Vitamin E and respiratory infections
Could vitamin E be bad for you? Don’t you believe it
It would certainly seem unlikely that a well-known antioxidant source like vitamin E could actually do any harm. And yet I came across an article from Reuters Health last week with this headline: “Vitamin E May Worsen Elders’ Respiratory Infections.”
My first reaction: I wasn’t buying it. And after reading the article I was no less skeptical. But before I had a chance to do some digging to locate the study, I received an e-mail from HSI panelist Allan Spreen, M.D., who had already read the report. And to say Dr. Spreen had a bone to pick would be an understatement. So I asked him if he would write a commentary about the inaccuracies hidden in the report, and he quite generously responded with a rare insider’s view of a clinical study – in this case, a study that went way off track somewhere.
Hang onto your hat. Dr. Spreen is in the building.
Cutting to the chase (meaning reading the ‘conclusions’ paragraph, which is all most docs have time for), we are enlightened with the following: “Neither daily multivitamin-mineral supplementation at physiological dose nor 200 mg of vitamin E showed a favorable effect on incidence and severity of acute respiratory tract infections in well-nourished noninstitutionalized elderly individuals. Instead we observed adverse effects of vitamin E on illness severity.”
Guess that about settles it. No need now to waste any money taking vitamins for this problem anyway.
Mama mia, where do I begin?
The list of vagaries in such a useless piece of trash is so long that we could take two sessions to handle it all. I take it back – the article is not useless. It’s an excellent example of how conventional medicine tries to trample on the effects of simple, inexpensive, and amazingly safe alternatives to pharmaceuticals (which are not so simple, inexpensive, or safe). In that light it’s worth a good look.
So let’s play with the only named nutrient in the entire work, vitamin E. Other than a generalized (and deliberately weak) multivitamin-mineral preparation, vitamin E is the spotlighted nutrient, so we’d certainly expect it to be handled appropriately as the star of the show.
First, the nutrient selection. I can’t really explain why vitamin E would be someone’s first choice for respiratory infections. It’s like giving an antibiotic for insomniait may be a great agent, but not necessarily for everything. In this case, the idea is that vitamin E was shown in a previous study to demonstrate a positive effect on the immune system in general (they admit to that), but not specifically respiratory infections.
A bit of a leap there, but not necessarily altogether a bad idea. I mean, I’d have studied some of the really well known nutrients for acute illness (such as vitamin C, n-acetyl cysteine (NAC), alpha lipoic acid or others), but still the idea may have some worth.
Okay, milligram and IU use may be close, in general, but it’s not really proper to interchange them – especially since we’re reading this in one of the premier medical journals in the U.S.!
Another goof is that the vitamin E is also measured in units that make absolutely no sense, specifically “mg/dL” when they say that the vitamin E supplement “contained 200 mg/dL of alpha-tocopheryl acetate. This normally means ‘milligrams per deciliter,’ meaning the number of milligrams contained in 100 cubic centimeters of whatever solution is being measuredgibberish in this context. Other than just sloppy work this also could be forgiven, except that the mistake comes at THE ONLY TIME IN THE ENTIRE PAPER WHERE THE ACTUAL FORM OF VITAMIN E IS DESCRIBED (and you guessed it: there are several forms of the stuff).
Fear not, it gets worse. Say, for sake of argument, that these paragons of nutritional wisdom used natural vitamin E (this would be signified by the term ‘d alpha-vitamin E’ instead of ‘dl alpha’). Any nutritional doc who knows anything at all knows not to use alpha tocopherol, natural or otherwise, because using the alpha fraction without the other fractions – beta, delta, and gamma – causes the other fractions to decrease in value. This is why good supplements are always of the ‘mixed tocopherol’ variety, containing all the fractions.
And guess what. In the body of the report (not on the first page, like the abstract’s conclusions), they made an amazing discovery: “In the vitamin E group, alpha-tocopherol and cholesterol-adjusted alpha-tocopherol levels increase significantly, while gamma-tocopherol levels decreased significantly.”
Really.
Now, check this out. The Alzheimer’s researchers used dietary vitamin E in their study, and the September 2002 edition of Life Extension explains exactly why: “Dietary vitamin E is rich in the gamma tocopherol fraction of vitamin E, whereas vitamin E supplements consist primarily of alpha tocopherol [depending on which you buy/ed. note]. IT IS THE GAMMA TOCOPHEROL FRACTION OF VITAMIN E THAT HAS BEEN SHOWN TO BE THE CRITICAL FACTOR IN SUPPRESSING FREE RADICALS.” (emphasis mine)
And our erstwhile researchers were using a synthetic supplement that ITSELF lowered that very fraction.
Hopefully, the problems above will not be seen as insignificant, as I’ve gone to considerable length to demonstrate that they are anything but. Bear in mind, however, that your doc sees the one-liner in the conclusions on page one ‘showing’ him how useless vitamin E is, when what’s useless is the report itself.
We could go on to examine the incredibly tiny dosages used of all the other nutrients in the study (the puny RDA of the vitamins, and only one half to one quarter the RDA of the minerals!)
But I figured these rats had already led us through enough of a maze.
Good Health,
Allan N. Spreen, MD
If you enjoyed Dr. Spreen’s commentary as much as I did, I strongly recommend you look for a copy of his fascinating book “Nutritionally Incorrect: Why the American Diet is Dangerous and How to Defend Yourself” (Woodland Publishing). Not only is it a wealth of information on nutrition and vitamin supplements, but it’s also a very lively read.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
