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Vitamin E Oils Suspected in Vaping Respiratory Illness Investigation

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  • New York State health officials are investigating whether vitamin E oil in cannabis-containing vaping products may be to blame for a recent surge of respiratory illnesses.
  • So far, over 200 cases of illness have been suspected to be a result of a component found in vaping-related products.
  • While investigators say it is too early to determine if vitamin E acetate is a singular or contributing factor in the illnesses, when inhaled, they believe the lungs are poorly equipped to handle the substance.

New York State Investigation

State Health Officials in New York are investigating whether vitamin E oil in vaping products had lead to an uptick in respiratory illnesses.

As of Thursday, state health departments across the country have logged more than 200 illnesses suspected to be linked to a substance known as vitamin E acetate. Notably, two fatality cases have been reported in Illinois and Oregon.

In a news release, the New York Department of Health said it is investigating 34 reported cases of “severe” pulmonary illnesses in the state. In every case, individuals used at least one vape product containing cannabis, but each of the individuals also reported using other types of vape products, too.

The New York Department of Health then tested both cannabis and nicotine vaping products, while also continuing to test the purity of state-approved marijuana products. 

The report states that while vitamin E acetate was not found nicotine-based products that were tested, it was found in cannabis-based products, despite vitamin E acetate not being an approved additive by the New York State Medical Marijuana Program.

The health department now suspects some of the products tested are counterfeits of medically-approved marijuana.

Still, health officials have yet to conclude whether or not vitamin E acetate is causing the illnesses.

The investigation has prompted the Food and Drug Administration’s involvement. It is now testing over 100 samples from across the country, hypothesizing there may be other contributing substances such as THC, synthetic cannabinoids, opioids, pesticides, and nicotine. 

“No one substance, including vitamin E acetate, has been identified in all of the samples,” the FDA said in a statement.

The situation has been made all the more difficult because while states must report certain infectious diseases to federal authorities, they are not required to report illnesses suspected to be caused by vaping. 

“We urge the public to be vigilant about any vaping products that they or any family members may be using and to immediately contact their health care provider if they develop any unusual symptoms,” Health Commissioner Dr. Howard Zucker said in the statement. “In general, vaping of unknown substances is dangerous, and we continue to explore all options to combat this public health issue.”

What is Vitamin E acetate?

As its name suggests, the compound is derived from vitamin E, which can be found in foods like almonds and canola oil. It is typically used as a vitamin supplement and has been associated with improved wound healing and reduced scarring, though studies have not found any evidence to support such claims.

While Vitamin E acetate is safe to ingest or use on the skin in products such as creams, its safety is much less clear when used as an oil meant to be inhaled.

In 13 cannabis-contaminated samples submitted from the New York cases, researchers found “very high levels” of vitamin E acetate, with some samples containing up to 50% of the oil.

Recently, health officials have noticed a rise in the number of lipoid pneumonia cases. Lipoid pneumonia is a disease in which immune cells collect excess fat not normally stored in the lungs. Those cells may then initiate an inflammatory response that could hinder oxygen’s ability to get into the bloodstream. 

That can then lead to a host of respiratory problems, including coughing, shortness of breath, or weight loss. It could also lead to a series of gastrointestinal issues such as nausea, vomiting, or diarrhea. 

Past studies have confirmed that oil inhalation can cause lipoid pneumonia, as oils are high in fat. Though inhaled as a vapor, it will eventually return to its oil state in the lungs, which function poorly to remove any substances other than gas. 

The only other major way in which to acquire lipoid pneumonia involves physical injury causing fat to seep into the lung, so health officials do not suspect this form to be at play with the cases involved in the investigation.

Past cases have also suggested vitamin E oil’s contribution to lipoid pneumonia. In 2000, a woman was diagnosed with the lung illness after having inhaled marijuana oil with the vitamin.

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