The Overlooked Supplement for Osteoporosis: Vitamin E (Annatto Tocotrienols)

Why Tocotrienols Are Suddenly Everywhere

You’ve probably heard Dr. Barrie Tan talk about tocotrienols—especially the delta and gamma forms extracted from the annatto plant. The excitement is real, and the research is interesting. But when something “new” hits the supplement world, we need context: What is it, what does the data actually show, and does it change how we build a bone-health protocol right now?

“Vitamin E isn’t just one thing—there are eight forms: four tocopherols and four tocotrienols. Most older ‘vitamin E’ products are alpha-tocopherol; newer data point to benefits from tocotrienols.”

First, a quick clarification: annatto (the red-orange seed from a Central/South American tree) ≠ natto (a fermented soy food high in vitamin K2 and nattokinase). We’re talking annatto-derived tocotrienols here.

What the Research Shows (Bone-Specific Highlights)

Animal model: estrogen-deficient “postmenopausal” rats (2021)

• Annatto-derived tocotrienols (a self-emulsified preparation) improved osteoblast numbers, trabecular mineralization, and overall remodeling—less loss, more building.

Human RCT: postmenopausal women (2018, 12 weeks, n=89)

• Compared placebo (olive oil) vs. annatto DeltaGold® tocotrienols at two doses.
• Findings:
  • ↓ NTX (urine bone resorption marker; CTX analog)
  • Small ↓ bone alkaline phosphatase (a building marker) but…
  • ↑ Bone formation-to-resorption ratio (BAP/NTX) — similar to a P1NP/CTX ratio improvement
  • ↓ Serum RANKL and better RANKL/OPG balance (think: less “turn on the osteoclast” signaling)
  • ↓ 8-OHdG (urine oxidative stress/DNA damage marker)

Dose note: the lower and higher tocotrienol doses performed similarly in this trial. That matters for cost, capsule load, and practicality.

Products & Dosing Reality

• DeltaGold® is a standardized annatto tocotrienol extract used by multiple brands (Dr. Tan’s Designs for Health, AlgaeCal D3 Complete, others).
• In our practice, when patients use AlgaeCal Plus for multi-minerals, we commonly pair it with AlgaeCal D3 Complete, which includes DeltaGold® at a lower dose (plus alpha/gamma tocopherols from a separate source).
• Could you jump to ~300 mg tocotrienols? You could—but:
  • Current human data are short (12 weeks) and show modest BTM shifts, not BMD changes.
  • The “more is better” threshold isn’t defined; the higher dose didn’t outperform the lower in that RCT.
  • Splitting out D/K2/retinol just to raise E often creates capsule fatigue (and adherence drops).

My stance right now: keep tocotrienols in the stack via a combination product; don’t rearrange your whole protocol or triple your capsules yet. If someone wants to trial a higher dose, it’s reasonable—just measure.

How I’d Integrate Tocotrienols (Without Hype)

1. Keep the fundamentals first. Protein targets, calcium/magnesium/K2/D, resistance + impact/simulated impact training, and bone-savvy hormones where appropriate.
2. Include annatto tocotrienols as part of a fat-soluble bundle (e.g., D3/K2/E/retinol) for antioxidant and anti-inflammatory support.
3. Monitor, don’t guess. Track BTMs (CTX or NTX, plus P1NP) and consider RANKL/OPG and 8-OHdG if available. Recheck at ~12–16 weeks to see if your ratio (P1NP ÷ CTX/1,000) improves.
4. Avoid pill creep. If moving to standalone 300 mg tocotrienols explodes your capsule count, adherence will suffer. Outcomes beat intentions every time.

“Promising? Yes. Protocol-changing on its own? Not yet. It’s a smart add-on—measured against your markers.”

Should You Switch Right Now?

• If you’re already using a quality D/K2/E blend that includes DeltaGold®, you’re likely covered while we wait on longer, larger human data.
• If you want to experiment with ~300 mg, do it with baseline labs (P1NP/CTX ratio, ± RANKL/OPG, ± 8-OHdG) and repeat at 12–16 weeks. Keep the rest of your plan consistent so you can attribute changes.

Want Help Translating This Into a Plan?

👉 Join my free OsteoCollective masterclass. I’ll walk you through the biggest mistakes we see (supplements included), how to prioritize what actually moves bone, and how to use biomarkers to make decisions. Bring your questions to the live Q&A.