Tocopherols, the vitamin E family, are taken as supplements for disease prevention. Large trials of the common supplement form lowered neither heart disease, cancer nor death; some showed small rises in bleeding strokes, prostate cancer in men, and heart failure in heart disease or diabetes. Best-replicated gains lie outside longevity: fewer imaging-dye injuries to impaired kidneys, less menstrual pain. Fatty-liver inflammation eases, lower doses appearing comparable; long-term outcomes remain unproven. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Serum α-tocopherol | 7.0–25.1 mg/L (ages 40–59); 9.0–29.0 mg/L (over 59) | Confirms intake and absorption |
| Serum γ-tocopherol | 0.5–5.5 mg/L (ages 40–59); 0.5–4.9 mg/L (over 59) | Falls with high-dose α-tocopherol |
| ALT (alanine aminotransferase) | At or below 33 U/L for men, at or below 25 U/L for women | Expected to change in fatty liver use; paired with AST (aspartate aminotransferase) |
| INR (international normalized ratio) | Prescriber's target (reference range 0.8–1.2) | Safety check for warfarin users: rising value prompts dose reduction or stopping |
| PSA (prostate-specific antigen) | 0.0–4.0 ng/mL | Safety check for men on 400 IU/day or more: rising value prompts stopping |
Cadence: Baseline panel before starting, including PSA and, where testing is available, selenium status for men considering 400 IU/day or more; clotting tests 1–2 weeks after starting or changing the dose for warfarin users; liver enzymes at 12 and 24 weeks, then every 6–12 months for fatty-liver use; serum tocopherols at 3 months, then every 12 months; PSA every 12 months for men on higher doses.