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Supplement Savvy for Cancer: Vitamin E

By Jill Place, MA, RD

What It Is . . .

Vitamin E is an essential human nutrient and a fat-soluble vitamin. Fat-soluble means that it's metabolized along with the dietary fat in your body and needs fat for absorption in your gut. There are eight different forms in nature, but the four tocopherol forms-alpha, beta, gamma, and delta-are mostly used in supplements. The richest sources of this vitamin are found in unrefined edible vegetable oil, including wheat germ, safflower, cottonseed, canola, and olive oils. Vitamin E is also found in fatty portions of meat, fish oil, unrefined cereal grains, fruits, nuts, and vegetables.

What It Does . . .

Vitamin E:
is a primary antioxidant, which means that it finds and stops free radicals. Free radicals are atoms with an odd number of electrons. These electrons want to pair up with other electrons. So they run around trying to find another electron to marry. While they're running around, they can cause damage to DNA or cell membranes. This damage may cause cancer. Antioxidants marry with free radicals and stop them from doing damage.
works better when combined in synergy with other antioxidants such as Selenium, Vitamin C, Vitamin A, and Beta-Carotene or mixed carotenoids.
may inhibit a variety of cancers including esophageal, stomach, lung, and prostate.
has a profound positive effect on the immune system.
inhibits the production of an enzyme, protein kinase-C. Too much protein kinase-C may cause cancer and the spread of cancer throughout your body.
can be depleted with a wide range of kidney, liver, and intestinal dysfunctions. Deficiency may increase cancer risk, so it's important that you get enough.
may protect against prostate cancer in the gamma-tocopherol form.
In short, there's some pretty positive evidence that supplementation with Vitamin E may prevent cancer.

What To Do . . .

Even though Vitamin E seems to be a "must-take" for your supplement list, there's a lot of disagreement as to whether Vitamin E and other antioxidants are appropriate to take during treatment. Many professionals agree that antioxidants may protect cancer cells as well as normal cells during chemotherapy and radiation and make treatment less effective. At this point, there aren't enough human studies to show that taking antioxidants is safe during treatment. So it might be wise to stop taking Vitamin E as well as other antioxidants and multivitamins one to two weeks before treatment and resume taking them one or two weeks after treatment.

Vitamin E could be a "must-take", however, for your cancer prevention supplement list after treatment. Vitamin E can be found in most multivitamins. Since Vitamin E works well when combined with other nutrients, a multivitamin might be a good idea if you want to take supplements. You might want to ask your dietitian or Supplement Savvy Specialist to help you choose a good form and an appropriate dosage of Vitamin E.

What to Watch Out For . . .

There are many precautions with Vitamin E usage.

Since Vitamin E is an anticoagulant, it shouldn't be used if you have bleeding lesions such as peptic ulcers, a history of hemorrhagic stroke, or inherited bleeding disorders such as hemophilia. Pregnant and nursing mothers should avoid doses of more than 15 and 19 mg a day respectively. Also, you need to stop supplementation about a month before surgery and not resume it until you are recovered.

There are also many drug and supplement reactions that increase or decrease the absorption of either the drug or the supplement. That doesn't mean that you should avoid taking Vitamin E supplements if you're taking one of these drugs or supplements. It merely means that you might want to adjust the dosage of the Vitamin E supplement you're taking. Ask your dietitian or Supplement Savvy Specialist what a good dose might be if you're using any of the following:

DRUGS

Increased Absorption

Vitamin E inhibits the side effects of amiodarone, cyclosporin, and zidovudine
Vitamin E may enhance the effects of antiplatelet drugs such as aspirin.
Vitamin E decreases resistance of such chemosensitizing agents such as cyclosporin A and verapamil to doxorubicin and vinblastine.

Decreased Absorption

Anticonvulsants such as phenobarbital and phenytoin and other drugs such as cholestyramine, colestipol, isoniazid, mineral oil, neomycin, orlistat, and sucralfate may decrease Vitamin E absorption.
Those taking wayfarin shouldn't take more than 100 mg of Vitamin E.

NUTRITIONAL SUPPLEMENTS AND FOOD

Increased Absorption

Selenium may function synergistically with Vitamin E. Vitamin C may spare Vitamin E and keep it in its antioxidant form.
Plant phenolic compounds and flavonoids keep Vitamin E in its antioxidant form.
Medium -chain triglycerides may enhance absorption of Vitamin E.
Vitamin E works in synergy with some herbs, including garlic and ginkgo.
Vitamin E supplementation decreases the oxidation in high polyunsaturated fat meals, such as those that contain a lot of vegetable oils.

Decreased Absorption

Dietary fiber may decrease absorption of Vitamin E.
Phytosterols and phytostanols may lower plasma Vitamin E levels.
Supplemental lipids such as flaxseed oil, gamma-linolenic acid, DHA, EPA, and CLA may increase vitamin E requirements.
The fat substitute Olestra (Olean) inhibits absorption of Vitamin E and other fat-soluble vitamins.

© Copyright 2002 Jill Place, MA, RD