Acute coronary thrombosis: 450 to 1,600 IU a day started as soon as possible and maintained.

Older cases of coronary thrombosis: 450 to 1,600 IU if systolic pressure is under 160 Otherwise 450 IU for the first four weeks, particularly if a hypotensive agent is used concurrently.

Acute rheumatic fever: 450 to 600 IU daily.

Chronic rheumatic heart disease: give 90 IU daily first month, 120 IU daily second month and 150 IU daily for third month. 150 IU may be ideal dose. Occasionally more is necessary and advisable. Response will necessarily be slow.

Anginal Syndrome: 450 to 1,600 IU if systolic pressure is under 160. Otherwise start on 150 IU for four weeks then 300 IU for four weeks, particularly if hypotensive agent is used.

Hypertensive heart disease: 75 IU daily for four weeks, 150 IU daily for four weeks, then cautiously increase.  Should be used with hypotensive agents.  High doses of vitamin E have been shown to reduce high blood pressure in rats with chronic kidney failure. (Vaziri N.  Hypertension, Jan 2002.) 

Thrombophlebitis and Phlebothrombosis: 600 to 1,600 IU daily.

Thrombocytopaenic Purpura: 800 to 1,200 IU daily.

Diabetes Mellitus: Same schedule as for cardiacs.

Acute and Chronic Nephritis: as for cardiac patients.

Burns, Plastic Surgery, Mazoplasia: 600 to 1,600 IU daily, using vitamin E ointment or vitamin E spray as adjunct.  (Editor’s note: vitamin E may also be dripped from a thumbtack-punctured capsule.)
 

CAUTIONS

The maintenance dose equals the therapeutic dose.

Do not take iron and vitamin E at same time. If iron is indicated, separate the doses by about nine hours.

The digitalis requirement is often reduced after vitamin E takes hold, so over-digitalization should be avoided. A patient receiving vitamin E should not be digitalized by the Eggleston massive dose technique nor any of its modifications. It is usually sufficient for full digitalization to give what is ordinarily a maintenance dose of 1 1/2  grains digitalis folia or 0.1 mg digitoxin per day. By the second day the patient is often digitalized.

Insulin dosages in diabetic cardiacs must be watched closely, for the insulin requirement may be considerably reduced very suddenly.

Hyperthyroidism is sometimes a contraindication.

Estrogens should rarely be given at the same time as alpha tocopherol (vitamin E).

(Editor's note: The Shutes also recommend caution with patients who have untreated high blood pressure, a rheumatic heart, or congestive heart failure. If you are a person with these or any other preexisting medical condition, you need to WORK WITH YOUR PHYSICIAN TO DETERMINE YOUR OPTIMUM VITAMIN E LEVEL.)

TWELVE EFFECTS  OF ALPHA TOCOPHEROL (Vitamin E)

1.  It reduces the oxygen requirement of tissues.
Hove, Hickman, and Harris (1945) Arch. Biochem. 8:395.

Telford et al (1954) Air University School of Aviation Medicine Project #21-1201-0013, Report #4, May. Randolph Field, Texas.

2.  It melts fresh clots, and prevents embolism. 
Shute, Vogelsang, Skelton and Shute (1948) Surg., Gyn. and Obst. 86:1.

Wilson and Parry (1954) Lancet 1:486.

3.  It improves collateral circulation.
Enria and Fererro (1951) Arch. per Ia Scienze Med. 91:23. 

Domingues and Dominguez (1953) Angiologia 5:51. 

4.  It is a vasodilator.
Shute, Vogelsang, Skelton and Shute (1948) Surg., Gyn. and Obst. 86:1.

5.  It occasionally lyses scar tissue.
Steinberg (1948) Med. Clin. N. America 30:221, 1946.

6.  It prevents scar contraction as wounds heal. 
Shute, Vogelsang, Skelton and Shute (1948) Surg., Gyn. and Obst. 86:1.

7.  It increases low platelet counts. 
SkeIton, Shute, Skinner and Waud (1946) Science 103:762.

8.  It decreases the insulin requirement in about 1/4 of diabetics. 
Butturini (1950)  Gior. di Clin. Med. 31:1.

Tolgyes (1957) Summary 9:10.

9.  It is one of the regulators of fat and protein metabolism. 
Hickman (1948) Rec. of Chem. Progress, p.104.

10.  It stimulates muscle power. 
Percival (1951) Summary 3:55.

11.  It preserves capillary walls. 
Ames, Baxter and Griffith (1951) International Review of Vitamin Research 22:401.

12.  It prevents haemolysis of red blood cells. 
Rose and Gyorgy (1951) Fed. Proc.10:239. 1951.
 

OTHER  RELEVANT  PUBLICATIONS

Tolgyes, S. and Shute, E. V. (1957), Alpha Tocopherol in the Management of Small Areas of Gangrene. Can. M. A. J.  76:730.

Shute, E.V. (1957) The Prevention of Congenital Anomalies in the Human: Experiences with Alpha Tocopherol as a Prophylactic Measure.  J. Ob. & Gyn. Brit. Emp. 44:390.

Hauch, J. T.  (1957) A New Treatment for Resistant Pressure Sores. Can. M.A.J. 77:125.

Shute, E. V. (1957) Alpha Tocopherol in Cardiovascular Disease. Oxford University Med. Gaz. 9:96. 
 

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