It was breast pain (mastalgia) that led me to find the irregular area in my breast on Friday. I gave up caffeine for less than 24 hours – no evidence to support its effectiveness in reducing cysts and one small study suggests it can improve pain, although other studies say no. I went with the “other studies” as they had far more patients and seemed for better quality. Anyway, I didn’t care about the pain, just what it led me to find.
I had my mammogram (both a screening and spot compression views of the irregular area). Fortunately all negative. Also, about a billion (okay, maybe six) people felt my breast and all have come to the same conclusion as I have: a cyst or breast tissue. Anyway, feeling somewhat reassured (although I still need an ultrasound of the area, booked for Friday) and knowing that ditching caffeine was not supported by science, I wondered just how effective was the vitamin E, also recommended, at reducing breast pain/cysts?
Well, I am as unimpressed with vitamin E as quitting caffeine.
There are 5 studies in the world literature addressing vitamin E and breast pain/cysts (and they aren’t large studies and only two show a positive effect!).
Three studies (all randomized, double blinded, placebo-controlled) say no effect from vitamin E on breast pain/cysts:
- 105 women, 400 mg dose (I can only assume that means units, but don’t know for sure, by Meyer EC in Surgery, 1990)
- 62 women, 600 IU dose (Ernster VL in Surgery 1985)
- 150 women, 150, 300, 600 IU dose (London RS, Obstet Gynecol 1985)
Two randomized double-blinded placebo-controlled studies say it is beneficial:
- 150 women, 200 mg tested (again, I guess this means 200 IU, published in Breast K 2009)
- 62 women 1,200 IU a significantly higher dose than all other studies (a pilot study, Pruthi S, Alt Med Review 2010). Of note, while this study reported a statistically significant difference in breast pain, when you look at the numbers, the pain score went down by one point. Therefore, if the worst pain was 6 it went down to 5 (on a scale of 0 to 10). Average pain reduced by a score of 1.5, although the placebo arm had a 0.64 reduction in average pain, so really compared with placebo, average pain also was also only reduced by 1 point on a scale of 0-10. Hard to know if this is clinically significant.
Is there a down side to vitamin E? Well, some studies suggest high dose vitamin E (> 400 IU/day) could be associated with increased mortality, although other studies have questioned this association. It’s hard to know.
No evidence to support the use of vitamin E for reducing cysts.
What about pain?
Well, in doses of 600 IU or less it’s 3 studies say no and 1 study says yes. One study with a dose of 1,200 IU a day says yes, but the reduction in pain scores is underwhelming (going from a pain score of 6 to 5). I would argue that is not a clinically significant improvement. Also, the safety profile of 1,200 IU a day of vitamin E is not established.
When faced by the panic of a lump, well, I jumped at everything offered. We are just so desperate to do something. Anything. Desperation is the mother of vulnerability. But now that I have pulled myself together, I’m ditching the vitamin E. The evidence is just too weak to support it and the idea of taking 1,200 IU a day with unanswered questions regarding safety for a minor improvement in pain, well, that’s not worth it for me.
Although I would like to leave you with this one parting thought.
Isn’t it amazing how something can be so poorly studied yet so universally recommended?
It just boggles my mind. Really.