VRx insights TexturesIconsImagesFontsColorGradientsBordersHelpSitemap insights.vrx.palo-alto.ca.us
The role of Tocopherol in the human antioxidant system.

You can think of E as the oil version of C, it can be considered the primary lipid ("fat") antioxidant in the human antioxidant system. It can not be stressed enough that E, C and GSH (which has an absolute need for Selenium in its synthesis) work together. E recharges C, C recharges E while Glutathione also recharges C.

Thus if you run out of E can not not be recharged and this Glutathione now does all the work and if that runs out you are in big trouble. Long recovery times might be explained by a loss of selenium from body stores, if the illness is of sufficient duration it is possible this can happen. With that gone the chances of survival are slim.

Sepsis

The role of Tocopherol in neonatal sepsis

1. Have other neonatal centers seen unusual symptomatology that appeared since utilization of intravenous vitamin E?
2. Are there any clinical dose/serum level data available on this product that might benefit potential utilization to obtain physiologic and not pharmacologic levels of serum vitamin E? (Note: Manufacturer’s recommen- dation is “25-50 mg added to an appropriate intravenous solution.”)
3. Is anyone aware of possible toxicology associated with polysorbate 80 or 20 in neonates, especially small premature infants?
CARL J. BODENSTEIN, MD
Suite 216 South Center Medical Building
W 105 Eighth
Spokane, WA 99204


E-ferol
The E-Ferol debacle

Vitamins C and E worth together with glutathione and by implication selenium/selenocysteine to provide aquaes and lipid antioxidants. An intravenous commercial Vit. E solution sold for neoatal ICU purposes contained a presevative known to cause an allergic reaction in some people. Sadly Vit E is essential for the body to be able to remediate allergic reactions and this failure led to the death of a fair number of infants.

"No clinical trials regarding safety or efficacy were carried out. The product was immediately accepted and used in many medical centers throughout the United States. Subsequent events have shown that E-Ferol, which contains (per muliliter) 25 USP units of dl-a-tocopheryl acetate solubilized in a mixture of polysorbate 80 (9%) and polysorbate 20 (1%), is toxic in small infants. The product was stocked in 159 hospitals according to an early survey; 62 of these hospitals never used EFerol and 62 reported “no problem” associated with its use. However, 35 hospitals reported side effects in a total of 81 cases. There were 38 deaths reported from 11 states and 43 other infants sustained serious effects."

Unfortunately many lay-press reports (ie, NYT) confused the toxicity of the preservative, Polysorbate 80, with toxicity of vitamin E, which does not exist as it is essential to life. You can not be allergic to vitamins, you would never have been born or developed past a certain point: you can'e be allergic to a chemical you would die without.

See also:

  1. Lorch 1984 Unusual Syndrome Among Premature Infants: Association With a New Intravenous Vitamin E Product
  2. Martone 1985 Polysorbate 80 in medical products and nonimmunologic anaphylactoid reactions
  3. Coors 2005 Illness With Fatalities in Premature Infants: Association With an Intravenous Vitamin E Preparation, E-Ferol