"Recent news" regarding that high doses of vitamin E (400 IU or higher) may lead to a 10% increase in the chance of premature death is not new news as there have been numerous reports in the past of many supplements, including vitamin E, to cause various degrees of harm. Let’s take a look at why vitamin E may be a problem, and what you may need to concern yourself with.

We have known for a long time that many people begin to overdose on vitamin E when supplemental levels approach the 400 IU per day dose. Yet, many people take that dose daily and many more take doses of 800 IU or even 1200 IU per day as these levels have been shown by some studies to be beneficial, especially in regards to the cardiovascular system. Just how much vitamin E, (or any other vitamin or mineral), an individual should take depends not only on that individual’s biochemistry, but also the type of vitamin E they may need to take (or not take). The quality and quantity of vitamin E is especially important.

Like most supplements, there are many forms of the same vitamin or mineral. For example, there is zinc aspartate, zinc citrate, and zinc glucurate. Vitamin E is commonly sold as d-alpha tocopherol. However, d-alpha tocopherol is only one of the eight naturally occurring plant constituents. Vitamin E also contains three other tocopherol isomers - beta, delta, and gamma. There are also four active tocotrienols which have powerful antioxidant capabilities. The majority of nutritional supplements are stripped not only of the other three active tocopherols but also the tocotrienols. Additionally, gamma tocopherol is the superior tocopherol of the four.

Gamma tocopherol exhibits major anti-inflammatory effects by blocking an enzyme called cyclooxygenase. This is also known as the COX-2 enzyme which has been under much scrutiny lately through the Vioxx fiasco. Alpha tocopherol, found in "vitamin E" supplements, does nothing to block this enzyme and therefore, the typical vitamin E supplement will do very little if anything to help you fight inflammation. Studies on prostate cancer also show benefit only when gamma tocopherol is present.

Many synthetic forms of vitamin E are sold on the market today, especially in cheaper drug-store type multiple supplements. You can identify synthetic vitamin E as it will be listed as dl-alpha tocopherol. This is not easily compatible in the body and we usually see a problem (absorption and/or toxicity) when patients take this type of vitamin E, no matter what the dose. Many vitamin E supplements on the market are also filled with soybean oil, which makes them very hard for some people to absorb and the overall potency is reduced.

Different people need different supplements. They need different doses and certain forms to be compatible with their biochemistry. We see some patients that need the whole form of vitamin E while others may only benefit from the tocotrienols. We see some people that need 400 IU a day, while others respond wonderfully to a very low dose, whole-nutrient form of only 5 IU a day. And of course, not everybody needs to supplement with vitamin E. You should not take any supplement without being aware of not only the benefits, but also the risks involved. Likewise, many studies are done using poor forms of vitamin E – from the synthetic to the incomplete form. If you look at the image that most people have of nutritonal supplements, one of that all supplements are equal as long as the words match, you can see how a study done with a synthetic, filler-added nutrient can turn out harmful and then have a blanket effect on the industry as a whole. Unfortunately, this is what fuels many of the industries that want to regulate nutritional supplements. But, without going down that road, pure forms of vitamin E can have remarkable effects on a person's health.

Vitamin E has a great impact not only on the cardiovascular system, but also the hormonal system. Clinically, there is a strong relationship between vitamin E and the muscles of the hips, lower back, and abdominals. Therefore, too little or too much (deficiency or toxicity) of vitamin E may result in a problem in those muscles resulting in low back, hip, or leg pain. This correlates often with hormonal issues where vitamin E shows benefit – from hormonal imbalances, (PMS), to breast lumps in women and prostate problems in men.

For more information on supplements, head on over to my supplement facts article.

As always, any questions can be emailed to me, and always responded to.

-Dr. Gangemi