To Your Health

A. You probably heard the news concerning a report in the online edition of the Annals of Internal Medicine on Nov. 10, 2004 (to be published Jan. 4, 2005), asserting that vitamin E supplements more than 400 IU per day increase the risk of death. They base this speculation on the pooled results of 19 studies representing about 136,000 people who took vitamin E supplements for a year or more, most of whom had been diagnosed with some illnesses. Their statistics indicate that those taking 400 IU or more of vitamin E per day had a 5% greater risk of dying over a four-year period than those who were taking less than 150 IU per day or none.

It appears that the major purpose of the publication was more to generate sensational headlines than to convey accurate information. The study has some serious flaws and flies in the face of several previous studies that indicate benefits from vitamin E supplements.

The first concern, also pointed out in a rare editor's note accompanying the article, is that the conclusions of the study should not be generalized to include healthy adults. However, some of the most trustworthy research indicates that vitamin E supplements of several hundred IU per day provide protection from a number of medical conditions such as blood clots in leg veins. Such levels of intake cannot be obtained from diet alone. Thus, people who would benefit most from vitamin E supplements are advised not to take them.

A second concern is the type of vitamin E used in the various studies. A great deal of research is done using synthetic vitamin E or dl-alpha tocopherol, instead of the more expensive types derived from food, d-alpha tocopherol, or mixed tocopherols. The authors do not discriminate between results obtained using synthetic vitamin E and "natural" vitamin E. The authors of the study are aware of the different types, since they convert the amounts of vitamin E used in the various studies, whatever the type, to equivalent amounts of alpha tocopherol. There is evidence that gamma-tocopherol or another form of vitamin E known as tocotrienols perform considerably better than dl-alpha tocopherol, both in terms of clinical results and safety.

Thirdly, it is now well-established that all the antioxidants are capable of inflicting damage when used alone. The authors mention that the vitamin E studies reviewed sometimes included other nutrients but fail to point out whether results differed when a team of nutrients was used, as compared to vitamin E alone.

The authors only speculate on a mechanism for the way in which vitamin E supplements could upset the body's normal functioning, but to be fair there is as yet no agreement on exactly how vitamin E helps the body maintain health. It is certainly part of the team of antioxidants that slows cellular aging and, along with vitamin K, is an effective anticoagulant that keeps our blood flowing through our veins. When used with a multivitamin/mineral to supply vitamin C, vitamin A, selenium, and a legion of other nutrients, it is a safe and efficient approach to continued health.