by Dr. Mercola 
Vitamin E is an important fat-soluble vitamin and antioxidant  that helps combat damaging free radicals. It also plays a role in the making of red blood cells and helps your body use vitamin K, the latter of which is important for heart health. 
Unfortunately, estimates suggest about 6 billion people worldwide are deficient in this basic micronutrient.
According to a recent review presented at the World Congress of Public Health Nutrition, more than 90 percent of Americans fail to reach the recommended daily allowance (RDA) of vitamin E. 
An earlier review  published in 2012 found that over 75 percent of Americans and Britons failed to meet minimum RDA levels for vitamin E. The RDA for people over the age of 14 is 15 milligrams (mg) of vitamin E per day, but most Americans get only half that amount. 
Insufficient vitamin E can increase your risk for a wide variety of diseases, including immune dysfunction, cognitive deterioration and cardiovascular disease. As noted by Prevent Disease: 
Adequate levels of vitamin E, an essential micronutrient, are especially critical for the very young, the elderly, and women who are or may become pregnant.
Deficiency of the vitamin is occurring at an alarming frequency, and the effects of this are less obvious in the short-term affecting everything from fertility to Alzheimer’s .
How Much Vitamin E Do You Need for Optimal Health?
According to the most recent review mentioned above, ,  a mere 21 percent of the people studied had a protective level of serum alpha-tocopherol (vitamin E), which studies have pegged at 30 micromol per liter (μmol/L).
This appears to be the threshold above which “definable effects on human health in multiple areas” are obtained.  Human studies have also found that in order to achieve a level of 30 μmol/L, you need a daily intake of at least 50 international units (IUs) of vitamin E. 
Not surprisingly, the primary reason for such widespread deficiency is the fact that most people eat a primarily processed food diet, which tends to be lacking not only in vitamin E but also in many other important antioxidants and micronutrients, including healthy fats.
Vitamin E is fat-soluble, and if you’re on a low-fat diet you may simply have too little fat to properly absorb the vitamin E present in the foods you eat or supplements you take.
In fact, studies have shown your body will only absorb about 10 percent of the vitamin E from a supplement when you take it without fat.  This is yet another adverse effect of the flawed recommendation to eat a low-fat diet.
Signs, Symptoms and Health Effects of Vitamin E Deficiency
Signs and symptoms of serious vitamin E deficiency include: , 
- Muscle weakness and unsteady gait
- Loss of muscle mass
- Cardiac arrhythmia
- Vision problems, including constriction of your visual field; abnormal eye movements; blindness
- Liver and kidney problems
As mentioned, vitamin E is important throughout life, but deficiency during pregnancy can be particularly problematic. Worldwide, about 13 percent of people have vitamin E levels below the “functional deficiency” threshold of 12 μmol/L, and most of these are newborns and young children.
Babies who are deficient in vitamin E are at increased risk for immune and vision problems. Being deficient in vitamin E during pregnancy also raises your risk for miscarriage. 
Studies have also found that low vitamin E levels tend to be associated with a higher risk of cancer and heart disease. 
It may be worth noting that while some studies have found vitamin E supplementation may actually increase your risk of cancer   and has no beneficial effect on heart health, such studies appear to demonstrate the difference between synthetic and natural vitamin E, which I’ll review below.
Synthetic vitamin E is derived from petrochemicals and has known toxic effects, yet synthetic alpha-tocopherol is the type most commonly used when investigating the health effects of vitamin E.
Hence, it’s not so surprising that synthetic vitamin E supplements would fail to provide certain health benefits and potentially increase certain health risks.
Metabolic Syndrome Raises Your Risk of Vitamin E Deficiency
Obese people with metabolic syndrome are at increased risk for vitamin E deficiency, in part because they need more vitamin E to begin with (due to increased oxidative stress), and in part because their condition impairs their body’s utilization of vitamin E., 
Metabolic syndrome refers to a cluster of symptoms that include excess abdominal fat, high blood pressure, low HDL cholesterol, high blood sugar and elevated triglycerides. As noted by Maret Traber, Ph.D., who is a principal investigator with the Linus Pauling Institute: 
Vitamin E is associated with lipids, or the fats found in the blood, but it’s mostly just a micronutrient that’s going along for the ride … [T]issues of obese people are rejecting intake of some of these lipids because they already have enough fat … In the process they also reject the associated vitamin E.
Natural Versus Synthetic Vitamin E
Vitamin E includes a total of eight different compounds, and having a balance of all eight helps optimize its antioxidant functions. These compounds are divided into two groups of molecules as follows:
Tocopherols are considered the “true” vitamin E, and many claim it’s the only kind that has health benefits. Part of the problem is that tocotrienols simply haven’t received as much scientific attention. The studies looking at tocotrienols account for a mere 1 percent of the total vitamin E literature.
Despite that, studies suggest tocotrienols may help support normal cholesterol levels, protect against free radical damage and the normal effects of aging, and in combination with tocopherols appear to promote brain health.
In my view, it’s safe to assume you would benefit from a balance of all of them and not just one. Foods are the ideal source of vitamin E, as all eight vitamin E compounds are naturally available.
Synthetic vitamin E supplements typically include only one of the eight, alpha-tocopherol. A supplement will not actually tell you it’s synthetic, but you can usually tell by carefully reading the label.
• Synthetic alpha-tocopherol is typically listed with a “dl” (i.e., dl-alpha-tocopherol)
• Non-synthetic or naturally-derived is typically listed with a “d” (d-alpha-tocopherol)
Vitamin E Supplements to Avoid
I strongly recommend avoiding synthetic vitamin E supplements as they’ve been shown to have toxic effects in higher amounts and/or over the long-term. So if you opt for a supplement, make sure you’re getting a well-balanced all-natural vitamin E supplement, not a synthetic one.
Another major issue with most supplements is that if you take high amounts of alpha-tocopherol in isolation, it could potentially deplete the other tocopherols and tocotrienols from your body.
This is true whether you’re taking a natural or a synthetic one, so I recommend looking for one where alpha-tocopherol is not the sole form of vitamin E. Many vitamin E supplements can also contain other harmful ingredients, such as soy, which contains a number of problematic compounds, including:
• Goitrogens that can block synthesis of thyroid hormones and interfere with iodine metabolism
• Isoflavones that resemble human estrogen and may disrupt your endocrine function
• Phytic acid, which bind to metal ions, preventing the absorption of certain beneficial minerals, including calcium, magnesium, iron and zinc
For these reasons, I recommend avoiding foods and supplements containing unfermented soy in general and soybean oil in particular. The majority of soy  grown in the U.S. has the added disadvantage of being genetically engineered (GE), which means it may be heavily contaminated with the toxic herbicide Roundup .
Foods Rich in Vitamin E
Supplements are best taken in addition to, not in place of, a healthy diet, and only if you actually need them. One way to evaluate your need for a vitamin E or other supplements is to use a nutrient tracker, such as Cronometer.com/Mercola , which is the most accurate one on the market because of their decision to eliminate inaccurate crowd sourced data.
Vitamin E can easily be obtained from a healthy diet, so before considering a supplement, I strongly recommend including more vitamin E-rich foods in your diet. Three general categories of foods that contain higher amounts of vitamin E are:
• Leafy greens
• High-fat foods such as nuts, seeds and fatty fish/seafood, including shrimps and sardines
• Oil-rich/high-fat plants such as olives and avocados
Most of these foods are best eaten raw, as cooking will destroy some of the natural nutrients. Obvious exceptions exist of course. Do not eat raw shrimp, for example. More specific examples of foods high in vitamin E include: 
Food – Serving Size – Vitamin E (mg)
- Wheat germ oil – 1 tablespoon – 20.3 mg
- Sunflower seeds – 1 ounce – 7.4 mg
- Almonds – 1 ounce – 6.8 mg
- Sunflower oil – 1 tablespoon – 5.6 mg
- Hazel nuts – 1 ounce – 4.3 mg
- Avocado (sliced) – ½ a whole avocado – 2.0 mg
- Broccoli (boiled/steamed) – ½ cup – 1.2 mg
- Mango (sliced) – ½ cup – 0.7 mg
- Spinach (raw) – 1 cup – 0.6 mg
Identifying a High-Quality Vitamin E Supplement
If you decide to take a supplement, make sure it’s a high-quality supplement made with all-natural ingredients. Here are a number of criteria to consider when making your selection:
• Made with natural vitamin E. Synthetic versions are typically identified by the “dl” at the beginning (dl-alpha-tocopherol), while non-synthetic uses a “d” (d-alpha-tocopherol).
• Free of soy or soybean oil derivatives. Due to the potential health risks (detailed above), avoid vitamin E supplements that contain any kind of soy.
• Free of GE ingredients. This can be a bit challenging since manufacturers are not required to list specifics on GE ingredients. However, since vitamin E is naturally formed in a variety of plants and many of these plants are now GE, (especially when grown in the U.S.), I recommend avoiding supplements made from corn, soybeans and cotton seed.
• Has a balance of all four tocopherols. If it’s a synthetic form of vitamin E, it most likely will not contain any of the other tocopherols (beta, gamma and delta). I believe these are important to your overall health and should be included.
• Has a balance of all four tocotrienol nutrients. Rarely do you find these important compounds listed on vitamin E labels and the reason for that is because synthetic formulas will not contain tocotrienols. In my view, they’re an important part of a well-balanced formula.
Sources and References
- 1,  11,  14  University of Maryland Medical Center, Vitamin E 
- 2,  5,  6  Prevent Disease July 26, 2016 
- 3  British Journal of Nutrition 2012 Aug;108(4):692-8 
- 4  National Institutes of Health, Vitamin E Fact Sheet 
- 7  Nutraingredients-USA.com July 19, 2016 
- 8,  9  International Journal for Vitamin and Nutrition Research, ISSN 0300-9831 (PDF)
- 10,  17  Science Daily October 7, 2015 
- 12  Medscape Vitamin E September 6, 2013 
- 13  Johns Hopkins December 3, 2014 
- 15  Science Daily May 19, 2016 
- 16,  18  Science Daily November 2, 2015 
- 19  The World’s Healthiest Foods Vitamin E 
Read the full article at Mercola.com.