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breast health, evidence based medicine, Supplements, vitamins

Does vitamin E help breast pain?

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.

Waiting for my mammogram...

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.

Verdict?

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.

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Discussion

13 thoughts on “Does vitamin E help breast pain?

  1. I went through pretty much the same as you last year. Painful breasts, find a lump, get poked and prodded by the hordes, mammogram, ultrasound and, finally, fine needle aspiration. Diagnosis of fatty necrosis. Huge sighs of relief all round.

    Doesn’t help the pain, though.

    I’m already on a large number of assorted pain meds for other health issues which do help the pain; and have been caffeine-free for years (in fact, I have to avoid all stimulants because of one of my heart problems; so no chocolate, even) which hasn’t made one iota’s difference to the pain.

    Thank you for doing the research. I am severely limited in the supplements I am allowed to take because of my other medications so I play safe and don’t take any. I’m glad to know that I’m not missing out on anything useful!

    Posted by Tigger_the_Wing | February 8, 2012, 3:49 am
    • I was told by the radiologist at Advanced Radiology and also given a print-out that said to take d-alpha tocopheryl form of vitamin E and NOT to take the dl-alpha tocopheryl form. The latter is the synthetic form of vitamin E and can actually make breast cysts worse. I have just started taking it so I can’t comment on the effectiveness yet.

      Posted by Jennifer | September 21, 2013, 5:23 am
  2. Don’t just stand there, do something.

    Prescribe me a diet and an exercise regimen. Give me a sense of participation, if not control.

    Inject me with something. Anything. No pain, no gain.

    My first year in practice, I debunked the diverticulitis diet recommendations (avoid popcorn, etc.) at the cost of undermining the recommendations of every referring provider and taking away the patient’s sense they could effect their health through effort. Later I realized it was the referring providers who needed the update, not the patients. Avoiding popcorn, after all, is harmless.

    Posted by Chris Porter | February 8, 2012, 8:29 am
  3. My $0.02:

    In my reading of the studies, the evidence is pretty solid that vitamin E decreases the number of ischemic strokes while increasing the number of hemorrhagic strokes – therefore increasing the mortality rate. Within my narrow field (metabolic neurobiology), vitamin E has a nasty side-effect of increasing conversion of free Fe3+ to Fe2+, which increases the rate of the Fenton reaction, and therefore production of hugely damaging hydroxyl radicals. On the balance, I consider vitamin E (and, even more strongly, vitamin A) supplements to be quite dangerous, and would not recommend them to anyone.

    (Most other supplements are useless but not dangerous. Iron, magnesium and vitamin B6 supplements might be somewhat problematic for post-menopausal women, but evidence is still weak. Calcium, well, you know yourself what a mess that field is. The only supplement that might have a marginal-to-moderate benefit is DHA; but I believe that might regress to the mean as more studies gather. Exercise and a diet rich in protein and vegetables seem to be the only way to go.)

    Posted by M. | February 12, 2012, 2:13 pm
  4. I would like to know why there is really bad pain in my breast and the doctors act like it is nothing but this pain takes my breath away when it hits me it was in my left breast and not it is in my right after getting a biopy done on my right side so if you can tell me why the doctor told me to take vitamen E . and over the counter pain meds ????? I already take the vitamen E and c. and b 5 b 12 iron ; calcem citrate ; evening primrose ; and it still is pain ful very sharp pains . I strongly do not feel and or think that anyone is listening to me . for crying out loud you don’t just have pain for no reason what so ever is there anyone out there that can help me at all ??????? Also I have lost a lot of weight after having surgery and yes my boobs are big and they were big before i lost the weight ! ! ! ! ! ! ! I need help and can’t seem to get any help at all I eat fish after having Bariatric surgery I eat a lot of fruit and vegtables also well as fish and that so please is there anyone out there that can help me ? I am disabled now with a spianl cord injury and need help thank you kindly for your time & understanding

    Posted by penny | May 13, 2012, 10:26 pm
  5. I would like to know if you have looked at acupuncture to alleviate breast pain. Thanks.

    Posted by Victoria Sonstroem | May 28, 2012, 9:05 am
  6. Im not sure if this will help anyone but wanted to share my experience. Eight years ago I had a benign cyst removed. The scar tissue was irritating at times but didnt really give me any issues. Three years ago in the same breast I found another cyst. Again they determined benign. This cyst however started to grow to the size of a walnut and with the growth significant pain. After dealing with the pain for about 6 months I recently started taking 1 vitamin E supplement a day and within 3 days the pain went away. I have only been taking for a week now and plan on trying for 3 months before electing surgery again. I would like to add that I am 41, in shape, excercise 3x a week, I take no medications (not even aspirin for aches) and have absolutely no other health conditions. If interested I will update in 3 months.

    Posted by Michelle Haasz | January 31, 2013, 4:52 am
    • I would love to hear about your results.

      Posted by Cas M | February 22, 2013, 2:15 pm
    • I would be interested. I am due form my annual mammogram, which made me think about my breasts. There are less cysts/lumps than ever. The only changes in my lifestyle are that I started taking a multivitamin, and separate Vitamin D/calcium tablet -almost daily. I have, also, reduced my intake of caffeine. -a little, sustituting more de-caff.

      Posted by Regina swindal | June 7, 2013, 3:12 am
    • I would also love to hear about your results, I am in the same situation

      Posted by Antonia | June 3, 2014, 12:58 am
  7. I also had good results taking Vitamin E for breast pain. I took 400 iu/ day. When the pain subsided I stopped taking the E. It DID stop my pain at the time.

    That was 15 years ago. Pain is back. I have fibrocystic breast disease.

    Not sure now at 51, I want to risk a stroke from the E.

    Posted by Kate B. | January 9, 2014, 2:22 am
  8. I thought I would look this up because I have breast pain so bad that I cannot lower my arms to my sides. I had to walk with my arms out away from my body.I was told after all the test were done to cut out some caffeine and take a vitamin E. In three days I was able to walk with my arms down and I still take the E everyday. I didn’t know a vitamin could be harmful !!!

    Posted by Donna | February 24, 2014, 3:21 pm

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