Vitamin E (natural d-alpha vs synthetic dl-alpha tocopherol) and healthy aging

What 2 graded rows on vitamin e (natural d-alpha vs synthetic dl-alpha tocopherol) agree on for healthy aging, and where they differ. Counted side by side, never averaged.

Consensus finder Rows from the Vitamin E (natural d-alpha vs synthetic dl-alpha tocopherol) page, reviewed Oct 21, 2026 How it decides

What the rows agree on

Each block and row is one graded row from the Vitamin E (natural d-alpha vs synthetic dl-alpha tocopherol) page, with its PubMed record.

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Heart3 Healthy aging2

Supplement

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Vitamin E (natural d-alpha vs synthetic dl-alpha tocopherol) and healthy aging

2 rows · 170,854 people

They agree: both rows found a worse outcome.

Worse

Improved

Each block is one evidence row, sized by how many people it enrolled, with its grade inside. Red: a worse outcome.

Grade B× 1
Grade C× 1

Rows: 2
Trials: 2; At least: a review without a trial count
People: 170,854; Pooled reviews may count some twice

What the rows share

From the rows

The best-graded row, grade B, is a randomized trial of 34,887 people (2011) and found a worse outcome.

The rows run from 34,887 to 135,967 people, published from 2005 to 2011: 1 pooled review and 1 single study.

The rows

2 worse

Grade BProstate outcome in healthy men (SELECT extended follow-up) · Worse
RCT · n 34,887 · 2011 · Relatively healthy men aged 50+ (black men) or 55+ in the US, Canada and Puerto Rico
400 IU/day vitamin E · Planned follow-up of 7 to 12 years
Prostate cancer was 17% more common with vitamin E than placebo (HR 1.17; 99% CI 1.004-1.36): 620 vs 529 men, an absolute increase of 1.6 per 1000 person-years.
Row on the Vitamin E (natural d-alpha vs synthetic dl-alpha tocopherol) page · PubMed 21990298 (opens PubMed)
Grade CAll-cause mortality with high-dosage vitamin E · Worse
Meta-analysis · n 135,967 · 2005 · Participants in 19 clinical trials of vitamin E alone or with other vitamins or minerals
16.5 to 2000 IU/d (median 400 IU/d) · Varied across trials
Trials of ≥400 IU/d showed 39 more deaths per 10,000 persons (95% CI 3 to 74); low-dosage trials showed no increase. Risk rose with dosages above 150 IU/d.
Row on the Vitamin E (natural d-alpha vs synthetic dl-alpha tocopherol) page · PubMed 15537682 (opens PubMed)

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