Life Extension Magazine March 2005
False and Misleading
Why Test Vitamin E in Sick People?
You may be wondering why millions of dollars were spent evaluating the effects of alpha tocopherol on people in serious disease states. Since vitamin E is not patentable, a scientific basis must exist for a grant to be awarded to fund these kinds of studies.
The reasons why so many dollars have been spent to see whether individual supplements could save the lives of sick people are:
Based on studies showing beneficial effects in people who supplement with vitamin E, doctors wanted to know whether this same effect occurs in people who have already entered a state of deteriorating health.
The regrettable fact is that once serious disease manifests, it takes a lot more than an alpha tocopherol supplement to give people a chance of regaining their health. Alpha tocopherol has been shown to help prevent a number of common disorders, but it is not a miracle cure, especially when taken by itself or in the form of low-potency multi-vitamins.29,30
What has been happening over the past several years is that an increasing number of studies shows that single nutrients do not provide a significant beneficial impact on existing disease. A few exceptions are studies showing that high-dose coenzyme Q10 dramatically slows the deterioration and even induces some functional improvement in those afflicted with Parkinson’s disease.31,32
Danger of Testing Single Nutrients
Expecting that alpha tocopherol alone, or in combination with low doses of other nutrients, will effectively treat disease is being optimistic, to say the least. All one has to do is look at what happens when only alpha tocopherol is used in a laboratory setting, and the results are not encouraging for single-nutrient supplementation.
For instance, in response to lipid peroxidation (free radical activity) that occurs on cell membranes, antioxidants like glutathione peroxidase are produced inside the cells. If one takes only alpha tocopherol, lipid peroxidation rates are suppressed in cell membranes, with a corresponding reduction in glutathione peroxidase production inside the cell. This deficiency of glutathione peroxidase makes the DNA and mitochondria inside the cells more vulnerable to free radical attack.33-35
When supplementing with selenium, however, glutathione peroxidase levels increase significantly, even with alpha tocopherol simultaneously protecting cell membranes against lipid peroxidation.36-38
Vitamin supplement users usually take selenium along with vitamin E. Seriously ill people who enroll in studies are told not to take any other supplement. These study participants are thus denied the benefit of taking the wide variety of supplements needed to protect against degenerative disease.
Selenium is one of several nutrients that can enhance the effectiveness of alpha tocopherol. After alpha tocopherol is used to suppress damaging free radicals, the remnants of alpha tocopherol can themselves induce oxidative stress in the body. Nutrients like vitamin C, lipoic acid, coenzyme Q10, and gamma tocopherol can help regenerate depleted alpha tocopherol.39
Based on this understanding, it is quite easy to see why alpha tocopherol is not going to keep sick people alive longer. It also shows the fallacy of expecting any one nutrient, or low doses of several nutrients, to provide the broad-spectrum biological effects needed to maintain or regain good health.
The bottom line is that serious supplement takers are simultaneously using many different nutrients to protect against the multiple mechanisms involved in the development of age-related disease. This means that a report stating that any one nutrient by itself did not achieve desired results is quite irrelevant, especially when many of the study subjects already had established disease.
How Many Lives Will Be Lost?
The media has often disseminated reports that unjustly attack the value of dietary supplements. The way this flawed Johns Hopkins report has been sensationalized is perhaps more egregious than any other media distortion to date.
Instead of recognizing obvious flaws in this report, the media turned it into headline news, causing widespread fear that vitamin E supplements might actually shorten life span. Never before has the public been exposed to such an outrageous farce.
The result of the media’s handling of this flawed study will be that many people will be duped into believing that there is no value to supplements. Yet even the researchers who authored this study admit that it has no relevance to what healthy people should do to prevent disease.
Of the many rebuttal articles Life Extension received concerning this flawed vitamin E study, we have chosen to publish the following article that provides a little humor regarding what regrettably will someday be recognized as an unfortunate event that will cost the lives of people who put too much faith in news media headlines.
1. Available at: http://www.annals.org/cgi/content/full/0000605-200501040-00110v1. Accessed December 22, 2004.
2. Huang HY, Appel LJ. Supplementation of diets with alpha-tocopherol reduces serum concentrations of gamma- and delta-tocopherol in humans. J Nutr. 2003 Oct;133(10):3137-40.
3. Not all vitamin E is created equal. Life Extension. February 1998.
4. Losonczy KG, Harris TB, Havlik RJ. Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons: the Established Populations for Epidemiologic Studies of the Elderly. Am J Clin Nutr. 1996 Aug;64(2):190- 6.
5. Seth RK, Kharb S. Protective function of alpha-tocopherol against the process of cataractogenesis in humans. Ann Nutr Metab. 1999;43(5):286-9.
6. Stampfer MJ, Hennekens CH, Manson JE, et al. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med. 1993 May 20;328(20):1444-9.
7. Zandi PP, Anthony JC, Khachaturian AS, et al. Reduced risk for Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study. Arch Neurol. 2004 Jan;61(1):82-8.
8. Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Wilett WC. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med. 1993 May 20;328(20):14550-6.
9. Walda IC, Tabak C, Smit HA, et al. Diet and 20-year chronic obstructive pulmonary disease mortality in middle-aged men from three European countries. Eur J Clin Nutr. 2002 Jul;56(7):638-43.
10. Semba RD, Blaum C, Guralnik JM, Moncrief DT, Ricks MO, Fried LP. Carotenoid and vitamin E status are associated with indicators of sarcopenia among older women living in the community. Aging Clin Exp Res. 2003 Dec;15(6):482-7.
11. Nagle CM, Purdie DM, Webb PM, Green A, Harvey PW, Bain CJ. Dietary influences on survival after ovarian cancer. Int J Cancer. 2003 Aug 20;106(2):264-9.
12. Heinonen OP, Albanes D, Virtamo J, et al. Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. J Natl Cancer Inst. 1998 Mar 18;90(6):440-6.
13. Kline K, Yu W, Sanders BG. Vitamin E and breast cancer. J Nutr. 1998 Mar 18;90(6): 440-6.
14. Salonen RM, Nyyssonen K, Kaikkonen J, et al. Six-year effect of combined vitamin C and E supplementation on atherosclerotic progression. Circulation. 2003 Feb 25;107(7):947-53.
15. Hercberg S, Galan P, Preziosi P, et al. The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med. 2004 Nov 22;164(21):2335-42.
16. Wright ME, Mayne ST, Stolzenberg-Solomon RZ, et al. Development of a comprehensive dietary antioxidant index and application to lung cancer risk in a cohort of male smokers. Am J Epidemiol. 2004 Jul 1;160(1):68-76.
17. Palan PR, Woodall AL, Anderson PS, Mikhail MS. Alpha-tocopherol and alpha tocopherol quinone levels in cervical intraepithelial neoplasia and cervical cancer. Am J Obstet Gynecol. 2004 May;190(5):1407-10.
18. Chan AC. Vitamin E and atherosclerosis. J Nutr. 1998 Oct;128(10):1593-6.
19. Fleischauer AT, Simonsen N, Arab L. Antioxidant supplements and risk of breast cancer recurrence and breast cancer-related mortality among postmenopausal women. Nutr Cancer. 2003;46(1):15-22.
20. Bonilla-Fernandez P, Lopez-Cervantes M, Torres-Sanchez LE, Tortoler-Luna G, Lopez-Carrillo L. Nutritional factors and breast cancer in Mexico. Nutr Cancer. 2003;45(2):148-55.
21. Ryglewicz D, Rodo M, Kunicki PK, et al. Plasma antioxidant activity and vascular dementia. J Neurol Sci. 2002 Nov 15;203- 204:195-7.
22. Jacobs EJ, Henion AK, Briggs PJ, et al. Vitamin C and vitamin E supplement use and bladder cancer mortality in a large cohort of US men and women. Am J Epidemiol. 2002 Dec 1;156(11):1002-10.
23. Nathens AB, Neff MJ, Jurkovich GJ, et al. Randomized, prospective trial of antioxidant supplementation in critically ill surgical patients. Ann Surg. 2002 Dec;236(6):814-22.
24. Bressler S. Health after 50. Johns Hopkins School of Medicine newsletter. February 2004.
25. Clemons TE, Kurinij N, Sperduto RD. Associations of mortality with ocular disorders and an intervention of high-dose antioxidants and zinc in the Age-Related Eye Disease Study: AREDS Report No. 13. Arch Ophthalmol. 2004 May;122(5):716-26.
26. Machlin LJ. Critical assessment of the epidemiological data concerning the impact of antioxidant nutrients on cancer and cardiovascular disease. Crit Rev Food Sci Nutr. 1995 Jan;35(1-2):41-50.
27. Frei B. Efficacy of dietary antioxidants to prevent oxidative damage and inhibit chronic disease. J Nutr. 2004 Nov;134(11):3196S-8S.
28. De la FM. Effects of antioxidants on immune system ageing. Eur J Clin Nutr. 2002 Aug;56 Suppl 3S5-S8.
29. Ricciarelli R, Zingg JM, Azzi A. Vitamin E: protective role of a Janus molecule. FASEB J. 2001 Nov;15(13):2314-25.
30. Winklhofer-Roob BM, Rock E, Ribalta J, Shmerling DH, Roob JM. Effects of vitamin E and carotenoid status on oxidative stress in health and disease. Evidence obtained from human intervention studies. Mol Aspects Med. 2003 Dec;24(6):391-402.
31. Muller T, Buttner T, Gholipour AF, Kuhn W. Coenzyme Q10 supplementation provides mild symptomatic benefit in patients with Parkinson’s disease. Neurosci Lett. 2003 May 8;341(3):201-4.
32. Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol. 2002 Oct;59(10):1541-50.
33. Seven A, Guzel S, Seymen O, et al. Effects of vitamin E supplementation on oxidative stress in streptozotocin induced diabetic rats: investigation of liver and plasma. Yonsei Med J. 2004 Aug 31;45(4):703-10.
34. Fridovich I. In: Free Radicals in Biology. New York: Academic Press; 1976.
35. Matsuo M, Gomi F, Dooley MM. Age-related alterations in antioxidant capacity and lipid peroxidation in brain, liver, and lung homogenates of normal and vitamin E-deficient rats. Mech Ageing Dev. 1992 Jul 15;64(3):273-92.
36. Sneddon AA, Wu HC, Farquharson A, et al. Regulation of selenoprotein GPx4 expression and activity in human endothelial cells by fatty acids, cytokines and antioxidants. Atherosclerosis. 2003 Nov;171(1):57-65.
37. Actis-Goretta L, Carrasquedo F, Fraga CG. The regular supplementation with an antioxidant mixture decreases oxidative stress in healthy humans. Gender effect. Clin Chim Acta. 2004 Nov;349(1-2):97-103.
38. Nagyova A, Krajcovicova-Kudlackova M, Horska A et al. Lipid peroxidation in men after dietary supplementation with a mixture of antioxidant nutrients. Bratisl Lek Listy. 2004;105(7-8):277-280.
39. Liebler DC. The role of metabolism in the antioxidant function of vitamin E. Crit Rev Toxicol. 1993;23(2):147-69.