Some type 2 diabetics have unique vitamin E requirements

High Cost of Free Advice

High doses of vitamin E are dangerous.

That’s what a surgeon actually told a friend of mine named Tom. And by “high doses” he meant anything over the paltry 22 IU daily intake recommended by the USDA. In a follow up visit after his surgery, Tom’s doctor brought up the subject again in a dismissive way, offering this free advice: “I hope you’re not still taking 300 IU of vitamin E. That’s very bad for you.”

This was a bariatric surgeon talking – not a nutritionist or someone with any level of dietetic expertise, unless you count the “M.D.” that appeared after his name. No wonder patients are reluctant to discuss supplement use and other forms of alternative health care with their doctors.

Nevertheless, if you’re a type 2 diabetic, or if you’re pre-diabetic, I hope you’ll bite the bullet and talk to your doctor about a study that shows just how important it is for many diabetics to get ample amounts of vitamin E.

Sending in extra protection

Cigarette smoke, excessive alcohol intake, radiation, environmental pollutants, highly refined junk food – these are some of the most common factors that prompt oxidative stress in the body, increasing the risk of a wide range of health problems.

According to a study published in the Journal Arteriosclerosis, Thrombosis, and Vascular Biology, an antioxidant protein known as haptoglobin helps prevent inflammation in artery walls and is a key element in preventing cardiovascular events such as heart attack in type 2 diabetes patients.

Unfortunately, some diabetics have a haptoglobin gene called Hp 2-2 that’s been linked to poor antioxidant protection and a greater risk of heart problems.

A group of Israeli researchers conducted a study to test their hypothesis that vitamin E supplements might boost antioxidant protection and reduce cardiovascular events in diabetics with Hp 2-2.

STUDY PROFILE
* Researchers recruited more than 1,400 subjects over the age of 55
* Each subject had type 2 diabetes and the Hp 2-2 gene
* Subjects were randomly divided into two groups to receive either 400 IU of vitamin E daily, or a placebo
* At 18 months, when researchers first evaluated subjects’ medical records, rates of heart attack, stroke, and death due to cardiovascular events were about twice as high in the placebo group compared to the vitamin E group
* The study was terminated early to make vitamin E supplements available to subjects in the placebo group

The ABCs of E

The Israeli team notes that the Hp 2-2 gene is present in a relatively small percentage of the population. But given the importance of vitamin E and the fact that no adverse effects were reported over the 18 months of this study, there would appear to be no downside for diabetics who supplement with vitamin E, provided they first discuss supplement usage with their doctors.

So…how much is enough?

In a previous e-Alert I told you about a Vanderbilt study that showed how subjects at high risk of heart disease who took 3,200 IU of vitamin E for 20 weeks significantly lowered levels of a biomarker that measures oxidation of fats.

Obviously, 3,200 IU a huge daily dose, but in that same e-Alert HSI Panelist Allan Spreen, M.D., explained that reliable research shows that taking large doses of E is not dangerous. Dr. Spreen’s general recommendation: 400 IU for everyone, 800 for those at risk of heart disease.

As always, any discussion of vitamin E supplementation requires this note: D-alpha tocopherol is an acceptable form of E (AVOID dl-alpha tocopherol, which is synthetic and shouldn’t be taken internally), but an E supplement with the full spectrum of mixed tocopherols will probably produce the best results.

And one final tip (especially for diabetics): In 2003 I told you about a Danish study in which vitamin E (680 IU daily) and vitamin C (1,250 mg daily) taken together reduced concentrations of a liver protein that can damage the kidneys.

Source:
“Vitamin E Supplementation Reduces Cardiovascular Events in a Subgroup of Middle-Aged Individuals With Both Type 2 Diabetes Mellitus and the Haptoglobin 2-2 Genotype. A Prospective Double-Blinded Clinical Trial” Arteriosclerosis, Thrombosis, and Vascular Biology, Published online ahead of print 11/21/07, atvb.ahajournals.org