Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status

Cases of enhanced anticoagulant effect in response to high-dose vitamin E supplementation have been reported among patients taking oral anticoagulants. Although a vitamin E-vitamin K interaction was proposed to underlie this effect, it has not been systematically investigated in adults with normal b...

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Published in:The American journal of clinical nutrition 2004-07, Vol.80 (1), p.143-148
Main Authors: BOOTH, Sarah L, GOLLY, Ines, SUCHECK, Jennifer M, ROUBENOFF, Ronenn, DALLAL, Gerard E, HAMADA, Koichiro, BLUMBERG, Jeffrey B
Format: Article
Language:English
Subjects:
Adult
Adults
Aged
Aged, 80 and over
alpha-Tocopherol - blood
Antioxidants - administration & dosage
Antioxidants - pharmacology
Arthritis, Rheumatoid
Biological and medical sciences
Blood Coagulation - drug effects
Dietary Supplements
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
Humans
Male
Middle Aged
Nutritional Status
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Vitamin E
Vitamin E - administration & dosage
Vitamin E - pharmacology
Vitamin K - blood
Vitamins
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Summary:Cases of enhanced anticoagulant effect in response to high-dose vitamin E supplementation have been reported among patients taking oral anticoagulants. Although a vitamin E-vitamin K interaction was proposed to underlie this effect, it has not been systematically investigated in adults with normal baseline coagulation status. The objective was to study the effect of 12 wk of supplementation with 1000 IU RRR-alpha-tocopherol/d on biochemical measures of vitamin K status in men and women not taking oral anticoagulants. Vitamin K status, which was assessed with the use of plasma phylloquinone concentrations, the degree of under-gamma-carboxylation of prothrombin (proteins induced by vitamin K absence-factor II, PIVKA-II), and the percentage of undercarboxylated osteocalcin (ucOC), was determined in 38 men and women with rheumatoid arthritis (study A) and in 32 healthy men (study B) participating in 2 independent, 12-wk randomized clinical trials of vitamin E supplementation (1000 IU/d). Mean (+/- SD) PIVKA-II increased from 1.7 +/- 1.7 to 11.9 +/- 16.1 ng/mL (P < 0.001) in study A and from 1.8 +/- 0.6 to 5.3 +/- 3.9 ng/mL (P < 0.001) in study B in response to 12 wk of vitamin E supplementation. An increase in PIVKA-II is indicative of poor vitamin K status. In contrast, the other measures of vitamin K status (ie, plasma phylloquinone concentration and percentage of ucOC) did not change significantly in response to the supplementation. High-dose vitamin E supplementation increased PIVKA-II in adults not receiving oral anticoagulant therapy. The clinical significance of these changes warrants further investigation, but high doses of vitamin E may antagonize vitamin K. Whether such an interaction is potentially beneficial or harmful remains to be determined.
ISSN:0002-9165
1938-3207
DOI:10.1093/ajcn/80.1.143