TO E OR NOT TO E: THAT IS THE QUESTION
In November of 2004, the national press reported on a John Hopkins meta-analysis of 19 studies involving vitamin E supplementation by people suffering from heart disease, end-stage renal failure and Alzheimer’s disease. It was reported that those who took 400 international units (IU) or more per day of vitamin E, were 6% more likely to die from any cause than those who did not take vitamin E supplements. The media proclaimed that supplementation with vitamin E above 400 IU per day increased the risk of death.
What the press didn’t report was that further analysis of this study showed increased risk of death statistically significant only for those taking 2000 IU/day, and that the authors of the study readily admitted that their findings might not apply to healthy people. The authors also pointed out that the analyzed studies were often small and were conducted on patients with chronic disease.
What the press also didn’t report was the results of three other meta-analysis of multiple studies involving people with cardiovascular disease taking vitamin E. These studies, as reported by the Linus Pauling Institute, showed supplementation up to 800 IU/day had no bearing on death from any cause.
Unfortunately, the John Hopkins report has caused some to discontinue supplementation with vitamin E or greatly reduce the dosage. It must be pointed out that thousands of studies have been done showing the efficacy of vitamin E supplementation. Vitamin E is one of the most researched nutrients.
Studies:
In the Cambridge Heart Antioxidant Study reported in Lancet (1996), investigators found that 400 to 800 IU/day of vitamin E supplementation significantly reduced cardiovascular disease and improved mortality.
In a study by Boaz reported in Lancet (2000), hemodialysis patients with cardiovascular disease (age 40 to 75 years old) received either 800 IU/day of vitamin E or a placebo for approximately 519 days. The results showed a significant decrease in cardiovascular disease and myocardial infarction among users of vitamin E.
In the Nurses’ Health Study reported in Stampfer (1993), of the 13% of 87,000 nurses who regularly used vitamin E supplements, there was a 31% reduction in relative risk for non-fatal myocardial infarction and death from cardiovascular disease compared with women who did not take vitamin E.
Another study reported in 2000 showed that a combined supplementation of vitamin E and slow-released vitamin C reduced the progression of atherosclerosis in men by 74% over a three-year period.
In a study by Rimm (1993) in which 39,000 male health professionals were studied for four years, 17% of the men took vitamin E supplements. Those who took the highest dose (median of 419 IU/day) had a 40% reduction in the relative risk for non-fatal myocardial infarction or death from coronary heart disease.
Unfortunately, these kinds of studies are never picked up by the national press.
WHAT IS VITAMIN E?
In nature, vitamin E occurs as a complex of four tocopherols (alpha, beta, gamma, delta) and four tocotrienols (alpha, beta, gamma, delta). Alpha-tocopherol has been studied the most and it is this form of vitamin E most often found in supplements.
Supplemental vitamin E as d-alpha tocopherol is generally derived from soy bean oil while dl alpha tocopherol is synthetically produced from petroleum. Synthetically produced vitamin E has a different molecular structure than natural E and is not utilized by the body as well as natural E.
Increasing interest has centered on the role of the other tocopherols as well as the tocotrienols in human health. Some research indicates that gamma tocopherol may provide superior protection against cancer and heart disease.
Research on vitamin E has demonstrated its effectiveness in overall support of the cardiovascular and circulatory systems. It is shown to suppress tumor growth, slow the development of Alzheimer’s and dementia, reduce pain of rheumatoid arthritis, protect vision and support the immune system as a strong anti-oxidant.
The National Academy of Sciences has defined the “tolerable upper intake level” as 1,500 IU per day for natural d-alpha tocopherol. Supplementation with 400 to 800 IU per day is adequate for most people.
Food sources of E are wheat germ, soy, eggs, whole grains and vegetables. Most diets are deficient in E. We recommend daily supplementation with a mixed tocopherol/tocotrienol formula.
ADDENDUM 01-18-14:
A recent study reported that patients with mild to moderate Alzheimer's disease who daily took 200 IU's of vitamin E were able to care for themselves longer and needed less help performing everyday tasks compared to a group taking a daily placebo (a fake pill). This research was published in the Journal of the American Medical Association (JAMA). This study involved 561 patients from 14 Veterans Affairs medical centers from around the country. Subjects were tracked from six months to as long as four years. The authors of the study indicated the results obtained in this study were better or equal to those seen in clinical trials using prescription drugs which are far more expensive and often produce negative side effects.