Journal of Dietary Supplements最新文献

{"title":"Curcumin Supplementation as a Preventive Strategy Against Tamoxifen-Induced Nonalcoholic Fatty Liver Disease in ER+ Breast Cancer Patients: A Triple-Blind Randomized Placebo-Controlled Trial.","authors":"Simin Hemati, Fatemeh Mehrabinejad, Mohammadreza Elhaie, Nadia Najafizade","doi":"10.1080/19390211.2025.2465412","DOIUrl":"10.1080/19390211.2025.2465412","url":null,"abstract":"<p><p>Tamoxifen, a common treatment for estrogen receptor (ER)‑positive breast cancer, is associated with an increased risk of developing nonalcoholic fatty liver disease (NAFLD). Curcumin, a compound in turmeric, has shown potential in mitigating liver disease progression. This study aims to evaluate the efficacy and safety of curcumin in preventing NAFLD in breast cancer patients initiating tamoxifen therapy.In this 6‑month triple‑blind, randomized placebo‑controlled trial, 44 ER+ breast cancer patients scheduled to receive tamoxifen were assigned to receive either curcumin (500 mg daily) or a placebo. NAFLD grade was assessed via ultrasound at baseline and after 6 months. Laboratory values and demographic data were collected, and adverse effects were monitored. Statistical analyses was performed using SPSS version 16.Data of a total of 44 participants (22 participants in each group, mean age: 47.1 ± 6.0 years) were analyses. There were no significant differences between the placebo and curcumin groups regarding the demographic and baseline laboratory values. At study completion, significantly fewer patients in the curcumin group showed an increased NAFLD grade compared to the placebo group (13.6% vs. 54.5%; p = 0.03). Additionally, the prevalence of NAFLD grade ≥ 2 was lower in the curcumin group (13.6% vs. 40.9%; p = 0.04). No adverse effects related to curcumin were reported. Curcumin supplementation demonstrated a protective effect against tamoxifen‑induced NAFLD in ER+ breast cancer patients, suggesting its potential as a prophylactic adjunct to tamoxifen therapy. Larger multi‑centric trials are warranted to confirm these findings.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"274-283"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creatine Supplementation in Combat Sport Athletes: A Narrative Systematic Review.","authors":"Damoon Ashtary-Larky, Darren G Candow, Scott C Forbes, Leila Hajizadeh, Corey A Peacock, Douglas Kalman, Tony Ricci, Jose Antonio","doi":"10.1080/19390211.2025.2539880","DOIUrl":"10.1080/19390211.2025.2539880","url":null,"abstract":"<p><p>Creatine is a widely studied ergogenic aid known for its effects on muscle performance and body composition. However, its impact or utility for athletes involved in combat sports, who often aim to reduce body mass to meet a specific weight class, remains unclear. To conduct a narrative systematic review of peer-reviewed published studies that examined the effects of creatine supplementation on body mass, body composition, muscular strength, power, endurance, fatigue, recovery, and cognitive performance in combat sport athletes. A comprehensive search was conducted in multiple public databases up to March 2025. Databases searched included PubMed, Scopus, Web of Science, and Google Scholar. Studies evaluating creatine supplementation in combat sports (eg wrestling, judo, taekwondo, boxing) were included. Outcomes assessed included changes in body mass and body composition, performance metrics, and markers of fatigue and recovery. Nineteen studies met the inclusion criteria. Creatine supplementation increased body mass, especially during longer-term interventions (≥6 wk) or when combined with structured resistance training. Creatine supplementation also increased measures of body mass and fat-free mass (FFM). Muscular power and maximal strength outcomes improved significantly after creatine supplementation, particularly in studies utilizing short-duration, high-intensity exercise protocols. Creatine supplementation did not influence measures of sport-specific endurance, recovery or fatigue. No serious adverse effects were reported across studies for creatine supplementation. Creatine supplementation enhances body mass, FFM, muscle strength and power in combat sport athletes. Given its safety and efficacy profile, creatine supplementation remains a promising supplement for supporting some aspects of athletic performance in combat sports.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"844-869"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food Supplements Marketed Worldwide: A Comparative Analysis Between the European and the U.S. Regulatory Frameworks.","authors":"Andrea Zovi, Antonio Vitiello, Michela Sabbatucci, Umberto Maria Musazzi, Gianni Sagratini, Carlo Cifani, Sauro Vittori","doi":"10.1080/19390211.2024.2389397","DOIUrl":"10.1080/19390211.2024.2389397","url":null,"abstract":"<p><p>In recent decades, a new health paradigm emerged which increasingly places diet and nutrition at the center of citizens' healthcare. The resulting evolution of the food market has prompted country governments to adapt their regulatory frameworks to ensure product safety and preserve the health of citizens. Dietary supplements (DS) are products which are increasingly occupying a significant market share in Western countries, contributing to meeting the nutritional and physiological needs of a large portion of the global population. Food supplements must be safe for use by the final consumer who has access to the global market, but currently they are framed by a different legislation worldwide. This search aimed of comparing the legislative frameworks currently in force in the European Union (EU) and in the United States (USA), the two main markets in which DS are purchased, to focus on the strengths, similarities and possible shortcomings, against the backdrop of a global market which often transcends the regulatory barriers of individual countries. Both in the EU and the USA, food supplements are governed by specific regulations to ensure their safety and quality. However, the regulatory approaches differ sharply in some cases. It is expected that more and more operators will launch new DS in Western markets. As a result, it is crucial for competent authorities in food safety to deepen and develop additional regulatory tools aimed to control and safeguard the DS market.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"25-40"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroprotective Effects of Folic Acid: A Review.","authors":"Bidemi Emmanuel Ekundayo, Olusola Bolaji Adewale, Tajudeen Olabisi Obafemi","doi":"10.1080/19390211.2024.2436842","DOIUrl":"10.1080/19390211.2024.2436842","url":null,"abstract":"<p><p>Folic acid also known as folate and vitamin B9 is of the class of B complex vitamins. It is crucial for homeostatic function of the biological system and is not endogenously produced. It is medically approved for the treatment of megaloblastic anemia. Neurological conditions describe a class of disease conditions that affect the brain, spinal cord and nerves impacting several important functions such as cognition, movement, emotion and sensation. They can arise from a number of causes which may include one or more of genetic factors, infections, injuries, toxins and degenerative process. Homocysteine, a neurotoxic amino acid converted by folic acid has been identified in the pathology of many neurological conditions while folic acid on the other hand has been investigated multiple times for its neuroprotective function and mechanism. Folic acid is involved in the neutralization of homocysteine to its nontoxic form. This article highlights some of the reports of the neuroprotective effect of folic acid against homocysteine toxicity, neurodegenerative diseases, neuropsychiatric conditions, fetal and neonatal neuronal health.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"345-363"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phytochemicals in <i>Ginkgo biloba</i> for Age-Related Eye Disease - A Review.","authors":"John Osilama Thomas, Ifeoluwa Margaret Idowu","doi":"10.1080/19390211.2025.2560365","DOIUrl":"10.1080/19390211.2025.2560365","url":null,"abstract":"<p><p><i>Ginkgo biloba</i> is a rich source of phytochemicals and antioxidants derived from plant extracts, and its therapeutic potential is increasingly recognized in ocular health. Eye diseases such as glaucoma, diabetic retinopathy (DR), and age-related macular degeneration (AMD) are among the leading causes of vision impairment worldwide, with current therapies often failing to counteract oxidative stress and retinal neurodegeneration. <i>Ginkgo biloba</i>, a medicinal plant used for centuries in Traditional Chinese Medicine (TCM), contains diverse flavonoids and terpenoids with potent antioxidant, anti-inflammatory, and neuroprotective properties. However, the specific contributions of these phytochemicals to ocular protection and the optimization of delivery strategies for standardized plant extracts remain insufficiently explored.</p><p><p>This review examines evidence on standardized <i>Ginkgo biloba</i> extracts (GBEs) for ocular health, highlighting their ability to reduce oxidative damage, regulate inflammation, and protect retinal cells in major eye diseases. We hypothesize that standardized GBEs, when formulated <i>via</i> advanced ocular drug delivery systems, could enhance retinal bioavailability and efficacy, serving as viable adjunct or alternative therapies for glaucoma, DR, and AMD. The objectives are to summarize current knowledge on the phytochemical composition of <i>Ginkgo biloba</i> and its mechanisms of ocular protection, critically evaluate preclinical and clinical evidence of its use in eye diseases, and explore novel formulation and delivery strategies to overcome the bioavailability challenges of these plant extracts.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"907-938"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the Flavonoid Diosmin on Post Exercise Muscle Soreness - A Randomized Controlled Trial.","authors":"Fabiana Cristina Barreiros da Cunha, Giovana Bobato Cortez, Isabela Mayer Pucci, Mariana Martins Silva, Jayne Maria Borim, Mariana M Bertozzi, Jeferson L Jacinto, Thacyana T Carvalho, Andreo F Aguiar, Juliano Casonatto, Eros de Oliveira Júnior, Waldiceu Aparecido Verri, Sergio Marques Borghi","doi":"10.1080/19390211.2025.2547167","DOIUrl":"10.1080/19390211.2025.2547167","url":null,"abstract":"<p><p>Delayed-onset muscle soreness (DOMS) is hypothesized to be due to reversible damage at the cellular level, affecting both recreational and professional athletes. For elite athletes, the prevalence of DOMS is more pronounced during the beginning of the sports season, when they return to the reality of exercise training after a period of inactivity, thus potentially having a negative impact on performance. Era evaluate the effects of supplementation with the flavonoid diosmin (DSM) on athletic performance and DOMS-related symptoms in the pre-season of a futsal team from the Brazilian women's league. A randomized, double‑blind and placebo‑controlled crossover trial was conducted in 15 professional futsal female athletes. They received one daily capsule of DSM or placebo (750 mg) for 3 days as a preventive regimen, and an intense dynamic exercise protocol (concentric/eccentric actions) was applied to the lower limbs. Evaluations on the effects of DSM on athletic performance and DOMS‑related muscle soreness, blood oxidative stress, recovery of strength capacity, and postural balance were performed during a 48 h‑period. Although DSM had no greater effect than placebo on athletic performance, it presented trivial‑to‑moderate effects in other parameters without statistical significance, with the best effects including containing oxidative damage (through reduction in lipid peroxidation) (<i>p</i> = 0.3857, EF = 0.72) and muscle soreness upon climbing stairs (<i>p</i> = 0.7136, EF = 0.50) at the 48^th hour, and in preventing the reduction of muscle strength (<i>p</i> = 0.6784, EF = 0.61) and improving unipedal postural balance in contralateral leg (<i>p</i> = 0.7446, EF = 0.69) at the 24th hour. Althought not significant in the ANOVA, the flavonoid DSM seems effective for futsal athletes as a dietary supplement for some variables evaluated. These include preventing muscle soreness, oxidative stress, impairment of muscle strength, and postural balance postexercise, which is desirable to promote better results in sporting terms. Clinical trial registry number: NCT06125002.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"977-998"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Boswellic Acids Reduce Systemic Inflammation in Patients with Moderate COVID-19 Through Modulation of NF-κB Pathway.","authors":"Sepideh Barzin Tond, Sara Abolghasemi, Seyyed Hossein Khatami, Sajad Ehtiati, Tayebe Zarei, Somayyeh Shateri, Somayeh Mahmoodi Baram, Sahar Yarahmadi, Soudabeh Fallah, Farzaneh Salmani, Mohammad Reza Shahmohammadi, Nasim Khajavirad, Abbas Tafakhori, Ali Riazi, Saeed Karima","doi":"10.1080/19390211.2025.2468484","DOIUrl":"10.1080/19390211.2025.2468484","url":null,"abstract":"<p><p>Prevention and/or management of the dysregulated immune response in patients with COVID-19 is expected to help in the treatment of COVID-19. Boswellic acids (BAs) have great therapeutic potential because they have anti-inflammatory and immunomodulatory effects. Here, we aimed to investigate the mechanism of action of a BA formulation, Inflawell syrup, which was previously shown to be effective in reducing disease symptoms in patients who suffer from mild to moderate COVID-19. Patients with mild to moderate COVID-19 were treated with either Inflawell containing boswellic acids or a placebo for 14 days. The serum levels of inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-8, IL-1α, IL-17, IL-1Ra, and Monocyte Chemoattractant Protein-1 (MCP-1), were measured both at study onset and on day 14 after treatment started. In addition, to further investigate the signaling pathway(s) underlying the changes in cytokine levels, we evaluated the expression of tumor necrosis factor receptor 1 (TNFR1), tumor necrosis factor receptor 2 (TNFR2), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) p65 mRNAs and phospho-inhibitor of nuclear factor kappa B (IκB) and IκB proteins. In our study, a significant decrease in the serum levels of IL-1α (<i>p</i> < .009), IL-8 (<i>p</i> < .04), TNF-α (<i>p</i> < .0001), and MCP-1 (<i>p</i> < .007) was detected in patients treated with Inflawell. Additionally, our data revealed a decrease in phospho-IκB protein levels (<i>p</i> < .02) and NF-κB p65 mRNA levels (<i>p</i> < .002), whereas the amount of IκB protein (<i>p</i> < .01) in the Inflawell group was significantly greater than that in the placebo group. Furthermore, despite the decreasing trend in the expression of TNFR1 and TNFR2 in the Inflawell group, there was no statistically significant difference compared with that in the placebo group. In general, treatment with Inflawell syrup led to a lower level of proinflammatory cytokines and a decrease in the activity of the TNF-α/NF-κB signaling pathway.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"365-381"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Probiotic Supplementation with <i>Lactiplantibacillus plantarum</i> Strains on Gastrointestinal Tract Function - A Randomized Controlled Trial.","authors":"Ruma G Singh, Fumiki Aoki, Maria Rodriguez-Palmero Seuma, Meritxell Aguilo, Motohisa Washida, Jordi Espadaler-Mazo, Huda Al-Wahsh, David C Crowley, Najla Guthrie, Malkanthi Evans, Marc Moulin, Erin D Lewis","doi":"10.1080/19390211.2025.2507610","DOIUrl":"10.1080/19390211.2025.2507610","url":null,"abstract":"<p><p>Gastrointestinal (GI) dysfunction in older adults may be associated with gut microbiota activity or composition changes. <i>Lactiplantibacillus plantarum</i> strains KABP031 and KABP032 have been shown to beneficially influence the frequency of bowel movements (BMs) and nutritional status in older adults. This study investigated the efficacy of this probiotic blend on defecation/stool consistency, GI symptoms, nutrient uptake, and mental well-being in older adults with occasional constipation. Subjects 50-85 years of age with infrequent BMs, straining during defecation and hard stool consistency, were randomized to either the Probiotic or Placebo group for 84 days. Changes in bowel function, GI symptoms, and stress were assessed by the daily bowel habits diary, Gastrointestinal Symptoms Rating Scale (GSRS) and the Perceived Stress Scale (PSS), respectively. Improvements in bowel movement frequency (<i>p</i> = 0.027, 95% CI: 0.22-2.39) and stool consistency (<i>p</i> = 0.002; 95% CI: 0.32-1.30) with the Probiotic were significantly greater compared to Placebo after 42 days. There was also significant decrease in the percentage of weekly BMs with a Bristol Stool Scale score of ≤2 with Probiotic vs. Placebo (-28.6% vs. -3.2%, <i>p</i> < 0.001). A significantly lower proportion of participants in the Probiotic group reported moderate stress following 84 days of supplementation compared to the Placebo group (9.4% vs. 37.9%, <i>p</i> = 0.013). Further, within-group significant improvements in stool consistency and BM frequency from baseline at days 42 and 84 were observed with the Probiotic (<i>p</i> < 0.001), but not the Placebo. The findings suggest the probiotic blend alleviated constipation symptoms and improved the mental well-being in older adults with occasional constipation.</p><p><strong>Clinical trial registry number and website: </strong>NCT04147923; https://clinicaltrials.gov/study/NCT04147923.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"549-570"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The National Center for Natural Products Research (NCNPR) at 30: A Legacy of Pioneering Research in Natural Products and Dietary Supplements.","authors":"Bill J Gurley, Amar G Chittiboyina, Mahmoud A ElSohly, C Ryan Yates, Bharathi Avula, Larry A Walker, Shabana I Khan, Ikhlas A Khan","doi":"10.1080/19390211.2024.2410758","DOIUrl":"10.1080/19390211.2024.2410758","url":null,"abstract":"<p><p>Since its establishment in 1994, the National Center for Natural Products Research (NCNPR) at the University of Mississippi has made notable contributions to the field of natural product research, coinciding with the passage of the Dietary Supplement Health and Education Act. Over the past three decades, the Center has focused on studying plants, herbs, and other natural materials for applications in medicine, agriculture, and nutraceuticals, particularly in the area of botanical dietary supplements. NCNPR scientists have been actively engaged in developing and improving quality control measures to help ensure the safety of dietary supplements in response to a growing market. The Center's research efforts have led to its designation as a U.S. Food and Drug Administration Center of Excellence, reflecting its role in advancing scientific understanding of natural products. Through collaborations with various stakeholders and regulators, NCNPR has contributed to shaping the regulatory landscape for botanical dietary supplements, highlighting both their potential health benefits and associated risks, such as product adulteration. The Center's influence is also evident internationally, as demonstrated by its annual International Conference on the Science of Botanicals, which will mark its 26th year in April 2025. This overview outlines NCNPR's role in supporting research, regulation, and safety in the natural products field.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"193-218"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Subtle Iron Deficiency During Vitamin E Treatment For Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Maren C Podszun, Ahmad Samer Alawad, Shilpa Lingala, Nevitt Morris, Wen Chun A Huang, Yaron Rotman","doi":"10.1080/19390211.2025.2465414","DOIUrl":"10.1080/19390211.2025.2465414","url":null,"abstract":"<p><p>Vitamin E is an effective treatment for metabolic dysfunction-associated steatohepatitis (MASH) but associated with hemorrhagic complications when used for other indications. We aimed to determine the risk of developing iron deficiency during treatment of metabolic dysfunction-associated steatotic liver disease (MASLD) with vitamin E. Iron status was monitored prospectively in 20 people with MASLD treated with 200 - 800 IU/d vitamin E (https://clinicaltrials.gov/study/NCT01792115). To gain mechanistic insights liver histology, hepatic gene expression, hepatic 4-hydroxynonenal, haptoglobin genotype and plasma vitamin E levels were assessed. We found iron deficiency to occur in 11/20 subjects (55%) after a median 11 weeks (range 4-13) of vitamin E treatment, and anemia to occur in 6 of the 11 (30% of study population) after 23 weeks (16-36). Ferritin (84.5 ± 85.2 to 47.8 ± 54.9μg/L, <i>p</i> < 0.001) and mean corpuscular volume (MCV, 86.2 ± 4.9 to 84.3±4.3fL, <i>p</i> = 0.003) significantly decreased, with a concomitant rise in red-cell distribution width (RDW, 13.4 ± 1.3 to 14.4 ± 1.9%, <i>p</i> = 0.003). A gastrointestinal bleeding source was found in 75% of subjects with complete work-up. Iron deficiency occurred in all diabetics vs. 47% of non-diabetics (<i>p</i> 0.007). Iron deficiency risk was not associated with cirrhosis, platelet count, prothrombin time, haptoglobin genotype, or plasma vitamin E level. Changes in hepatic gene expression and oxidative stress were suggestive of an extrahepatic effect. Iron deficiency resolved with appropriate care even with continued vitamin E treatment. We conclude that occult gastrointestinal bleeding and iron deficiency were frequently observed during vitamin E treatment, possibly reflecting an effect on platelet function. Close monitoring is warranted during the first months of treatment, especially in diabetics and subjects with risk factors for gastrointestinal bleeding.</p>","PeriodicalId":15646,"journal":{"name":"Journal of Dietary Supplements","volume":" ","pages":"284-299"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}