In 2004 the best available research indicated that supplementation with vitamin E slowed Alzheimer’s disease.  A major clinical trial at the time indicated that taking 2000 IU of vitamin E per day delayed placement in care facilities by several months compared to placebo.  By the way, treatment with selegiline (a type of antidepressant) produced the same effect.  Another study at the time demonstrated that eating a diet high in vitamin E was correlated with higher mental function in men and women aged 65 – 100.  Hence, many were taking high doses of vitamin E and supplementation was the standard of care for Alzheimer’s disease.

However, there were concerns regarding such a high dose of vitamin E as it produced side effects such as potentiating the effects of anticoagulants such as aspirin and Coumadin and increasing bruising and risk of bleeding.  There was also evidence that doses above 1500 IU suppressed immune function as suggested by a study in the Netherlands showing slower resolution of upper respiratory infections in institutionalized elderly.  Other studies at the time (Annals of Internal Medicine, 2005, 142,37-46) indicated that supplementation with vitamin E did not reduce the risk of cancer or major cardiovascular events but did increase the risk of heart failure and mortality.   Finally, treatment did not alter the course on Mild Cognitive Impairment “converting” to Alzheimer’s disease.

Hence, the recommendation was that generally using more than 400 IU of vitamin E was not prudent because the risks were too high.

Fortunately research continued.  The most recent clinical trial of vitamin E showed that treatment of those with mild to moderate Alzheimer’s disease slowed functional decline in activities in daily living (“High-dose vitamin E slowed the decline of people with mild and moderate Alzheimer’s disease,  Journal of the American Medical Association, 2014, 11, 29-30, 33-44).

The study was conducted at 14 VA medical Centers on 613 mostly male participants.  Participants were randomly assigned to receive Vitamin E (20000 IU per day), Namenda, vitamin plus Namenda, or placebo treatments.  Nearly all (97%) were treated with either donepezil or galantamine before and during the study and diagnosed with mild to moderate Alzheimer’s disease.  Over the course of 2.3 years those treated with vitamin E had less functional decline.  Namenda had no effect and, surprisingly, the combination of Namenda and vitamin E had no effect.  There was no increase in mortality as a result of treatment with this high dose of vitamin E.

In short, treatment with high dose vitamin E was effective and did not appear to cause harm.  On the other hand, treatment with Namenda did not have an effect and treatment with Namenda and vitamin E cancelled the benefits. None of the treatments delayed cognitive decline.  Vitamin E or Namenda have no preventative action for those without memory symptoms or for those with Mild Cognitive Impairment.  Apparently the stage of Alzheimer’s disease is an important factor in treatment that is only beginning to be understood.

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