"Doc, what's your take on Vitamin E?" Ashley Twain Davis NY. NY.
I will admit I have shied away from this question for a while because it is a very complex topic!
But the volume of emails I get on this can simply no longer be ignored.
First I do take Vitamin E, about 400 i.u. a day.
Next it is in my "Dr Dave's Best Monster Multi with Minerals" tm the long awaited multi that is due out in late September.
Then, there is some research that shows that it may help slow the progression of Alzheimer's Disease at least in some people.
So for those reasons I do take it and include it in several of my supplements as "mixed tocopherols" and a derivative "tocotrienols".
A couple of things it does not do.
Vitamin E does not Prevent or treat heart disease in any fashion as proven by the latest research.
Go to any site that sells vitamin E products and see if they talk about that. Believe me they don't!
Next and for the millionth time vitamin E does not enhance the effects of fish oil in cardiac illness in any way shape or form.
Let me state it gently:
If you see some health baboon saying this ignore his/her advice. Its just plain wrong and totally outdated!
Research suggests that Vitamin E does indeed reduce the mediators of inflammation, at least some of them.
Unfortunately in study after study, Vitamin E has failed to demonstrate actual clinical benefit in animals and people.
The following is an excerpt from the GISSI Prevenzione study:
In GISSI-Prevenzione, 11,323 patients were enrolled in a clinical trial aimed at testing the effectiveness of omega-3 PUFA and vitamin E. Patients were invited to follow Mediterranean dietary habits, and were treated with up-to-date preventive pharmacological interventions. Long-term omega-3 PUFA 1 g daily, but not vitamin E 300 mg daily, was beneficial for death and for combined death, non-fatal myocardial infarction, and stroke. All the benefit, however, was attributable to the decrease in risk for overall, cardiovascular, cardiac, coronary, and sudden death. In GISSI-Prevenzione, long-term administration of omega-3 PUFA (1 g daily) significantly decreased the risk of overall (-20%), cardiovascular (-30%), and sudden death (-45%). At variance from the orientation of a scientific scenario largely dominated by the "cholesterol-heart hypothesis", GISSI-Prevenzione results indicate omega-3 PUFA (virtually devoid of any cholesterol-lowering effect) as a relevant pharmacological treatment for secondary prevention after myocardial infarction.
And most recently:
Arch Intern Med. 2004 Jul 26;164(14):1552-6.
Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease.
CONCLUSIONS: The ORs and CIs provide strong support for a lack of statistically significant or clinically important effects of vitamin E on cardiovascular disease. The use of agents of proven lack of benefit, especially those easily available over the counter, may contribute to under use of agents of proven benefit and failure to adopt healthy lifestyles.
Now you have to remember the Archives of Internal Medicine is totally predictable in that it almost always presents only negative data.
I also think that this journal is being a little bit heavy handed in suggesting that people who take vitamins are less likely to have healthy lifestyles!
The summation of this data pretty much puts the nail in the coffin of vitamin being the savior vitamin that people were looking for.
Unfortunately this holds very much true for Vitamin A and C as well, but that is for another time.
Now one of the explanations that were used in the past for the failure of Vitamin E was that people were using the wrong kind, like Alpha tocopherol.
Commercial Vitamin E preps have long since switched to "mixed natural tocopherols".
It is unclear from the study in the Archives is which form they were evaluating.
If you look at the individual studies they evaluated there were probably some with the old form of Vitamin E that might skew the data.
Overall however I ten to think the results in heart disease would be the same.
Now take a trip to your friendly neighborhood vitamin store and look at the reams of different solo Vitamin E products.
Or look at how many "ME TOO" anti-oxidant formulas are based on Vitamins E, C, and A.
While I don't think this stuff should be wiped off the face of the Earth or the shelves, I would be very concerned if it was the mainstay of my sales.
Problem: most people do not read the medical literature!
So a lot of this will never get to the vitamin store or the buying public.
Now there have been some reliable studies that do show that vitamin E does decrease the mediators of inflammation. So it is entirely possible that Vitamin E may help with other inflammatory conditions.
It may reduce the frequency or severity of colds in older people.
It may help reduce the problems of Alzheimer's.
There is some questionable data to suggest that Vitamin E may help prevent some types of cancer, but these are not very strong studies.
Then there is the question of Co-administration with other anti-oxidants.
Originally it was suggested that Vitamin C be used with vitamin E to improve its anti-oxidant ability.
This was done because it turns out that certain forms of Vitamin E can actually act as pro oxidant and pro inflammatories!
However, if you must take vitamin E, you should take some Co Q (or Regenerizer which has multiple anti-oxidants!).
A recent study showed that Co Q "significantly enhances the anti-inflammatory effects of Vitamin E".
Bottom line: The antioxidants in Regenerizer will cover an awful lot of ground and help many of the other vitamins you might be taking do there job more effectively.
All the Best from the King of Pharmaceutical Grade Fish Oil, Dr Dave.
Reference: the American Journal of Clinical nutrition, vol.80, No 3, 649-655, September 2004.
Disclaimer - These statements have not been evaluated by the FDA. none of the products listed or mentioned should be used as a substitute for medical advice, or to diagnose, treat or cure any illness. Always consult your personal physician before consuming any new supplements and never change any medications without his/her expressed permission
