Vitamin E Therapeutics

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Vitamin E Therapeutics

 

 

VITAMIN E: A CURE IN SEARCH OF RECOGNITION

 

by Andrew W. Saul

 

(Reprinted with permission from the Journal of

Orthomolecular Medicine, 2003; Vol. 18, Numbers 3 and

4, p. 205-212.)

 

" Some doctors claim that vitamin E helps many heart

cases, but the official view is that the substance has

not been proved of value in treating heart disease. "

 

This statement could have been taken verbatim from any

of a number of recent news media reports. But in fact,

this particular quote is from a 1953 article in

Maclean's Magazine entitled " The Fight Over Vitamin

E. " (1)

 

Half a century later, it would seem that little has

changed.

 

" (W)e do not support the continued use of vitamin E

treatment and discourage the inclusion of vitamin E in

future primary and secondary prevention trials in

patients at high risk of coronary artery disease. " (2)

 

This statement is from a 2003 analysis that looked at

studies employing daily treatment dosages between 50

and 800 IU. Yet since the 1940's, clinicians have been

reporting that vitamin E dosages between 450 and 1,600

IU or more are required to effectively treat

cardiovascular disease. I would enjoy seeing a

meta-analysis of the work of Drs. Wilfrid and Evan

Shute, who treated coronary thrombosis with 450 to

1,600 IU; angina with 450 to 1,600 IU; and

thrombophlebitis with 600 to 1,600 IU of vitamin E

daily. (3) The recent Lancet meta-analysis did not

include them. There is nothing capricious about either

study selection or dosage choice. Researchers and

analysts know full well that high dosage will obtain

different results than low dosage. Statistical

analysis of meaningless studies will rarely enable a

meaningful conclusion.

 

DOUBLE STANDARD

 

Countless comedians have made fun of the incompetent

physician who, when called late at night during a

life-threatening disease crisis, says, " take two

aspirin and call me in the morning. " Now it’s no

longer funny. Recently, one of the largest

pharmaceutical conglomerates in the world ran

prime-time national television commercials that

declared: " Bayer aspirin may actually help stop you

from dying if you take it during a heart attack. " The

company also promotes such use of its product on the

Internet. (4) This statement comes forth after a

century of widespread aspirin consumption.

Cardiovascular disease remains the number one killer

of men and women and there are over a million heart

attacks annually in the US alone.

 

If you produced a TV ad that said that megadoses of

wheat germ oil, or the vitamin E in it, could save

your life by preventing a heart attack, not only would

people disbelieve you, you’d also be subject to arrest

for breaking federal law. Foods and vitamins may not

be advertised as treatments for specific diseases.

" All statements of nutritional support for dietary

supplements must be accompanied by a two-part

disclaimer on the product label: that the statement

has not been evaluated by FDA and that the product is

not intended to " diagnose, treat, cure or prevent any

disease. " " (5)

 

Yet even traditional nutrition textbooks acknowledge

the extensive scientific proof of successful treatment

of intermittent claudication with vitamin E. " This

therapy helps reduce the arterial blockage, " says

Nutrition and Diet Therapy, Seventh Edition, a

standard dietetics work. (6) Unless there be something

absolutely unique about arterial real estate between

the knee and the ankle, would not vitamin E also help

" reduce the blockage " in other arteries? This is

rationale the Shutes used when, 65 years ago, they

employed vitamin E to successfully treat circulatory

diseases in thousands of patients, using daily dosages

as high as 3,200 IU. For that achievement, they were

praised by their patients and ostracized from the

ranks of orthodox physicians.

 

By 1971, it was increasingly clear that the Shutes had

gotten it right. Intermittent claudication, now

regarded as a reliable sign of peripheral arterial

disease, was shown by double-blind study to be

diminished 66% with the use of vitamin E. The dosage

administered was 1600 mg/day. (7)

 

A TORRID HISTORY

 

1922 was the year the USSR was formed and " Little

Orphan Annie " began. Trumpeter Al Hirt and future

heart transplant pioneer Christiaan Barnard were born.

Alexander Graham Bell died. And vitamin E was

discovered by H. M. Evans and K. S. Bishop. (8)

 

In 1936, Evans' team had isolated alpha tocopherol

from wheat germ oil and vitamin E was beginning to be

widely appreciated, and the consequences of deficiency

better known. Health Culture Magazine for January,

1936 said, " The fertility food factor (is) now called

vitamin E. Excepting for the abundance of that vitamin

in whole grains, there could not have been any

perpetuation of the human race. Its absence from the

diet makes for irreparable sterility occasioned by a

complete degeneration of the germinal cells of the

male generative glands. (T)he expectant mother

requires vitamin E to insure the carriage of her

charge to a complete and natural term. If her diet is

deficient in vitamin E . . . the woman is very apt to

abort. . . It is more difficult to insure a liberal

vitamin E supply in the daily average diet than to

insure an adequate supply of any other known vitamin. "

(9)

 

And that very same year, 1936, the Shutes were already

at work employing tocopherol from wheat germ oil to

relieve angina symptoms. (10)

 

Since the word " tocopherol " is taken from the Greek

words for " to carry offspring " or " to bring forth

childbirth, " it is easy enough to see how Evan Shute

and other obstetricians were drawn into the work. As

early as 1931, Vogt-Moller of Denmark successfully

treated habitual abortion in human females with wheat

germ oil vitamin E. By 1939 he had treated several

hundred women with a success rate of about 80%. In

1937, both Young in England and the Shutes in Canada

reported success in combating threatened abortion and

pregnancy toxemias as well. A. L. Bacharach's 1940

statistical analysis of published clinical results

" show quite definitely that vitamin E is of value in

recurrent abortions. " (11) And also in 1940, the

Shutes were curing atherosclerosis with vitamin E. By

1946, thrombosis, phlebitis, and claudication.

 

Yet when the MDR's (Minimum Daily Requirements) first

came out in 1941, there was no mention of vitamin E.

It was not until 1959 that vitamin E was recognized by

the U.S. Food and Drug Administration as necessary for

human existence, and not until 1968 that any

government recommendation for vitamin E would be

issued. That year, the Food and Nutrition Board of the

US National Research Council offered its first

Recommended Daily Allowance: 30 IU. It has been as low

as 15 IU in 1974 . In 2000, it was set at 22 IU (15

mg) for all persons, including pregnant women. This is

somewhat odd in view a 70-year established research

history showing how vital vitamin E is during

gestation. It is another curious fact that today, when

the public has been urged to increase its consumption

of unsaturated fats, the official dietary

recommendation for vitamin E is substantially lower

than it was 35 years ago. " The requirement for vitamin

E is related to the amount of polyunsaturated fatty

acids (PUFAs) consumed in the diet. The higher the

amount of PUFAs, the more vitamin E is required. " (12)

 

One reason the RDA was lowered is that " dieticians

were having difficulty devising diets of natural foods

which had the recommended amount (30 IU) of vitamin

E. " (13) There are about 39 IU of vitamin E in an

8-ounce cup of olive oil. A full pound of peanuts

yields 34 IU. Professor Max K. Horwitt, Ph.D., who

spent 15 years serving on The Food and Nutrition

Board's RDA committees, said in an interview that " The

average intake by adults, without supplements, seems

to be about 8 milligrams of alpha-tocopherol per day,

or 8 tocopherol equivalents. This is equivalent to 12

International Units (IU). " (14) So it might be said

that, in the end, the accommodation was not to raise

the bridge but rather to lower the river.

 

Vitamin E is the body's chief fat-soluble antioxidant.

It is a powerful one indeed, when you consider that 22

IU is presumed adequate to protect each one of the

tens of trillions of body cells in a human being. Even

though there has been a veritable explosion in

antioxidant research since 1968, the RDA for vitamin E

has been decreased.

 

POSTAL FRAUD

 

" Any claim in the labeling of drugs or of foods

offered for special dietary use, by reason of Vitamin

E, that there is need for dietary supplementation with

Vitamin E, will be considered false. " (United States

Post Office Department Docket No. 1/187 (March 15,

1961)

 

On October 26, 1959, the US government charged an

organization known as the Cardiac Society with postal

fraud for selling 30 IU vitamin E capsules through the

mail. Specifically, the charge was " the operation of a

scheme or device for obtaining money through the mails

by means of false and fraudulent pretenses,

representations or promises . . . that Respondent's

product 'E-FEROL 30 I.U.' (containing vitamin E) is

therapeutically effective and beneficial in the

treatment of heart and cardiovascular diseases for any

person so afflicted; that Respondent's said product

will prevent heart disease; that " It (vitamin E) is

the key both to the prevention and treatment of all

those conditions in which a lack of blood supply due

to thickened or blocked blood vessels or a lack of

oxygen is a part or the whole story of the disease " ;

that " Vitamin E seems to be a natural anti-thrombin in

the human blood stream. . . It is the only substance

preventing the clotting of blood which is not

dangerous " ; that the book " Your Heart and Vitamin E "

tells you " What Vitamin E is and Does, How It Treats

Heart Disease, Its Success In Circulatory Diseases,

Your Foods' Deficiency in Vitamin E " . . . That " It

(the book) explains medical facts in every-day

language concerning the help that is available for

sufferers from diseases of the heart and blood vessels

such as Coronary Heart Disease, Angina Pectoris,

Phlebitis, Buerger's Disease, Diabetes, Strokes, etc. "

(15)

 

A four-day hearing in Washington, D.C. generated

sufficient testimony to fill " four volumes totaling

856 pages. Seventy-six exhibits were received in

evidence. . . for the consideration of the Hearing

Examiner. His Initial Decision covers forty-two

pages. "

 

It is an oddity of history that, at the height of the

Cuban Missile Crisis, the United States of America

found both the reason and the resources to prosecute

such a case as this.

 

" The record here shows that the consensus of medical

opinion is that Respondent's claims are false and that

this is the universality of medical opinion on the

subject. Numerous tests and experiments have been

conducted to attempt to substantiate the claims made

by Respondent that Vitamin E is efficacious for

treatment of a number of conditions but these have

failed to substantiate the claims. It appears

perfectly clear from the testimony of the expert

witnesses that Respondent's claims and representations

are devoid of scientific support. . . The Hearing

Examiner correctly found that the Respondent intends

to deceive by its false representation and that actual

fraud under established law is proven. . . A fraud

order shall issue forthwith forbidding the delivery of

mail and the payment of money orders incident to such

scheme, to the Respondent, its agents and

representatives, all in accordance with 39 U.S.C. 259

and 732. " (15)

 

After this, all mail addressed to the Cardiac Society

was returned to the sender, with " Fraudulent " stamped

on the envelope.

 

DOSAGE AND UTILITY

 

Vitamin E has many clinically important and seemingly

unrelated properties. In their books (16, 17, 18, 19,

20, 21) the Shutes discuss a number of them.

 

1) Vitamin E strengthens and regulates heartbeat, like

digitalis and similar drugs, at a dose adjusted

between 800 to 3,000 IU daily.

 

2) Vitamin E reduces inflammation and scarring when

frequently applied topically to burns or to sites of

lacerations or surgical incisions. Internally, vitamin

E helps to very gradually break down thrombi at a

maintained oral dose of between 800 IU and 3,000 IU.

 

3) Vitamin E has an oxygen-sparing effect on the

heart, enabling the heart can do more work on less

oxygen. The benefit for recovering heart attack

patients is considerable. 1,200 to 2,000 IU daily

relieves angina very well. My father, duly diagnosed

with angina, gradually worked up to 1,600 IU over a

period of a few weeks. He never had an angina symptom

again. In this, he had the identical success that

thousands of Shute patients had.

 

4) Vitamin E moderately prolongs prothrombin clotting

time, decreases platelet adhesion, and has a limited

" blood thinning " effect. This is the reason behind the

Shutes' using vitamin E (1,000 - 2,000 IU/day) for

thrombophlebitis and related conditions. The

pharmaceutical industry and the medical profession are

well aware of vitamin E's anticoagulant property and

that " very high doses of this vitamin may act

synergistically with anticoagulant drugs. " (21)

However, this also means that vitamin E can, entirely

or in part, substitute for such drugs but do so more

safely. Perhaps this is best summed up by surgeon

Edward William Alton Ochsner, M.D. (1896-1981) who

said, " Vitamin E is a potent inhibitor of thrombin

that does not produce a hemorrhagic tendency and

therefore is a safe prophylactic against venous

thrombosis. " (23)

 

5) Vitamin E is a modest vasodilator, promotes

collateral circulation, and consequently offers great

benefits to diabetes patients. (24) The Shutes used a

dose of about 800 IU or more, tailored to the patient.

For this, among other reasons, Evan Shute, author of

over 100 scientific papers, was literally judged to be

a fraud by the United States Post Office Department.

The 1961 court decision said, " Vascular degenerations

in a diabetic are not effectively treated in the use

of vitamin E in any dosage. . . vitamin E has been

thoroughly studied and that there is no doubt

whatsoever as to its lack of utility. " (15)

 

This statement was premature to say the least. The

" thorough study " of vitamin E was not quite completed

by 1961. Thirty-eight years later, a crossover study

of 36 patients who had Type I diabetes, and retinal

blood flows that were significantly lower than

non-diabetics, showed that those taking 1,800 IU of

vitamin E daily obtained normal retinal blood flow.

The patients with the worst initial readings improved

the most. " (V)itamin E may potentially provide

additional risk reduction for the development of

retinopathy or nephropathy in addition to those

achievable through intensive insulin therapy alone.

Vitamin E is a low-cost, readily available compound

associated with few known side effects; thus, its use

could have a dramatic socioeconomic impact if found to

be efficacious in delaying the onset of diabetic

retinopathy and/or nephropathy. " (25) Vitamin E also

works synergistically with insulin to lower high blood

pressure in diabetics. (26)

 

QUANTITY AND QUALITY

 

The most common reason for irreproducibility of

successful vitamin E cures is either a failure to use

enough of it, or a failure to use the natural form

(D-alpha, plus mixed natural tocopherols), or both.

For example, in an oft-quoted negative study (27),

researchers who gave 300 milligrams of synthetic

vitamin E to patients who had recently had a heart

attack saw no beneficial effect. Such failure is to be

expected. You can set up any experiment to fail. The

Shutes would have used only the natural form, and four

times as much.

 

Natural vitamin E is always the dextro- (right-handed)

form. On the other hand, " synthetic vitamin E is a

mixture of eight isomers in equal proportions

containing only 12.5% of d-alpha tocopherol. One mg of

dl-alpha tocopherol has the lowest Vitamin E

equivalence of any of the common vitamin E

preparations. " (28)

 

There may be other differences. " Vitamin E derived

from natural sources is obtained by molecular

distillation and, in most cases, subsequent

methylation and esterification of edible vegetable oil

products. Synthetic vitamin E is produced from fossil

plant material (coal tar) by condensation of

trimethylhydroquinone with isophytol. " (12)

 

While personal philosophy is the only possible basis

for a decision to conduct a study using only the

synthetic form of a vitamin, the use of low dosage is

generally explained away by alleging doubts about

safety.

 

SAFETY

 

The most elementary of forensic arguments is, where

are the bodies? Poison control statistics report no

deaths from vitamin E. (29) There is a reason for

this. Vitamin E is a safe and remarkably non-toxic

substance. Even the 2000 report by the Institute of

Medicine of the National Academy of Sciences, which

actually recommends against taking supplemental

vitamin E, specifically acknowledges that 1,000 mg

(1,500 IU) is a " tolerable upper intake level . . .

that is likely to pose no risk of adverse health

effects for almost all individuals in the general

population. " (30) The Shutes observed no evidence of

harm with doses as high as 8,000 IU/day. In fact,

" toxicity symptoms have not been reported even at

intakes of 800 IU per kilogram of body weight daily

for 5 months " according to the Food and Nutrition

Board. (31) This demonstrated safe level would work

out to be around 60,000 IU daily for an average adult,

some 2,700 times the RDA!

 

In addition to an awareness of anticoagulation

medications, " Dr. Shute advises starting with small

doses for patients who have rheumatic heart disease.

He starts with 90 IU. and very slowly works up the

dose. The reason for this is that if too much is given

at the beginning the increased strength of the

heartbeat may create some difficulty. The same applies

to heart failure. The initial dose should be small and

gradually increased. If this is done the final dose

can safely reach 800 to 1200 IU. " (31)

 

SAFETY IN THE ELDERLY

 

A Columbia University study reported progression of

Alzheimer's disease was significantly slowed in

patients taking high daily doses (2,000 IU) of vitamin

E for two years. (32) The vitamin worked better than

the drug selegiline did. The patients in the

Alzheimer's study tolerated their vitamin E doses

well. Perhaps the real story is that 2,000 IU per day

for two years is safe for the elderly.

 

SAFETY IN CHILDREN

 

Children using anti-epileptic medication have reduced

plasma levels of vitamin E, a sign of vitamin E

deficiency. So doctors at the University of Toronto

gave epileptic children 400 IU of vitamin E per day

for several months, along with their medication. This

combined treatment reduced the frequency of seizures

in most of the children by over 60 percent. Half of

them " had a 90 to 100 percent reduction in seizures. "

(33) This extraordinary result is also proof of the

safety of 400 IU of vitamin E per day in children

(equivalent to at least 800 to 1,200 IU/day for an

adult). " There were no adverse side effects, " said the

researchers. It also provides a clear example of

pharmaceutical use creating a vitamin deficiency, and

an unassailable justification for supplementation.

 

SAFETY IN INFANTS

 

Overexposure to oxygen has been a major cause of

retrolental fibroplasia (retinopathy of prematurity)

and subsequent blindness in premature infants.

Incubator oxygen retina damage is now prevented by

giving preemies 100 mg E per kilogram body weight.

That dose is equivalent to an adult dose of about

7,000 IU for an average-weight adult. " There have been

no detrimental side effects " from such treatment, said

the New England Journal of Medicine, Dec. 3, 1981.

(34) Nevertheless, the 1989 (sixth) edition of the

textbook Nutrition and Diet Therapy (6) advised that

" healthy persons stand the chance of developing signs

of toxicity with the megadoses that are recommended in

these studies. " (p. 225) That incorrect statement was

dropped in the book's next edition. Instead, the 7th

edition (1993) said under " Toxicity Effects " that

" Vitamin E is the only one of the fat-soluble vitamins

for which no toxic effect in humans is known. Its use

as a supplement has not shown harmful effects. " (p

186)

 

IMMUNE FUNCTION

 

" Worst Pills, Best Pills " is a monthly newsletter

published by Public Citizen, Ralph Nader’s " Health

Research Group. " http://www.citizen.org/hrg/ The

October, 2002 issue (Vol 8, No 10) contained this

statement by editor Sidney M. Wolfe, M.D.: " You should

not take dietary supplements. These products have not

been tested or shown to be effective for any use, and

their safety is unknown. The only exception to this

advice is an inexpensive vitamin or mineral

preparation. " (p 80) On page 77, the doctor presents a

JAMA study (35) alleging that a mere 200 mg of vitamin

E is somehow detrimental to patients over the age of

60 with respiratory tract infections.

 

But there are other studies that Public Citizen might

do well to present to its readership. Emanuel

Cheraskin, M.D., writes: " The effect of daily vitamin

E supplementation (800 IU alpha tocopherol for 30

days) on immune responses of 32 healthy subjects (60+

years old) was examined in a placebo-controlled,

double-blind trial in a metabolic research unit. The

data suggest that vitamin E supplementation improves

immune responsiveness in healthy elderly. " (36) In a

second study, " using a double blind protocol, immune

response was studied in a group receiving vitamin E

(800 mg per day) versus placebo. The increased

immunocompetence was matched by blood vitamin E levels

which jumped from 1.1 to 3.1 mg%. No such change in

blood vitamin E occurred in the control group (1.1 to

1.0 mg%). " (37)

 

A recent and perhaps even more important study looked

at patients with colon cancer " who received a daily

dose of 750 mg of vitamin E during a period of 2

weeks. Short-term supplementation with high doses of

dietary vitamin E leads to increased CD4:CD8 ratios

and to enhanced capacity by their T cells to produce

the T helper 1 cytokines interleukin 2 and IFN-gamma.

In 10 of 12 patients, an increase of 10% or more

(average, 22%) in the number of T cells producing

interleukin 2 was seen after 2 weeks of vitamin E

supplementation. " The authors concluded that " dietary

vitamin E may be used to improve the immune functions

in patients with advanced cancer. " That improvement

was achieved in only two weeks merits special

attention. (38)

 

Note that the doses in these positive studies were

nearly four times the dose used in the negative JAMA

study cited by Dr. Wolfe.

 

HYPERTENSION

 

Recent research has indicated that Vitamin E

normalizes high blood pressure. (39, 40, 41) In some

hypertensive persons, commencement of very large

vitamin E doses may cause a slight temporary increase

in blood pressure, although maintained supplementation

can then be expected to lower it. The solution is to

increase the vitamin gradually, along with the proper

monitoring that hypertensive patients should have

anyway. High blood pressure has been called the

" silent killer, " and nearly one-third of adults have

it. It is all too frequently unrecognized and

untreated.

 

Nearly half of all deaths are due to cardiovascular

diseases, and often the first symptom is death.

Advocating daily supplementation with several hundred

IU's of vitamin E would be good public health policy.

Yet vitamin E, for decades lampooned as a " cure in

search of a disease, " remains virtually the " silent

healer " for as much as the public has been advised of

its benefits.

 

Back in 1985, Linus Pauling wrote: " The failure of the

medical establishment during the last forty years to

recognize the value of Vitamin E in controlling heart

disease is responsible for a tremendous amount of

unnecessary suffering and for many early deaths. The

interesting story of the efforts to suppress the Shute

discoveries about Vitamin E illustrates the shocking

bias of organized medicine against nutritional

measures for achieving improved health. " (10, vii)

 

Dr. Pauling would most likely have appreciated this

comment from a recent Harvard Health Letter: " A

consistent body of research indicates that vitamin E

may protect people against heart disease. . . The data

generally indicate that taking doses ranging from 100

to 800 IU (International Units) per day may lower the

risk of heart disease by 30%-40%. " (42) Over half a

century ago, the Shute brothers and colleagues showed

that, with even higher doses than those, and with an

insistence on the use of natural vitamin E, the

results are better still.

 

References:

 

1. Hutton, Eric (1953) The fight over vitamin E.

Maclean's Magazine, June 15.

 

2. Vivekananthan DP, Penn MS, Sapp SK, Hsu A, Topol,

EJ. Use of antioxidant vitamins for the prevention of

cardiovascular disease: meta-analysis of randomised

trials. Lancet 2003; 361: 2017-23.

 

3. Natural alpha tocopherol (vitamin E) in the

treatment of cardiovascular and renal diseases.

http://www.doctoryourself.com/shute_protocol.html

 

4. http://www.bayeraspirin.com/news/heart_attack.htm

 

5. Dietary Supplements: An Advertising Guide for

Industry, Part 3. Federal Trade Commission.

http://www.ftc.gov/bcp/conline/pubs/buspubs/dietsupp.htm#Application

 

6. Williams SR. Nutrition and Diet Therapy, Seventh

Edition. St. Louis: Mosby, 1993. (p 186). Sixth

edition, 1989. (p 225).

 

7. Williams HTG, Fenna D, MacBeth RA. Alpha Tocopherol

in the Treatment of Intermittent Claudication.

Surgery, Gynecology and Obstetrics 132:#4, 662-666,

April 1971.

 

8. Evans HM and Bishop KS. On the existence of a

hitherto unrecognized dietary factor essential for

reproduction. Science 56: 650, 1922.

 

9. Pacini AJ. Why we need vitamin E. Health Culture

Magazine, January, 1936.

 

10. Shute E, and Shute JCM (ed). The vitamin E story.

Burlington, Ontario: Welch Publishing, 1985.

 

11. British Medical Journal, i, 890, 1940 (cited in

Bicknell & Prescott. The vitamins in medicine.

Milwaukee: Lee Foundation, 1953, p 632)

 

12. Roche Vitamins: vitamin E in human nutrition.

http://www.roche-vitamins.com/home/what/what-hnh/what-hnh-vitamins/what-hnh-vita\

min-e

 

13. Horwitt MK. Vitamin E: a reexamination. American

Journal of Clinical Nutrition, 29(5):569-78. 1976.

 

14. HealthWorld Online Interviews with Nutritional

Experts: ''Vitamin E and the RDA''

http://www.healthy.net

 

15. United States Post Office Department Docket No.

1/187. March 15, 1961.

http://www.usps.gov/judicial/1961deci/1-187.htm

 

16. Shute EV et al. The heart and vitamin E. London,

Canada: Shute Foundation for Medical Research, 1963.

 

17. Shute WE. (Dr. Wilfred Shute's) Complete updated

vitamin E book. New Canaan, CT: Keats, 1975.

 

18. Shute WE and Taub HJ. Vitamin E for ailing and

healthy hearts. New York: Pyramid House, 1975.

 

19. Shute WE. Health Preserver. Emmaus, PA: Rodale

Press, 1977.

 

20. Shute WE. The Vitamin E Book. New Canaan, CT:

Keats Publishing, 1978.

 

21. Shute WE. Your Child and Vitamin E. New Canaan,

CT: Keats Publishing, 1979

 

22. Butterworth, Jr. CE. Vitamin Safety: A current

appraisal. Backgrounder, Vol 5, No 1. Vitamin

Nutrition Information Service, 1994.

 

23. Letter. New England Journal of Medicine 271, 4;

July 23, 1964.

 

24. Shute, Vogelsang, Skelton and Shute. Surg., Gyn.

and Obst. 86:1. 1948.

 

25. Bursell SE, Clermont AC, Aiello LP, Aiello LM,

Schlossman DK, Feener EP, Laffel L, King GL. High-dose

vitamin E supplementation normalizes retinal blood

flow and creatinine clearance in patients with type 1

diabetes. Diabetes Care. 1999 Aug; 22(8):1245-51.

 

26. Koo JR, Ni Z, Oviesi F, Vaziri ND. Antioxidant

therapy potentiates antihypertensive action of insulin

in diabetic rats. Clin Exp Hypertens. 2002

Jul;24(5):333-44.

 

27. Gruppo Italiano per lo Studio della Sopravvivenza

nell'Infarto miocardico. Dietary supplementation with

n-3 polyunsaturated fatty acids and vitamin E after

myocardial infarction: results of the

GISSI-Prevenzione trial. Lancet. 1999 Aug

7;354(9177):447-55.

 

28. Hoffer A. Personal communication, June 2003.

 

29. Rosenbloom M. Vitamin toxicity.

http://www.eMedicine.com . October 23, 2001.

 

30. Vita-Mania: RDA for C, E Raised; Limits Set

 

http://abcnews.go.com/sections/living/DailyNews/vitamin000411.html

 

The Associated Press, Washington, April 11, 2000.

 

31. Rosenberg H and Feldzamen AN. The book of vitamin

therapy. New York: Berkley Publishing Corp, 1974.

 

32. Sano M, Ernesto C, Thomas RG, Klauber MR, Schafer

K, Grundman M, Woodbury P, Growdon J, Cotman CW,

Pfeiffer E, Schneider LS, Thal LJ. A controlled trial

of selegiline, alpha-tocopherol, or both as treatment

for Alzheimer's disease. The Alzheimer's Disease

Cooperative Study. N Engl J Med. Apr 24;

336(17):1216-22. 1997.

 

33. Ogunmekan AO, Hwang PA. A randomized,

double-blind, placebo-controlled, clinical trial of

D-alpha-tocopheryl acetate (vitamin E), as add-on

therapy, for epilepsy in children. Epilepsia. 1989

Jan-Feb; 30(1):84-9.

 

34. Hittner HM, Godio LB, Rudolph AJ, Adams JM,

Garcia-Prats JA, Friedman Z, Kautz JA, Monaco WA.

Retrolental fibroplasia: efficacy of vitamin E in a

double-blind clinical study of preterm infants. N Engl

J Med. 1981 Dec 3; 305(23):1365-71.

 

35. Graat JM, Schouten EG, Kok FJ. Effect of daily

vitamin E and multivitamin-mineral supplementation on

acute respiratory tract infections in elderly persons:

a randomized controlled trial. JAMA. 2002 Aug

14;288(6): 715-21.

 

36. Cheraskin E. Antioxidants in health and disease:

the big picture. Journal of Orthomolecular Medicine

10: #2, 89-96, Second Quarter, 1995, citing Meydani,

S.N., Barklund, M.P., Liu, S., Meydani, M., Miller,

R.A., Cannon, J.G., Morrow, F.D., Rocklin, R.,

Blumberg, J.B. Effect of Vitamin E Supplementation on

Immune Responsiveness of Healthy Elderly Subjects.

FASEB Journal 3: A1057, 1989.

 

37. Meydani, S.N., Barkiund, M.P., Liu, S., Meydani,

M., Miller, R.A., Cannon, J.G., Morrow, F.D., Rocklin,

R., Blumberg, J.B. Vitamin E supplementation enhances

cell-mediated immunity in healthy elderly subjects.

American Journal of Clinical Nutrition 52:#3, 557-563,

September 1990.

 

38. Malmberg KJ, Lenkei R, Petersson M, Ohlum T,

Ichihara F, Glimelius B, Frodin JE, Masucci G,

Kiessling R. A short-term dietary supplementation of

high doses of vitamin E increases T helper 1 cytokine

production in patients with advanced colorectal

cancer. Clin Cancer Res. 2002 Jun; 8(6):1772-8.

 

39. Vasdev S, Gill V, Parai S, Longerich L, Gadag V.

Dietary vitamin E supplementation lowers blood

pressure in spontaneously hypertensive rats. Mol Cell

Biochem. 2002 Sep; 238(1-2):111-7.

 

40. Vaziri ND, Ni Z, Oveisi F, Liang K, Pandian R.

Enhanced nitric oxide inactivation and protein

nitration by reactive oxygen species in renal

insufficiency. Hypertension. 2002 Jan; 39(1):135-41.

 

41. Galley HF, Thornton J, Howdle PD, Walker BE,

Webster NR. Combination oral antioxidant

supplementation reduces blood pressure. Clin Sci

(Lond). 1997 Apr;92(4):361-5.

 

42. President and Fellows of Harvard College.

Antioxidants: what they are and what they do. Harvard

Health Letter. Feb 1999; 24(5)

 

A bibliography of selected books and papers by Wilfrid

and Evan Shute is posted at

http://www.doctoryourself.com/biblio_shute.html .

 

Dr. Evan Shute's autiobiography, The Vitamin E Story,

was reviewed by Andrew Saul in the Journal of

Orthomolecular Medicine, Volume 17, Number 3, Third

Quarter, 2002 (p 179-181) and is also posted online at

http://www.doctoryourself.com/estory.htm .