Tocopherol Excess in Man; Creatinuria Associated with Prolonged Ingestion

A N ESSENTIAL role for vitamin E in human metabolism has yet to be established. However, its well documented indispensability to certain functions in experimental animals, and its seeming relationship to metabolic ab-normalities described in patients apparently depleted of this substance suggest that vitamin E is probably also required by man. Although tocopherol therapy generally fails to benefit patients with muscular dystrophy, the creatinuria that accompanies the reversible muscular disorders characteristic of vitamin E deficiency in other species may have a clinical counterpart. In a recently reported case of fatal biliary cirrhosis, ’ creatinuria and pento-suria were associated with an absence of meas-urable tocopherols in the blood serum, and were temporarily alleviated by tocopherol ad-ministration. Similarly, vitamin E therapy has inhibited creatinuria in infants with cystic fibrosis of the pancreas and biliary atresia.2 The present report describes an instance in which the experimental ingestion of an excess of tocopherol over a period of three months by an apparently normal subject was associated with a transitory creatinuria in the absence of other significant adverse clinical or laboratory effects. CASE REPORT A 41-year old physician ingested a total of 296 g of alpha tocopherol over a period of 93 days, in the follow