Looks like that's one less pill to worry about taking

Vitamin E Supplements
Can Pose Serious Risks,
A New Study Concludes
By JENNIFER CORBETT DOOREN
DOW JONES NEWSWIRES
November 11, 2004; Page D1
Toss out those bottles of vitamin E. That's the recommendation coming from some doctors at the American Heart Association scientific meeting in New Orleans this week.

In research presented at the heart conference yesterday, Edgar R. Miller, an associate professor of medicine at Johns Hopkins University, says that taking a vitamin E supplement carries serious risks.

Dr. Miller's view is based on an analysis of 19 previous studies involving 136,000 patients. According to his analysis, those taking 400 international units per day or more (the amount in most vitamin E supplements) had higher overall mortality rates in given periods -- about 5% higher -- than those who didn't take supplements. As a result, he and other doctors recommend that people stop taking vitamin E supplements.

In the 1990s, sales of vitamin E began soaring when some studies started hinting of health benefits. One particular study released in the mid-1990s showed that vitamin E reduced the risk of having a fatal heart attack, and this prompted many physicians to recommend that patients take a daily vitamin E supplement. Other research has suggested that vitamin E, an antioxidant, reduces the risk of developing cardiovascular disease, cancer and might even protect against Alzheimer's disease. Indeed, foods high in antioxidants are overwhelmingly endorsed for their health benefits, and continue to be.

In the enthusiasm over the potential health benefits, some doctors initially overlooked findings that the overall risk of death from high-dose vitamin E supplements was slightly increased.

Dr. Miller cautioned that the 19 studies he analyzed involved many patients over 60 who had pre-existing conditions. Still, he says, "Increasing doses of vitamin E were linked to an increase in death." While the reasons weren't pinpointed, it could be because high doses of vitamin E displace other antioxidants in the body and also increase the risk of bleeding. There was no increased risk of death at levels of about 150 IUs or below.

A daily multivitamin is still considered fine for people to consume if they choose, because they contain a much lower amount of vitamin E. The amount found in a typical multivitamin ranges from 30 to 45 IUs.

Raymond Gibbons, a professor of medicine at the Mayo Clinic, says he and other physicians have unsuccessfully been trying to persuade their patients to stop taking vitamin E supplements for the past couple of years amid increasing evidence that high doses offer no benefit. Patients continue popping the vitamins, he says, because they are convinced that these and other supplements offer a range of perceived but unproven benefits.

While sales of vitamin E supplements have dropped in the past few years, they still totaled $706 million in 2003, according to the Nutrition Business Journal, which tracks trends in the supplement industry. Vitamin E sales peaked at $868 million in 1999.

For years doctors have said that a regular healthy diet provides enough vitamin E and supplements -- despite their popularity -- weren't needed.

Generally, Dr. Gibbons says, doctors were concerned that patients would forget to take a needed drug if they were busy taking supplements that did no good. Now amid new evidence that vitamin E could do harm, physicians say it's more urgent to call a halt.

"The idea that vitamin E isn't beneficial or even harmful is something we need to alert the public on," says Robert Eckel, a professor of medicine at the University of Colorado Health Sciences Center.

Most people easily get enough vitamin E from their diets, because it is contained in fats such as vegetable oil, nuts and green vegetables, Dr. Miller says, adding that people need only about 10 IUs of vitamin E each day.

Dr. Miller, the Johns Hopkins researcher, says he started looking at vitamin E studies for a chapter in a book he was writing about the benefits of vitamins in protecting against cardiovascular disease. He says he was surprised when he found negative impacts from high-doses of vitamin E rather than positive ones.

For his analysis, which appears in the latest edition of the Annals of Internal Medicine, Dr. Miller examined studies that took place between 1993 and 2004 and involved more than 136,000 patients in North America, Europe and China. The trials were all placebo-controlled; each had a group of patients that were given a sugar pill rather than the vitamin. The risk of death was estimated by comparing the death rates in the placebo group to that of the vitamin E group. Some of the studies also involved the use of other vitamins.

The Council for Responsible Nutrition, a Washington, D.C.-based group that represents supplement ingredient manufacturers, says it disagrees with the Miller analysis. John Hathcock, CRN's vice president for scientific and international affairs, says the findings were "driven by the results from a few of these clinical trials, some of which are suspect." He noted that the Institute of Medicine, which makes recommendations on upper limits for vitamin supplements has set a limit of vitamin E supplements of 1,000 milligrams.

The Institute of Medicine sets recommended daily dietary guidelines that it periodically updates. In an update in 2000, the IOM placed an upper limit on vitamin E of 1,000 milligrams or about 1,500 IUs of natural vitamin E or 1,000 of synthetic vitamin E. Amounts beyond that are not recommended because it raises the risk of bleeding, the IOM says.

But the dietary intake guidelines state that upper limits should not be considered the recommended amount.
Dr. Miller says his vitamin E findings are similar to earlier findings on beta carotene. Two major studies showed that beta carotene supplementation resulted in an increased risk for lung cancer and death. Doctors then stopped recommending beta carotene supplements.