This archived forum used to be called 'Peatarian' (in reference to Ray Peat).

Vitamin E and K supplementation

Was interesting in those, since I think I take enough A from the foods and enough D from the sun. My question is: are there some good evidence to supplement vitamin E as a lipid antioxidant and vitamin K for the brain and the calcium metabolism? Are there some studies talking about it? Even the WAPF article on K isn't convincing to me. And for vitamin E, it should raise progesterone and lower estrogens, so the effects should be good and noticeable if it is working. I think both vitamins can increase the cells uptake of glucose and T3, reducing "insulin resistance" of brain cells. Thanks everyone.
asked Apr 16, 2015 by John Frusciante
I take mixed tocopherols, about 500 mg once every three days. More than that gives me salt cravings, but that amount, subjectively, has good effects. It produces similar feelings to progesterone.

I find that I don't need to take a lot of vitamin K2. I do take it occasionally, but I think I don't need as much because I consume dairy fat (cheese, butter, whole milk), which contains vitamin K2. I also eat beef tongue occasionally which is a good source of vitamin K2. Weekly liver also provides vitamin K.

You can think about vitamin E not only from an antioxidant perspective. It allows the liver to store more vitamin A. It's also protective from taking excessive vitamin A.

If you believe supplementing vitamin E is good, then you should also believe that consuming vitamin K is good, because vitamin E increases vitamin K requirements.

Vitamin K reverses arterial calcification in rats. One thing that might make you like vitamin K2 is its effect on libido. Many people get that.

4 Answers

I'd like to make a searchable database of Peat's work to help answer questions like this.

I find references in Peat's work to Vitamin E helping with iron excess and PUFA poisoning that comes especially with aging, and to Vitamin K helping balance an environment that may be too stressful.

Here's an example of Peat describing this balance:

"Substances such as PTH, nitric oxide, serotonin, cortisol, aldosterone, estrogen, thyroid stimulating hormone, and prolactin have regulatory and adaptive functions that are essential, but that ideally should act only intermittently, producing changes that are needed momentarily. When the environment is too stressful, or when nutrition isn’t adequate, the organism may be unable to mobilize the opposing and complementary substances to stop their actions."

If you want to go outside Peat's work, this article  provides a research summary:

http://www.encognitive.com/files/Vitamin%20E%20and%20K%20interactions%20%E2%80%93%20a%2050-year-old%20problem.pdf

But I find many studies are unreliable, likely designed by people who lack an understanding of the role of gradient affinities in cell physiology.
answered Apr 17, 2015 by visionofstrength
No there is not good evidence. If you've lost all excess body fat and do not eat any free oils then vitamin E is of little value. It should only be used when going to a social function where free oils will be consumed. WAPF is not a good source of information. They are cultists selling products (Green Pasture butter oil etc.) Peat said broccoli was a good source of K in an email with Kasra, and in an audio interview Peat said that greens like kale etc. are good K sources.
answered Apr 20, 2015 by Westside PUFAs
Good post. Good boy.
haha!  So how much money is really being made on butter oil, when "vegan scallops" are selling for $6.99 a box?

Nutrition Facts
Serving Size 100g or 3.5oz (about 8 pieces)
Servings Per Container 2.5
Calories 50
Protein 0g
http://www.veganstore.com/product/sophies-kitchen-breaded-vegan-scallops/vegan-meat-alternatives  

I don't know, I just don't see the WAPF folks being in this for the big bucks.
Vegan scallops! Omg, the world has gone mad.

Ingredients: water, konjac powder, rice flakes (from brown rice), potato starch, beta glucan, carrageenan (seaweed based gelatin), alginate (from seaweed), organic agave nectar, white pepper, sea salt, calcium hydroxide.
The ECKO trial was a controlled study which gave postmenopausal women 5mg of vitamin K1 versus a placebo for about 2 to 4 years. Cancer and bone fracture rates were reduced.


http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0050196

Several other trials on vitamin K2 have also reported significant reductions in bone fracture risk.

http://archinte.jamanetwork.com/article.aspx?articleid=410550
answered Apr 17, 2015 by mscott
edited Apr 17, 2015 by mscott
The ECKO trial was a small study and had a very high dropout rate throughout the trial. Fractures and cancer were just secondary outcomes while the primary outcome was negative. That makes the the evidence hypothesis-generating but not confirmatory evidence. It needs to be confirmed in a larger studies. Keep in mind that similar profound results were also seen in the first smaller studies with fish oil, vitamin D or many other supplements and those couldnt be confirmed in better trials.
Hey Bukowski! Thanks for the comment, but I'm somewhat confused by it. Perhaps I don't understand how you define a study as "small" or a dropout rate as "high". The study started with 440 people, which I wouldn't classify as small myself. Also, it looks like less than 10% of participants were lost to follow up (if I read the paper correctly) which also doesn't strike me as a "very high dropout rate". I agree the paper's results were from 2ndary analysis, but a number of other studies (found in my second link) have found significant fracture benefits (albeit using mainly K2 MK4) which I think strengthens the fracture finding in ECKO.
Also, what are these vitamin D and fish oil papers? I'm not sure which you're referring to. Maybe the results were different because the subsequent studies were different (i.e. using 800IU vitamin D and seeing benefits but not in studies using 400IU's). So I question whether vitamin D or fish oil are really examples of profound results which couldn't be confirmed. I could be wrong though.
The trial was originally designed to run for 2 years. In that time indeed the dropout rate was rather low. But if you look at the graphs you also dont see a significant difference in cancer rate in that per-protocol time frame (and also for fractures no p-value at 24 months is reported). The significant differences in cancers is only observed on the post-hoc trial extension phase of 2-4 years, and in that phase there was significant drop out with only 100 patients of the original 440 available left for the 48 time point analysiss. The drop out could have created a big bias, leaving more healthy people in the active treatment arm.
Several large controlled studies with alpha-tocopherol-vitamin E (both chemical or natural versions) show that it doesnt improve cardiovascular disease, cancer or mortality.

No large controlled studies available for mixed tocopherol-vitamin E.

No large controlled studies available for tocotrienol-vitamin E.

No large controlled studies available for vitamin K.

In summary, we dont know. By supplementing, you do an experiment with unknown outcome, could end up either bad, neutral or good.
answered Apr 17, 2015 by Bukowski
edited Apr 19, 2015 by Bukowski
John, you have to keep in mind that unfortunately you can't go by large controlled studies to make decisions like this because there is typically financial motivation to fund studies with patentable drugs,  but less so with natural substances.

Ray Peat made a lot of his health decisions based on reasoning about how the body works, and it helped him and a lot of people. Although large studies are useful, they're not essential, and there is a lot of other information that can help you make a smart decision.

The focus on such large studies which don't exist for non-patentable substances is a strategy to sell more products, not that they are the only way to gain good knowledge. There are other ways. Bukowski of course supports the drug industry's campaign because he wants to needlessly kill more people with statins and other harmful patentable drugs and treatments.

He sounds like a doctor who prescribes statins. Thus, he gets paid to kill. So keep his interests in mind when you evaluate his answer.

Also, he exaggerates the lack of large studies. There are many studies in Japan about long term use of vitamin K.
Many of the large vitamin E trials were publicly funded and well done, including the large publicly funded WHS trial with natural alpha-tocopherol. They show that just giving vitamin E to a general public is not helpful. There may be merit in other forms of vitamin E as you mentioned, or a benefit of vitamin E in specific sub-populations, but I highly doubt their benefit in young people in their twenties (most of us here).

The habit of cherry-picking studies based in their own convictions but not on their scientific validity and to disregard and badmouth evidence that doesnt fit in the dogma is unscientific. It doesnt help with finding out what is actually true or helpful. Until people dont open themselves up to the idea that things are not as black and white as they think they are, peatarianism will not become a movement that actually helps people on a large scale.

By the way, the shute brothers, which made a fortune on selling the vitamin E dogma, both died from severe heart disease, the disease they claimed could be nearly eradicated by just taking "their" supplement.
There's disagreement about whether the WHI trial (that Bukowski alludes to?) was either funded in the public interest or well done:

http://www.lef.org/Featured-Articles/2013/12/Federally-Funded-Analysis-Attempts-to-Undermine-Vitamin-and-Mineral-Supplements/Page-01?checked=1

That said, Peat seems to say he stopped ingesting Vitamin E many years ago (though he may use it topically), on the suspicion that the manufacturing process had been corrrupted, and has seen more people helped by stopping supplements corrupted by the manufacturing process than by taking them.

Peat suggests (in email) that Vitamin E may help in the short term for iron excess or PUFA poisoning which, while more prevalent in the aged, can strike at any age.
what about the vitamin e in progest-e? Is that safe?
@janelle, good point! I think Peat's answer to that would be, yes, given the benefits of the formulation.

Progest-E is about 9 parts vitamin E for 1 part progesterone, so that's 27 mg Vitamin E to 3 mg progesterone (per drop). Not sure how many drops you take?
The article you linked does not discuss the trial i meant above. I meant the WHS trial, corrected the typo above (http://www.ncbi.nlm.nih.gov/pubmed/15998891). That lef.org argues against government recommendations against PSA screening tests or vitamin supplement is not suprising: The company makes its money by selling vitamin supplements and PSA blood tests.
@Bukowski, there's no threat of fraud from a conflict of interest in publishing a critique of a study. The threat of fraud comes when the author of the study has a conflict of interest.

I took all of a minute to review your corrected link, but I think you may still have linked to the wrong study, because in the Women’s Health Study you now link to, which followed 40,000 women for 10 years, vitamin E supplements of 600 IU every other day did not significantly reduce the risk of so-called “major cardiac events” (heart attack, stroke, or cardiovascular death).

But there was some encouraging news in the findings: When these major cardiac events were analyzed separately, vitamin E supplementation was linked to a 24 percent lower risk of cardiovascular death. And among women ages 65 and older, vitamin E supplementation reduced the risk of major cardiac events by 26 percent. A later analysis found that women who took the vitamin E supplements also had a lower risk of developing serious blood clots in the legs and lungs, with women at the highest risk of such blood clots receiving the greatest benefit"

More recent evidence suggests that vitamin E may have potential benefits only in certain subgroups of the general population: A trial of high dose vitamin E in Israel, for example, showed a marked reduction in coronary heart disease among people with type 2 diabetes who have a common genetic predisposition for greater oxidative stress.

So, not surprisingly, Peat's ideas are consistent with this, since he suggests Vitamin E for those who think they have a greater predisposition for greater oxidative stress -- namely, those with metabolic stress, iron excess or PUFA poisoning.
You have to look at the larger picture: Even though the cardiovascular death was reduced, no effect on total mortality was seen (4% risk increase with vitamin E). This can only be explained by an increase in non-cardiovascular deaths, and indeed there was a trend of increased cancer death (12% risk increase with vitamin E).

If vitamin E in that study had any of the purported direct anti-estrogen, anti-PUFA-toxicity properties as often claimed, then a clear benefit on cancers, especially breast cancer should have been seen. But there was absolutely no difference, even for breast cancer incidence. That argues against the claimed mechanism of action.

The subgroup analyses showed absolutely no benefit of vitamin E in people with diabetes (often claimed to be caused by PUFAs, iron, high metabolic and oxidative stress), obesity (often claimed to be caused by PUFA excess, high metabolic and oxidative stress) or current smoking (high oxidative stress).

If we want to postulate a population that may benefit from vitamin E in terms of cardiovascular events (but not cancer incidence) in that trial: It would be >65 year old postmenopausal apparently healthy women, that dont smoke, dont take multivitamins, are normal weight, dont take hormonal estrogen therapy, have no diabetes and dont have a family history of heart disease. The benefit of vitamin E in that population may mostly stem for the (vitamin K-antagonizing) blood-thinning property of vitamin E leading to reduced thrombotic events.
@Bukowski, my sense is English may be your second language? I'm not sure, but the things you say (at least in English) don't seem to come out with the nuances I feel you must mean.

For example, you say "This can only be explained by" but a nuanced speaker would say, "There is another explanation for this" (since it's a tacit assumption that the speaker may not have considered all possible explanations).

Similarly, you say "showed absolutely no benefit", or "was absolutely no difference," when a nuanced speaker might say "showed no benefit" or "was not different". The "absolutely" is considered redundant or meaningless (since it's a tacit assumption that opinions are not proved "absolutely").

Other than that, thanks for all the critical thinking!
Thanks, you are right, those things dont add to meaningful information.
Peat said that effect (about cancer, estrogen and PUFA toxicity) was reported in 1960 and then the products changed, and the modern ones act very differently in relation to the quinones, Coq10, etc.
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