Drug Profile

Do Not Use: Vitamin E deficiency is rare, and vitamin E has not been proven to prevent heart attacks, nor has it been approved for any other medical purpose.

Vitamin E is thought to work as an antioxidant, a substance that helps to protect cells from damage. Vitamin E is found in many foods (see "Foods High in Vitamin E" box above), and a well-balanced diet with a variety of healthful foods should supply all the vitamin E that the body needs. The recommended dietary allowance (RDA) of vitamin E is 15 milligrams (mg) [approximately 22 international units (IUs)] per day for both men and women over the age of 50.

Vitamin E deficiency is extremely rare and has not been known to occur solely from an inadequate diet. It has occurred mainly in people who have certain conditions of the intestines, pancreas or liver that interfere with the body's ability to absorb this fat-soluble vitamin.

Getting the right amount of vitamin E

A study that analyzed data pooled together from multiple clinical trials evaluating vitamin E supplementation was published in the medical journal Annals of Internal Medicine in 2005. It found that taking vitamin E in doses higher than 400 IU per day may increase the risk of death.[1]

Taking vitamin E in doses that far exceed the RDA can be harmful. Some people who have taken more than 300 mg have suffered muscle weakness, fatigue, headaches, nausea, high blood pressure and an increased tendency toward blood clotting.[2]  In Britain, the Expert Group on Vitamins and minerals found that:

Very high doses of vitamin E have been reported to cause a few sporadic adverse effects. These include headache, fatigue, gastrointestinal distress, double vision, muscle weakness and mild creatinuria. High levels of vitamin E also may antagonize the effects of the other fat-soluble vitamins. Vitamin E also has an anti-platelet and anti-coagulant effect.[3]

Vitamin E and your health

Vitamin E supplements have not been proven effective for the treatment of:

• beta-thalassemia
• cancer
• fibrocystic disease of the breast
• inflammatory skin disorders
• loss of hair
• habitual abortion
• leg cramps (intermittent claudication)
• menopausal syndrome
• infertility
• peptic ulcer
• sickle-cell disease
• burns
• porphyria
• neuromuscular disorders
• blood clots (thrombophlebitis)
• impotence
• bee stings
• liver spots on the hands
• bursitis
• diaper rash
• lung toxicity from air pollution
• aging

Studies show ...

Recent randomized, placebo-controlled studies examining a variety of alleged benefits of vitamin E are reviewed here.

Cancer

A major international clinical trial published in 2005 in the Journal of the American Medical Association (JAMA) found that 400 IU of natural vitamin E (alpha-tocopherol) taken daily did not reduce the overall risk of cancer or cardiovascular disease in men and women ages 50 to 75 who had existing cardiovascular disease or diabetes. Actually, there was an increase in the risk of heart failure in the patients taking vitamin E.[4]

A large study published in 2009 in JAMA refutes the belief that vitamins, specifically large quantities of vitamins C and E, can prevent cancer in men. The study’s authors concluded that "these data provide no support for the use of these supplements in the prevention of cancer in middle-aged and older men."[5]

Another large, randomized study of the use of vitamin E found that, compared with a placebo, vitamin E did not have a significant effect on the incidence of or mortality from pancreatic cancer.[6]

A study was conducted in China in which patients with precancerous lesions in their stomachs were randomized to receive either a combination of vitamins C and E and the micronutrient selenium, garlic or a placebo for more than seven years.. The trial found that neither the combination of vitamins and selenium or garlic had any effect on reducing the occurrence of gastric cancer.[7]

In 2011, JAMA published a study on the effects of vitamin E and the risk of prostate cancer. The study showed that healthy men who had an average risk of prostate cancer and were receiving long-term vitamin E treatment had a significantly increased risk of prostate cancer.[8]

In 2012, Prescrire International also published information on the use of vitamin E and prostate cancer. The article stated that based on clinical trial results, vitamin E was not found to prevent prostate cancer. However, prostate cancer was actually found to be more frequent in the vitamin E group than in the placebo group.[9]

Respiratory tract infections

A randomized, placebo-controlled study of the use of 200 IU of vitamin E supplements daily in well-nourished people aged 60 or older failed to show that vitamin E decreased the incidence of acute respiratory tract infections. It instead showed that those people using vitamin E had a significantly increased severity of respiratory infections when they did occur compared with people receiving a placebo.[10]

Osteoarthritis

A six-month randomized, placebo-controlled trial of vitamin E failed to show any benefit for the management of symptomatic osteoarthritis of the knee.[11]

Heart problems

A randomized, placebo-controlled trial found that vitamin E supplementation did not result in any significant improvements in heart failure or quality of life in patients with advanced heart failure.[12]

In another large study of women and men age 55 or older and at high risk of cardiovascular events such as heart attacks and strokes,. the use of 400 IU of vitamin E for an average of 4.5 years had no beneficial effect on cardiovascular outcomes.[13]

The British Medical Journal published an article in 2010 on the effects of vitamin E on the different types of stroke: ischemic and hemorrhagic. The article reviewed information from an analysis of multiple randomized, placebo-controlled trials. According to the article, vitamin E use was associated with an increased risk of hemorrhagic stroke (22 percent) and a reduced risk of ischemic stroke (10 percent). The authors of the article stated that “indiscriminate widespread use of vitamin E should be cautioned against.”[14]

Cataracts

Finally, in the ophthalmologic area, a four-year, placebo-controlled study involving people aged 55 to 80 years who did not have cataracts found that treatment with 500 IU of vitamin E daily did not prevent the development or slow the progression of age-related cataracts.[15]

Another large study sought to examine the use of vitamins C and E in ways that had not previously been studied. The authors of the study, published in 2010 in the Archives of Ophthalmology, stated, “There have been no data for vitamin E treatment durations longer than 6.5 years in men and no data for supplementation with vitamin C alone in men or women.” Previous lengthier studies in women had failed to show any benefit of vitamin E for cataract prevention.

The authors’ conclusion adds cataracts to the list of diseases not prevented by vitamins C or E: “Long-term alternate-day use of 400 IU of vitamin E and daily use of 500 mg of vitamin C had no notable beneficial or harmful effect on the risk of cataracts.”[16]

In 2016, Cochrane Database published an article showing that vitamin E did not improve cognitive (mental) function in patients with mild cognitive impairment (MCI) or Alzheimer-related dementia and did not prevent the progression of MCI to dementia.[17]

At this time, there is insufficient evidence to recommend using vitamin E to prevent cancer, heart attacks or for any other medical purpose.

A recent Journal of Parenteral and Enteral Nutrition (JPEN) systematic review revealed that, with a few possible exceptions, dietary supplements offer no benefits to well-nourished adults eating a Western diet and, in many cases, may be harmful. The results of this study reinforce Worst Pills, Best Pills News’ longstanding view that there is little evidence that dietary supplements are either safe or effective.

The study authors concluded that with the possible exception of vitamin D in elderly patients and omega-3 fatty acids in patients with a history of cardiovascular disease, no data support the widespread use of dietary supplements in the U.S. and other Western countries. Indeed, the data suggest that certain commonly used dietary supplements, including beta-carotene, vitamin A and vitamin E, may be harmful. We agree.[18]