High-Dosage Vitamin E Supplementation and All-Cause Mortality
Authors: Wee-Shiong Lim, Rajka Liscic, Chengjie Xiong, John C. Morris
Journal: Annals of Internal Medicine (2005)

Letters19 July 2005High-Dosage Vitamin E Supplementation and All-Cause MortalityWee-Shiong Lim, MBBS, Rajka Liscic, Chengjie Xiong, and John C. MorrisWee-Shiong Lim, MBBSFrom the Washington University School of Medicine, St. Louis, MO 63108.Search for more papers by this author, Rajka LiscicFrom the Washington University School of Medicine, St. Louis, MO 63108.Search for more papers by this author, Chengjie XiongFrom the Washington University School of Medicine, St. Louis, MO 63108.Search for more papers by this author, and John C. MorrisFrom the Washington University School of Medicine, St. Louis, MO 63108.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-2-200507190-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Miller and colleagues (1) highlighted the danger of assuming the safety of high-dose vitamin E in the absence of definitive long-term safety data. The impact of their study, however, may be mitigated by methodologic concerns.The first issue is the restrictive inclusion criteria stipulating that a trial have at least 10 deaths, apparently because the authors “anticipated that many small trials did not collect mortality data.” This exclusion contradicts the raison d'être of meta-analysis, which involves the statistical pooling of multiple trials that individually have inadequate statistical power. The exclusion of at least 3 reasonably large, well-conducted ...References1. Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med. 2005;142:37-46. [PMID: 15537682] LinkGoogle Scholar2. Berson EL, Rosner B, Sandberg MA, Hayes KC, Nicholson BW, Weigel-DiFranco C, et al. A randomized trial of vitamin A and vitamin E supplementation for retinitis pigmentosa. Arch Ophthalmol. 1993;111:761-72. [PMID: 8512476] CrossrefMedlineGoogle Scholar3. de Waart FG, Kok FJ, Smilde TJ, Hijmans A, Wollersheim H, Stalenhoef AF. Effect of glutathione S-transferase M1 genotype on progression of atherosclerosis in lifelong male smokers. Atherosclerosis. 2001;158:227-31. [PMID: 11500195] CrossrefMedlineGoogle Scholar4. Wluka AE, Stuckey S, Brand C, Cicuttini FM. Supplementary vitamin E does not affect the loss of cartilage volume in knee osteoarthritis: a 2 year double blind randomized placebo controlled study. J Rheumatol. 2002;29:2585-91. [PMID: 12465157] MedlineGoogle Scholar5. Graf M, Ecker D, Horowski R, Kramer B, Riederer P, Gerlach M, et al. High dose vitamin E therapy in amyotrophic lateral sclerosis as add-on therapy to riluzole: results of a placebo-controlled double-blind study. J Neural Transm. 2005;112:649-660. [PMID: 15517433] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Wee-Shiong Lim, MBBS; Rajka Liscic; Chengjie Xiong; John C. MorrisAffiliations: From the Washington University School of Medicine, St. Louis, MO 63108.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality Edgar R. Miller III , Roberto Pastor-Barriuso , Darshan Dalal , Rudolph A. 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Stone High-Dosage Vitamin E Supplementation and All-Cause Mortality Harri Hemilä Metrics Cited byStudy of the toxic effect and safety of vitamin E supplement in male albino rats after 30 days of repeated treatmentVitamin E Trafficking in Neurologic Health and DiseaseAntioxidants in Food: Mere Myth or Magic Medicine?Bioactive Nutritional Supplements for Chronic Kidney Disease: Potential Cost BenefitsNo evidence supports vitamin E indiscriminate supplementationAdverse effects of vitamin E by induction of drug metabolismCellular, molecular and clinical aspects of vitamin E on atherosclerosis preventionVitamin E Regulatory MechanismsThe Roles of α‐Vitamin E and Its Analogues in Prostate Cancer 19 July 2005Volume 143, Issue 2Page: 152KeywordsCardiovascular diseasesConflicts of interestMedical risk factorsMortalityNeurodegenerative diseasesObservational studiesParkinson diseaseSafetySafety studiesVitamin E ePublished: 19 July 2005 Issue Published: 19 July 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. 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