Do Selenium & Vitamin E Increase Prostate Cancer Risk?

Written by Dr. Steve Chaney on . Posted in Issues, Supplements and Health

Should Men Avoid Those Supplements?

 Author: Dr. Stephen Chaney

Vitamin EYou’ve probably seen the headlines saying “Supplementation with selenium and vitamin E increases the risk of prostate cancer.” The authors of the study even said “Men aged greater than 55 should avoid supplements with either vitamin E or Se (selenium) at doses that exceed recommended dietary intakes.”

In a recent “Health Tips From The Professor” I debunked the headlines saying “Omega-3 fatty acids increase prostate cancer risk“.

What about vitamin E and selenium? Is it true that they increase prostate cancer risk? If you are a man over 55, should you be concerned? Should you stop using supplements containing vitamin E and selenium?

Do Selenium & Vitamin E Increase Prostate Cancer Risk?

Previous Studies On Selenium, Vitamin E And Prostate Cancer Risk

The study that generated the initial excitement in the field was the Nutrition Prevention of Cancer (NPC) Trial that ended in 1998 (Clark et al, British Journal of Urology, 81: 730-734, 1998; Duffield-Lillico et al, British Journal of Urology, 91: 608-612, 2003).

That study showed that supplementing men who had low blood levels of selenium with 200 ug/day of selenium decreased their prostate cancer risk by 65%.

It was followed by a second, much larger trial called the Selenium and Vitamin E Cancer Prevention Trial (SELECT) (Lipmann et al, JAMA, 301: 39-51, 2009). It looked at supplementation with 200 ug/day of selenium and/or 400 IU/day of synthetic alpha-tocopherol.

The SELECT study found no protective effect of either selenium or vitamin E on prostate cancer risk, but did suggest that vitamin E might actually cause a slight increase in prostate cancer risk.

The Study That Generated The Headlines

The authors of the study that generated the recent headlines (Kristal et al, Journal of the National Cancer Institute, doi: 10.1093/jnci/djt456, 2014) were attempting to find a simple explanation for the unexpected results of the SELECT study.

They hypothesized that the baseline selenium status at the beginning of the study might have influenced the outcome of supplementation. Kristal et al reanalyzed the data from the SELECT trial, comparing the effect of selenium and vitamin E supplementation in men with low selenium status and men with high selenium status.

However, at face value their data were confusing rather simplifying. They found:

  • Supplementation with selenium had no effect on prostate cancer risk in men with low selenium status, but increased prostate cancer risk by 91% in men with high selenium status.
  • Conversely, supplementation with 400 IU of vitamin E had no effect on prostate cancer risk in men with high selenium status, but increased prostate cancer risk by 63% in men with low selenium status.

Based on this hodge-podge of data, they concluded that “Men aged greater than 55 should avoid supplements with either vitamin E or Se (selenium) at doses that exceed recommended dietary intakes.” That was the statement that generated the headlines. Was that recommendation justified?

What Do Other Experts Say?

There was an editorial evaluation of the paper by some of the top expects in the field in the same journal (Frankel et al, Journal of the National Cancer Institute, doi: 10.1093/jnci/dju005, 2014) that provided thoughtful explanations of the confusing data in the paper by Kristal et al. They examined three questions:

1)     Why did the SELECT study find no effect of selenium supplementation in men with low selenium status, while the earlier NPC trial found a 65% decrease in prostate cancer risk?

  • The authors of the editorial pointed out that the lowest baseline selenium status in the SELECT trial was much higher than the lowest baseline selenium status in the previous NPC trial. In fact the baseline selenium status in the SELECT trial was at a level in which no effect of selenium supplementation would have been expected based on the results from the NPC trial.

The authors speculated that the addition of selenized yeast to animal feed has improved selenium status in the US population to the point where selenium supplementation can no longer be expected to reduce prostate cancer risk.

2)     Why did selenium supplementation increase prostate cancer risk in men with high selenium status, but not in men with low selenium status?

  • The authors pointed out that for selenium there is a very narrow range between sufficient intake and toxicity. The daily value (DV) for selenium is 90 ug/day and the recommended upper limit (UL) for selenium intake is 400 ug/day.

The average selenium intake for adult men in this country is 151 ug/day. That’s just the average. It’s not hard to imagine that adding 200ug/day of selenium to men at the highest selenium intake could move them into the toxic range.

3)     Why did vitamin E supplementation increase prostate cancer risk in men with low selenium status, but not in men with high selenium status?

  • In part, the authors felt that the pure alpha-tocopherol used in the SELECT trial was not optimal. Pure alpha-tocopherol interferes with the absorption of the other naturally occurring forms of vitamin E, such as gamma-tocopherol – which is the form of vitamin E that decreases prostate cancer risk in animal studies.
  • The authors also noted that vitamin E and selenium work together to inactivate free radicals in cell membranes. Vitamin E reduces the free radicals to a chemically unstable intermediate that still has the potential to damage membranes. A selenium-containing enzyme is required to convert that unstable intermediate into a completely harmless compound.

So when vitamin E is present in much higher levels than selenium, as it was in the group with low baseline selenium status, unstable radicals can accumulate and membrane damage can occur. The authors felt that this was the most likely explanation of the increased prostate cancer risk when men with low selenium status were supplemented with high dose vitamin E.

The authors of the editorial had a much more nuanced interpretation of the data reported by Kristal et al. If you read their evaluation carefully you would likely conclude that you should avoid high dose selenium supplements. However, rather than simply avoiding vitamin E supplements, you should choose vitamin E supplements that contain all of the naturally occurring vitamin E forms and contain near DV amounts of selenium.

These recommendations would be a much better fit to the data, but don’t lend themselves to dramatic headlines – so the editorial has been largely ignored by the press.

The Bottom Line:

1)     Ignore the scary headlines about selenium and vitamin E causing prostate cancer. You can continue to use your supplements as long as you choose ones that are well balanced.

2)     Conversely, if you are at risk of prostate cancer, there is no good evidence that supplementation with either selenium or vitamin E will reduce your risk.

3)     The results of this study are fully consistent with my longstanding recommendation to follow a holistic approach to supplementation and to avoid high dose single nutrient supplements.

4)     There is no reason to supplement with 200 ug/day of selenium. If you are already getting good amounts of selenium from your diet, that dosage could be toxic and may actually increase your risk of cancer. Make sure that your supplements have no more than the DV (70 ug) of selenium.

5)     Avoid high purity alpha-tocopherol supplements. Look for vitamin E supplements containing the full spectrum of tocopherols and tocotrienols in addition to alpha-tocopherol. In addition, make sure that your vitamin E supplement also contains selenium at near DV levels.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Groin Pain Relief

Posted April 16, 2019 by Dr. Steve Chaney

What Is The Pectineus Muscle And Why Is It Important?

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

 

Spring Is In The Air

spring floridaI remember as a child we sang “Though April showers may come your way…they bring the flowers that bloom in May…”

Of course, here in Florida we are blessed with flowers all year, but there’s still a lovely feeling that happens in Spring.  It’s still cool enough most days to go out running, and the humidity is still low.  Traffic will soon be easing up as our friends from the north start their trek back home, and daylight savings time is giving us more time to get to the beach for sunset.  Lovely!

Fun Facts About Spring….

  • The earliest known use of the term “spring cleaning” was in 1857
  • The word “spring” has been used for the season since the 16th century
  • The first day of spring is called the vernal equinox
  • On the first day of spring, the sunrise and sunset are about 12 hours apart everywhere on earth
  • Spring fever isn’t just a saying. Experts say the body changes due to the temperature and can cause an upset in your health.
  • The actual start of spring varies from March 19th to the 21st, but it is commonly celebrated on the 21st.

Do you like to garden?  Now is the perfect time to get your gardens planted so you’ll have home grown veggies for the entire summer.  For me, it’s also a great time to do some spring cleaning and get the house in order before the summer closes all the windows and the air conditioning becomes our indoor relief.

But these activities can also cause a strain on muscles, so don’t forget to take care of yourself. If you put too much strain on muscles you haven’t used all winter, you can develop problems and need groin pain relief.

 

A Tiny Muscle Can Cause Groin Pain

groin pain relief pectineusLately I’ve had several clients come in because of groin pain that has their medical practitioners stumped.  Their symptoms are varied, but most complain that it feels like they hit their pubic bone with a rubber mallet.  Ouch!

One client loves to ride her horse, but the pain had prevented that for several weeks. Another was considering selling the motorcycle that she and her husband love because she just can’t sit on it anymore.

Several years ago, I had a male client tell me that he had this same pain and he was told it could be his prostrate causing the issue.  Fortunately, that wasn’t he problem at all.

The muscle that caused all these problems, and a lot more, is the Pectineus.

The Pectineus muscle originates on your pubic bone and inserts into the very top of your inner thigh bone (femur).

You can see the Pectineus and surrounding muscles more clearly by going to https://en.wikipedia.org/wiki/Pectineus_muscle

Most muscles have more than one function, and this is true for the Pectineus.  The function we’ll look at today is called adduction.  It brings your leg in toward midline.  If you think of a soccer player kicking the ball with the inside of his ankle, it was the Pectineus that helped draw his leg in so he could do the shot.

Each of my clients had pain while trying to bring their leg out so they could sit on their horse, or on their motorcycle.  The tight muscle was pulling on their pubic bone and causing a severe strain.

This muscle is easier to have someone else treat it for you because of its location but give it a try and see if you can locate & treat it yourself.

 

Groin Pain Relief

groin pain relief treatmentThe picture to the left is showing an athlete self-treating her adductors.  These muscles, and the Pectineus muscle, all originate at the same point on the pubic bone.  The picture is showing her massaging the middle of the adductors.

To reach the Pectineus, move the ball all the way up to the crease in your leg.  You can do the treatment with a ball, but because of the size of the muscle and its location, it’s easier to do it with your fingertips.

Sit as this athlete is sitting, and even bring your opposite leg up so your foot is flat on the floor.  For example, in this picture, the athlete would bring her right leg up so her right foot is on the floor, and then lean a bit further onto her left hip.  That opens up the area so she can reach a bit easier into the muscle while using her fingertips.

Press into the muscle, being careful to feel for a pulse, and moving if you feel one.  If the Pectineus is in spasm, you’ll know it immediately when you press on it.  If it’s not in spasm, you won’t be able to find it at all.

Remember to stay within your pain tolerance level, this isn’t a “no pain, no gain” situation.  Never go deeper than what feels tender, but not so much that you want to faint. Hold the pressure for 15 seconds. Then let up on the pressure, but keep your fingers in the same place.

Repeat this movement several times. Each time it will hurt less, and eventually it won’t hurt at all.  That’s when the muscle has completely released, and you will have relief from the pain.

It’s as simple as that!

Why stay in pain when it’s so easy to find the muscular source of the problem and eliminate it?

calf cramps remedy bookTreat Yourself to Pain-Free Living (https://julstromethod.com/product/treat-yourself-to-pain-free-living-hardcopy/). It is filled with over 100 pictures and descriptions proven to show you how to find and self-treat muscle spasms from head to foot!

Join the 1000’s of people worldwide who have discovered that tight muscles were the true source of pains they thought were from arthritis, fibromyalgia, and other serious conditions.  You have nothing to lose, and everything to gain by releasing tight muscles.

Treat Yourself to Pain-Free Living is your step-by-step guide to pain relief!

 

Wishing you well,

 

Julie Donnelly

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

julie donnellyAbout The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

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