Vitamin E: cautionary issues

  • Anne P. Spencer
Treatment News

Conclusion

Compared with many medications used in the patient with cardiovascular disease, vitamin E is a relatively safe supplement. There are a few populations in which caution needs to be employed, however. Patients receiving warfarin therapy should be discouraged from using vitamin E supplements and should be closely monitored if they do. Smokers should avoid vitamin E due to potential negative effects on vitamin C, and vitamin E should never be administered in conjunction with beta-carotene in this population. The rare patient requiring vitamin A therapy or having retinitis pigmentosa should also avoid vitamin E supplementation. Because of the increased risk of bleeding, vitamin E should be discontinued in the perioperative period in any patient requiring surgery.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    The Heart Outcomes Prevention Evaluation Study Investigators: Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med 2000, 342:154–160.CrossRefGoogle Scholar
  2. 2.
    GISSI-Prevenzione Investigators: Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999, 354:447–455.CrossRefGoogle Scholar
  3. 3.
    Stephens N, Parsons A, Schofield P, et al.: Randomised controlled trial of vitamin E in patients with coronary artery disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996, 347:781–786.PubMedCrossRefGoogle Scholar
  4. 4.
    Bendich A, Machlin L: Safety of oral intake of vitamin E. Am J Clin Nutr 1988, 48:612–619.PubMedGoogle Scholar
  5. 5.
    Diplock A: Safety of antioxidant vitamins and beta-carotene. Am J Clin Nutr 1995, 62(6 suppl):1510S-1516S.PubMedGoogle Scholar
  6. 6.
    Meyers D, Maloley P, Weeks D: Safety of antioxidant vitamins. Arch Intern Med 1996, 156:925–935.PubMedCrossRefGoogle Scholar
  7. 7.
    Meydani S, Meydani M, Blumberg J, et al.: Assessment of the safety of supplementation with different amounts of vitamin E in healthy older adults. Am J Clin Nutr 1998, 68:311–318.PubMedGoogle Scholar
  8. 8.
    The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994, 330:1029–1035.CrossRefGoogle Scholar
  9. 9.
    Steiner M: Vitamin E: more than an antioxidant. Clin Cardiol 1993, 16(suppl I):I16-I18.PubMedCrossRefGoogle Scholar
  10. 10.
    Liede K, Haukka J, Saxen L, Heinonen O: Increased tendency toward gingival bleeding caused by joint effect of alpha-tocopherol supplementation and acetylsalicylic acid. Ann Med 1998, 30:542–546.PubMedGoogle Scholar
  11. 11.
    Benson E, Rosner B, Sandberg M, et al.: A randomized trial of vitamin A and vitamin E supplementation for retinitis pigmentosa. Arch Ophthalmol 1993, 111:761–772.Google Scholar
  12. 12.
    Handelman G: High-dose vitamin supplements for cigarette smokers: caution is indicated. Nutr Rev 1997, 55:369–370.PubMedCrossRefGoogle Scholar
  13. 13.
    Rapola J, Virtamo J, Ripatti S, et al.: Randomized trial of alpha-tocopherol and beta-carotene on incidence of major coronary events in men with previous myocardial infarction. Lancet 1997, 349:1715–1720.PubMedCrossRefGoogle Scholar
  14. 14.
    Vitamin K, Vitamin E, and the coumarin drugs. Nutr Rev 1982, 40:180–181.Google Scholar

Copyright information

© Current Science Inc 2000

Authors and Affiliations

  • Anne P. Spencer
    • 1
  1. 1.Medical University of South Carolina, College of PharmacyCharlestonUSA

Personalised recommendations