Vitamin E benefits early Alzheimer's disease

 by Dr Ira Bernstein - 

An interesting study was published in the Journal of the American Medical Association (JAMA, Jan 1, 2014), starting off the New Year with good nutritional evidence. High dose vitamin E (2000 IU daily) was shown to slow the rate of functional decline in patients with mild to moderate Alzheimer’s disease. Patients were studied for an average of 2.25 years. Compared to placebo, there was a delay in clinical progression of 19% per year. Caregiver time increased the least in the vitamin E group. It should be noted that vitamin E was compared to an Alzheimer’s medication called memantine (also known by the brand names Ebixa or Namenda). There was no benefit seen in the memantine only group and interestingly no benefit in the memantine plus vitamin E group. Regarding safety, there were more serious adverse events seen in the memantine group and memantine plus vitamin E combination.

2000 IU of vitamin E is quite a high dose. I looked further into the study design and learned that the researchers used the synthetic form of vitamin E known as dl-alpha tocopherol. All nutrition experts frown on the use of the synthetic form of vitamin E which is known to be less bio-active since it contains only 50% of functional vitamin E. Think of vitamin E having a left and right mirror image, but only one side works. The synthetic form has both mirror images and so it is less effective (which may be why such a high dose was used, or needed in order to demonstrate benefit). I hypothesize that had they used natural vitamin E (d-alpha tocopherol), the same results could have been obtained with a lower dose of vitamin E.

I am also a little hesitant when I read about studies looking at single vitamins (except for vitamin D which is very different from all other vitamins). Vitamins like to work together, not in isolation, so that is why I feel it is important to have all the players of the game involved. This is why it is somewhat surprising that in this study they were actually able to demonstrate a measurable benefit with a single vitamin. More commonly, you will read a negative study that is then all over the media.

In my own clinical experience with patients with Alzheimer’s disease, I have seen some incredible performance gains when supplementing with high quality comprehensive vitamins, minerals and antioxidants. It is a pleasure to receive such positive feedback from the patient’s families and caregivers which is usually not the case seen in Alzheimer’s disease which has a dismal prognosis with standard medical therapy.

The recently published Physician’s Health Study looking at cognition not surprisingly showed no benefit for cognition when the multivitamin Centrum Silver was administered. This product currently contains a mere 60 IU of vitamin E and in the synthetic form (a far cry from the 2000 IU in the above study). The rest of the nutrients are in dosages too low and in cheap, poorly bioavailable forms (such as non-chelated minerals) so that the benefits are limited. If you really want to make a difference, encourage a quality comprehensive broad spectrum nutritional product. The families will thank you and their physicians will likely wonder what’s going on.

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