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Vitamin E Safety Controversy

For my first post, I thought I’d take on a topic that has been in and out of the media for the past few years, vitamin E.

Initially, vitamin E was thought to have a lot of potential for general health, from heart to prostate health.  Smaller studies and in vitro work showed promise, but then some big studies over the last year had conclusions that were disappointing: “vitamin E did not affect the overall risk of HF[heart failure]”1 or scary: “Dietary supplementation with vitamin E significantly increased the risk of prostate cancer among healthy men”2

How did this happen?  How did we go from ‘vitamin E for all’ to ‘vitamin E: useless and/or dangerous’?  The answer is pretty simple: people are taking the wrong vitamin E.

All of these large scale clinical trials use alpha-tocopherol, one of the eight forms of vitamin E.  Some of them even use synthetic versions of alpha-tocopherol, which is widely accepted to have less than half the potency of natural alpha-tocopherol (due to shortcomings in the synthesis process).

So why is that a problem?  Well, research going back more than a decade has shown that supplementing pure alpha-tocopherol actually reduces the amounts of the gamma-, beta- and delta-tocopherols in the blood.  It turns out that these other tocopherols are actually pretty important, and are stronger antioxidants than the alpha form.  There have even been studies that show that gamma-tocopherol, but not alpha-tocopherol, levels are reduced in men that develop prostate cancer3.

Wait, that sounds familiar, doesn’t it?  So alpha-tocopherol supplementation decreases blood levels of gamma-tocopherol, and low gamma-tocopherol is linked to prostate cancer.  Why are we then surprised to see that alpha-tocopherol supplementation is linked to prostate cancer?

How did AOR put those pieces together a decade ago to determine that vitamin E supplements should have a balanced blend of tocopherols and tocotrienols (didn’t even get a chance to talk about those, but guess what, also really important), but major clinical trials can’t get their act together?  In the meantime, millions of people have been scared away from taking vitamin E supplements, when complete vitamin E supplements have been shown in clinical trials to improve cholesterol status, increase levels of multiple types of vitamin E in the blood (without decreasing any), reduce overall oxidative stress, boost immune function, and decrease arterial stiffness, just to name a few.  High blood levels of all vitamin E forms have also been linked to reduced risk of Alzheimer’s disease4, and animal model experiments have demonstrated that gamma- and delta-tocopherol, but not alpha-tocopherol, have strong anti-cancer effects5.

So if you are taking just alpha-tocopherol, consider switching to a more complete vitamin E, and if you’re already taking something like Total E, don’t worry about the scary headlines, those studies won’t apply.

You may also be interested in:

3 Reasons to Think About Vitamin E This Summer

1 Chae UC et al. (2012) Vitamin E Supplementation and the Risk of Heart Failure in Women. Circ Heart Fail. 5(2):176-82.

2 Klein EA et al. (2011) Vitamin E and the Risk of Prostate Cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 306(14):1549-56.

3 Helzlsouer KJ et al. (2000) Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer. J Natl Cancer Inst. 92:2018-2023.

4 Mangialasche F et al. (2010) High plasma levels of vitamin E forms and reduced Alzheimer’s disease risk in advanced age. J Alzheimers Dis. 20(4):1029-37.

5 Yang CS et al. (2012) Does Vitamin E Prevent or Promote Cancer? Cancer Prev Res. Epub ahead of print April 13.


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