Vitamin E and Prostate Cancer

If you happen to be a vitamin supplement, you’ve had a bad week. At least as far as public relations go.

First there was that study on older women and vitamins, suggesting that women taking common vitamin supplements have a greater risk of death. (Last week I told you why I thought you should effectively ignore that study and keep taking your vitamins.)

Almost at the same time, another study came out suggesting that vitamin E supplements increase the risk for prostate cancer in men by 17%.

OK, let’s take a look.

The study everyone was talking about was actually an updated review of data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), which ended in 2008. The SELECT trial was originally intended to test whether vitamins could help prevent cancer. When the trial ended, in 2008, the conclusion was that taking vitamin E and selenium- either separately or together—did not reduce the risk of cancer.

The present study followed up the original participants for three more years- from the study’s end in 2008, to now. This time they did find a statistically significant 17% increase in prostate cancer risk for the vitamin E group (but not for the combination group nor the selenium-only group).

OK, a few things to call attention to here.

Number one is the type of vitamin E given. The men in the SELECT trial were given 100% synthetic vitamin E in the form of di-alpha-topcopheryl-acetate.

Let me tell you what you should do when you see a “di-“ on the label of any vitamin E supplement: throw it in the garbage where it belongs.

It’s no longer even a matter of debate that the synthetic form of vitamin E and the natural form of vitamin E are completely different, both in their composition and in their action. (The synthetic dl-alpha-tocopherol is a mixture of eight different molecular entities of which seven do not exist in nature.) I’m not even sure you can buy this crap anywhere, though I’m sure some big box stores have some cheap synthetic vitamin E collecting dust on their bottom shelves somewhere.

That researchers genuinely interested in finding out the effects of a vitamin on a disease would give an inferior type of the vitamin no longer surprises me. I’ve seen studies where the amount of the vitamin given is so ridiculously small that not getting a positive result was just about guaranteed before the study even started. It’s hard to know exactly why the researchers in the SELECT trial chose a next-to-useless form of synthetic vitamin E, but that’s exactly what they did.

The second thing worth pointing out is that vitamin E is actually a family of eight- count ‘em, eight—different compounds. Four of them are classed as topcopherols (alpha, gamma, beta and delta) and four are classed as tocotrienols. (The tocotrienols themselves are demonstrated very strong positive benefits, as research is beginning to show.)

For years, the most commonly available vitamin E supplement was d-alpha-tocopherol. While (natural) d-alpha-tocopherol is a step up from the synthetic dl-alpha-tocopherol-acetate, it still doesn’t contain much of the super-healthy tocotrienols and is significantly lacking in the most important vitamin E compound of all, gamma-tocopherol.

These days, nearly all the best health practitioners recommend a high-gamma vitamin E, since it now appears that gamma-tocopherol (not alpha-tocopherol) is the fraction of vitamin E that has the most biological activity and the greatest health benefits.

So what this study basically tells us is that there was a tiny increase in risk for prostate cancer among men taking 400 IUs of a crappy, synthetic vitamin E supplement which may or may not do much of what vitamin E is reported to do.

Now don’t get me wrong. I’m still not sure vitamin E is the first thing I’d reach for to prevent cancer. But I’m pretty damn sure about the other good things it does.

It’s a powerful antioxidant, “the most potent (fat)-soluble antioxidant in human plasma and tissues”, according to the NIH’s Encyclopedia of Dietary Supplements. Since oxidative damage from free radicals is a part of every major disease from heart disease to cancer to Alzheimer’s, it makes sense that we include vitamin E in our antioxidant defense army.