DEAR DR. DONOHUE: Please say something about vitamin E. It is hyped so much that I am confused. I am also confused about its many forms and which is best. Please set the record straight. – M.F.

ANSWER: The facts about vitamin E and the claims made for it are in a state of flux, so everyone is confused about it.

It’s an antioxidant. Antioxidants keep body cells from rusting. The multitude of chemical reactions taking place within body cells generate waste compounds that can damage (oxidize) cells unless they are neutralized.

Vitamin E is one neutralizing substance. That much is known about it.

In addition to its antioxidant property, it has a hand in boosting the immune system, in squelching inflammation and in keeping the blood free of clots.

It is said to have a protective effect on arteries and thereby to prevent heart attacks and strokes. It has been touted as a preventive for Alzheimer’s disease.

Claims are made that it reduces the risk for prostate and colon cancer. It might protect against colds. Trials are being conducted to prove these assertions. While waiting for the results, maintain a bit of healthy skepticism.

Natural vitamin E is a mix of eight compounds. Four are tocopherols (toe-KOF-ur-ols) – alpha, beta, gamma and delta; four are tocotrienols (TOE-koe-TRY-uh-nols) with the same Greek letters. Alpha tocopherol is the compound found in most vitamin E supplements, because that form of the vitamin is the one whose blood level is the highest.

The inference is that it, therefore, must be the most important. That might not be true. Gamma tocopherol, for instance, appears to be more effective in preventing prostate and colon cancer, and the tocotrienols might be better at preventing breast cancer.

For the present, just make sure you are getting the recommended daily allowance of 15 mg (for adults).

DEAR DR. DONOHUE: I was told I have elevated pressure in my eyes and was given a prescription for eyedrops – Travatan. I am to use this for the rest of my life. Is this necessary? Will my high pressure lead to blindness? I am really worried. – E.G.

ANSWER: The front one-third of the eye is filled with fluid. It’s like a sink whose faucet is always running.

So long as fluid enters the front third of the eye at a fixed rate and leaves it through a drainage canal in the corner of the eye at the same fixed rate, all is well.

If fluid production increases or if drainage is impeded, then pressure within the eye rises. That pressure presses on the optic nerve. If the pressure is not relieved, then the optic nerve can be permanently damaged, and that leads to blindness.

This is glaucoma. Travatan facilitates the drainage of fluid from the anterior eye chamber. Your pressure should have dropped by now, and your sight, therefore, should not be affected.

People with glaucoma must have lifelong treatment – a small price to pay for preserving vision.

DEAR DR. DONOHUE: I would like you to tell me what alkaline phosphatase is. What does it mean when it is elevated? Mine is high. – M.W.

ANSWER: Alkaline phosphatase is an enzyme. Enzymes are found in all body cells. They are the cells’ drill sergeants, keeping them performing at peak efficiency. Many organs and tissues have specific enzymes. If cells of those organs or tissues are damaged, they leak their enzymes into the blood. Blood level elevation of an enzyme, therefore, can pinpoint trouble in a specific organ or tissue.

Alkaline phosphatase is found in bones and the liver. A mild rise in this enzyme is common in many people older than 60, and therefore it does not always have significance.

If you have no symptoms and if your alkaline phosphatase level is not very high, a reasonable approach is to ignore it and recheck it at a later date. If the level rises higher, then an investigation of liver and bones will be made.

DEAR DR. DONOHUE: I’ve been told that penicillin doesn’t work anymore. Now we are given expensive pills that take forever to work. In the past, a shot of penicillin would clear me up in three days. I wish you would tell me why this has happened. – M.K.

ANSWER: Penicillin was and still is a miracle drug. It does not work for all infections. It never did. And it has lost its ability to cure some infections that it was able to eradicate with ease.

The reason for that is it has been used for illnesses that it should not be used for – viral infections are a case in point. That has caused the rise of resistant bacteria. Don’t pressure your doctor to give you antibiotics if the doctor does not feel you have a bacterial infection.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible.

Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.