heart attacks. Studies have shown that the antioxidants vitamin C and especially vitamin E do in fact inhibit the oxidation of LDL, thereby reducing heart disease. It makes good sense to recommend taking these vitamins to anyone who has an increased risk. They are both very safe and several large studies have revealed significantly lower rates of disease among individuals taking them.

Vitamin E is a fat soluble vitamin that exists in several forms. Alpha-tocopherol is the most active form of vitamin E in humans. Human trials with vitamin E have almost always been done with the alpha form. Therefore, since it is the most active form and the form used in the clinical trial, I recommend alpha-tocopherol.

The names of all types of vitamin E begin with either “d” of “dl.” The d form is natural vitamin E, and the dl form is synthetic vitamin E. Historically, the synthetic form was used in the clinical trials because the natural form is two to three times more expensive. There is no doubt that the dl alpha-tocopherol is a safe and effective form of vitamin E. However, while both forms are equally well absorbed by the gut, the liver clearly prefers the natural form. The natural form of vitamin E, the d alpha-tocopherol, is retained better and is more biologically active in the body. If cost is not an issue, the natural form of the alpha isomer is the best choice.

Most doctors of natural medicine would recommend 500 mg of vitamin C and at least 400 IU but no more than 800 IU of d alpha-tocopherol per day for this individual. There is no contraindication to this regimen if a prescription drug is later added to lower cholesterol.