The American College of Rheumatology had recommended that exercises be one of the mainstays of treatment, but doctors have been unclear about the type of exercise to recommend, or its duration.

Researchers from the Fitness Arthritis and Seniors Trial (FAST) tested the recommendation out on 365 sufferers who completed the 18 month trial. Those in the aerobic team walked in their neighbourhood as part of a programme that consisted of 10 minutes of warm up, 40 minutes of walking and then a final cool down period of 10 minutes, three times a week.

The second programme of resistance exercises followed a similar pattern but involved nine exercises to improve overall muscle fitness.

The researchers said that “modest” improvements were reported, although those who did more of the exercises reported greater benefits (JAMA, 1997; 277: 25-31).

Moderate exercise can also help people sleep better, researchers have found. Healthy, but sedentary, older people who had sleeping problems found they had a better night’s sleep if they did some exercise.

The programme consisted of 30 minutes of low impact aerobics or brisk walking four times a week, report researchers from Stanford University (JAMA, 1997; 277: 32-7).

The herb (and spice) cayenne is the ripe fruits (called peppers) of a blend
of varieties of Capsicum annuum var. minimum and small-fruited
varieties of C. fructescens from the nightshade family.

History of Use

The origins of this herb, now used as food and medicine in most countries
of the world, is uncertain. Cayenne was not mentioned in writings from ancient Egypt (1500 BC), Greece (455 BC to 50 BC), Rome (25 BC to 150 AD), Persia (13th century), India and China, so historians claim Cayenne peppers originated from the Americas, most likely from the banks of the Amazon. It is impossible for modern botanists to say where cayenne grew in some ancient time as a wild plant, because it has been domesticated and widely cultivated for so many centuries. Thus, we are content today to enjoy its fruits without being sure of its true origin and much of its history, though it is likely that
cayenne went to India and China as early as the 14th or 15th century, and
began to be cultivated in Europe in the 16th century.

Today, cayenne is as popular as ever as a food, and modern science has continued to support its use as a healing herb with a number of well-designed clinical and laboratory studies. It’s world-wide acceptance as an effective medicine is supported by ts official status in the Pharmacopoeias of Austria, Egypt, Germany, Hungary, Italy, Japan, Switzerland and Belgium.

Popular and Folk Uses

As anyone knows who has eaten a very spicy meal at a Thai or Mexican restaurant, Capsicum at first causes a strong burning sensation of the lips and mouth, followed by a sense of warmth spreading to the stomach and intestines.

Casein-containing foods (such as milk) can quickly lessen the burning feeling
of cayenne on the lips and mouth, probably because the heat-producing compounds of cayenne are fat-soluble and are taken up and removed from the local area.

Not only do people of warm climates love cayenne in spicy dishes, but as
a folk remedy for weak digestion and loss of appetite accompanied by gas
and sluggish elimination, and as a stimulant to the circulation and the
powers of resistance to help ward of colds and flus.

Cayenne is a favorite with herbalists from many countries, and in the U.S.,
it was the “number two” favorite remedy of Samuel Thompson of
the early 1800s, who started a popular herbal multi-level marketing extravaganza with his patent formulas–sort of a 19th century Herbal Life. He used it especially for helping to ward off and even expel the contagion of serious infectious diseases. It was also a favorite of the well-known Dr. Christopher, a Mormon herbalist who traversed the country in the 1960s and 70s, helping to bring herbal medicine back into American consciousness. In the late 70s, I remember watching him in a dynamic Seattle lecture, to the amazement of onlookers, put cayenne directly into his eyes as a healing and clearing remedy (don’t try this at home folks!). He was enthusiastic about its use for numerous complaints, including as a styptic to help stop the bleeding
of cuts.

Today, cayenne is one of the most-often used herbal remedies and is commonly recommended by herbalists for increasing circulation in people with cold hands and feet, as a metabolic stimulant for people with sluggish metabolisms who are overweight, as a warming stimulant with other herbs such as garlic and ginger for protecting against colds and upper respiratory tract infections, and externally as a liniment or in ointments for sore muscles, arthritis, rheumatism, low back pain, strains, sprains, bruises and neuralgia.

Scientific Investigations and Medical Uses

The most important active ingredient in cayenne are components of a pungent oleoresin, most importantly, capsaicin, but also a number of other related compounds. Capsaicin Cayenne is also rich in carotenoids (orange and red coloring compounds), which are receiving current interest for their cancer-protective and strong anti-oxidant properties, as well as a number of vitamins (especially A and C).

There has been some discussion about whether cayenne, if it is used excessively, can irritate or even cause ulceration of the intestinal tract. In reviewing the modern scientific literature, studies agree that cayenne not only does not harm the intestinal mucosa (the protective covering), but on the contrary, can speed healing–though some people seem to be more sensitive to the irritating effect than others. In one study, daily consumption of meals containing 3 grams of chili powder did not worsen patients with duodenal ulcers who were also taking antacids. A recent study, using a video camera threaded into the digestive tract, found no visible damage to the mucosa of the stomach or upper small intestine of 12 healthy volunteers who consumed 30 grams of jalapeno peppers. When the subjects were given a meal containing 2 grams of aspirin, multiple gastric ulcers were seen in 11 out of the 12.

In animal studies, cayenne has actually shown a protective effect on the
gastric mucosa, prompting some researchers to call for further human studies.

One of the more interesting effects of cayenne (or capsaicin) is its proven
enhancement of the metabolic rate and thermogenesis. Preliminary studies
suggest that capsaicin or cayenne may increase the burning of fat in the
body.

There is also an indication from laboratory studies that capsaicin can slow
fat absorption from the small intestine. Although more work needs to be
done before its effectiveness in weight loss programs can be proven, products are currently being developed and a few are already available in health food stores.

Capsaicin has received tremendous attention as a topical analgesic for relieving the pain that often accompanies herpes zoster (shingles) outbreaks and other skin ailments. Capsaicin is approved by the Food and Drug Administration as an Over-the-Counter (OTC) medication and is commonly recommended by doctors under the trade name ZostrixÆ for this purpose, as well as for controlling pain from rheumatoid arthritis and osteoarthritis. Studies show that capsaicin may block the feeling of pain by depleting and then blocking the production of “substance P,” which is thought to be the main chemical messenger of pain from the peripheral sensory nerves to the brain. It may also be involved with the release of inflammatory substances in affected joints of arthritis.

Because capsaicin is very alcohol-soluble, tincture of cayenne may be effective as a home-remedy for the relief of mild pain. Although I recommend seeking the advice of a qualified health professional for shingles or arthritis
before attempting to self-medicate with cayenne, I have found the tincture,
or ointments or salves that contain it are often effective for relieving
mild to moderate muscle aches or pains. The preparations should be applied
consistently at least 3 or 4 times daily (up to 5 or 6 times) for up to
2 weeks, or even a month before they are effective. After 4 or 5 months
of pain relief, up to 50% of the people who use a capsaicin product may
not experience further pain. For those that do, treatment can be continued.
A few drops of a tincture of cayenne was recommended in the British 19th
century medical press as a sure remedy for a toothache.

Redness and a burning sensation sometimes accompanies the application, but this usually disappears after two or three weeks. After control of the pain
is achieved, the cayenne preparation has to be used continuously for continued relief to occur. Clinical studies indicate that up to 80% of the volunteers who use a capsaicin cream experience some measure of relief, which is significantly better than placebo groups. Watch for any irritation or redness of the skin locally, which might indicate an individual sensitivity to cayenne, and make sure to keep all cayenne and capsaicin preparations away from the eyes. In this case, use less often or consult a qualified health care practitioner for guidance. Unlike mustard, which can blister and burn the skin, cayenne, even in its most powerful forms will not cause these undesirable side-effects. Finally, there is some recent evidence to suggest that capsaicin-containing preparations may be useful for treating psoriasis.

In the food industry, cayenne is used in numerous foods and beverages besides hot sauces and condiments, including alcoholic beverages, meat products, candy, baked goods, puddings, and frozen dairy desserts (cayenne ice-cream anyone?).

The next time you enjoy a spicy Thai dinner, think of all the additional
benefits from mother nature’s food pharmacy that accompany the warm glow
of a satisfying meal.

References Consulted

Martindale, The Extra Pharmacopoeia (3oth ed., 1993).

The Physician’s Desk Reference (47th ed., 1993).

Potter’s New Cyclopaedia of Botanical Drugs and Preparations, 1988.

Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics, 1980.

United States Pharmacopeia, Complete Drug Reference, 1993.

A Modern Herbal (Grieve), 1930.

Some aromatherapists use rosemary and lemongrass to ease stiffness. According to Dr. Dietrich Gumbel, they remove lactic-acid buildup in the muscles. The following formula may also be used for arthritis.

Pain Formula

6 drops helichrysum

4 drops marjoram

2 drops juniper

4 drops birch or wintergreen

3 drops chamomile

3 drops lavender

3 drops ginger

2 ounces of carrier oil

Combine ingredients. This formula can be used in massage or bath.

Herbal Adjuncts-Anti-inflammatories include meadowsweet, willow bark and devil’s claw, or cayenne, ginger, mustard and horseradish added to foods. Dandelion, sarsaparilla, burdock, celery seeds, parsley and yarrow help eliminate toxins through the kidneys. Pain relievers include valerian and St. John’s wort.

Organo-Germanium

Germanium is a trace mineral that has recently come to the attention of the health world through some incredible work and results at a clinic in Japan. Germanium occurs naturally in very small amounts in the soil and in certain foods and herbs, such as shiitake mushrooms, ginseng root, garlic, shelf fungus, and aloe vera. It has been used for its semiconductor properties in making computer chips. Its possible medical value was discovered in the 1950s by Kazuhiko Asai when he noticed that fairly high amounts of germanium were present in coal, peat, and some of the more powerful and useful Oriental healing herbs. In 1967, Dr. Asai and his associates isolated an organo-germanium compound soluble in water and labeled it Ge-132 (bis-carboxyethyl germanium sesquioxide, the 132nd form they had synthesized). In 1968, Dr. Asai founded the Asai Germanium Research Institute to study the clinical application of Ge-132 further. Over the next 15 years, Dr. Asai and coresearchers found that germanium was essentially nontoxic and had an incredible effect on many pathological conditions, particularly in suppressing tumor activity in tumor-bearing animals. In 1980, Dr. Asai published a book very optimistically called Miracle Cure: Organic Germanium.

Germanium is trace element number 32 in the periodic table. It is twice as heavy as oxygen (16) and seems in some way related to it, as it supports cellular and tissue oxygenation. Research in Japan also verified a number of effects of Ge-132 on the immune systems of animals and humans. (This is not the effects of the trace mineral but of this special organo-germanium; see the discussion in Chapter 6, Minerals.) Ge-Oxy 132, as it is sometimes called, has been shown to have both antitumor and antiviral effects. These may be a result of its varying immunological actions, such as stimulating interferon production, stimulating macrophage (“Pac-man” white cells) and NK (natural killer) lymphocyte activity, and enhancing cell-mediated immunity. There is some suggestion that Ge-132 helps in pain relief; particularly dramatic relief has occurred in some cases of severe cancer pain.

Most of these effects are noted more in people who are immune suppressed than in normal individuals. Research on the topic has begun at the University of Texas. In an article published in the November 1984 issue of the Journal of Interferon Research, Fugio Suzulu and Richard B. Pollard commented, “Ge-132 belongs to a group of compounds capable of modulating immune response in hosts that have an alteration of immune homeostasis. Although there are a few reports describing enhancement of Ge-132 on natural killer cell activity in healthy subjects, studies in immune suppressed animals and patients with malignancies or rheumatoid arthritis suggest that Ge-132 restores the normal function of T-cell lymphocytes, B lymphocytes, antibody-dependent cellular cytotoxicity, natural killer cell activity, and numbers of antibody-forming cells, but does not enhance them above normal limits.”

Interestingly, in both sick and normal animals and humans, Ge-132 is virtually nontoxic. Suzulu and Pollard’s article continues, “Preliminary toxicological and pharmacological studies of this compound (Ge-132) indicate that it has several unique physiological activities without any significant toxic effects.” Ge-132 really could be classified as a “highly safe drug” even though it is a trace mineral compound. It has practically no toxicity or influence on reproductive or other functions.

More research is needed on Ge-132. Organic germanium from Japan, as Ge-Oxy 132, has become available only recently in the United States as a pure white powder that can be made into tablets, capsules, or dissolved in water. It is still fairly expensive and will continue to be until it is produced in this country. Now, many companies are marketing germanium products; make sure that it is in this organo-germanium sesquioxide form. Amounts in supplements range from 25–150 mg. or are available as pure powder. Suggested dosages for treatment range from 50–100 mg. daily (probably the minimum needed for an effect), up to 3–6 grams daily (the doses used in Japan for cancer therapy). The level of germanium sesquioxide needed to induce interferon synthesis in humans is a daily intake of 50–75 mg./kg. body weight.

Ge-132 looks very promising, and I am quite excited about it. Its use in the treatment of viral disorders, especially Epstein-Barr, and other problems of immunological suppression appears helpful. Gastrointestinal diseases, such as diverticulitis, circulatory problems, mental symptoms, or really any problem that might be aided by improved oxygenation could be helped by organo-germanium (Ge-132) supplementation. In my clinical experience, I have found that allergies have also been reduced by the use of this nutrient, particularly those allergies that arise to foods based on weakening of the intestinal mucosa. Germanium’s effect on cancer is probably due to its immunostimulating effects rather than a direct effect on cancer cells. Its current use by cancer patients may move it into the political arena soon, which will prompt the FDA and the medical establishment to set controls on its use.

Germanium is currently considered a food supplement. Since it is found in the soil and in many healing herbs, some levels of mineral germanium will always be available to us. More research into this fascinating, semiconductor trace element may help us to better understand the mysterious powers of some of our great, ancient healing plants.

Royal Jelly

Royal jelly is another panacea for health and longevity seekers. Worker bees make this exotic substance their queen bee. And all of us want to be queen or king bees, of course. Royal jelly is definitely an energizer. It is high in certain unique fatty acids, simple carbohydrates, and pantothenic acid, which is supportive of the adrenals. It also contains the other B vitamins, all of the essential amino acids, and many minerals, such as iron, calcium, silicon, sulfur, and potassium. Royal jelly has been used to support weight loss, as it is a rich and energizing nutrient yet low in calories (20 calories per teaspoon), and to treat problems such as fatigue, insomnia, digestive disorders, ulcers, and cardiovascular ailments. Whether this mysterious substance really is a great rejuvenator and supporter of youth and longevity will need to be studied. But many people, especially women, experience an uplifting feeling when they take either liquid or encapsulated royal jelly.

Propolis

Propolis is a resin obtained from the buds of some trees and flowers. This sap is rich in such nutrients as minerals and the B vitamins. Bees collect it along with pollen. Propolis is thought to contain a natural antibiotic, called galangin, and is used in a variety of remedies to treat or prevent low-grade infections, especially in people who do not want to take antibiotics. Many people have described to me positive results from using propolis products. Bees spread the propolis around their hives to protect them from bacteria and viruses. (The name “propolis” comes from Greek words meaning “defenses before a town.”) Other theories suggest that propolis improves energy and endurance and helps immunity by stimulating thymus activity. All of these claims must be helpful in potentizing the placebo effect, but more research needs to be done before propolis is readily adopted by the scientific community.

Arguments against laetrile as a therapy cite concerns about possible cyanide toxicity as well as studies that show it is not effective as a cancer treatment. Studies, however, cannot be completely objective, especially on a subject as complex as cancer, which is influenced by so many factors. The proponents of laetrile claim that cyanide is a natural molecule found in food and is not toxic in normal doses; laetrile treatment itself is not known to have any side effects in usual dosages. But, obviously, considering Western medicine’s use of chemotherapy, radiation, and surgery, side effects are not the main concern when treating a life-threatening disease. The proof in any treatment is, ultimately, whether it works.

Amygdalin is not digested in the stomach by hydrochloric acid, but passes into the small intestine where it is acted on by enzymes that split it into various compounds, which are then absorbed.

Sources: Laetrile is found primarily in apricot kernels and comprises about 2–3 percent of the kernel. It is also available in the kernels of other fruits, such as plums, cherries, peaches, nectarines, and apples. The fruit kernels or seeds generally have other nutrients as well—some protein, unsaturated fatty acids, and various minerals. B17 is not found with other B vitamins in yeasts. Many plants do, however, contain some B17, with the sprouting seeds, especially mung bean sprouts, containing the highest amount.

Functions: The specific theoretical function of laetrile is its effect on cancer cells. Normal cells have an enzyme, rhodanase, that inactivates the cyanide molecule of the laetrile compound. Cancer cells do not possess this enzyme. In fact, they have an enzyme, beta-glucosidase, that releases the cyanide, which then poisons the cancer cells.

Uses: The main use for laetrile is in the treatment of cancer, particularly to reduce tumor size and further spread, and to alleviate the sometimes severe pains of the cancerous process. As I stated, more well-designed research needs to be done to determine whether this compound in its natural form is effective. Other uses reported for laetrile have been in the treatment of high blood pressure and rheumatism.

Deficiency and toxicity: There are no known problems caused by not consuming this “vitamin,” other than, theoretically, a deficiency could increase the likelihood of developing cancer. There are, however, concerns over toxicity, due to the cyanide within the vitamin or possibly from other metabolic effects. Usually, treatment amounts are limited to 1 gram to reduce potential side effects, which initially are most likely gastrointestinal in nature. Toxicity of this molecule must be researched further.

Requirements:This nutrient is not required as far as we know; in fact, it is against the law in the United States. When used, laetrile is administered at 250–1,000 mg. (1 gram) daily. Higher amounts—up to 3 grams per day—have been used, but divided into several smaller dosages, each usually limited to 1 gram. If the source is whole apricot kernels, the quantity is usually about 10–20 kernels per day; 1–2 cups of fresh mung bean sprouts may provide an equivalent amount. If apricot kernels are blended or pulverized, it is suggested that they be consumed immediately

Vitamin E was discovered in 1922 with experiments on rats. When fed a purified diet devoid of vitamin E, the rats became infertile. Wheat germ oil added to their diet restored their fertility. Later, the oil-based substance was isolated and called the “antisterility” vitamin. (Tokos and phero are the Greek words for “offspring” and “to bear,” so tocopherol literally means “to bear children.”) Though there is no clear deficiency disease in humans, vitamin E is well accepted as an essential vitamin. There is some question, however, as to whether vitamin E is needed for fertility. From general public experience, though, it seems to be clear that vitamin E makes a difference to many. The average diet today contains much less natural vitamin E than it did 50 years ago; we will see soon why, and what vitamin E actually does in the body.

Alpha-tocopherol is basically stable in heat and in acids; other forms are lost in heat, with storage or freezing, or when oxidized by exposure to the air. All vitamin E’s are slightly unstable in alkali and are readily used up when in contact with polyunsaturated oils or rancid fats and oils, which are protected from oxidative destruction by vitamin E. Frying oils, the processing and milling of foods, the bleaching of flours, and cooking remove much of the vitamin E content of whole foods. During the refinement and purification of vegetable oils, vitamin E is lost; the vitamin E-rich by-products of this process are used to make some of the E used in supplements.

Vitamin E is absorbed from the intestines, along with fat and bile salts, first into the lymph and then into the blood, which carries it to the liver to be used or stored. Vitamin E is not stored in the body as effectively as the other fat-soluble vitamins, A, D, and K. Over half of any excesses may be lost in the feces, but some vitamin E is stored in the fatty tissues and the liver and to a lesser degree in the heart, muscles, testes, uterus, adrenal and pituitary glands, and in the blood. Vitamin E is partially absorbed through the skin when used as an ointment or oil application. Intestinal absorption, however, is reduced somewhat with chlorine, inorganic iron, and mineral oil. Unsaturated oils and estrogen also deplete vitamin E, increasing the body’s demand for it.

Sources: Vitamin E, as its various tocopherol forms, is found in both plant and animal foods. In general, the animal sources of E are fairly poor, with some being found in butter, egg yolk, milk fat, and liver. The best sources of vitamin E are the vegetable and seed or nut oils. It was first isolated from wheat germ oil, which is still a commonly used, rich source of vitamin E.

The oil component of all grains, seeds, and nuts contain tocopherol. The protective covering or germ part of the grains is what contains the E, and this is lost easily in the milling of flour or in the refinement of grains. For the vitamin E to be preserved, extraction of the oils from nuts and seeds must be done naturally, as by cold pressing, rather than by heat or chemical extraction, used commonly in food processing. Because of these forms of processing, the average American diet has lost many of its natural sources of tocopherols, and intake is commonly very low. The cold-pressed vegetable oils are really the best source of vitamin E, and these are most healthfully used in their raw form in salad dressings and sauces rather than in cooking, since most are polyunsaturated oils, which are adversely affected by heating. With refined or cooked polyunsaturates, more vitamin E is needed to prevent oxidation, which could lead to free radical formation, the invisible, underlying cause of many diseases. Free-radical-induced changes occur at the cellular level, the primary processes leading to many chronic degenerative diseases. The vitamin E content of most foods is related to the content of linoleic and linolenic acids, our most essential fatty acids (see Chapter 4, as well as Vitamin F). Also, the content of active alpha-tocopherol varies among the different foods and oils. Safflower oil is one of the best sources, with about 90 percent of the E being the alpha variety. Corn oil has only about 10 percent alpha-tocopherol. Some other foods that contain significant amounts of vitamin E are soybeans, some margarines and shortenings made from vegetable oils, and a few vegetables, such as uncooked green peas, spinach, asparagus, kale, and cucumber; tomato and celery also have a little.

Functions: The primary function of vitamin E is as an antioxidant, which is very important, I believe, in our present-day society with widespread pollution, processed food diets, and chemical exposure. Vitamin E is protective because it helps reduce oxidation of lipid membranes and the unsaturated fatty acids and prevents the breakdown of other nutrients by oxygen. This protective, nutritional antioxidant function is also performed and enhanced by other antioxidants, such as vitamin C, beta-carotene, glutathione (L-cysteine), and the mineral selenium. Oxidation in our body of such substances as the fat molecules, particularly from polyunsaturated fats, and from eating other oxidized fats such as hydrogenated oils and rancid oils, causes the genesis of free radicals, unstable molecules that can lead to cellular and tissue irritation and damage, which leads to chronic inflammation, especially in the vascular lining. Excess free radical formation comes from a variety of chemical reactions in the body and is the biochemical basis of many diseases, such as atherosclerosis, heart disease, hypertension, arthritis, senility, and probably even cancer. A number of experiments have shown that the antioxidant nutrients such as vitamin E can protect the tissues from oxidation and free radicals.

Without vitamin E, cell membranes, active enzyme sites, and DNA are less protected from free radical damage. Oxidation by circulating peroxides and superoxides (two types of free radicals) is also reduced by enzymes such as glutathione peroxidase and superoxide dismutase. As does vitamin E, these antioxidant enzymes also protect, by indirect mechanisms, the polyunsaturated fatty acids and vitamin A from oxidative destruction. Fried foods have more oxidized fat by-products, which increase the requirement for vitamin E, but they do not contain any E. This is partly why they are so dangerous when consumed on a regular basis.

More specifically, vitamin E as an antioxidant helps to stabilize cell membranes and protect the tissues of the skin, eyes, liver, breast, and testes, which are more sensitive to oxidation. It protects the lungs from oxidative damage from environmental substances. And vitamin E helps maintain the biological activity of vitamin A, another very important oil-soluble vitamin. Vitamin E protects the unsaturated fatty acids in the body and prevents the oxidation of some hormones, such as those released from the pituitary and adrenal glands. Free radical formation and oxidation are tied to cancer development, so the family of nutritional antioxidants, including vitamin E, may help in preventing tumor growth. More definitive research is needed in regard to this important function.

In simple terms, vitamin E’s key function is to modify and stabilize blood fats so that the blood vessels, heart, and entire body are more protected from free-radical-induced injury. Vitamin E also has some anticlotting (antithrombotic) properties and protects the red blood cells’ membranes from oxidative damage. Because it helps heart and muscle cell respiration by improving their functioning with less oxygen, vitamin E may help improve stamina and endurance and reduce cardiovascular disease (CVD) risk, especially in those with already existing CVD. Vitamin E has recently been shown to reduce platelet aggregation and platelet adhesiveness to collagen, even more so than aspirin. These platelet functions are linked to an increased risk of atherosclerosis and cardiovascular disease, especially in high-risk groups. Vitamin E has also been shown to neutralize free radicals generated during surgery, particularly cardiopulmonary bypass surgery. It would also protect against the toxicity of some of the gases used in anesthesia.

Although vitamin E was first discovered as the fertility, or at least the antisterility, nutrient, there is no clear evidence that it enhances fertility if there is not a specific deficiency prior to its use. Many people, especially men, take vitamin E with some claimed success in regard to sexuality and vitality. Much of this effect, however, may be due to the antioxidant function and improved circulation and oxygenation.

Uses: There is quite an extensive list of uses for this popular nutrient, most commonly in the middle-aged and older populations. And there are many positive effects. Some of these claims are backed by good research, and more investigation is being done on vitamin E by medical and nutritional scientists. There is hope that the results of this research will enable us to better understand its mechanisms and apply them most effectively to prevent and treat our industrial-age medical conditions.

The antioxidant function that we have discussed gives vitamin E a variety of uses. The protection of cells and tissues against oxidation and injury from unstable molecules, pollution, and fats may also be the basis for the prevention of aging and many chronic diseases. Claims about vitamin E’s role in preventing premature aging and promoting longevity are big areas of investigation for vitamin E researchers. These claims are often made and with some good reason. Aging, tissue degeneration, and skin changes may be brought about by the damage that free radicals cause to cells unprotected by antioxidant nutrients in the body. Cancer and heart and vascular disease may also be created in this way, and vitamin E therapy may help reduce the risks of these major illnesses. Decreased blood clotting and increased tissue oxygenation may also help reduce symptoms of heart and vascular limitations, such as angina pectoris, intermittent claudication (leg pain with walking due to insufficiency of blood and oxygen, for which vitamin E has clearly been helpful), and problems of arterial spasm. In both congenital and rheumatic heart diseases, vitamin E may help reduce symptoms caused by impaired tissue oxygenation.

Vitamin E may be of help in the prevention of atherosclerosis. Its antioxidant effect reduces thrombin formation and thus helps decrease blood clotting, and it also appears to minimize platelet (blood-clotting component) aggregation and stickiness, aspects that either generate or perpetuate the atherosclerotic process. Vitamin E was thought to raise HDL (“good”) cholesterol levels, especially when they were low; however, recent research suggests it has a very mild, if any, effect in this regard. Vitamin A and E together can help to decrease cholesterol and general fat accumulation. To assist in healing and to minimize clotting, tocopherol is a useful nutrient before and after surgery, but is limited to dosages of 200–300 IUs per day (higher amounts may actually suppress the healing process). Also, pre- and postsurgery, vitamin E neutralizes free radical formation and thus reduces possible problems from that. Recently, this antioxidant effect of vitamin E was shown in cardiopulmonary bypass surgery. In regard to its healing powers, vitamin E is used most commonly both internally and externally to assist in the repair of skin lesions, ulcers, burns, abrasions, and dry skin and to heal and/or diminish the scars caused from injury or surgery. (Vitamin A also appears to work in this regard, possibly even better than E in some instances where skin and tissue healing are needed.) Decreasing scars internally may be important in resolving damage from inflammation of blood vessels and may reduce the potential for clotting and thrombophlebitis. Vitamin E, with the help of vitamins C and P (bioflavonoids), may be useful in preventing progression of varicose veins, more so than treating them once they have occurred.

Vitamin E may be very helpful to women. Research shows relief from menstrual pains, as well as general relief from various menstrual disorders. Many problems of menopause, such as headaches, hot flashes, or vaginal itching due to dryness, may be reduced with the use of supplemental vitamin E. When birth control pills are used, the tocopherols may help protect the body from their possible side effects. Estrogen may decrease the effect of vitamin E, so more is needed when estrogen therapy is used. Vitamin E has been used both topically and orally with some success in the treatment of fibrocystic breast disease, or cystic mastitis, likely due to its protective mechanisms against estrogen, which seems to potentiate this disease.

Vitamin E’s antioxidant functions help to protect our cell membranes and lung tissue from pollution, particularly from ozone (O3) and nitrogen dioxide (NO2) in the air. Research in rats clearly showed their ability to tolerate increased ozone levels and to survive much longer with vitamin E. There is also some cardiac protection from smoke and alcohol with vitamin E, and it protects against the cardio-toxic effects of adriamycin, an anticancer drug.

Vitamin E has also been used to enhance immunity in the treatment of viral illness and to reduce the neurologic pain from shingles, a viral infection of the nerves and skin. It is also helpful in preventing eye problems, such as poor vision or cataracts, that may be due to oxidation of fatty tissues and free radical formation leading to areas of inflammatory damage. Headaches may sometimes be helped with tocopherol treatment, depending on the cause. Various kidney and liver diseases and muscular dystrophy have all been treated with vitamin E, though more immediate inflammatory problems, as in bursitis, gout, and arthritis seem to benefit more. Leg cramps and circulatory problems associated with diabetes may be helped with vitamin E treatment. For various skin rashes, including those of lupus erythematosus, vitamin E, usually along with vitamin A, may be of some help.

Deficiency and toxicity: Vitamin E is not stored as readily as are the other fat-soluble vitamins. Excess intake is usually eliminated in the urine and feces, and most doses clear the body within a few days. For these reasons, toxicity from vitamin E use is unlikely. In animal studies, very high amounts of E have been shown to retard growth and decrease muscle tissue, decrease the red blood count, and cause poor bone calcification, though in humans these seem more likely to be signs of E deficiency. High intakes of the vitamin E oil can cause nausea, diarrhea, or flatulence in some people.

Large doses of vitamin E are generally avoided for people with high blood pressure as it has been thought to raise blood pressure, though this has not been easily reproduced experimentally. Usually, though, 400–600 IUs daily (the nonoily, water-dispersible vitamin E succinate may be preferable for patients with hypertension) can provide some antioxidant and circulatory benefits without increasing blood pressure. It is possible that large doses of vitamin E (over 1,200 IUs), may have a mild immune-suppressing effect; smaller doses seem to be immune supportive. There is also some concern about using higher doses of vitamin E in people with rheumatic heart disease and administering it to people undergoing digitalis or anticoagulant therapy, as vitamin E may increase the anticoagulant effects of these medicines. Its effects on blood clotting must be watched carefully in such cases. Vitamin E does not contribute to blood clots or abnormal lipid patterns as is sometimes thought.

Vitamin E deficiency is fairly rare with vague symptoms that are difficult to diagnose, causing some question as to its importance since there is no clear deficiency disease in humans as there is with deficiency of vitamin C or many of the B vitamins. Infertility as an effect of vitamin E deficiency has not been revealed as clearly in humans as it was in the rat study. It is likely that vitamin E deficiency is simply more difficult to diagnose symptomatically because of its wide range of effects on the nervous, reproductive, muscular, and circulatory systems and because other nutrients may mask vitamin E deficiencies. However, biochemically, low levels of vitamin E can be measured in the blood and have been seen in such conditions as acne, anemia, infections, some cancers, periodontal disease, cholesterol gallstones, neuromuscular diseases, and dementias such as Alzheimer’s disease.

Deficiencies are more of a concern in premature babies, since there is no maternal-fetal vitamin E transfer; vitamin E depletion may also appear in newborns fed on cow’s milk, which contains no vitamin E, instead of breast milk, which does contain some if the mother’s diet is healthy. Deficiency is also more likely in adults with gastrointestinal disease, with poor fat digestion and metabolism, or with pancreatic insufficiency.

Iron, especially the inorganic form, depletes vitamin E absorption in the small intestine. The two should not be taken together, as this causes the absorption of both to be diminished. Chlorine, ferric chloride, and rancid oils also deplete or destroy vitamin E.

The first sign of vitamin E deficiency may be loss of red blood cells due to fragility caused by the loss of cell membrane protection. Oxidized polyunsaturated fatty acids may also weaken the red blood cell membranes and cause rupture. The generalized decrease in cell and tissue protection from free radical molecules may lead to abnormal fat deposits in muscles, muscle wasting, and problems in the kidneys and liver because of the circulating dead cells and toxins released. Men may have changes in the testicular tissue with vitamin E deficiency.

With increased oxidation, there is an increased requirement for vitamin E. Vitamin E deficiency may lead to free radical effects on the unsaturated fatty acids, inhibiting their functions in the health of cell membranes and tissues. Pituitary and adrenal function may be lowered, as these glands may suffer from the cumulative effects of oxidation. Degenerative changes produced by deficiency of vitamin E may not be corrected by vitamin E therapy.

There is some question as to whether tocopherol (“to bear children”) deficiency reduces the ability to carry pregnancy to term and increases the likelihood of premature birth or causes problems in infants. Is it related to increased heart disease or atherosclerosis or even cancer? Surely, there is a lot more to learn about vitamin E.

Requirements: The amount of vitamin E required depends upon body size and the amount of polyunsaturated fats in the diet, since vitamin E is needed to protect these fats from oxidation. More is needed when any refined oils, fried foods, or rancid oils are consumed. Supplemental estrogen or estrogen imbalance in women increases the need for vitamin E, as does air pollution. And, as I have mentioned, vitamin E should not be taken with iron, especially inorganic iron, such as ferrous sulfate or the iron added to food products. Selenium, another important antioxidant, however, may increase the potency of vitamin E.

Even though the RDA for vitamin E is really quite low, many people do not consume this in their diet alone.

For the d-alpha tocopheral form of this vitamin, 1 mg. equals 1.49 IUs. The different forms of vitamin E have various potencies, with d-alpha the most active and most prevalent in nature. Vitamin E extraction, purity, and activity also vary. The best forms, in my opinion, are those that contain the natural, unesterified d-alpha tocopherol along with the other (beta, gamma, and delta) naturally occurring tocopherols. This type of E is not

easy to find because it is more difficult and costly to produce. The vitamin E palmitates and acetates are synthetic water-dispersible forms of vitamin E that have a good level of activity and are often easier to take, as they can be taken with other vitamins. Vitamin E oil is taken ideally in the morning before breakfast or at night before bed. It can also be taken after meals containing some fat. Approximately 400–600 IUs is used preventively, whereas for therapeutic effects, an amount between 800–1600 IUs daily is suggested. With therapeutic uses of vitamin E, it is best to start with a low level and gradually increase it. Levels over 1,600 IUs per day are not recommended unless there is close medical supervision.