Contradictory results have been obtained in clinical studies that have investigated whether vitamin E affects platelet aggregation or coagulation. A dose of 1200 lU/day (800 mg of D-alpha-tocopherol) taken for 28 days had no effects on platelet aggregation or coagulation according to one clinical study (Morinobu et al 2002). Similarly, a second clinical study found that a lower dose of 600 mg (900 IU) of RRR-alpha-tocopherol daily taken for 12 weeks did not alter coagulation activity (Kitagawa et al 1989). Alternatively, increased risk of gingival bleeding at doses of 50 mg/day was found by another study (Liede et al 1998).

Overall, it appears that people with reduced levels of vitamin K may be more susceptible to the effects of vitamin E potentiating warfarin activity. Until further research can clarify whether the interaction is clinically significant for most people, it is recommended that prothrombin time ratio or INR should be closely monitored with the addition and withdrawal of treatment with high-dose vitamin E supplements.

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