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"In holding on to any moment, the specialness of the next moment goes unnoticed". Science of Mind

The Way Up Newsletter
Volume 38


The topic this time is:
It was difficult to avoid hearing about the November 2004 sensationalized mass press release on the meta-analysis of “some” previous Vitamin E studies published over the last 11 years. This engendered alarm in many sincere health seekers who started phoning and emailing me with questions. No doubt thousands of people have responded to this news by erroneously decreasing their vitamin supplementation.  So the bottom line effect of the way this study was distorted and handled is detrimental to the general public. 

The Headline for the study was High Dosage Vitamin E Supplementation May Increase All-Cause Mortality and should be avoided---high dosage meaning greater than 400 IU/day.  Since there are more than 2000 studies on Vitamin E, most of them favorable, this news was somewhat surprising. 

So let’s look at this Meta-analysis of Vitamin E studies.

First of all, meta-analysis is a controversial research tool and technique of exploration.
Researchers for the John Hopkins School of Public Health study decided to specifically look to see if “high dose Vitamin E” significantly increased total mortality.  They undertook a meta-analysis which is a review of other studies, pooling them together and looking for certain variables.  

They only wanted to review randomized controlled trials with follow up longer than 1 year and which included mortality information on death from any cause during the evaluation timeline.    Thirty six of the few thousand studies met their criteria.  But then they excluded 12 of those 36 because “there were fewer than 10 deaths” in those trials.  To my way of thinking, this was major error number 1 and it produced a skewed statistical review.   

There is nothing like excluding from your analysis those studies which don’t seem to support your hypothesis and selectively including what supports your view.  Though including the 12 omitted studies would have only increased the death number by less than 10, the total number of subjects in the meta-analysis would likely have been increased greatly.   This would have changed the marginal statistics to who knows what…but different, because there would be more people and less deaths. The questionable selection process alone invalidates the results as far as I am concerned because they eliminated a possibly positive response group. Additionally, the excluded studies were obviously done on healthier people.  They also excluded 5 other studies where the mortality data was not clear.  So they ended up analyzing 19 trials, of the 36 originally suitable studies.

These researchers only focused on the issue of death in an elderly ill population and ignored some of the positive findings from the studies they analyzed.  

Interestingly, a sentence in the study says “Overall, Vitamin E supplementation did not affect all- cause  mortality  They further stated , “The possibility of a small mortality benefit with low-dosage vitamin E supplementation also deserves comment. The effect of vitamin E in low-dosage studies, however, must be interpreted with caution because these studies were often performed in malnourished populations or used other vitamins and minerals in combination with vitamin E. Further research is needed to determine whether low-dosage vitamin E supplementation is beneficial in western populations.”  Give me a break…are they suggesting the healthier populations in the low-dose studies were more malnourished and in worse shape than the Alzheimer’s, Parkinson’s, kidney failure,  and heart disease, age-related macular degeneration  patients of the higher dose group?

Though they suggest interpreting beneficial results with caution, did we see any caution in their spurious interpretation and recommendations about the results they may have engineered?  Since the participants in the high dose E studies suffered from severe illnesses they cautioned, “Trials that tested high dosages involved adults with chronic diseases, and these findings may not be generalizable to healthy adults.” And again, they said, “We could not evaluate the generalizablity of our findings to healthy adult populations.”  After which they proceeded to do so!  Can we detect politicization in their statement, “Policymaking bodies, which currently do not recommend antioxidant vitamin supplement use to the general population should also caution the public against the use of high-dosage vitamin E supplementation…….and use of any high-dosage vitamin supplements should be discouraged until evidence of efficacy is documented from appropriately designed clinical trials.”  What about their design? What about their generalization to ALL supplements, many of which have been exceedingly studied.  Do you detect bias yet??

Roche participated in the funding and we are aware of the competition between the pharmaceutical and nutriceutical industries. 

There are those who believe this sort of “scientific engineering” is for the ultimate purpose of justifying a world effort to limit the doses in vitamins to minimum amounts.  You can search this under the term Codex.  I would like to not believe this, but it makes one wonder and the researchers in this analysis involved Spain, Scotland, Norway, The United Kingdom, and The United States. In the Washington Post Nov. 10,2004  we can read  Within days of the international regulatory body called CODEX notifying the world that it intends to establish a worldwide maximum dosage limit on vitamin supplements, headlines news stories warned that high-dose vitamin E supplements "increase the risk of dying."
I’ve always wondered why then, is there not a call for policymaking bodies to restrict or to ban cigarettes, alcohol, coffee, sugar, white flour products, environmental chemicals and all items known to contribute to mortality?  Why do they persist in targeting the supplement industry? 

You guessed it.

Even though I obviously question the selection process of this study, let’s go with their findings.  The high dose vitamin E group had a 5% overall mortality increase over the control group.  If this were true, what could explain these findings?

Vitamin E is an important antioxidant. Possibly, high doses of vitamin E in the absence of other important nutrients  acts to disrupt the natural balance of antioxidants increasing the vulnerability to oxidative damage. Antioxidants function together in the body in a complex network of interactions. Most antioxidants require partner antioxidants for more efficient functioning.  Any single antioxidant may be less effective or not effective at all in the absence of a supporting cast. Vitamins C, E, Alpha-lipoic acid, Selenium, Co Enzyme Q10, Glutathione and Vitamin B2 for instance coexist within a self-perpetuating cascade working together to regenerate antioxidant function.  A significant excess of any of these over the others may produce a malfunctioning system and actually stimulate oxidation ( the production of free radicals). Synergists to Vitamin E are: Vitamin A, B6, B12, Folic acid, Estradiol, Testosterone, Zinc, Selenium,  and Vitamin C 

A basic issue I have with a number of nutrient studies is that the researchers administer and study a single nutrient when that is not how nature works.  In foods multiple nutrients exist and act together synergistically to achieve benefits.  In some case taking high doses of a single nutrient without also taking a good foundational multivitamin mineral, can actually create depletion of other nutrients.
  I clearly make this point on our web site by saying “Always take a good potent multi-vitamin mineral before adding any additional supplementation.  Sometimes the multivitamin mineral alone will give you the results you desire.”  

Testing a single nutrient by itself especially in a very ill likely highly depleted population is irresponsible and flawed science.  This would be analogous to giving someone only one food repeatedly without any kind of balanced diet, then making global sweeping generalization about the benefits or lack of benefits of that single food.

What we also do not know, is the effect of interactions with medications the high dose E very ill subjects were taking.  No doubt some were taking blood thinners or anti platelet drugs.  Since Vitamin E can potentiate an increase in clotting time it would augment the effect of blood thinners which would not be a good idea. One way Vitamin E reduces the risk of cardiovascular disease is by decreasing platelet stickiness,  yet we do not know how many of these subjects had reduced platelets which can occur in the elderly chronically ill, in which case they would not be good candidates for high dose Vitamin E.

The meta-analysis combined 19 studies, 18 of which showed no statistically significant increase in mortality, one which was a combination study of Vitamin E and estrogen which did .  How can you decide the impact of the E verses the Estrogen?  What about the study in Parkinson’s patients on Deprenyl and 2000 IU of Vitamin E  showing 73 deaths per 399 in the medicated group verses 64 deaths per 401 in the control group?  How do you adjust for the Deprenyl verses the vitamin E effects?  You get the gist.

The studies in the meta-analysis were not designed to evaluate all- cause mortality  and many actually showed positive results on the conditions for which they were designed.  They evidenced  reduced progression of advanced age-related macular degeneration and cataracts, reduced incidence of heart attacks, slowed progression of atherosclerosis and Alzheimer’s Disease, and  reduced rates of prostate, lung, colon, rectal, liver, and pancreatic cancers.   
There was also no differentiation about the form of Vitamin E given, natural verses synthetic and so on.  Some of the researchers used the synthetic DL-alpha tocopherol instead of the more active natural D-alpha tocopherol.  There are also mixed tocopherols on the market with beta, gamma and delta forms. The activity of natural or natural source d- alpha tocopherol is about twice that of the synthetic  tocopherol. 

There were no reported measures of actual vitamin E levels in these studies of those with mortality so we really do not know their vitamin E status.  Vitamin E  may be poorly absorbed, as low as 21% in some.  Absorption is significantly lower on an empty stomach since vitamin E requires bile and fats for absorption. Transfer through the body requires adequacy of an enzyme called lipoprotein lipase.  

The study itself does not say Vitamin E was the cause of death among these people who already had a life threatening illness, but the implication was clearly there in the press releases which cautioned against the use of Vitamin E in doses above 400 IU.

News of numerous previous positive clinical studies re vitamin E have not been widely reported.  This is the case for most positive studies on any nutrients. But the research is there and available to any person searching the web. 

For instance, chances are you didn’t read in the paper about the conclusions of a study released in February 2004 in the American Journal of Clinical Nutrition.  They reported “vitamin E deficiency is more closely linked to death from heart disease than such better-known risk factors as high cholesterol and high blood pressure.”  The researchers found there is an “Inverse correlation between plasma vitamin E and mortality from ischemic heart disease in cross cultural epidemiology”  This means the lower your vitamin E blood levels, the greater your chance of dying from heart disease.  Researchers in this United Nations study said they could predict 62% of heart disease deaths by looking at blood levels of vitamin E.

For more on the symptoms of Vitamin E deficiency and the benefits of Vitamin E.
  • Increased fragility & shortened life of red blood cells
  • Abnormal blood viscosity
  • Heart rhythm disorders
  • Accelerated aging
  • Neuromuscular impairment such as:
    • Loss of reflexes
    • Gait disturbance
    • Eye muscle incoordination
    • Decreased balance
    • Decreased vibratory sensation
  • Breakdown of skin
  • Predisposition to gallstones
  • Fatty infiltration of the liver
  • Excess lipid deposits or tumors
  • If you want to know even more, see the comments from The Linus Pauling Institute at  or the Dietary Supplement Information Bureau.

The foods highest in Vitamin E are:

Unrefined oils such as:soybean, safflower, wheat germ, sunflower, sesame, cottonseed, canola, castor, coconut, peanut, olive, palm, walnut, and cod liver
Margarine, mayonnaise, sunflower seeds
Alfalfa, soybeans, lima beans, poppy seeds, sesame seeds, wheat germ
Chocolate, rose hips, cocoa butter, peanut butter, mint, corn, sweet potatoes
Almonds, brazil nuts, chestnuts, pecans, walnuts, and peanuts

….just the average American diet…

Until next time, many blessings

Priscilla Slagle M.D.

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