An Editorial Update: Annus horribilis for Vitamin E

Editorials19 July 2005An Editorial Update: Annus horribilis for Vitamin EEliseo Guallar, MD, DrPH, Daniel F. Hanley, MD, and Edgar R. Miller III, MD, PhDEliseo Guallar, MD, DrPHFrom Johns Hopkins University Bloomberg School of Public Health, Johns Hopkins Medical Institutions, Baltimore, MD 21205., Daniel F. Hanley, MDFrom Johns Hopkins University Bloomberg School of Public Health, Johns Hopkins Medical Institutions, Baltimore, MD 21205., and Edgar R. Miller III, MD, PhDFrom Johns Hopkins University Bloomberg School of Public Health, Johns Hopkins Medical Institutions, Baltimore, MD 21205.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-2-200507190-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In January 2005, we published a dose–response meta-analysis showing that high-dosage (≥400 IU/d) vitamin E supplementation was associated with a small but statistically significant increased risk for mortality (relative risk, 1.04 [95% CI, 1.01 to 1.07]) (1). The precise dosage of vitamin E at which the relative risk for mortality exceeded 1 and the magnitude of the risk increase were uncertain. However, the analysis showed that high-dosage vitamin E supplementation was likely to be harmful. Even in the best case, it offered no benefit in prolonging life. These findings were highly controversial: Together with our response, this issue of Annals ...References1. Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med. 2005;142:37-46. [PMID: 15537682] LinkGoogle Scholar2. Lee IM, Cook NR, Gaziano JM, Gordon D, Ridker PM, Manson JE, et al. A randomized trial of E in the primary prevention of cardiovascular disease in 39,876 women: The Women's Health Study. American College of Cardiology Annual Scientific Session, 7 March 2005. Accessed at www.acc05online.acc.org/highlights/keyLectures.aspx?sessionId=8030&&date=7 on 11 June 2005. Google Scholar3. Lonn E, Bosch J, Yusuf S, Sheridan P, Pogue J, Arnold JM, et al. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized, controlled trial. JAMA. 2005;293:1338-47. [PMID: 15769967] CrossrefMedlineGoogle Scholar4. 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Vitamin E and donepezil for the treatment of mild cognitive impairment. 2005;352:2379-88 N Engl J Med. . [PMID: 15829527] CrossrefMedlineGoogle Scholar13. Clegg A, Bryant J, Nicholson T, McIntyre L, DeBroe S, Gerard K, et al. Clinical and cost-effectiveness of donepezil, rivastigmine, and galantamine for Alzheimer's disease. A systematic review. Int J Technol Assess Health Care. 2002;18:497-507. [PMID: 12391943] CrossrefMedlineGoogle Scholar14. Birks JS, Harvey R. Donepezil for dementia due to Alzheimer's disease. Cochrane Database Syst Rev. 2003;:001190. [PMID: 12917900] MedlineGoogle Scholar15. Graf M, Ecker D, Horowski R, Kramer B, Riederer P, Gerlach M, et al. High dose vitamin E therapy in amyotrophic lateral sclerosis as add-on therapy to riluzole: results of a placebo-controlled double-blind study. J Neural Transm. 2005;112:649-60. [PMID: 15517433] CrossrefMedlineGoogle Scholar16. Areosa SA, McShane R, Sherriff F. Memantine for dementia. Cochrane Database Syst Rev. 2004;:003154. [PMID: 15846650] MedlineGoogle Scholar17. Langa KM, Foster NL, Larson EB. Mixed dementia: emerging concepts and therapeutic implications. JAMA. 2004;292:2901-8. [PMID: 15598922] CrossrefMedlineGoogle Scholar18. Doody RS, Stevens JC, Beck C, Dubinsky RM, Kaye JA, Gwyther L, et al. Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:1154-66. [PMID: 11342679] CrossrefMedlineGoogle Scholar19. Tabet N, Birks J, GrimleyEvans J, Orrel M, Spector A. Vitamin E for Alzheimer's disease (Review).. In: The Cochrane Collaboration, eds. The Cochrane Library, Issue 2, CD002854. Chichester, UK: J Wiley; 2005:1-15. Google Scholar20. Ford ES, Ajani UA, Mokdad AH. Brief communication: the prevalence of high intake of vitamin E from the use of supplements among U.S. adults. Ann Intern Med. 2005;143:116-20. LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins University Bloomberg School of Public Health, Johns Hopkins Medical Institutions, Baltimore, MD 21205.Disclosures: None disclosed.Corresponding Author: Eliseo Guallar, MD, DrPH, Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 2024 East Monument Street, Room 2-639, Baltimore, MD 21205; e-mail, [email protected]edu.Current Author Addresses: Dr. Guallar, Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 2024 E. Monument St., Room 2-639, Baltimore, MD 21205.Dr. Hanley: Brain Injury Outcomes Division, Department of Neurology, Johns Hopkins Medical Institutions, Jefferson 1-109, 600 North Wolfe Street, Baltimore, MD 21205.Dr. Miller: Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, and Division of General Internal Medicine, Department of Medicine, Johns Hopkins Medical Institutions, 2024 E. Monument St., Room 2-624, Baltimore, MD 21205. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHigh-Dosage Vitamin E Supplementation and All-Cause Mortality David H. Blatt and William A. Pryor High-Dosage Vitamin E Supplementation and All-Cause Mortality Koyamangalath Krishnan , Sharon Campbell , and William L. 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