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What Doctors Don't Tell You

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July 2020 (Vol. 5 Issue 5)

Going for Gold

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Is vitamin E good or bad for you? It all depends on the type of vitamin E you chooseVitamin E has been taking a bit of a bashing recently

Is vitamin E good or bad for you? It all depends on the type of vitamin E you choose

Vitamin E has been taking a bit of a bashing recently. Studies have linked it to increased risks for prostate cancer, heart failure and death, while the media has used it as an example of why you shouldn't take supplements.
But if you've been bypassing the vitamin E section on your healthfood store's shelves, you could be missing out on a whole host of amazing benefits.

Here are five reasons why you shouldn't ignore those little golden capsules.

1. There's more than one form of vitamin E. Vitamin E is not just a single compound, but a whole family of distinct molecules comprising four tocopherols and four tocotrienols, each with an important role to play in health. Most research-including the negative studies-has been done with alpha-tocopherol, a form that has become pretty much synonymous with vitamin E. But taking this single compound alone may not be the best thing for your health. In fact, lesser-known members of the vitamin E family are now stepping into the spotlight and may be far superior to the alpha-tocopherol form.

2. Tocotrienols have powerful anticancer effects. This half of the vitamin E family-made up of alpha-, beta-, gamma- and delta-tocotrienol-has been shown in animal models to have potent effects against cancers of the breast, prostate, lung and colon (Cancer Prev Res [Phila], 2012; 5: 701-5). In one test-tube study of human breast cancer cells, tocotrienols were found to arrest the growth of these cells by 50 per cent, whereas alpha-tocopherol was ineffective (Lipids, 1995; 30: 1139-43).

Few clinical trials have been done, but one in Malaysia of women eating a tocotrienol-rich diet (from palm oil) concluded that tocotrienols may have a protective effect against breast cancer. The scientists discovered higher concentrations of tocotrienols in the fatty tissues of women with benign (non-cancerous) breast lumps compared with levels in women with malignant (cancerous) tumours (Asia Pac J Clin Nutr, 2007; 16: 498-504).

More recently, the results of a preliminary trial have suggested that taking tocotrienol as a supplement with the breast-cancer drug tamoxifen could slash the risk of dying from breast cancer as well as reduce the chances of it coming back compared with taking tamoxifen alone (Genes Nutr, 2012; 7: 3-9).

3. Certain tocopherols can help fight cancer too. Scientists at Rutgers University in New Jersey recently reported that two forms of vitamin E commonly found in the diet (as soybean, canola and corn oils as well as nuts) have cancer-preventative effects. Gamma- and delta-tocopherols both displayed strong anticancer activity in animal studies-whether they were injected directly or fed to the animals in food-while alpha-tocopherol, the type usually found in supplements, had no such benefit (Cancer Prev Res [Phila], 2012; 5: 644-54).

Although these results may not apply to humans, a study of men taking part in the National Institutes of Health American Association of Retired Persons Diet and Health Study came to a similar conclusion.

Those getting the most gamma- and delta-tocopherols from their diets had significantly reduced risks of prostate cancer, while those taking vitamin E supplements in the form of alpha-tocopherol were no better off than the men not taking the supplements (Cancer Epidemiol Biomarkers Prev, 2007; 16: 1128-35).

This might help to explain why studies of vitamin E and cancer have been so conflicting: the type of vitamin E being used makes all the difference.

4. Tocotrienols can boost heart health. If you're looking for a supplement to prevent heart disease, tocotrienols may be the way to go. While some studies suggest alpha-tocopherol has no benefit or even a negative effect on heart health, tocotrienols are showing greater efficacy and positive results (Curr Pharm Des, 2011; 17: 2147-54; Townsend Lett, 2012: 346: 85-92). They've been found to improve several risk factors for heart disease, including lowering high blood pressure (J Nutr Sci Vitaminol [Tokyo], 2006; 52: 473-8) and cholesterol (Lipids, 1995; 30: 1171-7) while increasing the elasticity of the arteries (Arch Pharm Res, 2008; 31: 1212-7).

In people with carotid stenosis-narrowing of the carotid artery so that less oxygen reaches the brain-88 per cent of those taking tocotrienol supplements experienced regression or stabiliza-tion of the disease. In those taking a placebo, only 8 per cent improved while 60 per cent got worse (Lipids, 1995; 30: 1179-83).

Tocotrienols also appear to be of benefit for people with type 2 diabetes and the metabolic syndrome-a group at high risk for heart disease (Atherosclerosis, 2005; 182: 367-74).

5. Vitamin E can protect the brain. Research carried out at the Aging Research Center at the Karolinska Institutet in Stockholm, Sweden, suggests that when it comes to brain health, all forms of the vitamin are important. A study of 232 elderly patients found that those with higher levels of the whole family of vitamin E forms had a lower risk of developing Alzheimer's disease compared with those who had lower levels. Tocotrienols and tocopherols each on their own were associated with a reduced risk of Alzheimer's, but when the researchers looked at the individual forms of vitamin E, only beta-tocopherol was significantly linked to a lower risk of having the disease (J Alzheimers Dis, 2010; 20: 1029-37).

This suggests that the different forms of vitamin E may all be working together to deliver greater brain-protective effects. And it may explain why the results of some trials of vitamin E supplements in neurodegenerative diseases-which have mostly used only the alpha-tocopherol form-have been disappointing (Crit Rev Food Sci Nutr, 2010; 50: 414-9).

WDDTY verdict

As alpha-tocopherol falls from stardom, mounting evidence for the other members of the E family shows that the vitamin still has value as a supplement. There's still a lot more research to be done, but so far the tocotrienols are showing the most promise as the vitamin E of the future. For now though, if you're looking for a vitamin E supplement, it may be best to choose a full-spectrum product with both tocopherols and tocotrienols to increase your chances of maximum benefits. And go for one with small amounts of alpha-tocopherol as, at high doses, it can interfere with the benefits of the other forms of vitamin E (see box above). Above all, make sure your vitamin E comes from a natural, not synthetic, source (see box above), so always read the label.

Joanna Evans

Where to buy

  • NOW Tocotrienols and E Complex
lb26.95 for 60 softgels;;
tel: 020 8752 8450
  • Swanson Ultra Full Spectrum E with Tocotrienol lb40.94 for 120 softgels;; tel: 01534 885 960
  • Weil Nutritional Supplements Vitamin E Complex lb19.36 for 60 vegicaps;
A few studies have reported that vitamin E supplements can increase the risk of certain diseases-and even death-but can this nutrient really do us harm? A closer look at the evidence reveals the studies are seriously flawed.
One Johns Hopkins School of Medicine review, for example, concluded that high-dose (400 IU/day or more) vitamin E supplements "may increase all-cause mortality and should be avoided" (Ann Intern Med, 2005; 142: 37-46). But the 'meta-analysis' (pooled analysis) of 19 trials included only one trial that used natural vitamin E, while the others used a synthetic version of the vitamin-so true vitamin E wasn't even tested. What's more, only nine of the trials tested vitamin E on its own; the rest tested vitamin E combined with other vitamins and minerals-so who's to know whether the results are down to vitamin E or any of the other nutrients. In fact, the high dose of zinc (twice the upper limit of safety) used in one study may well have led to the observed negative effects (Integr Med, 2005; 4: 14-7).
The Johns Hopkins report also failed to follow one of the basic rules of a good meta-analysis: to analyze data from similar populations using similar study protocols. By including results from widely differing studies, the results may have been biased. Even the researchers themselves admitted this, noting that "high-dosage trials were often small and were performed in patients with chronic diseases". So the people taking high-dose vitamin E were already at a higher risk of dying. Put all this together and it's hardly proof that vitamin E's a killer.

Another negative trial reported that vitamin E can boost the risk of prostate cancer (JAMA, 2011; 306: 1549-56) but, again, this wasn't a true test of vitamin E as a synthetic version of the vitamin was used (all-rac-alpha-tocopheryl acetate; the natural form is d-alpha-tocopherol, d-alpha tocopheryl acetate or d-alpha tocopheryl succinate). Plus, as the latest research shows (see main story), vitamin E is a whole family of compounds and taking just one on its own-whether natural or synthetic-may not be what's best for your health. In fact, high doses of alpha-tocopherol may be reducing the levels of other members of the vitamin E family, such as gamma- and delta-tocopherol, so also reducing their anticancer and other beneficial effects (J Nutr, 2003; 133: 3137-40).

WDDTY November 2012 vol 23 no 8

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