Vitamin E is Still Important

Journalists love to turn conventional wisdom on its head. What fun it is to learn that something previously considered bad is good for you, and something considered good is now bad! So now chocolate is declared good for you, and if recent headlines are to be believed, vitamin E, that antioxidant cure-all supreme, is now pronounced bad.

Delightfully, chocolate does deserve its newly redeemed reputation, providing it's bittersweet and eaten in moderate portions. But Vitamin E is being unfairly trashed.

Vitamin E is a fat-soluble vitamin stored in fatty tissue, liver, and muscle. The RDA for vitamin E is set at 30 mg/day, but this may well be inadequate for many people. Because of its function as an antioxidant and free radical scavenger 20% of the American public currently take vitamin E supplements, usually between 200-800 mg/day, but sometimes as high as 3200 mg/day. Unlike other fat-soluble vitamins, like vitamin A, megadoses of E appear to have few adverse effects. But as dosages increase, so does the possible risk.

Vitamin E, in large doses, thins the blood, making it less likely to clot. This effect is normally countered by standard blood levels of vitamin K. When patients are low in vitamin K (a rare situation) vitamin E increases the risk of hemorrhage. Use of other blood thinners, such as aspirin (high doses only) and Warfarin, can also create a dangerous situation. The only study that shows increased mortality rates from vitamin E (at doses of 50 mg/day) pertained to just this: an increase in fatal brain hemorrhages in men ages 50-69 who smoked. While the increase was large (95%) it was limited to just this one group and has not been duplicated in any other study. Perhaps smoking middle aged men should be concerned, but unless they're also taking anticoagulants, I think they'd be better off quitting cigarettes.

Some problems have been seen in premature infants, who are often given doses of Vitamin E up to 1mg/kg to combat blindness. Preemies are often lacking adequate vitamin K, and two studies indicate that preemies on vitamin E are 12% more likely to develop necrotizing enterocolitis, a life-threatening bowel inflammation.

Vitamin E is transported through the bloodstream by VLDL's (very low density lipoproteins). Supplements may cause up to an 8% increase in total cholesterol, but this all is in the "good" cholesterol (HDLs). Vitamin E also decreases thyroid hormone levels slightly. Rarely people have reported idiosyncratic side effects from vitamin E ranging from emotional disturbances to fatigue to intestinal distress. All these effects disappeared when the affected people stopped taking the supplement.

Contrast these minor and highly individualized risks with the many benefits of this powerful vitamin. According to the Journal of American Medicine, vitamin E improves immune system function, especially in the elderly. It appears to significantly lessen cancer risk, prevent the early artery damage that leads to cardiovascular disease, and decrease the risk of stroke. It may lessen the risk of Parkinson's disease, which is linked to oxidative cell damage. It protects against eye damage from ultraviolet rays and lung damage from ozone pollution. Some vitamin E supplements are absorbed better than others (ask your pharmacist) and absorbed differently by different people.

As always, it's optimal to get your vitamin E from whole foods. Good vitamin E sources include almonds, filberts, peanuts, wheat germ and whole grain breads, spinach and other dark green veggies, broccoli, egg yolks, and whole milk. The very best source of all is vegetable oils such as canola, safflower, and olive. However, diet alone may not supply all the vitamin E that many people need. We live in a world far denser in free radicals than our bodies were designed to fight off, whether they are from pollutants, ultraviolet rays, or chemicals such as herbicides and tobacco. I generally recommend supplements around 200 mg/day, more if you are elderly or exposed to an unusual number of free radicals. Levels over 1000 mg/day do not show enough benefits to justify their increased risk.

If you happen to be a Warfarin-taking smoking middle-aged man or a premature baby, ignore this advice.