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Vitamin E and Alzheimer's Disease: Which form of vitamin E is appropriate?

Vitamin E and Alzheimer’s
Are We Using The Right Form?
by Andreas M. Papas, Ph.D.
President YASOO Health Inc.
Adjunct Professor, James Quillen College of Medicine, East Tennessee State University
Background
The American Psychiatric Association in its official practice guidelines recommends vitamin E for newly diagnosed and mildly or moderately impaired Alzheimer's patients. This recommendation was based on a major study, funded by the National Institutes of Health (NIH) and conducted in 27 medical centers across the United States (N Engl J Med 1997: 336:1216-1222). In Alzheimer's patients taking large doses of vitamin E (2,000 IU/day), progression of the memory-robbing disease was delayed by approximately seven months. Actually vitamin E was slightly more beneficial than the drug selegeline, which also was evaluated in this study.
The role of nitrogen radicals and inflammation
Oxidative stress and inflammatory processes have been recognized as contributing factors in the pathogenesis of Alzheimer's disease. Reactive nitrating species have specifically been implicated based on detection of nitrotyrosine in brain protein of Alzheimer's patients. Inflammation is associated with increased activity of pro-inflammatory enzymes and excess production of free radicals, especially nitrogen radicals
Are we using the right form of vitamin E
While vitamin E has become synonymous with alpha tocopherol and most vitamin E supplements contain only alpha tocopherol, recent findings that gamma tocopherol, may be beneficial in the prevention and delaying the progression of Alzheimer's.
1. Gamma tocopherol is more effective than alpha tocopherol in neutralizing the nitrogen radicals (Proc Natl Acad Sci U S A 1997;94:3217-22).
2. Gamma-tocopherol and its metabolite ( -CEHC or LLU- ), exhibited stronger anti-inflammatory effects than alpha tocopherol (Proc Natl Acad Sci U S A. 2000;97:11494-11499).
3. Gamma tocopherol but not alpha-tocopherol attenuated the inhibition by nitrogen radicals of the oxidation-sensitive Kreb's cycle enzyme alpha-ketoglutarate dehydrogenase in the Alzheimer brain (Nitric Oxide 2002:221-7).
4. Gamma tocopherol is more potent than alpha tocopherol in increasing superoxide dismutase (SOD) activity as well as Mn SOD and Cu/Zn SOD protein expression (J Cardiovasc Pharmacol Ther 1999: 219-226). Antioxidant enzymes play a role in normal function of the mitochondria and may help prevent or delay the progression of Alzheimer's.
Alpha tocotrienol was reported to reduce neuronal cell death J Biol Chem. 2003;278:43508-15. The NIH is funding research at Ohio State University to elucidate the mecha

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