Posted on 11/10/2004 7:16:06 PM PST by neverdem
People who take high doses of vitamin E to improve their health may not be getting any benefits and may, in fact, be slightly increasing their risks of dying earlier, researchers reported yesterday.
The adverse effect was tiny, however, and some experts with no connections to the vitamin industry say they are not convinced it was demonstrated. It emerged only when the researchers pooled the results from 19 clinical trials involving 135,967 participants. That led them to conclude that there were 39 additional deaths per 10,000 people who were taking vitamin E doses exceeding 400 international units a day.
The recommended daily amount of vitamin E is about 20 international units a day, and the dose in a multivitamin pill is about 30 units. People take much higher doses because they believe that at high doses the vitamin acts like a drug, protecting them from disease.
The new study, by Dr. Edgar R. Miller III, an associate professor of medicine and epidemiology at Johns Hopkins University, will be published on Jan. 4 in The Annals of Internal Medicine. Dr. Miller presented the data at the American Heart Association meeting yesterday in New Orleans, and the journal is making the paper available free on its Web site, www.annals.org.
The results, some nutrition experts said, were disconcerting because vitamin E is widely used by people who hope it will act as an antioxidant and prevent heart disease, cancer, Alzheimer's disease, and even the common cold. In fact, said Dr. William Thies, the vice president for medical and scientific affairs at the Alzheimer's Association, taking vitamin E has become "part of the standard of care" for Alzheimer's patients, even in the absence of solid evidence that it helps.
The Council for Responsible Nutrition, an industry group, says the exact number of people who take vitamin E is not known, but the vitamin is among the most popular of all nutritional supplements. In 2003, sales of the vitamin totaled $710 million and it accounted for 11 percent of all vitamin sales, behind multivitamins , B vitamins and vitamin C.
Dr. Miller said he began the study when he was asked to write a chapter on antioxidants and heart disease for a textbook on preventive cardiology. When he looked at data from clinical trials, however, he noticed that many seemed to show that vitamin users had more heart disease, not less.
"The a priori hypothesis would be that antioxidants are protective, but there hasn't been any evidence of protection and there has been a hint of harm," he said. But the evidence of harm was weak, so he and his colleagues decided to pool data from 19 studies to get more definitive answers. Their paper, however, failed to convince some statisticians, who noted that it is notoriously difficult to pool data from disparate studies with different populations and weak results.
"They may well be right, but as a statistician I find this paper unpersuasive," said Dr. David Freedman, a statistician at the University of California at Berkeley. But since there also is no evidence that the vitamin can help, he added, "I personally wouldn't recommend that you take large doses."
Dr. James Robins, a Harvard statistician, had a similar reaction.
"They may be right but they somewhat oversold it statistically," Dr. Robins said. "It is definitely true that there is no evidence that the low dose does anything for you, and a high dose may be bad. I wouldn't tell anyone to take this stuff, but this is hardly definitive evidence."
But even a hint of risk should swing scientists' reasoning, some said.
Dr. John Erdman, a professor of nutritional sciences at the University of Illinois at Urbana-Champaign, said doctors and scientists themselves were taking high doses of vitamin E.
"I remember going to meetings where they said, 'Raise your hands if you're taking vitamin E.' An awful lot of people raised their hands."
Now, he said, "The increase in risk is extremely small, but it appears to be real."
Dr. Benjamin Caballero, the director of the Center for Human Nutrition at Johns Hopkins Bloomberg School of Public Health, said the study showed the problem with assuming that vitamins at least would do no harm.
"This reaffirms what many have already said," Dr. Caballero said. "The evidence for supplementing with any vitamin, and particularly vitamin E, is just not there. This idea that people have that even if it does not have any effect, at least it will not hurt, may not be that simple."
But Dr. John Hathcock, the vice president for scientific and nutritional affairs at the Council for Responsible Nutrition disagrees. He is not convinced by the new study's conclusion that high doses of vitamin E are risky, Dr. Hathcock says, and he believes there is at least presumptive evidence that it can help.
For the past 15 years he has taken 400 international units of vitamin E a day, he says, and he does not intend to stop.
E is a fat-soluble vitamin - and as such excess amounts accumulates instead of being flushed like is true for the water soluble vitamins (B and C).
A, D, and E are all toxic at high doses - I thought that was long-established.
Just as FLAME BAIT since I haven't read the article...
Could it be possible that the studies looked at HEART PATIENTS (already at increased risk of death) and found higher incidence of mortality due to the population studied?
By analogy if one studied runners (Jim Fixx...) who had a family history of heart disease, would the study conclude that running was not ameliorative?
Oh, did Pfizer or Merck help fund this work?
[Asbestos suit DONNED while running away, popping Vitamin E capsules...]
They forgot to test me. Have been taking 1200 IU daily since 1976. Checked the obits today & I still wasn't there...
Yep...about 20+ years ago.
Concur. Polar bear liver is toxic due to high concentrations of E.
Funny, the study doesn't tell us what KIND of vitamin E. It has been known by those on the cutting edge for some time now that most Vit E supplements are only comprised of alpha tocopherols, which actually eliminates other forms of the vitamin like gamma, which may be more important.
A complete Vitamin E with all the various subfractions and forms is much less likely to have any negative consequence and is much more likely to have positive consequences.
Most who take E supplements are likely taking a very inferior form that very well could be a problem, but certainly is helping less than it should.
All the Doctors quoted in the article could certainly mention that not all Vit E Supps are the same and the study cold have noted that poor quality, unbalanced E supps may the real problem, but they would rather blame Vit E in the generic sense. Us rubes can't be trusted to critically think about the matter, so they simplify it for us. They would love to outlaw supps altogether so that we can depend on them for costly pharmaceuticals, which generally have more questionable safety records themselves!
This leads me to conclude that the study is simply another scare piece, pushed by somebody with an anti-supplement bias. If that bias was centered around shoddy marketing practices by the supplement industry or general supplement ignorance, I wouldn't have a problem with it. Yet typically, these kinds of studies are advanced by those on a crusade against supplementation in general, with a relious zealotry that the concept itself is somehow evil.
I believe that is vitamin A, not E.
Yes, indeed. They would rather you took Coumadin (rat poison) so that you can weaken yourself and die good and early the way a member of my family did. Tragic thing is the man had no symptoms that called for blood thinning.
FReepmail me if you want on or off my health and science ping list.
ping
No mention of control groups. No mention of other possible contributing factors.
The old saying about correlation not equaling causation is certainly true in regard to this meta study.
Once vitamin E is available by prescription only it's safety and efficacy will be trumpeted. < / sarcasm >
WELL...DUH....maybe those who THINK they may have or get heart disease take more VIT E. Plus, if these people use vitamins primarily, instead of food, for nutrition, that could also be a problem. I am at war with the alliopathic industry right now (on a personal level)....so please ignore my rant.
Agreement ping.
There are a couple different types of Vitamin E. I use d-Alpha tocopherol. It has been shown in numerous studies going back to the 1950's to be extremely safe, even in large doses. 'Mixed' tocopherol's are unstable and were probably the ones used in this study.
GINA KOLATA is the NYT science reporter who wrote about 10 years ago that AIDS had been eradicated from a corpse of a man who died from AIDS.
I remember stickers all over the NYC subways and on NYT newspaper vendor boxes that said, "GINA KOLATA the worst science reporter in America."
If I recall, she is related to someone high up in the NYT organization, which is why her job was protected.
I just have one question. Who funded the study?
The best thing is to be careful and eat right. Pills give people a false sense of security -- they believe they can load up on junk foods --- pop a pill and be okay. Good food contains all the nutrition and vitamins we need.
Limitations: High-dosage (400 IU/d) trials were often small and were performed in patients with chronic diseases. The generalizability of the findings to healthy adults is uncertain. Precise estimation of the threshold at which risk increases is difficult.
Discussion
In our meta-analysis, we identified a dose-dependent relationship between vitamin E supplementation and all-cause mortality. Specifically, all-cause mortality progressively increased for dosages approximately greater than 150 IU/d. This dosage is substantially lower than the tolerable upper intake level for vitamin E, which is currently designated at 1000 mg of any form of supplementary alpha-tocopherol per day (corresponding to 1100 IU of synthetic vitamin E per day or 1500 IU of natural vitamin E per day) (1).
I haven't read the whole article, but apparently gamma-tocopherol per se wasn't a consideration. I think the only thing you can say with certainty is that more study is needed.
Yes - I am sure they want to scare people. Dr. Schultz years ago did experiments on people (including his own mom who had heart problems) on the benefits and side effects of taking large doses of Vitamin E. He found it is good for heart patients.
Although there are precautions on taking supplents like Vitamins A and E -there are plenty of people who have been taking large doses of those vitamins for a number of years.
I believe the government should - instead - go after the drug companies that kill more poeple with their pills than you could find in all the natural supplement industry!
There are many more people that are injured or die with medicines that were prescribed by their doctors than people who take supplements!
And people do not take time to read up on the fine little print of the tablets they are prescribed by their doctors before taking the pills.
For instance - even my doctor was surprised that I knew that the ingredient that Premarin is made from is pregnant mare's urine. There has been controvery on that but that is what it said in the sheet with tiny print in the box the Premarin came in. I read that the last time (a few years ago) when I was reading what ingredients and side effects were from taking Premarin.
I just feel - People are responsible for their own health!
Read up on the meds and natural you take!
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