Taking vitamin E as mixed tocopherols would not be expected to increase prostate cancer risk, and might even help prevent it.

A Healthnotes Newswire Opinion: Questioning the Report that Vitamin E Causes Prostate Cancer

The Journal of the American Medical Association recently published a study suggesting that vitamin E may increase a man’s risk of developing prostate cancer. While the study findings are cause for concern, they support existing evidence that taking the isolated alpha-tocopheral form of vitamin E apart from the other tocopherols found in vitamin E’s natural form may be the problem. Natural vitamin E, in which its four forms are mixed together, has not been shown to increase prostate cancer risk, and might even offer some protection.

In the study, 35,533 men were randomly assigned to receive 400 IU per day of vitamin E (in the form of alpha-tocopherol) or a placebo for an average of five and a half years, and the men were then followed for a total of approximately seven years. During that time, 17% more men developed prostate cancer in the vitamin E group than in the placebo group, a statistically significant difference.

“E’s” not all equal

Although the study was well designed, it only examined one type of vitamin E, which is not how it occurs naturally. Vitamin E is found in food in four different forms: alpha-, beta-, gamma-, and delta-tocopherol. However, alpha-tocopherol is the form most commonly sold and studied, as early research suggested that most, if not all, of the biological activity of vitamin E is due to alpha-tocopherol. But it is now known that at least one of the other components—gamma-tocopherol—has important functions. Furthermore, large doses of alpha-tocopherol have been shown to deplete gamma-tocopherol, potentially upsetting the natural balance of the different forms of vitamin E in the body. "Mixed tocopherols," on the other hand, a supplement that contains all four types of vitamin E, would not be expected to cause such an imbalance.

“E-valuating” tocopherols

In a previous study, both alpha-tocopherol and gamma-tocopherol inhibited the growth of human prostate cancer cells in a test tube, but gamma-tocopherol was the more potent of the two. In another study, higher blood levels of alpha-tocopherol and gamma-tocopherol were each associated a lower risk of developing prostate cancer, but gamma-tocopherol’s protective effects were greater than that alpha-tocopherol’s.

These observations raise the possibility that alpha-tocopherol actually may protect against prostate cancer (contrary to the results of the new study) when given in amounts that do not negatively affect the body’s chemistry. When alpha-tocopherol is given by itself in large doses (such as 400 IU per day or more), it depletes gamma-tocopherol, which could more than negate any beneficial effect that alpha-tocopherol might have. Thus, taking vitamin E as mixed tocopherols would not be expected to increase prostate cancer risk, and might even help prevent prostate cancer. Further research is needed to examine that possibility.

(JAMA 2011;306:1549–56; Nutr Res 2005;25:877-89; J Natl Cancer Inst 2000;92:2018–23.)

An expert in nutritional therapies, Chief Medical Editor Alan R. Gaby, MD, is a former professor at Bastyr University of Natural Health Sciences, where he served as the Endowed Professor of Nutrition. He is past-president of the American Holistic Medical Association. Dr. Gaby has conducted nutritional seminars for physicians and has collected over 30,000 scientific papers related to the field of nutritional and natural medicine. In addition to editing and contributing to The Natural Pharmacy (Three Rivers Press, 1999), and the A–Z Guide to Drug-Herb-Vitamin Interactions (Three Rivers Press, 1999), Dr. Gaby has authored Preventing and Reversing Osteoporosis (Prima Lifestyles, 1995) and B6: The Natural Healer (Keats, 1987) and coauthored The Patient's Book of Natural Healing (Prima, 1999). He has recently completed a 30-year project, a textbook called Nutritional Medicine (www.doctorgaby.com).

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