Tocotrienols

Tocotrienols/Drug Interactions:

  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Tocotrienols are a type of vitamin E. High-dose vitamin E (greater than 400 IU daily) appeared to increase PT and INR in patients with vitamin K deficiency, and inhibit platelet aggregation (58; 59; 60; 61; 62).
  • Antidiabetic agentsAntidiabetic agents: In human research, PalmVitee? (high in tocotrienols) reduced plasma glucose (56).
  • Antilipemic agentsAntilipemic agents: Based on in vitro and clinical evidence, tocotrienols may lower cholesterol levels (42; 46; 48; 72; 73; 5; 74; 75; 68; 76).
  • Antineoplastic agentsAntineoplastic agents: Based on in vitro evidence, a combination of lovastatin and d-gamma-tocotrienol has been shown to block cell growth of melanoma cells, prostate carcinoma cells, and lung carcinoma cells (77). In another study, a mixture of alpha-, gamma- and delta-tocotrienols inhibited the proliferation of estrogen receptor-negative human breast cancer cells, effects that may be synergistic with tamoxifen (78). Based on animal evidence, a combination of lovastatin and d-delta-tocotrienol resulted in lower tumor weights in mice (77).
  • Cytochrome P450: substrates, inhibitors, inducersCytochrome P450: substrates, inhibitors, inducers: Based on secondary sources, tocopherols and tocotrienols are metabolized by side chain degradation initiated by cytochrome P450 (CYP)-catalyzed omega-hydroxylation followed by beta-oxidation (79). Examples of CYP4F2-metabolized drugs and herbs include vitamin K, warfarin, and statins. Based on gene expression analysis, delta-tocotrienol increased CYP1A1 gene, a phase I enzyme (80).
  • Gastrointestinal agentsGastrointestinal agents: Halliwell et al. have reviewed the potential beneficial effects of tocotrienols on the gastrointestinal tract (81).
  • Immunomodulating agentsImmunomodulating agents: The ability of tocotrienols to interfere with mast cell proliferation, survival, degranulation, and migration has been reviewed (82).
  • Neuroprotective agentsNeuroprotective agents: Research has suggested that alpha-tocotrienol is more potent than alpha-tocopherol in vitro in protecting HT4 and primary neuronal cells against toxicity induced by glutamate as well as by a number of other toxins (19). At nanomolar concentrations, tocotrienol, but not tocopherol, completely protected neurons by an antioxidant-independent mechanism.
  • StatinsStatins: Based on in vitro evidence, a combination of lovastatin and d-gamma-tocotrienol has been shown to block cell growth of melanoma cells, prostate carcinoma cells, and lung carcinoma cells (77).
  • Weight loss agentsWeight loss agents: Based on secondary sources, alpha- and gamma-tocotrienol may help prevent immature fat cells from turning into mature fat cells. This would prevent the storage of more fat and may help prevent obesity.
  • Tocotrienols/Herb/Supplement Interactions:

  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Tocotrienols are a type of vitamin E. High-dose vitamin E (greater than 400 IU daily) appeared to increase PT and INR in patients with vitamin K deficiency, and inhibit platelet aggregation (58; 59; 60; 61; 62).
  • AntilipemicsAntilipemics: Based on in vitro and clinical evidence, tocotrienols may lower cholesterol levels (42; 46; 48; 72; 73; 5; 74; 75; 68; 76).
  • AntineoplasticsAntineoplastics: Based on in vitro evidence, a combination of lovastatin and d-gamma-tocotrienol has been shown to block cell growth of melanoma cells, prostate carcinoma cells, and lung carcinoma cells (77). In another study, a mixture of alpha-, gamma- and delta-tocotrienols inhibited the proliferation of estrogen receptor-negative human breast cancer cells, effects that may be synergistic with tamoxifen (78). Based on animal evidence, a combination of lovastatin and d-delta-tocotrienol resulted in lower tumor weights in mice (77).
  • AntioxidantsAntioxidants: Based on in vitro evidence, tocotrienol may exert antioxidant effects, as evidenced by inhibition of human glutathione S-transferase P1-1 (GST P1-1) (36) and reactions with peroxyl radicals in circulating human lipoproteins (37).
  • Citrus flavonoidsCitrus flavonoids: Based on animal evidence, citrus flavonoids, when combined with tocotrienols, may inhibit proliferation of mammary tumors (83).
  • Cytochrome P450: substrates, inhibitors, inducersCytochrome P450: substrates, inhibitors, inducers: Based on secondary sources, tocopherols and tocotrienols were metabolized by side chain degradation initiated by cytochrome P450 (CYP)-catalyzed omega-hydroxylation followed by beta-oxidation (79). Examples of CYP4F2-metabolized drugs and herbs include vitamin K, warfarin, and statins. Based on gene expression analysis, delta-tocotrienol increased CYP1A1 gene, a phase I enzyme (80).
  • Gastrointestinal herbs and supplementsGastrointestinal herbs and supplements: Halliwell et al. reviewed the potential beneficial effects of tocotrienols on the gastrointestinal tract (81).
  • HypoglycemicsHypoglycemics: In human research, PalmVitee? (high in tocotrienols) reduced plasma glucose (56).
  • Immunomodulating herbs and supplementsImmunomodulating herbs and supplements: The ability of tocotrienols to interfere with mast cell proliferation, survival, degranulation, and migration has been reviewed (82).
  • Neuroprotective herbs and supplementsNeuroprotective herbs and supplements: Research has suggested that alpha-tocotrienol is more potent than alpha-tocopherol in vitro in protecting HT4 and primary neuronal cells against toxicity induced by glutamate as well as by a number of other toxins (19). At nanomolar concentrations, tocotrienol, but not tocopherol, completely protected neurons by an antioxidant-independent mechanism.
  • Weight loss agentsWeight loss agents: Based on secondary sources, alpha- and gamma-tocotrienol may help prevent immature fat cells from turning into mature fat cells. This would prevent the storage of more fat and may help prevent obesity.
  • Tocotrienols/Food Interactions:

  • CitrusCitrus: Based on animal evidence, citrus flavonoids, when combined with tocotrienols, may inhibit proliferation of mammary tumors (83).
  • Tocotrienols/Lab Interactions:

  • CholesterolCholesterol: The cholesterol-lowering effects of tocotrienols have been reviewed (42; 46; 48; 72; 73; 5). Clinical support is lacking.
  • C-reactive proteinC-reactive protein: Based on various reviews, decreases in C-reactive protein may be partially responsible for the cardioprotective effects of tocotrienols (22; 23).
  • CytokinesCytokines: Based on various reviews, decreases in proinflammatory cytokines may be partially responsible for the cardioprotective effects of tocotrienols (22; 23).
  • GlucoseGlucose: In human research, PalmVitee? (high in tocotrienols) reduced plasma glucose (56).
  • IkappaB kinase-associated protein gene (IKBKAP) mRNA levelsIkappaB kinase-associated protein gene (IKBKAP) mRNA levels: IKBKAP levels were not shown to be altered in patients with familial dysautonomia who received tocotrienols (84).
  • PT/INRPT/INR: Tocotrienols are a type of vitamin E. High-dose vitamin E (greater than 400 IU daily) appeared to increase PT and INR in patients with vitamin K deficiency, and inhibit platelet aggregation (58; 59; 60; 61; 62).
  • Tocotrienols and tocopherolsTocotrienols and tocopherols: Based on clinical evidence, tocotrienol-rich vitamin E supplementation resulted in significantly increased alpha-, delta-, and gamma-tocotrienol concentrations (75).