The vitamin E complex has both tocopherol and tocotrienol fractions. The tocopherol fractions are mass-marketed supplements designed to improve the metabolic syndrome and type 2 diabetes. Let's look into the vault of Designs for Health, a science-based company, for the evidence of this second fraction of vitamin E and your eye health.
Vitamin E: Tocopherol and Tocotrienol
Vitamin E has long been regarded as a beneficial nutrient to support eye health, owing in part to its antioxidant properties. It was included in the original Age-Related Eye Disease Study (AREDS) and in AREDS2, studies from the National Institutes of Health's National Eye Institute. The first AREDS trial set out to assess the effect of high doses of vitamins C and E, beta-carotene, copper and zinc on the progression of cataracts and age-related macular degeneration. AREDS2 eliminated beta-carotene and added omega-3 fats, plus the antioxidants lutein and zeaxanthin. However, the form of vitamin E used in these trials was alpha-tocopherol only.
More recent research suggests that tocotrienols warrant more thoughtful consideration and that they may be more effective than tocopherols.
Tocotrienols have been shown to inhibit angiogenesis—the formation of new blood vessels. For this reason, they may have applications in improving ocular conditions related to abnormal blood vessel growth, such as macular degeneration and diabetic retinopathy. Alpha-tocopherol does not have this effect, and in fact, appears to be directly antagonistic to the anti-angiogenic effects of tocotrienols.
Vitamin E and Macular Degeneration
In macular degeneration, abnormal neovascularization in the retina beneath the macula leads to loss of central vision, and leaking blood vessels push up the retina. Diabetic retinopathy, the leading cause of adult blindness in the West, is also caused by damage to blood vessels of the retina. In both cases, the aberrant growth of new blood vessels is responsible. Being that tocotrienols are such potent anti-angiogenic agents (with delta-tocotrienol being the most effective), they might be worth adding to the supplement regimen of those experiencing compromised vision and eye health due to conditions involving neovascularization.
Vitamin E and Glaucoma
Nearly 3 million Americans have glaucoma, a condition involving elevated intraocular pressure that may result in permanent damage to the optic nerve and can lead to blindness. (Prevalence is projected to more than double by 2050, to 6.3 million people.) An in vitro study showed that tocotrienols inhibit proliferation, migration and collagen synthesis of human Tenon's fibroblasts. Often scarring of these cells occurs during glaucoma filtration surgery, so tocotrienols may someday be employed as anti-scarring agents in these procedures.
Vitamin E and Cataracts
Tocotrienols accumulate in the eye, possibly owing to their antioxidant effects and protection against cataract development. The prevalence of cataracts is staggering. According to the National Eye Institute of the National Institutes of Health, the risk of cataract increases with each decade of life beginning around age 40. By age 80, cataract affects 70% of Caucasian Americans, 53% of African Americans, and 61% of Hispanic Americans. Individuals with diabetes who develop cataracts typically develop it at younger ages. A cataract is more common among women than men; based on 2010 data, 61% of Americans with cataract were women, compared to 39% of men.
A Malaysian study tested the effect of tocotrienols on cataract formation in galactosemic rats. In the study, topically applied tocotrienol at 0.01-0.05% delayed the onset and progression of cataract by reducing lenticular oxidative and nitrosative stress. In a follow-up study on diabetic rats, tocotrienols were applied topically via eye drops (a concentration of 300ppm). Diabetic rats that did not receive tocotrienols progressed quickly to stage 3 and 4 cataracts, whereas progression was arrested among those receiving tocotrienols. Impressively, tocotrienol application restored lens transparency to normal. The anti-cataract effect of tocotrienols may be attributable in part to their anti-inflammatory and antioxidant actions. It should be noted, of course, that these studies employed eye drops to deliver tocotrienols topically. We cannot assume that oral tocotrienols would have the same effects, but the AREDS studies indicate that vitamin E can be helpful for eye health, particularly when taken along with other supportive nutrients.
Elevated blood glucose and high blood pressure are clear drivers of much loss of vision and general declines in ocular health. In addition to a healthy diet and other lifestyle interventions to improve these factors, tocotrienol supplementation may be helpful for patients experiencing or at risk for compromised eye health.
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