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First, Do No Harm

Vitamin E's role in health causing widespread controversy

While a recent study by Johns Hopkins University School of Medicine has consumers and retailers wondering whether they should start dumping their stocks of vitamin E, many wonder something else entirely: Have the media sent the wrong message?

"The message should be that people should not try to take a high dose of one supplement without considering that it may increase our need for other nutrients," Neil E. Levin, a certified clinical nutritionist and educator for NOW Foods, recently wrote in rebuttal to the article. "Elderly, sick people need a more holistic approach rather than using a single nutrient in high doses, as if it were a drug."

Levin is just one of many weighing in on the Hopkins study, published in the Nov. 10 Annals of Internal Medicine. The authors conducted a meta-analysis of 19 studies on the effects of "high-dose" vitamin E supplementation. They concluded that people who take more than 400 international units daily of vitamin E have a 5 percent greater risk of death than those who don't supplement. "In view of the increased mortality ? use of any high-dosage vitamin supplements should be discouraged," the authors warned.

Many who read the study found flaws in its design. "One of the things with a meta-analysis is that it adds power to statistics," said Judy Blatman, a spokeswoman for the Council for Responsible Nutrition. "If you looked at their 19 studies individually, 18 did not find a statistically significant increase in mortality."

Even the authors admit that the high-dosage trials they studied often had small sample sizes of chronically ill people. "The generalizability of the findings to healthy adults is uncertain," the authors wrote.

"And yet everything you heard them say was generalizing to healthy adults," criticized Blatman. Vitamin E is frequently recommended for cardiovascular disease, but healthy people also use it to protect against heart attack, stroke, Alzheimer's disease and cancer.

"[The researchers] are trying to say the ones who are using the most [vitamin E] had the most mortality, but maybe there's a reason they're using the most: They're sicker and desperate to try something that helps," Levin noted.

Others in the supplements business pointed out that most of the studies analyzed used only alpha-tocopherol, a synthetic form of vitamin E. The Alliance for Natural Health, a British lobbying organization, said in a press release, "The authors of the study make no mention of the good body of evidence that shows that synthetic forms of vitamin E, or purified natural forms that are limited to a-tocopherol, have the ability to reduce the body's absorption of other forms of vitamin E, which are much more powerful antioxidants."

Levin notes that the Johns Hopkins study assumes people take vitamin E using a traditional medical model—that is, in isolation, as a drug—when many people who use supplements prefer a holistic approach.

Some also suspect the timing of the study's release, which coincides with the European CODEX commission's guidelines on dosages for vitamins and minerals. "[It] seems set to give the regulators justification to be excessively restrictive," ANH commented.

For its part, CRN thinks such criticism neglects the heart of the matter. "The bottom line is this should not change the way consumers look at vitamin E," Blatman said. "We're working hard to get the message out that vitamin E is safe and vitamin E is good for you."

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