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David G. Meyers, MD; Pierre A. Maloley, PharmD; David Weeks, PharmD

Arch Intern Med. 1996;156(9):925-935.

Abstract
As a result of the many scientific and popular press reports of the benefits of antioxidant vitamins (vitamin A, beta-carotene, vitamin E, and ascorbic acid), it is estimated that 40% of the US population is consuming vitamin supplements. The efficacy of these supplements is not yet proved, and some have questioned their safety. Approximately 10 to 15 cases of vitamin A toxic reactions are reported per year in the United States, usually at doses greater than 100 000 IU/d. No adverse effects have been reported for beta-carotene. The frequency of vitamin E toxic reactions is not well delineated, but case reports are few at dosages less than 3200 mg/d. Ascorbic acid toxic reactions are rare at dosages less than 4 g/d. Despite a lack of clinical trial data, it seems that antioxidant vitamins are safe, although prudence might dictate their avoidance by women of childbearing potential, persons with liver disease or renal dysfunction, and those taking certain medications or undergoing specific laboratory tests.

(Arch Intern Med. 1996;156:925-935)

Author Affiliations
From the Departments of Internal Medicine and Preventative Medicine, Kansas University Medical Center, Kansas City (Dr Meyers); and Departments of Pharmacy Practice (Dr Maloley), Internal Medicine (Dr Maloley), and Pharmaceutical Services (Dr Weeks), University of Nebraska Medical Center, Omaha.

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