I was wrong about Vitamin E

As you know, I have been writing and talking extensively about the poor research on the wrong type of vitamin E – alpha tocopherol.

This week I came across two incidences regarding this topic:

1. A patient of mine saw an oncologist for a second opinion and  they vehemently suggested to discontinue the vitamin E supplement I suggest from Advanced Prostate Support pack. Of course, the vitamin E I suggested has ample gamma-tocopherol along with alpha, delta and beta tocopherol. In that formula you also find tocotrienols (another subgroup of vitamin E) that seems to have significant anti-cancer properties (Ling et al. 2012)

2. I have been saying all along that 400IU of alpha-tocopherol is NOT accessible now and it has not been in the market for over 10 years. Every vitamin E bottle I have scrutinized has had 400IU of  mixed-tocopherols – not only alpha tocopherol.  I was wrong. Recently a patient brought to my office a bottle sold in a pharmacy of 400 IU of alpha-tocopherol (picture above) – the kind and dosage that can increase the risk of prostate cancer.

A Review:

• There are 8 forms of vitamin E: Tocopherol (alpha, beta, gamma, delta) and Tocotrienols (alpha, beta, gamma, delta)
• The SELECT study just used one form – alpha tocopherol
• Gamma tocopherol is maybe more protective than alpha-tocopherol alone
• Tocotrienols may be also important for prostate cancer  (CaP) protection
• 50 units of alpha-tocopherol has shown to be protective against prostate cancer in a big study (Helzlsouer et al. 2000)
• 400 units ( 8 times a as much as the previous study) of alpha-tocopherol has shown to increase the risk of prostate cancer in a bigger study (Klein et al. 2011)
• Treatment with large doses of αlpha-tocopherol reduces serum concentrations of gamma-tocopherol, thereby upsetting the natural balance of vitamin E isomers in the body (Huang el al. 2003)
• In a 10,456 men study at the prestigious Johns Hopkins School of Public Health, men who had the highest blood levels of gamma-tocopherol were five times less likely to get prostate cancer (Helzlsouer et al. 2000).
• Conclusion: the research suggest that too much alpha-tocopherol (>400 units), by itself, can increase the risk of prostate cancer. 50 units of alpha-tocopherol can be helpful. More importantly, the addition of the other tocopherol members, particularly gamma-tocopherol, maybe even more protective. Lastly, the data with the tocotrienol subgroup type of vitamin E and its protective effects are compelling.

What should you do?

Read labels. Clearly, there are companies still selling alpha-tocopherol vitamin E in the market. That is not what you want.

Print this blog post, including the references, when you see your physician about vitamin E. They will, in a knee-jerk type of reaction, recommend against it.  Remember, nutrition is not part of a medical school curriculum.

References:

Helzlsouer, K.J., Huang, H.Y., Alberg, A.J., Hoffman, S., Burke, A., & Norkus, E.P., et al. (2000). Association between alpha-tocopherol, gamma-tocopherol, selenium, and subsequent prostate cancer. Journal of National Cancer Institute, 92(24), 2018-2023.

Ling MT, Luk SU, Al-Ejeh F, Khanna KK. Tocotrienol as a potential anticancer agent. Carcinogenesis. 2012 Feb;33(2):233-9

Klein et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2011 Oct 12;306(14):1549-56.

Huang, H.Y., Alberg, A.J., Norkus, E.P., Hoffman, S.C., Comstock, G.W., Helzlsouer, K.J., et al. (2003). Prospective study of antioxidant  micronutrients in the blood and the risk of developing prostate cancer. American Journal of Epidemiology, 157(4), 335-344.