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vitamin E

HIGH DOSE OF VITAMIN MAY INCREASE AND CAUSE MORTALITY – (12-09-04)

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HIGH-DOSAGE VITAMIN E SUPPLEMENTATION MAY INCREASE ALL-CAUSE MORTALITY

My, wasn’t this one a hot one for a day or so? This always brings up the question about how some of these articles manage to make it to the mainstream media when other topics much more important (like Syndrome X) remain unheard of. A couple comments. First, the end results from the study were very weakly positive. 1.04 X risk. 1.00 risk means no effect, so a .04 increase in risk is very small.

Also, the “p” value is .035–this is an evaluation of how much the study results are a result of chance (p value of coin flip is 1). The lower the number the stronger the study. I prefer p values lower than .001. That being said, there’s still the possiblity of a risk, which is NOTHING NEW. I’ve included a strong article that reviews the pro-oxidant effects of Vit E. Vit E can act as a pro-oxidant but THIS IS ABOLISHED BY CO-ANTIOXIDANTS LIKE VIT C. From a natural perspective, we don’t treat supplements in a vacuum and lifestyle changes would ALWAYS be done in a package, not with just one supplement. I’m sure that taking Vit E along with Vit C and other compounds like green tea and red wine will show nothing but a strongly protective effect.

Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality — Miller et al., — Annals of Internal –

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IMPORTANCE OF A BALANCE OF TOCOPHEROLS – (12-06-05)

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Importance of tocopherols beyond tocopherol: evidence from animal and human studies

It’s nice to see a review illuminating the importance of a balance of tocopherols. Remember that what we normally consider as vitamin E is really alpha tocopherol, and that there are at least four known tocopherols, all of which have interactions between one another to generate health. Mother nature provided a nice blend of these tocopherols in natural oils. This is yet another big difference between the cheap multivitamins and the higher quality ones–most higher quality vitamins contain mixed tocopherols.

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WHY TO STAY AWAY FROM VITAMIN E? – (04-30-07)

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Antioxidant vitamin therapy alters sepsis-related apoptotic myocardial activity and inflammatory responses

I realize this is a mouse study (probably hard to find living humans willing to have their hearts homogenized…) but it has some pretty important implications for cardioprotection, especially given the irrational fear induced by several studies released indicating that Vit E may worsen cardiac risk. Keep in mind that, of the tocopherols, alpha is NOT the most cardioprotective, and that we realize that the gamma fraction is most likely the much stronger player in protecting the heart. Unfortunately, given high levels of alpha tocopherol (what is commercially known as “Vit E”) will lower serum levels of gamma.

So, if your cardiologist told you to stay away from Vit E, he/she was misinformed and probably just did you a great misservice by NOT explaining what likely happened in those studies showing an increase in CVD risk.

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REDUCTION IN RISK OF PROSTATE CANCER WITH HIGH DIETARY INTAKE – (01-21-08)

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Supplemental and Dietary Vitamin E Intakes and Risk of Prostate Cancer

This study again points out that there is definitely a difference in what we call “Vitamin E.” In most lower quality Vit E supplements, only the alpha form is used. However, Mother Nature uses primarily the gamma form, and, from many studies the gamma form has the more powerful effect on our risk of chronic disease.

Interestingly, many studies have pointed to the fact that higher levels of the alpha form will lower the level of gamma forms in the blood. The history as to why the alpha form is the principle form marketed has been covered in past issues of Updates.

In this study, higher dietary intakes of gamma tocopherol, but NOT alpha, resulted in a 38% reduction in risk of prostate cancer.

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A STUDY ON VIT E, EXERCISE, STRESS MANAGEMENT AND “HEALTHY” DIET – (03-17-08)

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Combined Effect of Low-Risk Dietary and Lifestyle Behaviors in Primary Prevention of Myocardial Infarction in Women

One of the things that consistently irritates me about studies on “natural” approaches is that they frequently look at single interventions. A study on Vit E. A study on exercise. A study on stress management. A study on a “healthy” diet. While these interventions usually fair well, this is NEVER the approach from a functional medicine standpoint. Functional medicine involves looking at all aspects of a patient’s lifestyle.

So what happens when you do address more than one factor? How about a staggering 92% reduction in heart attacks in women? And the dietary recommendations, while good, are non-specific. This is the elimination of heart disease. So why, after 6 months, did this study not get picked up by the mainstream press when statins are all over with a mere 4% or so reduction (at the tune of billions of dollars per year)??

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FUNCTIONAL ASPECT OF VITAMIN E SUPPLEMENTATION LEVELS – (03-17-08)

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The relationship between dose of vitamin E and suppression of oxidative stress in humans

Over the past few years, Vit E has taken somewhat of a beating in the medical literature. However, when you look at several aspects of the literature, a few problems have jumped to mind.

First, almost all studies have looked at the alpha tocopherol form of Vit E, despite the fact that Mother Nature provides her tocopherols mainly in the form of gamma tocopherol and that giving high doses of alpha tocoperol lowers serum levels of gamma. Next, Vit E was given as an isolated supplement, and yet we have know for several decades now that Vit E, when there are no water soluble antioxidants nearby, can actually become a pro-oxidant instead of an antioxidant.

Finally, in this study, the authors actually look at a functional aspect of Vit E supplementation levels and found that there were no real changes until we hit a rather large dose of 1600 IU per day. Kind of makes all prior studies looking at only 400 IU usage somewhat obsolete, huh?

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CONTROVERSIES OVER VITAMIN E AND HEART DISEASE – (04-28-08)

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Effect of high-dose gamma-tocopherol supplementation on biomarkers of oxidative stress and inflammation and carotid atherosclerosis in patients with coronary artery disease

There has been much controversy lately over Vit E and heart disease. I’ve addressed this in past issues of the Updates, but suffice it to say that I feel this scare against Vit E has been perpetuated by physicians who don’t really understand how Vit E works.

One of the concerns with these studies is that they used to synthetic form of Vit E instead of the natural, RRR-tocopherol form. Well, in this study we see that 2 years of relatively high dosages of RRR-tocopherol lowered markers of oxidative stress but had no impact on the thickening of the carotid arteries.

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POSITIVE ROLE OF VITAMIN E ON OUR HEALTH – (08-25-08)

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Serum Micronutrient Concentrations and Decline in Physical Function Among Older Persons

With some negative research on Vit E that was published several years ago, many physicians who do not understand the physiology behind Vit E began to recommend patients stop taking it. So, instead of taking the opportunity to educate their patients on Vit E differences (different tocopherols, tocotrienols, natural synthetic), we’ve really messed them up further.

There is absolutely no doubt that Vit E plays of positive role on our health, but there are some caveats. Mother Nature provides a blend of tocopherols and tocotrienols in foods, with gamma-tocopherol being the dominant form. The vast majority of supplements for Vit E are only the synthetic alpha-tocopherol form. High intake of alpha will lower serum levels of gamma.

So, the idea that we would have some limited problems with high dose only alpha tocopherol supplementation is not that surprising. We should’ve used this research as a teaching tool for our patients. The problem is that we’ve been seeing some evidence of increased rates of diabetes and now declining physical function in patients with lower serum levels of Vit E.

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