Vitamin E May Do More Harm Than Good, Study Finds

Wednesday, November 10, 2004

By Maggie Fox, Health and Science Correspondent


NEW ORLEANS (Reuters) - Vitamin E supplements, which millions take in the hope of longer, healthier lives, may do more harm than good, researchers reported on Wednesday.

In fact, people taking high doses of vitamin E may in some cases be more likely to die earlier, although the reasons are not clear, said Dr. Edgar Miller of Johns Hopkins University in Baltimore, who led the study.

"I think people take vitamin E because they think it is going to make you live longer, but this (study) doesn't support that," Miller told reporters.

Miller and colleagues re-analyzed 19 studies of vitamin E and health between 1993 and 2004. The trials involved more than 136,000 mostly elderly patients in North America, Europe and China.

People who took 200 international units of vitamin E a day or more died at a higher rate during the study, which lasted three years, than people who did not take supplements, they told a meeting of the American Heart Association (news - web sites).

"It's about a 5 percent increased risk at 45 years in the trials pooled together," Miller said.

"That doesn't sound like a lot but if you apply it to 25 percent of the (U.S.) adult population taking vitamin E, that is significant."

Miller, whose findings are also being published online by the Annals of Internal Medicine, said two-thirds of people who take vitamin E supplements take 400 IU or more.

"We don't think that people need to take vitamin E supplements, that they get enough from the diet," he said. Nuts, oils, whole grains and green leafy vegetables are all rich in vitamin E.

MUCH MORE THAN NEEDED

The average U.S. diet supplies six to 10 IU of E, Miller said. The Institute of Medicine, which sets recommended doses of vitamins and minerals, gives 1,500 IU of E as a daily upper limit.

"I would say it is too high," Miller said. The U.S. government's Food and Drug Administration is barred by law from regulating dietary supplements so the limits are voluntary.

People take large doses of vitamin E in the belief that it helps counter oxidation by unstable "free radical" molecules, which damages cells and can accelerate aging and lead to heart disease and cancer.

Miller, who was surprised by the findings of the study, said there could be several ways the vitamin supplementation is damaging the body.

While vitamin E in low doses is a powerful antioxidant, in higher doses its effects may promote oxidative damage, and may also overwhelm the body's natural antioxidants, he said.

Dr. Raymond Gibbons of the Mayo Clinic in Rochester, Minnesota, said the evidence has been building against vitamin E supplements.

"Despite this ... I see many, many patients still taking vitamin E and I have to convince them not to," he told a separate news conference.

But the Council for Responsible Nutrition, a trade group for supplement makers, criticized the report.

"This is an unfortunate misdirection of science in an attempt to make something out of nothing for the sake of headlines," said the group's John Hathcock.


http://story.news.yahoo.com/news?tm...eart_vitamin_dc

.

washingtonpost.com
High Doses Of Vitamin E Found to Raise Risk of Dying

By Rob Stein
Washington Post Staff Writer
Thursday, November 11, 2004; Page A01


High doses of Vitamin E, which millions of people take to protect themselves against heart attacks, Alzheimer's disease and other ailments, appear to actually increase the overall risk of dying, researchers reported yesterday.

A new analysis of data from 19 studies involving nearly 136,000 people concluded that the overall risk of dying began to increase at the dose in a typical single capsule of Vitamin E, and that the more Vitamin E people took, the more their risk of death rose. Someone taking 400 international units of Vitamin E a day for five years, for example, would face a 5 percent higher risk of dying, the researchers found.

The study found no increased risk from lower doses, particularly at doses of 200 international units or below, and perhaps even a benefit. A typical multivitamin contains 30 to 60 international units of Vitamin E.

Although the study did not examine how high-dose Vitamin E might increase the risk of death, other studies have suggested that the substance may boost the danger of heart attacks and strokes, perhaps by affecting blood clotting or blocking the beneficial effects of other nutrients, the researchers said.

Whatever the mechanism, the findings indicate that no one should take high doses regularly and that current guidelines for what is considered a safe maximum daily intake should be lowered, the researchers said in a study presented at an American Heart Association meeting in New Orleans.

"A lot of people take vitamins because they believe it will benefit their health in the long term and prolong life," said Edgar R. Miller III, an associate professor of medicine at the Johns Hopkins University School of Medicine, who led the research. "But our study shows that use of high-dose Vitamin E supplements certainly did not prolong life but was associated with a higher risk of death."

The findings are the latest in a series of recent findings undermining the theory that "antioxidant" substances may provide powerful protection against a host of illnesses. Evidence had suggested that vitamins and other compounds found naturally in many foods might reduce the risk of heart disease, cancer and other illnesses by preventing unstable oxygen molecules known as free radicals from damaging DNA. That has prompted many Americans to take supplements containing high doses of antioxidants, including Vitamin E.

In 2003, Americans spent $710 million on Vitamin E, making it the second most popular individual vitamin, behind Vitamin C, according to the Nutrition Business Journal, which tracks industry trends.

But when researchers have attempted to give antioxidants to prevent disease, the results largely have been disappointing, and sometimes alarming. Beta carotene, for example, was found to increase rather than decrease the risk of lung cancer.

The latest study suggests that may be true for Vitamin E, as well, experts said.

"This just shows us once again that very high level of individual nutrients can have adverse effects," said Alice H. Lichtenstein, a professor of nutrition at Tufts University who chairs the nutrition committee of the American Heart Association, which in August issued an advisory against taking antioxidant supplements to reduce the risk of heart disease.

Other researchers, however, questioned the new findings, saying the analysis was flawed and that other studies have shown a benefit from taking Vitamin E and other antioxidants.

"There is a small statistical effect here that they have found, but we don't believe it's necessarily an important biological effect," said Annette Dickinson, president of the Council for Responsible Nutrition, an industry-funded group. "We think they've overstated the importance of the findings."

Maret G. Traber, an Oregon State University researcher who served on a National Academy of Sciences panel that evaluated Vitamin E, agreed. "Vitamin E won't kill you," Traber said. "Everything we know about Vitamin E is that it's incredibly safe."

While there is only weak evidence that antioxidants reduce the risk of cancer, there is strong evidence that Vitamin E and Vitamin C can reduce the risk of heart and kidney disease, said Ishwarlal Jialal, an antioxidant researcher at the University of California at Davis.

"Vitamin E is clearly an antioxidant and an anti-inflammatory agent, and it's been shown in some studies to reduce heart disease either alone or in combination with Vitamin C," he said.

The latest study, however, found that the overall death rate appeared to increase beginning with people taking 400 international units per day, Miller and his colleagues reported in a paper that will be published in the Jan. 4, 2005, issue of the Annals of Internal Medicine. They reached that conclusion by reanalyzing data collected by 19 studies conducted between 1993 and 2004 involving a total of 135,967 patients in North America, Europe and China using a technique known as meta-analysis.

On average, people get about 10 international units of Vitamin E from diet, primarily from consuming foods such as corn, nuts, seeds, olives, asparagus, spinach, other leafy green vegetables, and vegetable oils. But Vitamin E supplement capsules contain anywhere from about 400 to 800 international units.

Federal nutritional guidelines do not recommend Vitamin E supplementation but state that doses as high as 1,000 international units per day are safe. Based on the findings, Miller and his colleagues recommended the upper limits be reevaluated.

"Certainly there's no benefits to high-dose Vitamin E intake, and we did demonstrate harm, so we're not recommending people take high-dose Vitamin E supplementation," Miller said.

Original article here:

http://www.annals.org/cgi/content/f...0501040-00110v1

Haven't had a chance to read it yet!

Thankyou tortoise

I read with interest the Rapid Response postings .. http://www.annals.org/cgi/eletters/...0501040-00110v1 .. which asked the same question I had when I was first aware of this article. What type of vitamin E was used in the studies? Synthetic or natural? ... d- or dl- type? .. alpha-tocopherols only or mixed??

I'm not about to stop my daily vitamin E supplement (which is nat. source mixed tocopherols) but then again, I'm not taking >400 units/day.


Doreen

i was also wondering if the studies were based on natural or synthetic E while i was reading.

another question i had was who was funding this research? one of the big pharmaceutical corps?

This just arrived via newsletter, from Dr Michael Murray (website
http://www.doctormurray.com)

Val

Vitamin E, Heart Disease, and Mortality

Introduction

In 2003 during a keynote address to the dietary supplement industry titled "Challenges, Solutions, & Inspirations" I spoke on how the results from clinical studies will be used to adversely effect the public's appreciation for natural products. The two primary examples that I gave were studies with echinacea utilizing less than ideal preparations and studies on the effect of vitamin E in cardiovascular disease. The recent proclamation by a set of researchers that vitamin E may actually increase the risk of mortality and the resulting media fervor reporting this story is not surprising to me at all. In fact, I predicted it and based upon the research it is easy to understand how this conclusion could be made.

Although many experts and organization will be focusing on the shortcoming in the methodology in the recent meta-analysis, my feeling is that time is better spent trying to understand the results instead of trying to discredit them. The results simply reflect some inherent defects in the manner in which research is conducted with antioxidant nutrients. Nonetheless, it is important to point out that the interpretation of the data is based upon an analysis of 19 earlier published vitamin E studies with a built-in bias toward the risk of harm rather than potential benefit. Focusing on the impact on the all-cause mortality outcome seems inappropriate given that none of the 19 studies analyzed were designed with this as the primary endpoint; the studies chosen represented quite a diversity of subjects, disease conditions, treatments and durations of intervention; and the follow-up time was relatively short ranging from 1.4 years to 8.2 years. It is also important to point out that while these studies were not designed to evaluate all-cause mortality statistics as the primary outcome, many of the studies used in the meta-analysis showed positive results on the primary outcomes they were designed to measure such as reduced progression of advanced age-related macular degeneration and cataracts; reduced incidence of heart attacks, and slowed progression of atherosclerosis and Alzheimer's Disease.

The Beta-carotene Analogy

The results from this analysis of vitamin E research are quite similar to those of synthetic beta-carotene in cancer prevention. In case you missed this line of research with beta-carotene, studies indicated that synthetic beta-carotene supplementation contributed to earlier death in high-risk groups for cancer and cardiovascular disease. These studies did not invalidate the hundreds of studies showing the preventive effect of a diet rich in carotenes and nutritional antioxidants against cancer and cardiovascular disease. These results seem to indicate the need for a diet high in carotenes and, if carotene supplementation is desired, people should not smoke, natural forms should be used, and the beta-carotene needs to be protected against the formation of toxic derivatives by taking extra vitamin C and E, and selenium.

It is important to realize that not all antioxidants are created equal. When it comes to quenching free radicals, antioxidant compounds exert different (and usually very narrow) range of activity. For example, beta-carotene is an effective quencher of a free radical known as singlet oxygen, but is virtually powerless against the dozens of other types of free radicals. As a result, it has a very narrow range of benefit and is very susceptible to being damaged itself and forming a free radical without additional antioxidant support. Most antioxidants require some sort of "partner" antioxidant that allows it to work more efficiently. And scientists have discovered that beta-carotene itself can become damaged if it's used alone (that is, without its partner antioxidants vitamin C, vitamin E, and selenium). For example, while studies showed that synthetic beta-carotene supplements given alone actually increased the risk of cancer in smokers, when beta-carotene was given along with vitamin E and selenium it reduced cancer deaths by a significant 13 percent. Damaged beta-carotene is extremely toxic to the liver, the lining of the arteries, and the lungs. This fact alone may explain some of the disappointing results from the recent beta-carotene studies.

Undoubtedly there will be similar discoveries about the importance of other antioxidant nutrients in the support of vitamin E's antioxidant benefit.

The Importance of Synergy

While the scientific research is quite clear that diets high in antioxidants are protective against many diseases, the data is not as solid with antioxidant supplements. There are three main points to keep in mind when looking at research with antioxidant supplements:

The antioxidant system of the body relies on a complex interplay of many different dietary antioxidants.
Taking any single antioxidant nutrient is not enough. Total protection requires a strategic, comprehensive dietary and supplement program.
Although dietary supplements are important, they cannot replace the importance of consuming a diet rich in antioxidants.
A shortcoming of many of the intervention studies with antioxidant nutrients is that researchers often focus on the effects of just one factor. In a way, this is like judging an entire symphony by listening to a single trombone. Such research has its value, but it's not complete and often raises more questions than it answers.

Antioxidants and Heart Disease

The research is quite clear that dietary antioxidant nutrients like vitamin E, lycopene, lutein, selenium, and vitamin C offer significant protection against the development of cardiovascular disease. Fats and cholesterol are particularly susceptible to free radical damage. When damaged, fats and cholesterol form lipid peroxides and oxidized cholesterol which can then damage the artery walls as well as accelerate the progression of atherosclerosis (hardening of the arteries). Antioxidants block the formation of these damaging compounds.

While diets rich in antioxidant nutrients have consistently shown tremendous protection against cardiovascular disease, clinical trials utilizing antioxidant vitamins and minerals have produced inconsistent results.1,2 This failure may be due to several factors, most importantly the fact that the human antioxidant system represents a complex scenario of interacting components. It is unlikely that any single antioxidant would be proven to be effective especially in the absence of a supporting cast. Most antioxidants require some sort of "partner" antioxidant that allows it to work more efficiently. The most salient example of this point is the partnership between the two primary antioxidants in the human body - vitamin C and vitamin E. Vitamin C is an "aqueous phase" antioxidant while vitamin E is a "lipid phase" antioxidant. Although some studies have shown that supplementation with these nutrients reduces atherosclerotic lesions more protection is likely required to insure optimal effect.3 In addition to vitamin C, vitamin E also requires selenium and coenzyme Q10 to work efficiently (discussed in more detail below). Further adding to the shortcoming of many of the studies on antioxidant nutrients is the lack of consideration on the importance of phytochemicals and plant derived antioxidants that in addition to exerting benefit on their own are well-known to potentiate the activities of vitamin and mineral antioxidants.

The support of non-antioxidant vitamins and minerals may also be important in assisting the effectiveness of antioxidants. Taking a multiple vitamin and mineral supplement seems appropriate.

The Research on Vitamin E

Although clinical studies have shown inconsistent effects, it is clear that vitamin E does play a role in the protection against the oxidation of LDL cholesterol because of its ability to be easily incorporated into the LDL molecule. Vitamin E may offer additional benefit in protecting against heart disease and strokes by its ability to:

reduce LDL cholesterol peroxidation and increase plasma LDL breakdown
inhibit excessive platelet aggregation
increase HDL cholesterol levels
increase fibrinolytic activity
reduce C-reactive protein levels
improve endothelial cell function
improve insulin sensitivity
Two early large-scale studies with relatively low dosages of vitamin E supplements demonstrated a significant reduction in the risk of dying of a heart attack or a stroke. The Nurses Health Study of 87,245 nurses concluded that those who took 100IU of vitamin E daily for more than 2 years had a 41% lower risk of heart disease compared with non-users of vitamin E supplements.81 In the Physicians Health Study of 39,910 male health care professionals found similar results: a 37% lower risk of heart disease with the intake of more than 30 IU of supplemental vitamin E daily.4 Subsequent studies have been equivocable.5

Large-scale studies examining the impact of vitamin E supplementation in patients with existing heart disease have also shown somewhat conflicting results.6 Some the disappointing results may have been the choice of synthetic vitamin E (D,L-alpha tocopherol) versus the more active natural form (D-alpha tocopherol). There is also the problem with interference by statin drugs of vitamin E and coenzyme Q10 metabolism - thereby increasing the needs for both compounds. In fact, one of the reasons why more recent studies with vitamin E have not shown the same benefit as earlier studies may turn out to be that higher dosages of vitamin E alone and in combination with CoQ10 are required to compensate for the detrimental effects of the now extremely popular statin drugs have on their metabolism.

Table 1. Examples of intervention trials with vitamin E for secondary prevention
Study # Subjects Dosage Duration Outcome
HOPE (2000) 9,541 400 IU
(d-alpha) 4.5 y No Effect
SPACE (2000) 196 800IU
(d-alpha) 1.4 y -70%
GISSI (1999) 11,324 300 IU
(synthetic) 3.5 y -35% (vs. placebo)
CHAOS (1996) 9,541 400-800 IU
(d-alpha) 1.4 y -47%

HOPE = Heart Outcomes Protestion Evaluation Trial; CHAOS = Cambridge Heart Antioxidant Study; GISSI = Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico

Vitamin E and CoQ10 work synergistically and each is required for the regeneration of the other. For example, CoQ10 is present in the blood in both oxidized (inactive) and reduced (active) form. During times of increased oxidative stress or low vitamin E levels, more CoQ10 will be converted to its oxidized (inactive form). Thus, by providing higher levels of vitamin E and the biological activity and function of CoQ10 is enhanced and vice versa. Several studies in humans and animals have shown that the combination of vitamin E and CoQ10 work better than either alone. For example, in a study in baboons, while supplementation with vitamin E alone reduced C-reactive protein (CRP) levels, co-supplementation with CoQ, however, significantly enhanced this effect of vitamin E. Similar results have been seen in other animal studies on other aspects associated with atherosclerosis including LDL oxidation and lipid peroxide content within the aorta.7-9 It appears that taking 50 mg of CoQ10 for every 400 IU of vitamin E offers a rational approach to supporting the antioxidant activities of both nutrients.

In addition to CoQ10, vitamin E also requires adequate selenium status for optimal antioxidant effects. Selenium functions primarily as a component of the antioxidant enzyme glutathione peroxidase. This enzyme works closely with vitamin E to prevent free radical damage to cell membranes. Studies looking only at vitamin E's ability to reduce cancer and heart disease are often faulty because they failed to factor in the critical partnership between selenium and vitamin E not to mention the interrelationship between vitamin E and coenzyme Q10. Several studies have clearly demonstrated that low selenium status is significantly associated with CAD.10,11 Failure to cosupplement with selenium as well as vitamin C and CoQ10, may be a major reason for the inconsistent results in intervention trials with vitamin E supplementation alone. A dosage of 100 to 200 mcg of selenium per day is all that is usually required.

The "Take Home" Message

In regards to supplementation with vitamin E at higher dosages (e.g., >400 IU daily), I will continue to make this recommendation to people with heart disease, diabetes, etc., and will do so in the same manner that I have consistently done over the past 20 years. I have repeatedly written and stated that the use of any single antioxidant nutrient at higher dosages must be made within the context of a truly comprehensive approach that focuses on a diet rich in antioxidant nutrients (i.e., vegetables, fruits, nuts, seeds, and legumes) and a strong foundation of nutritional supplementation. The three key dietary supplements that I recommend to provide a strong foundation for a proper nutritional supplement plan are:

A high-potency multiple vitamin and mineral formula (MultiStart).
A "greens" drink product (Enriching Greens).
A pharmaceutical grade fish oil supplement (RxOmega-3 Factors).
The dietary recommendations and foundational supplements work synergistically and in harmony with each other because of the key roles they each play in promoting vibrant health.



Key References:

Clarke R, Armitage J. Antioxidant vitamins and risk of cardiovascular disease. Review of large-scale randomised trials. Cardiovasc Drugs Ther 2002;16:411-5
Vivekananthan DP, Penn MS, Sapp SK, et al. Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials. Lancet 2003;361:2017-23
Salonen RM, Nyyssonen K, Kaikkonen J, et al. Six-year effect of combined vitamin C and E supplementation on atherosclerotic progression: the Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) Study. Circulation 2003;107:947-53
Stampfer MJ, Hennekens CH, Manson JE. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993;328:1444-9
Rimm EB, Stampfer MJ, Ascherio A. Vitamin E consumption and the risk of coronary heart disease in men. New Engl J Med 1993;328:1450-6
Eidelman RS, Hollar D, Hebert PR, Lamas GA, Hennekens CH. Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease. Arch Intern Med. 2004;164(14):1552-6.
Kaikkonen J, Nyyssonen K, Tomasi A, et al. Antioxidative efficacy of parallel and combined supplementation with coenzyme Q10 and d-alpha-tocopherol in mildly hypercholesterolemic subjects: a randomized placebo-controlled clinical study. Free Radic Res 2000;33:329-40
Wang XL, Rainwater DL, Mahaney MC, et al. Cosupplementation with vitamin E and coenzyme Q10 reduces circulating markers of inflammation in baboons. Am J Clin Nutr 2004;80:649-55
Thomas SR, Leichtweis SB, Pettersson K, et al. Dietary cosupplementation with vitamin E and coenzyme Q(10) inhibits atherosclerosis in apolipoprotein E gene knockout mice. Arterioscler Thromb Vasc Biol 2001;21:585-93
Yegin A, Yegin H, Aliciguzel Y, et al. Erythrocyte selenium-glutathione peroxidase activity is lower in patients with coronary atherosclerosis. Jpn Heart J 1997;38:793-8
Bor MV, Cevik C, Uslu I, et al. Selenium levels and glutathione peroxidase activities in patients with acute myocardial infarction. Acta Cardiol 1999;54:271-6

Here's another article: http://www.kansascity.com/mld/kansa...10148716.htm?1c (registration is required, but free)

(bold is mine)

the Health Sciences Institute e-Alert debunked the "vite e harms theory" today...

------------------------------------------------------------
Media overboard!
------------------------------------------------------------

Pity the mainstream media outlets. Every hour they
strain to get
our attention in an information environment that's
become a 24-7-
365 buzz of hyped up info-bites. To draw our eye amid
all this
chaos, they'll promote anything that's sensational,
even if it's not
actually sensational at all.

This is what happened last week when the Annals of
Internal
Medicine released a Johns Hopkins School of Medicine
meta-
analysis of vitamin E supplementation. Researchers
analyzed the
results of 19 studies in which vitamin E supplements
played a role.
Their conclusion: Doses of vitamin E in excess of 400
IU per day
may slightly increase the risk of (drum roll please)
death!

The media outlets immediately seized on this and sent
out the
sensational, detail-free message: Vitamin E
supplements can kill
you. Here are just three of the wildly generalized
scare headlines:

"Vitamin E's Fatal Flaw"
"Vitamin E Can Be Deadly"
"Vitamin E Dosages May Be Lethal"

Run for your lives! The vitamin E sky is falling!

------------------------------------------------------------
What a joke
------------------------------------------------------------

I knew that HSI Panelist Allan Spreen, M.D., would
have some
choice words for the Johns Hopkins results, and I was
right.

Dr. Spreen: "Good Lord... what a joke. I can't believe
such a
moronic study even got published."

Dr. Spreen cites a major problem with the length of
the individual
studies. The 19 studies represent a total of 45 years
of research.
That averages to less than three years per study.
"First of all,"
writes Dr. Spreen, "three years when you're talking
about long-
term mortality studies means nothing. Second, the
'conclusions'
certainly weren't definitively backed up by the study.

"This flies in the face of decades of research, using
doses up to
2400 IU. The Shute brothers (both M.D.s) used even
higher
amounts and documented excellent results. (But I guess
'old'
research somehow becomes untrue due to age or
something.)"

Dr. Spreen's take on the Hopkins conclusions run
parallel to a
response from the Council for Responsible Nutrition
(CRN). A
CRN representative pointed out to NutraIngredients.com
that it
was inappropriate for the researchers to draw
conclusions for the
entire population based on studies of subjects who
were "already at
grave risk with existing diseases including cancer,
heart disease,
Alzheimer's, Parkinson's and kidney failure."

Funny... I didn't hear that detail pointed out on the
evening news.

------------------------------------------------------------
Getting generalized
------------------------------------------------------------

In short, the Hopkins conclusion is a stretch. And
even the editors
of the Annals of Internal Medicine seem to agree. In a
note that
accompanies the study, the editors state that, "these
findings may
not be generalizable to healthy adults." And they add
this
interesting detail (also missing from the evening
news): "Some
trials evaluated multivitamin combinations."

In other words, some of these studies weren't even
exclusive to
vitamin E! And yet network news anchors had no qualms
about
delivering the sweeping generalization that vitamin E
supplement
intake may be fatal.

Which all leads to MY sweeping generalization: Vitamin
E
supplements will not kill you.

But that's not to say that ANY vitamin E supplement
will do. Dr.
Spreen again: "There are a few caveats to vitamin E,
of course. No
one should be taking the synthetic form of the
nutrient (dl-alpha
tocopherol) – it should be d-alpha tocopherol at
least. Even better
is to take 'mixed' tocopherols (alpha, beta, delta,
gamma). Also,
vitamin E functions better when it's mixed with
selenium (neither
mentioned, nor, of course, used in the study)."

Once again, we see how the major media outlets can be
completely
trusted to go to any lengths to grab our attention.
But when it
comes to accuracy and responsibility they get a
failing grade.

Sometimes I wish that I could find a few trustworthy sources of information and turn off all other news. Every media outlet has turned to various degrees to National Inquirers.

I forgot to post my analysis of this study (I did it a week ago, but my life has suddenly revved up to full speed!):

http://turtleway.modblog.com/core.m...&blog_id=351556

The study showing negative effects for Vitamin E was all over the news last week. The morning news show doctors were talking about it, and almost every news paper and outlet carried an article. Many of them had quite a dire tone about taking Vitamin E, so I decided to take a little extra time and look at the report for myself.

Summary: If there is an effect for Vitamin E and mortality, that effect is extremely small, and only for large doses. I find no evidence in the study that supports any danger at all for doses under 500 IU per day. The media has had an overblown reaction to this analysis, and often statistics are misquoted (and conflict with each other from article to article). On the other hand, it is not yet clear what role, if any, high doses of Vitamin E can play in which situations or conditions, and what other supplements in what dosages would have the best synergistic effects. There are certain conditions for which there is preliminary evidence that Vitamin E supplement could be helpful.

Background: Dietary antioxidants are unquestionably a Very Good Thing. Because of this, food supplements containing relatively high doses of various antioxidants have become widely available. Unfortunately, the supplements haven’t always lived up to the promise shown in animal and laboratory studies, nor in results obtained from eating whole high-antioxidant foods. In fact, there has been some evidence that high doses of supplements of antioxidants can be counter-productive.

The reasons for this aren’t obvious, but many have been proposed. There is some evidence that certain antioxidants work best in combination with certain others (for example, vitamins C, E, and selenium, or Vitamin E and CoEnzyme Q). Or it could be that synthetic forms of these chemicals don’t have the same impact on the body as the natural forms found in food. Or the whole system may be fairly sensitive to the impact of a great amount of one component, as different antioxidants work specifically to counteract different free radicals. Too much of one may actually produce free radicals of its own.

Some people have criticized this study on methodological grounds – my plan is merely to report the results I think that people are interested in hearing (although probably in more detail than most care about).

Study:This analysis looked at 19 studies where vitamin E was used as part of a treatment group, where there was also a control group, and where mortality statistics were kept. There was quite a mishmash of different studies – mostly people either at risk for or who had various conditions including cardiovascular disease, cancers, Parkinson’s disease, and retinitis pigmentosa. The length of the studies varied from 1.4 years to 8 years. The ages of the participants were also quite varied, and I noted that all of the studies that reported mean ages in the 40’s and 50’s were lower dose, whereas all of the high-dose trials reported mean ages in the 60s and above. (If the ages were equivalent within studies, this probably shouldn’t matter too much, but it was another difference between the low and high dosage studies.) Slightly over half the trials combined Vitamin E with other vitamins or minerals.

None of the studies in the analysis were studying mortality – they all wanted to know something else about the effects of vitamin E. Some cited studies had positive effects other than longevity. this one. Depending upon length of each study, and the health and age of the participants, the death rates also varied widely. Overall, a little over 9% of the total number of participants died – 12 504 out of 135 967. In one study, the mortality rate was one-third. The authors presented their data in terms of how many people per 10,000 died:

Overall: 1022 out of 10,000 died
Vitamin E did not have a significant effect overall, BUT:
Low dosage Vitamin E (under 400 IU daily): 1008 out of 10,000 died
High dosage Vitamin E (400 IU or over): 1039 out of 10,000 died

What does this mean? Is it important that there were .12% (yes that’s a bit over a TENTH OF A PERCENT) fewer deaths in the low-dosage group and about .17% more in the high dosage group? It could be, because it might inform future research. But these are VERY small numbers, and it stretches my imagination to think it indicates that Vitamin E could be as dangerous as the reports and articles I’ve seen indicate.

More observations:

- Two of the groups were receiving dosages of Vitamin E which are above the currently recognized safety limits – 2000 IU per day (safety limits are considered to be 1100 IU for artificial vitamin E and 1500 for natural forms). It’s an arguable point whether an analysis looking at death as the end point should include studies where the safety limits were exceeded.
- Of the two studies where the participants took 400 IU per day (the lower limit for “high dose”, 11% of the Vitamin E group died, while 10.8% of the control group died – essentially even. In another study, where the participants were given 440 IU per day, twice as many died in the control group as the Vitamin E group (29 vs 15). Therefore, I’m not at all sure why the researchers decided that the cutoff for “high dosage” should be 400 IU. It would make more sense to start it at 500 IU, since it’s true that most of the studies from that point on had slightly more deaths in the Vitamin E group.
- No attempt was made to classify studies using natural forms of Vitamin E vs artificial, even though there is a recognized difference in safety between the two.

On the other hand, I would say that looking at this study alone, it would also tend to indicate no longevity benefit for taking over 400 IU per day of Vitamin E. On the third hand, there may be other benefits besides longevity for any particular condition. I think we are still in the beginning stages of sorting it all out. But it’s nothing to get too worried about at this point.

Oh wonderful! Are we ever safe? I've been taking vitamin-e daily for almost three years now!

Cissie