Vitamin E Savior?

By Jessica Girdwain

A new study suggests a previously untested form of vitamin E may reduce stroke risk, but doctors are urging caution.

A new study gives hope that vitamin E may defend against catastrophic disease. The research, recently published in the Journal of Cerebral Blood Flow & Metabolism, discovered that 10 weeks of preventive use of the tocotrienol (TCT) form of vitamin E on dogs offered robust protection in the event of a stroke.

Vitamin E occurs naturally in eight forms, including tocopherols and TCTs. “Most of the previous studies on vitamin E was on tocopherols,” says lead author Chandan Sen, PhD. “Tocotrienols are hardly studied, but we found that it’s much more neural protective than the others.”

In the study, researchers fed dogs either a TCT supplement or a placebo and then induced strokes in the animals. Twenty-four hours later, the dogs that had taken TCT preventively showed 80% less brain tissue damage than the placebo group.

Sen says TCTs bolster the protective pathway in nerve cells and induce a higher collateral blood flow. “These fine blood vessels in your brain normally lie dormant and when you block the main one, they wake up. In the event that the main blood vessel is blocked, tocotrienol can improve this collateral circulation,” he notes.

The therapy could benefit people at risk of stroke, especially those who have suffered a prior ministroke or have high lipid profiles. “Our study shows that there are ways of preventing disaster. Brain tissue doesn’t regenerate, but tocotrienol could minimize the damage. A stroke might not cripple,” Sen says.

He advises at-risk groups to take TCT much like an aspirin and notes that big supplement companies have started to carry and distribute this form of vitamin E. However, while vascular doctors are calling this study promising, they advise practicing caution regarding the results.

The reason? History. Earlier studies on vitamin E involved the more common form called alpha-tocopherol. This form of vitamin E was previously thought to promote vascular health and provide antioxidant benefits, which is the reason the public at large began taking it routinely. During the late 1990s and early 2000s, new evidence emerged suggesting that tocopherol wasn’t effective for this purpose.

One study even found that it raised the risk of hemorrhagic stroke by 22%. “Because of this increased risk, the healthcare community at large no longer promotes vitamin E,” says Bart Demaerschalk, MD, a professor of neurology at the Mayo Clinic in Phoenix.

“That said, the [new] study is exciting,” he continues. “This form of vitamin E may limit brain injury or the extent of injury. Plus, it may even induce the development of new blood vessel growth or improve blood flow in the territory of the brain hurt by stroke.”

Regardless, “It’s a very early trial,” he says. “There are a lot of experiments that need to be done, including clinical research on humans, to say whether or not TCT works for those at a high risk for stroke.”

“It’s a huge leap. It’s interesting in the way that it breaks apart vitamin E and looks at a new component, but there have been hundreds, if not thousands, of chemicals that, in animal studies, suggest that they might be protective,” explains Lewis Morgenstern, MD, director of the stroke program at the University of Michigan School of Public Health. “But when we’ve moved them to human trials to test safety and efficacy, we ended up with zero to use.”

The key, Morgenstern says, is that approving any therapy takes time. “Before any drug is considered safe and effective, it must go through years of studies to prove it,” he notes. “Many people feel it moves slowly, but it is a necessity. People can be harmed if the process moves quickly and drugs widely distributed in haste.”

Regardless of this new trial, know that your patients may still be taking the tocopherol form of vitamin E. “Research suggests that up to half of Americans may be taking vitamin E, and maybe even 10% of those are taking it specifically to reduce their risk of vascular diseases, including stroke, but again, this isn’t something stroke doctors recommend,” says Demaerschalk. He explains that there can be a long lapse between scientific research and the results making their way to the public.

As for TCT right now, Demaerschalk says practitioners should not recommend these supplements and the public should not be taking them. “It’s premature to promote this form of vitamin E,” he says. “Let’s not replicate the error we made a decade ago on vitamin E by adopting an early therapy that’s not yet proven to be effective in humans.”

However, it is important to remind your patients about strategies for stroke prevention. “Stroke is a disease we know how to prevent and treat more than any other catastrophic disease,” says Morgenstern. Some risk factors and proven therapies include the following:

• High blood pressure is a major risk factor. Antihypertensive or blood pressure medications are highly effective for lowering blood pressure and thus stroke risk. A diet low in total calories that includes fruit, vegetables, and whole grains and reduces salt is also preventive.

• High cholesterol is another risk factor. Again, cholesterol-lowering medication can reduce stroke incidence.

• Antiplatelet medications such as Plavix or aspirin prevent platelets from sticking together and aggregating in the walls of the blood vessels, decreasing the likelihood of a stroke.

• Diabetes is another factor. Treating the disease and controlling blood sugar is imperative and will make a dramatic difference.

• Lifestyle factors such as smoking cessation and avoiding secondhand smoke as well as regular exercise also go a long way to reducing stroke risk.

— Jessica Girdwain is a Chicago-based freelance writer who has contributed health-related articles to several national magazines.