Background And Relevant Pharmacokinetics

Alpha-tocopherol is absorbed from the intestinal lumen and is dependent upon adequate fat digestion. After micellisation, it enters the lymphatic circulation and then the systemic circulation where it is transported in chylomicrons. Breakdown of chylomicrons in the blood releases somevitamin E, which is then taken up by circulating lipoproteins such as LDL and HDL. The remaining vitamin E is transported via chylomicron remnants to the liver. Here, the RRR alpha-tocopherol form is preferentially secreted back into the circulation in VLDL. It is suspected that hepatic alpha-tocopherol transfer protein is responsible for discriminating between the different types of tocopherols at this point (with the natural form preferentially taken up). Vitamin E is ultimately delivered to tissues when chylomicrons and VLDL are broken down by lipoprotein lipase. Vitamin E transported by LDL is also taken up by tissues via the LDL receptor. The bulk of vitamin E is stored in adipose tissue, although some storage also occurs in the heart, muscles, testes, uterus, adrenal and pituitary glands, and blood. Vitamin E metabolites are mainly excreted in the faeces, although some is also excreted by the kidneys and the skin (Shils et al 1999).

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