Vitamin E Trials: Heart Disease, Cancer, Prostate Cancer and Dementia
What large vitamin E trials found for heart disease, cancer, prostate cancer, dementia and death rates, with the amounts, forms and groups studied, and what official panels concluded.
Content last updated . This page has not been medically reviewed.
Quick answer
Large trials of vitamin E supplements in generally healthy adults did not show that they prevent heart disease or cancer, and some found harm. The US Preventive Services Task Force (USPSTF, 2022) recommends against vitamin E supplements for preventing cardiovascular disease or cancer in community-dwelling, nonpregnant adults. [1] This page is about supplements. Vitamin E in food is different; MedlinePlus says eating vitamin E in foods is not risky or harmful. [2] See Vitamin E for the main profile.
Read the amounts as study amounts, not advice. Trials used different forms (natural, all-rac, alpha-tocopheryl acetate), amounts and groups, so one result cannot be moved to another. See vitamin E forms.
Evidence labels used: no good evidence of benefit, evidence of harm, mixed, insufficient evidence.
The large trials at a glance
| Trial (year) | Who | Vitamin E given | Length | Main finding |
|---|---|---|---|---|
| ATBC (1994) | 29,133 male smokers, Finland | Alpha-tocopherol 50 mg a day [3] | 5 to 8 years | No reduction in lung cancer; more deaths from hemorrhagic stroke [3] |
| HOPE-TOO (2005) | Adults 55+ with vascular disease or diabetes | Natural-source 400 IU a day [4] | Median 7 years | No effect on cancer or major cardiovascular events; higher risk of heart failure [4] |
| Women's Health Study (2005) | 39,876 healthy US women, age 45+ | Natural-source 600 IU every other day [5] | Average 10.1 years | No overall benefit for major cardiovascular events or cancer [5] |
| Physicians' Health Study II (2008, 2009) | 14,641 US male physicians, age 50+ | 400 IU every other day [6] | Mean 8 years | No effect on cardiovascular events, prostate or total cancer; more hemorrhagic stroke [6][7] |
| SELECT (2011) | 34,887 men, US, Canada, Puerto Rico | 400 IU a day of all-rac-alpha-tocopheryl acetate [8] | 7 to 12 years planned | More prostate cancer with vitamin E [8] |
Heart disease and stroke
In HOPE-TOO, vitamin E did not prevent cancer or major cardiovascular events and may increase the risk of heart failure, in people with vascular disease or diabetes. [4] In the Physicians' Health Study II, vitamin E had no effect on major cardiovascular events, and was associated with an increased risk of hemorrhagic stroke (hazard ratio 1.74). [6] In the Women's Health Study there was a significant 24% reduction in cardiovascular death, but no overall benefit for the main outcomes; the authors said the data do not support recommending vitamin E for cardiovascular or cancer prevention in healthy women. [5] A single secondary result among many is weaker evidence than the main outcomes. MedlinePlus (US) says high-dose alpha-tocopherol supplements might increase the risk of hemorrhagic stroke. [2]Cancer and prostate cancer
ATBC found fewer prostate cancers among men given alpha-tocopherol, and a 32% decrease in the later prostate analysis, but the authors said other controlled trials were needed. [3][9] Later trials did not confirm it. In the Physicians' Health Study II, vitamin E had no effect on prostate cancer (hazard ratio 0.97) or total cancer. [7] In SELECT, 620 men in the vitamin E group developed prostate cancer versus 529 on placebo, and the authors concluded supplementation significantly increased risk in healthy men. [8] Absolute increase: 1.6 cases per 1,000 person-years. [8]SELECT's later blood analysis suggested higher plasma alpha-tocopherol may interact with selenomethionine supplements to raise high-grade prostate cancer risk. [10] That is an observational finding inside a trial and does not settle the cause.
Dementia and memory
| Question | What the source found | Strength |
|---|---|---|
| Mild cognitive impairment turning into Alzheimer disease | 769 people, 2,000 IU vitamin E a day for 3 years: no benefit [11] | No good evidence of benefit |
| Mild to moderate Alzheimer disease | 613 US veterans, 2,000 IU alpha-tocopherol a day: slower decline in daily function than placebo [12] | Promising but limited (one trial) |
| Cochrane review of vitamin E in Alzheimer disease and mild cognitive impairment (2017) | No evidence it prevents progression from mild impairment, or improves cognition; moderate-quality evidence from a single study that it may slow functional decline [13] | Mixed |
| Cognitively healthy people | Low-certainty evidence of no effect on dementia incidence for vitamin E, alone or with selenium [14] | Insufficient evidence |
Anyone with memory loss should work with their care team. The 2,000 IU trial amounts are above the 1,500 IU (natural) or 1,100 IU (synthetic) that MedlinePlus gives as the highest safe level for US adults. [2] EFSA's upper level is 300 mg a day for EU adults, and it does not apply to people taking anticoagulants or antiplatelet medicines. [15] Do not stop or change prescribed medicines because of this page.
All-cause death
A 2005 meta-analysis of 19 trials (135,967 people) found 9 of 11 high-dose trials (400 IU a day or more) had an increased risk of death from any cause; the authors cautioned the trials were often small and in people with chronic disease, so the finding may not apply to healthy adults. [16] It is a pooled analysis from before several later trials, so read it with the table above.What official panels say
USPSTF (2022, US) found moderate certainty of no net benefit of vitamin E supplements for preventing cardiovascular disease or cancer. [1] MedlinePlus says whether vitamin E can prevent cancer, heart disease, dementia, liver disease and stroke needs further research. [2] EFSA reviewed bleeding, cardiovascular disease and prostate cancer when it kept its upper levels in 2024, and named blood clotting and bleeding risk as the critical effect. [15]Frequently asked questions
Does vitamin E prevent heart attacks?
Not in the large trials we read: HOPE-TOO, the Women's Health Study and the Physicians' Health Study II found no overall reduction in major cardiovascular events. [4][5][6]
Does vitamin E cause prostate cancer?
SELECT found more prostate cancer in the vitamin E group (hazard ratio 1.17), but the Physicians' Health Study II did not. The groups, forms and amounts differed. [8][7]
Does vitamin E help Alzheimer disease?
One trial found slower decline in daily function with 2,000 IU a day of alpha-tocopherol; the Cochrane review called the evidence moderate-quality from a single study. This is a decision for the person's care team. [12][13]
Is vitamin E in food also a concern?
MedlinePlus says eating vitamin E in foods is not risky or harmful; the concerns above are about high-dose supplements. [2]
What does the USPSTF recommend?
It recommends against vitamin E supplements to prevent cardiovascular disease or cancer in community-dwelling, nonpregnant adults. [1]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Who should ask first
Ask a clinician or pharmacist before using vitamin E if you take blood thinners or aspirin, have had a stroke, have heart failure or prostate cancer risk, are pregnant (MedlinePlus says high levels may raise birth-defect risk, which needs more research [2]), or have surgery planned. Neither kidney nor liver disease was addressed in the trials we read. See medication interactions, supplements before surgery, heart disease evidence, cancer prevention trials, and vitamins and cognition.
References
- Mangione CM et al. 2022. Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. PMID 35727271. Read 2026-10-23.
- MedlinePlus (US National Library of Medicine). Vitamin E. Review date 1/21/2025. Read 2026-10-23.
- 1994. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The New England journal of medicine. PMID 8127329. Read 2026-10-23.
- Lonn E et al. 2005. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA. PMID 15769967. Read 2026-10-23.
- Lee IM et al. 2005. Vitamin E in the primary prevention of cardiovascular disease and cancer: the Women's Health Study: a randomized controlled trial. JAMA. PMID 15998891. Read 2026-10-23.
- Sesso HD et al. 2008. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. JAMA. PMID 18997197. Read 2026-10-23.
- Gaziano JM et al. 2009. Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians' Health Study II randomized controlled trial. JAMA. PMID 19066368. Read 2026-10-23.
- Klein EA et al. 2011. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. PMID 21990298. Read 2026-10-23.
- Heinonen OP et al. 1998. Prostate cancer and supplementation with alpha-tocopherol and beta-carotene: incidence and mortality in a controlled trial. Journal of the National Cancer Institute. PMID 9521168. Read 2026-10-23.
- Albanes D et al. 2014. Plasma tocopherols and risk of prostate cancer in the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Cancer prevention research (Philadelphia, Pa.). PMID 24961880. Read 2026-10-23.
- Petersen RC et al. 2005. Vitamin E and donepezil for the treatment of mild cognitive impairment. The New England journal of medicine. PMID 15829527. Read 2026-10-23.
- Dysken MW et al. 2014. Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial. JAMA. PMID 24381967. Read 2026-10-23.
- Farina N et al. 2017. Vitamin E for Alzheimer's dementia and mild cognitive impairment. The Cochrane database of systematic reviews. PMID 28418065. Read 2026-10-23.
- Rutjes AW et al. 2018. Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life. The Cochrane database of systematic reviews. PMID 30556597. Read 2026-10-23.
- Turck D et al. 2024. Scientific opinion on the tolerable upper intake level for vitamin E. EFSA journal. European Food Safety Authority. PMID 39099617. Opinion abstract read on PubMed (publisher page returned HTTP 403). Read 2026-10-23.
- Miller ER et al. 2005. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Annals of internal medicine. PMID 15537682. Read 2026-10-23.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.