Vitamin E and the Healing of Bone Fracture: The Current State of Evidence

Abstract

Background. The effect of vitamin E on health-related conditions has been extensively researched, with varied results. However, to date, there was no published review of the effect of vitamin E on bone fracture healing. Purpose. This paper systematically audited past studies of the effect of vitamin E on bone fracture healing. Methods. Related articles were identified from Medline, CINAHL, and Scopus databases. Screenings were performed based on the criteria that the study must be an original study that investigated the independent effect of vitamin E on bone fracture healing. Data were extracted using standardised forms, followed by evaluation of quality of reporting using ARRIVE Guidelines, plus recalculation procedure for the effect size and statistical power of the results. Results. Six animal studies fulfilled the selection criteria. The study methods were heterogeneous with mediocre reporting quality and focused on the antioxidant-related mechanism of vitamin E. The metasynthesis showed α-tocopherol may have a significant effect on bone formation during the normal bone remodeling phase of secondary bone healing. Conclusion. In general, the effect of vitamin E on bone fracture healing remained inconclusive due to the small number of heterogeneous and mediocre studies included in this paper.

Advances and Promises of Nutritional Influences on Natural Bone Repair

“…Vitamin C supplementation accelerated fracture repair that included prominent chondrocyte hypertrophy at day 10 and a well‐developed fibrocartilaginous callus with osteoid formation on day 15, and faster transition of the cartilaginous callus into the bony callus . Unlike vitamin C, vitamin E supplements in the form of α‐tocopherol appear to be most beneficial during the bone remodeling phase of secondary bone healing . Although α‐tocopherol is the major vitamin E isoform utilized by the body, ingestion of tocotrienol‐enriched supplements resulted in superior biomechanical properties of healed bones compared with rats given an α‐tocopherol supplement, suggesting that there may be isoform‐specific effects of vitamin E on bone healing …”

“…93 Unlike vitamin C, vitamin E supplements in the form of α-tocopherol appear to be most beneficial during the bone remodeling phase of secondary bone healing. 94 Although α-tocopherol is the major vitamin E isoform utilized by the body, ingestion of tocotrienol-enriched supplements resulted in superior biomechanical properties of healed bones compared with rats given an αtocopherol supplement, suggesting that there may be isoform-specific effects of vitamin E on bone healing. 84 Though our understanding of the influence of nutritional supplements on fracture healing has advanced significantly over the years, there are several gaps in our knowledge that should be addressed in future studies.…”

Partial Protection by Dietary Antioxidants Against Ethanol‐Induced Osteopenia and Changes in Bone Morphology in Female Mice

“…However, the true effect of α-tocopherol on bone is uncertain. A review of studies on Vitamin E in fracture repair suggested that α-tocopherol may impact bone remodeling and healing due to its antioxidant properties but cited the need for more data to be collected (Borhanuddin et al, 2012). In a study using mice genetically unable to import α-tocopherol, mice displayed decreased bone mass due to increased osteoclast fusion.…”

Efecto de Vitamina E y Alendronato sobre la Densidad Mineral en Hueso Maxilar de Ratas

“…Sin embargo, el verdadero efecto de E en el hueso es incierto. Una revisión de los estudios sobre el efecto de tocoferoles en la reparación de fracturas sugiere que Vitamina E puede afectar la remodelación ósea y la curación debido a sus propiedades antioxidantes, pero citó la necesidad de más datos para ser recolectados (Borhanuddin et al, 2012). En un estudio utilizando ratones genéticamente incapaces de importar Vitamina E, los ratones mostraron disminución de masa ósea debido al aumento de la fusión de osteoclastos.…”