{"entity":{"id":"vitamin-e-supplements","kind":"technology","name":"Vitamin E supplements","aka":["Alpha-tocopherol","d-alpha-tocopherol"],"tldr":"Vitamin E supplements were tested to prevent prostate cancer in a very large trial and, after seven years, the men taking them had more prostate cancer, not less. High doses can also increase bleeding in people on the blood thinner warfarin. Small studies of vitamin E for hot flushes, nerve damage and radiotherapy skin reactions are too small to rely on.","summary":"Memorial Sloan Kettering's About Herbs entry records that data on vitamin E and cancer risk are mixed and that some studies suggest it may increase risk. In the SELECT trial, vitamin E alone or with selenium for five years did not reduce prostate cancer risk, and at seven years' follow-up the risk was significantly increased; vitamin E with soy and selenium also did not slow prostate cancer progression. Beyond cancer, large trials found no protection against cardiovascular death, and vitamin E may increase the risk of haemorrhagic stroke. MSK notes that daily supplementation above 400 IU may increase all-cause mortality and that toxicity can occur above 800 IU; in a large study of patients on warfarin, higher serum vitamin E predicted bleeding events. Limited studies suggest vitamin E may help hot flushes in breast cancer survivors, chemotherapy neuropathy including cisplatin neurotoxicity, and radiation dermatitis in breast cancer, but these are small and need confirmation. Product content varied in one analysis from 41 per cent less to 57 per cent more than the label. Vitamin E from food (plant oils, nuts, seeds, whole grains) carries none of these concerns.","status":"negative","asOf":"2026-11-04","links":[{"label":"MSK About Herbs: Vitamin E (page last updated 28 September 2023)","url":"https://www.mskcc.org/cancer-care/integrative-medicine/herbs/vitamin-e"},{"label":"MSK About Herbs: Beta-carotene, for the USPSTF position (page last updated 24 March 2023)","url":"https://www.mskcc.org/cancer-care/integrative-medicine/herbs/beta-carotene"}],"tags":["complementary","supportive-care","evidence:harm"],"related":["beta-carotene-supplements","vitamin-a-supplements"],"cancers":["prostate"],"sections":["supportive-care","nutrition-lifestyle","prevention"],"technologies":["integrative-oncology","dietary-supplements-treatment-interactions","cipn-recovery-and-treatment"],"targets":[],"drugs":["cisplatin"],"companies":[],"institutions":[],"pathways":[],"terms":["peripheral-neuropathy","radiation-dermatitis"],"trials":[],"people":[],"bottlenecks":["b-misinformation","b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"A fat-soluble antioxidant that scavenges peroxyl radicals in cell membranes; trials of the alpha form alone may have missed or counteracted activity of the other tocopherols, and antioxidant activity may also protect cancer cells.","strengths":["Large randomised evidence gives a clear answer on prevention","Small positive signals for hot flushes and neuropathy that could be tested properly"],"limitations":["Increased prostate cancer at seven years in SELECT","Bleeding risk with warfarin; haemorrhagic stroke signal","Doses above 400 IU a day linked to higher mortality"]},"route":"/technologies/vitamin-e-supplements/","neighbours":{"technology":[{"id":"beta-carotene-supplements","kind":"technology","name":"Beta-carotene supplements","route":"/technologies/beta-carotene-supplements/"},{"id":"dietary-supplements-treatment-interactions","kind":"technology","name":"Dietary supplements during cancer treatment: interactions and harms","route":"/technologies/dietary-supplements-treatment-interactions/"},{"id":"integrative-oncology","kind":"technology","name":"Evidence-based integrative oncology","route":"/technologies/integrative-oncology/"},{"id":"n-acetylcysteine-supplements","kind":"technology","name":"N-acetylcysteine (NAC) supplements","route":"/technologies/n-acetylcysteine-supplements/"},{"id":"cipn-recovery-and-treatment","kind":"technology","name":"Nerve damage from chemotherapy: what recovers, and what helps","route":"/technologies/cipn-recovery-and-treatment/"},{"id":"vitamin-a-supplements","kind":"technology","name":"Vitamin A supplements","route":"/technologies/vitamin-a-supplements/"}],"cancer":[{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"nutrition-lifestyle","kind":"section","name":"Diet, Exercise & Lifestyle","route":"/fronts/nutrition-lifestyle/"},{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"}],"term":[{"id":"peripheral-neuropathy","kind":"term","name":"Peripheral neuropathy (chemotherapy-induced)","route":"/terms/peripheral-neuropathy/"},{"id":"radiation-dermatitis","kind":"term","name":"Radiation dermatitis (skin reaction)","route":"/terms/radiation-dermatitis/"}],"bottleneck":[{"id":"b-misinformation","kind":"bottleneck","name":"Misinformation and unproven therapies","route":"/bottlenecks/b-misinformation/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}]}}