‘The evidence is strong’: Doctor weighs up evidence linking vitamin supplement to cancer

Dr Nighat discusses symptoms of prostate cancer

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Cancer claims millions of lives every year and anyone can succumb to its fate. However, ongoing research suggests you can modify your risk of developing and dying from cancer. Some associations are not surprising – the ills of eating processed meat are well documented, for example. However, the link to vitamin E supplementation may raise a few eyebrows.

It’s important to note that the jury is not entirely out on the association.

“Studies are mixed in terms of the risk of vitamin E supplementation on developing cancer,” explained Doctor Stacy D’Andre, Consultant, Medical Oncology at Mayo Clinic to Express.co.uk.

As Doctor D’Andre explained, some studies show no increased risk of cancer, but one large prevention trial (SELECT) did show that vitamin E taken as alpha-tocopheryl acetate at 400 IU per day increased prostate cancer risk compared to placebo.

Alpha-tocopherol acetate is a specific type of vitamin E that’s often found in dietary supplements. It is commonly used to treat a deficiency.

“It is important to understand that dietary supplements and food sources may have other forms of vitamin E, such as gamma, delta, and beta tocopherols,” explained Doctor D’Andre.

She continued: “The supplement used in the trial was only the alpha form, so we don’t know about taking a more mixed tocopherol in terms of cancer risk.

“Some studies have shown that dietary tocopherols may prevent certain cancers such as lung and liver cancer. More research is needed to determine if these other tocopherols can reduce cancer risk.”

Nonetheless, “the SELECT trial was very large, prospectively randomised, so the evidence is strong that vitamin E supplementation using 400 IU of the alpha form of tocopheryl increases the risk of prostate cancer”, Doctor D’Andre said.

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Is there a specific dosage that puts you at risk?

The doc said: “The dosage used in the SELECT trial was 400 IU per day of alpha-tocopheryl. Of note, the recommended dietary allowance for adults for vitamin E (alpha-tocopherol) is 15 mg (22.4 IU) per day.”

As she explained, vitamin E is a fat-soluble vitamin, and you can have side effects at doses higher than 400 IU per day, such as nausea, fatigue, dizziness, weakness, and rash.

“Vitamin E also can interact with other medications and vitamins, such as warfarin, statins, Vitamin K, and others.”

According to Doctor D’Andre, vitamin E has also been associated with excess bleeding.

What accounts for the association between vitamin E and cancer?

Doctor D’Andre said: “We do not know exactly how vitamin E may increase cancer risk. A recent study suggested that perhaps genetics plays a role.”

She continued: “People with certain changes in a gene called COMT had different risks of developing cancer when taking vitamin E.

“In animal lung cancer models, the actual antioxidant effect of vitamin E was responsible for cancer progression. And high doses of vitamin E may affect how your liver enzyme system works.”

In light of the association, what advice would you give to someone supplementing with vitamin E?

“I would not recommend taking high doses of alpha-tocopheryl,” said Doctor D’Andre.

“I would recommend most patients obtain vitamin E from natural sources such as nuts, seeds, green leafy veggies, whole grains, eggs, wheat germ oil, and other plant oils unless otherwise recommended by your doctor.”

General symptoms of cancer include:

  • Unexplained pain or ache
  • Very heavy night sweats
  • Unexplained weight loss
  • Unusual lump or swelling anywhere
  • Fatigue.

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