MedicinePharmacologyPharmacotherapyClinical PharmacologyPatient SafetyPharmacovigilancePulmonary EmbolismThromboembolism PreventionThrombosisVitamin E DeficiencyVitamin PhysiologyVitamin SupplementationRecurrent Pulmonary EmbolismVitamin E Toxicity
IN A recent editorial on vitamin E therapy, Oski<sup>1</sup>stated: "Fortunately, large doses of this vitamin appear to be tolerated with relative impunity." The purported safety of vitamin E also is repeatedly underscored by physicians in popular health-oriented publications. Wright asserted: "There's never been a case reported of vitamin E toxicity. None of my patients have ever had any problems" (<i>Prevention</i>, February 1978, p 74). This widely held attitude deserves scrutiny because it could pose a major public health concern. I continue to encounter patients with problems that seem to have been caused or aggravated by self-medication with vitamin E (used here to designate the various tocopherols) in high dosages.<sup>2-4</sup>The more serious ones include the following: (1) thrombophlebitis, pulmonary embolism, or both (my series now exceeds 80 such patients, averaging 62 years of age; four had recurrences on resuming vitamin E treatment); (2) hypertension (22 patients), generally
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