Natural vitamin E forms (4 isomers α, β, γ, δ)
ATC code: A11HA-TOCOTRIENOLS (Tocotrienols (vitamin E forms))
Brand names
Tocotrienol, EVNol
Tocotrienols are one of the two natural vitamin E subfamilies (the other is tocopherols). They differ from tocopherols by an unsaturated side chain with 3 double bonds. They distribute in lipid membranes, have antioxidant activity and in vitro inhibit cholesterol synthesis via HMG-CoA reductase and induce apoptosis in tumour cells. Oral bioavailability is low (5-10%); most is metabolised in the liver and excreted in bile.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Tocotrienols are a form of vitamin E, marketed as an antioxidant that slows ageing and extends lifespan. No convincing benefit has been shown for anti-ageing or longevity in this role, and the evidence for such use is lacking. What actually affects ageing: sun protection, not smoking, sleep, physical activity and diet; for the skin, proven ingredients such as retinoids do the work.
Not recommended
Tocotrienols are a form of vitamin E sold as supplements and promoted to protect the heart and blood vessels and to lower the risk of heart attack and stroke. For cardiovascular prevention, studies have not shown convincing benefit from vitamin E supplements, including tocotrienols: they do not reduce heart attacks, strokes, or mortality. What does help is controlling blood pressure and cholesterol, quitting smoking, regular physical activity, a Mediterranean-style diet, and proven medications when a doctor prescribes them (for example, statins where indicated). The substance is harmless in this role, but it is not something to rely on for protecting your vessels.
Not recommended
Tocotrienols are marketed for NAFLD and NASH based on small open-label trials of ALT reduction. 2023 in biopsy-proven NASH recommends α-tocopherol 800 IU/day (moderate evidence) in non-diabetic patients; for tocotrienols the guideline makes no recommendation. Cochrane 2017 on vitamin E in NAFLD analysed α-tocopherol data; high-quality RCTs of tocotrienols are absent. First-line NAFLD therapy is weight loss (5-10%), physical activity, T2DM and hypertension control; in proven NASH-fibrosis, pioglitazone or semaglutide per hepatologist judgement. If tocotrienols were recommended «for the liver», consider seeking a second opinion.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
FDA Category C. Tocotrienols are unstudied in pregnancy; AEMPS has not issued a ficha técnica. Not recommended during pregnancy. Daily vitamin E intake in pregnancy 15 mg (as α-tocopherol).
Not studied during lactation; better avoided. If vitamin E is needed in lactation, regular α-tocopherol at physiological 19 mg/day is preferred.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Tocotrienols is evaluated for the following indications with varying evidence strength: Non-alcoholic fatty liver disease (evidence tier D), Cardiovascular prevention through supplements (evidence tier D), Anti-aging and longevity (evidence tier D). See the full indication matrix with dosing and citations above on this page.
Common side effects of Tocotrienols (≥ 1 in 100): Nausea and epigastric pain at high doses, Transient diarrhoea, Fatigue. See the Safety section for uncommon and serious reactions.
FDA category C. FDA Category C. Tocotrienols are unstudied in pregnancy; AEMPS has not issued a ficha técnica. Not recommended during pregnancy. Daily vitamin E intake in pregnancy 15 mg (as α-tocopherol).
Not studied during lactation; better avoided. If vitamin E is needed in lactation, regular α-tocopherol at physiological 19 mg/day is preferred.
Tocotrienols is contraindicated in: Warfarin, acenocoumarol or DOAC therapy; Planned surgery within the next 2 weeks (high doses raise bleeding risk); Severe hepatic impairment. Full list in the Safety section.