A different side of vitamin E

A different side of vitamin E

WE all know that vitamins are good for us. In fact, many people nowadays tend to pop multivitamin pills to ensure that they get their required daily intake of vitamins.

In school, we learned that vitamins are essential for our bodies to grow and function properly. The lack of certain vitamins can actually cause deficiency disorders, like rickets (lack of vitamin D) and scurvy (lack of vitamin C).

But now, scientists are discovering that a certain form of vitamin E can also offer protective effects against some medical conditions.

Why not tocotrienol?

It started around 13 years ago when as a scientist at the University of California, Berkeley, Prof Dr Chandan Sen started to get interested in the tocotrienol form of vitamin E.

Now, contrary to what you might think, vitamin E is not one single substance, but actually refers to a certain group of fat-soluble compounds.

These compounds can be divided into two groups called tocopherols and tocotrienols.

Each group contains four members, namely alpha (a), beta, gamma and delta respectively.

While the compounds all share the same basic chemical structure, tocotrienols differ from tocopherols in that they have three double bonds in their side chain, where the tocopherols only have single bonds.

The four members of each group are isomers, which have the same chemical formula, but different arrangements of the various atoms within them. These unique arrangements give each isomer its own chemical properties.

In 1998, when Prof Sen began his study of tocotrienols, the vast majority of research articles published on vitamin E were focused on tocopherols.

There were only 56 articles on tocotrienols, compared to vitamin E as a whole, which was around 25,000 publications,” he told this writer.

There was no obvious reason for the neglect of this other major subgroup of vitamin E, other than what Prof Sen opines is the “bandwagon effect”, where people tend to follow what other people are doing – in this case, studying the more popular tocopherols.

Vitamin E is generally known for its antioxidant properties, which includes helping to protect the body against neurodegenerative diseases. This was the area Prof Sen, now associate dean of translational and applied research at the Ohio State University Medical Center, was most interested in.

In a blind study, Prof Sen and his team obtained pure samples of each member of the vitamin E family to see which had the most protective effect against induced nerve cell death in rats.

To their surprise, the study – published in the Journal of Biological Chemistry in 2000 – discovered that it was atocotrienol, rather than atocopherol, that was the most effective in protecting the nerve cells against damage and death. “Our observations demonstrated that tocotrienols can rescue nerve cells from death by toxins released in high levels during incidents like brain trauma and stroke,” he shares.

Another significant discovery, he adds, was that atocotrienol provided this effect at much lower concentrations (nanomols), compared to atocopherol (micromols).

Protection against stroke

Protection against stroke

While numerous beneficial effects have been seen with tocotrienols, Prof Sen has decided to concentrate on proving its protective effects against stroke.

He explains: “We wanted to focus on one disease procedure and take it all the way to the end. We looked at stroke because the areas that tocotrienols seemed most protective against were stroke and brain trauma.”

Prof Sen adds that the decision to focus on stroke was because the disease pathway was much better defined than that of brain trauma. In addition, stroke is the number one cause of human disability and the third leading cause of death in the world.

In the past 10 years, he and his colleagues have discovered five unique cellular pathways that tocotrienol – and no other substance – act on to not only protect, but also, rescue nerve cells from dying.

“The other aspect we have just found out this year (2011),” he adds. Performing live studies on dogs, Prof Sen and his team discovered that tocotrienols help provide additional blood supply to areas of the brain affected by stroke.

A stroke occurs when part of the brain dies because blood flow to that area is disrupted due to either blockage or bleeding.

Tocotrienols help overcome this loss of blood supply by activating the pial collateral vessels, which are the brain’s back-up blood supply system when the usual arteries are not functioning well.

Following this promising discovery, Prof Sen has submitted his plan for a phase one clinical trial involving tocotrienols to his university’s review board.

“We are targeting people who already have a mini-stroke, also known as a transient ischaemic attack (TIA),” he says.

This is because as many as one-third of TIA patients go on to have a stroke within the next year.

By comparing the outcomes of patients who receive the placebo versus those who receive tocotrienols, Prof Sen hopes to see whether tocotrienols really do help to reduce the incidence of stroke, or limit the damage caused if a stroke does occur.

He adds that if all goes well, he will begin recruiting patients for the trial at his medical centre this month.

Natural supplement

A natural supplement

The main advantage of tocotrienols over conventional medication is that vitamin E is a supplement, and not a drug.

“If you look at the history of pharmaceuticals, there are always drugs with fantastic effects, but also toxic side effects,” he says.

“We’ve seen, over several years, no side effects (of tocotrienols) in either animals or humans. It is also more affordable to the common man.”

The highest concentration of tocotrienols can be found in edible plant oils like palm oil, rice bran and wheat germ.

However, diet alone will not provide the sufficient amount of tocotrienols needed to protect against the effects of stroke, as this compound naturally occurs in very low amounts in nature.

For example, even though palm oil contains the highest natural amount of tocotrienol, you would need to consume at least 80g (around one teacup) of palm olein (cooking oil) to achieve the protective effects demonstrated in the studies.

Supplements containing tocotrienol are, however, available on the market. Consumers do need to check out the labels though, as most vitamin E supplements tend to consist of tocopherols, rather than tocotrienols.

Prof Sen adds: “It’s important to highlight that the human body is cautious in taking in tocotrienols. We have not seen any adverse effects because of the body’s own regulatory mechanisms.”

However, because of this very same regulatory mechanism, the question arose as to whether or not tocotrienol taken orally would be absorbed by the body’s major organs.

Wishing to answer this question, Prof Sen and his team started a study in 2006 on endstage disease patients who were scheduled for some sort of biopsy or surgery, These patients were given 200mg of either tocotrienol or tocopherol pills (for comparison) twice a day until their scheduled surgery.

Samples of the organs removed during the surgery were then examined by Prof Sen and his team, and did indeed prove to have tocotrienol in them.

Another study also found that the peak value of tocotrienols taken orally in blood plasma was around 3 micromols – much higher than the amount needed to be beneficial to humans.

The 2006 study also showed some promising effects in patients with end-stage cirrhosis of the liver, where tocotrienols either stabilised or decreased their MELD (Model for End-Stage Liver Disease) scores.

The higher the MELD score, the more severe the disease. Therefore, the implication is that tocotrienol supplementation might buy these patients more time while they wait for a suitable liver to be available for tramsplantation.

Another area researchers are exploring is the anti-scarring effect of tocotrienols.

Prof Sen was in town recently for the International Palm Oil Congress 2011 held in Kuala Lumpur, and was speaking at a dinner symposium organised by local pharmaceutical company Hovid.

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