Contradictory reports on vitamin E raise questions

March 29, 2000
Web posted at: 10:16 AM EST (1516 GMT)

In this story: High hopes take a tumble A new starring role for E? RELATEDS

(WebMD) -- When Alice Nadler heard the latest on vitamin E, she began to wonder if the experts really know what they're talking about.

"I've been taking vitamin E for a couple of years, ever since my doctor recommended it as a way to lower my risk of heart disease," says the 40-year-old mother of two boys, who lives in Northern California. "So now they're saying it may not?"

Like Nadler, many Americans began popping vitamin E -- now one of the top-selling supplements nationwide -- a few years ago after studies suggested that it might protect against heart disease. In one study published in "Lancet" in 1996, men and women with cardiovascular disease who took the vitamin each day cut their risk of a second heart attack almost in half. In 1993, the "Journal of the National Cancer Institute" published findings from a five-year Chinese study that followed nearly 30,000 adults. Those who took vitamin E supplements were 9 percent less likely to die during the study period.

Many researchers cautioned that more investigations were needed to confirm the power of E. But privately, some also admitted that they were taking a daily dose of the vitamin themselves, because the initial findings looked so good.

High hopes take a tumble

Now comes news from a January 20, 2000, issue of the "New England Journal of Medicine" that the golden pill may not live up to its promise. Canadian researchers tracked 2,545 women and 6,996 men aged 55 or older who took either vitamin E or a dummy pill. After five years, those taking the vitamin were no better off than those taking the dummy pill, suffering just as many heart attacks, strokes, and deaths from cardiovascular disease. The findings, ironically, are part of a study called HOPE, or the Heart Outcomes Prevention Evaluation.

Unfortunately for Nadler and tens of thousands of others pinning their hopes on vitamin E, this isn't the only study to cast a shadow over the vitamin's reputation. An Italian report published last year in "Lancet" tested 300 international units (IUs) of vitamin E against a placebo in a group of 11,000 heart attack patients. While the number of overall deaths related to cardiovascular disease for those taking the vitamin was lower, the number of second heart attacks in the same group was actually slightly higher. Neither of these numbers was, however, statistically significant, making it difficult to draw a firm conclusion.

Says Nancy Ernst, Ph.D., nutrition director for the National Heart, Lung, and Blood Institute, "Based on these latest studies, many of us are beginning to think that the evidence just isn't there for vitamin E, at least when it comes to slowing the progress of cardiovascular disease."

A new starring role for E?

Is it time to give up on vitamin E? Not quite yet, other findings suggest. Despite the disappointing news, some heart specialists think it's still worth taking -- especially by people who already have cardiovascular disease.

Douglas Morris, M.D., director of the Heart Center at Emory University in Atlanta, admits that he would still take vitamin E -- along with vitamin C, another potent antioxidant -- if he were diagnosed with heart disease. After all, vitamin E at doses of 800 IUs or less a day has no known side effects. And some cardiologists are still recommending the vitamin to patients with heart disease.

Moreover, other evidence suggests that vitamin E may provide additional important payoffs.

Research has found that E helps keep the immune system strong as we age. For instance, when researchers at Tufts University in Boston tested vitamin E capsules against placebos in healthy volunteers 65 or older, they found that those who took 200 IUs per day showed a 65 percent increase in the activity of their immune cells in response to foreign substances.

The vitamin E group also experienced a six-fold increase in antibodies to hepatitis-B vaccination -- evidence that their immune systems were much stronger in creating defenses against the disease.

Higher doses of vitamin E may also delay or even prevent Alzheimer's disease. Patients with the illness who took the supplement were much less likely to be hospitalized than those who didn't, according to a 1997 study by physician Michael Grundman of the University of California at San Diego.

"Vitamin E seemed to delay the onset of the worst symptoms of Alzheimer's," says Grundman, who is associate director of the Alzheimer's Disease Cooperative Study. "Because of its antioxidant property, it may work by blocking oxidative damage in the brain." Grundman and his colleagues are enrolling patients in a study to test whether vitamin E can help older people with symptoms of memory loss that could be early signs of Alzheimer's.

As for Alice Nadler, the flip-flop on vitamin E and heart disease has left her a little more skeptical of health claims in general. Still, she says, the fact that there may be other benefits to vitamin E is reason enough not to toss out her bottle of capsules.

"I figure I'll keep on taking one a day, just to be on the safe side."

© 2000 Healtheon/WebMD. All rights reserved.

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