Wednesday, March 5, 2014

Vitamins Don't Work - Enough is Enough

When I was in medical school, our nutrition researchers taught us that vitamins didn't do much good and only made expensive urine (where the water soluble ones end up).  We did learn about the classic vitamin deficiencies like scurvy, beriberi, rickets, etc.  But the evidence that healthy people should take vitamins was marginal at best.

Is our search for immortality the reason that we turn to the pill or potion?  Do we continue to look for the fountain of youth that is linked to the Spanish explorer Juan Ponce de Leon.  (Though de Leon was really looking for the isle of Bimini rather than Florida and there's no mention historically that he was searching for perpetual youth.)  Yet the myth and tourist site remain popular.

So why do we turn to vitamins, supplements, anti-oxidants, nutriments, etc?  William Osler commented that “the desire to take medicine is perhaps the greatest feature which distinguishes man from animals.” Also Osler taught his medical students, "One of the first duties of the physician is to educate the masses not to take medicine."

Osler's concerns have been valid over the years, but often have been drowned out by errant science and the hype of the vitamin and supplement industry.

There have been prominent scientists who have been strong proponents of vitamins and supplements. Linus Pauling discovered the structure of ascorbic acid (vitamin C) and won the Nobel Prize in Chemistry.  Unfortunately he became a "true believer" in vitamin C and other vitamins: "Pauling is largely responsible for the widespread misbelief that high doses of vitamin C are effective against colds and other illnesses. In 1968, he postulated that people's needs for vitamins and other nutrients vary markedly and that to maintain good health, many people need amounts of nutrients much greater than the Recommended Dietary Allowances (RDAs). And he speculated that megadoses of certain vitamins and minerals might well be the treatment of choice for some forms of mental illness. He termed this approach "orthomolecular," meaning "right molecule." After that, he steadily expanded the list of illnesses he believed could be influenced by "orthomolecular" therapy and the number of nutrients suitable for such use. No responsible medical or nutrition scientists share these views."

Finally in modern times we now have a better view and summary of the ineffectiveness and harms of vitamins and mineral supplements published in the December 13th Annals of Internal Medicine:  "Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force"

The bottom line is that vitamin and mineral supplements for healthy individuals don't work and some may be harmful.  The editorial in the same issue concludes:  "β-carotene, vitamin E, and possibly high doses of vitamin A supplements are harmful. Other antioxidants, folic acid and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases. Although available evidence does not rule out small benefits or harms or large benefits or harms in a small subgroup of the population, we believe that the case is closed— supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful. These vitamins should not be used for chronic disease prevention. Enough is enough."

Recently Dr. Oz had a disastrous take-down in a Senate hearing about his "magical" claims of dietary supplements.  This is reported with bitingly epic humor is this epic video.


13 comments:

  1. I see you're in Seattle; what are your thoughts on Vitamin D supplementation? Virtually everyone up here in the PNW is deficient, summer and winter. Do you believe there is merit in supplementing?

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    1. Thanks for bringing this up. Folks in northern climates may well be Vit D deficient so supplementation with 600IU daily is often recommended. Also, aging seniors at risk for osteoporosis are often recommended to take Vit D3 along with calcium - especially women. Vitamin D has relatively low toxicity and may be safe even up to 2000IU daily. But I wouldn't recommend doses higher than that.

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  2. There have been hundreds of published studies demonstrating the efficacy of Vitamin C, Vitamin D3, Vitamin B-12, Vitamin K2, Magnesium, Fish Oil, DHA, Resveratrol, Quercetin, ginger, curcumin, boswellia serrata, astaxanthin, glucosamine, chondroitin, MSM,and many others, In fact, many herbal supplements are the historic and pharmacologic building blocks and antecedents of many patented drugs. For instance, French lilac was a folk remedy for diabetes, which became the chemical basis for metformin, now considered a wonder drug.
    Why haven't these same folks taken a forceful and principled stand against the advertising and sale of insufficiently tested pharmaceutical drugs, which have caused infinitely more suffering and harm than any vitamin or supplement? Take a look at the list of withdrawn pharma drugs on Wikipedia and the dire consequences suffered by those who took them. Google problems with Vioxx, Premarin, Nexxium, Avandia, statins, Fosamax, etc., etc., if you want want to read some truly hair-raising stuff.
    37 •Share ›

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    1. I agree that we take too many drugs - and also too many supplements. There are indeed many studies about herbal medications. My sister-in-law was treated for malaria in the Philippines during WWII with a tea made from the cinchona bark (quinine).

      However, the point in my post is that the evidence for healthy people needing supplements is minimal. The answer for most of us is a healthy life style, and not looking for answers from supplements, drugs, etc.

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  3. Inhibitory effects of curcumin on tumorigenesis in mice.J Cell Biochem Suppl 1997;27:26-34
    Jeong CH, Bode AM, Pugliese A, et al. [6]-Gingerol suppresses colon cancer growth by targeting leukotriene A4 hydrolase. Cancer Res. 2009 Jul 1;69(13):5584-91.
    Chow HH, Garland LL, Hsu CH, et al. Resveratrol modulates drug- and carcinogen-metabolizing enzymes in a healthy volunteer study. Cancer Prev Res (Phila). 2010 Sep;3(9):1168-75.
    . Tsujioka T, Miura Y, Otsuki T, et al. The mechanisms of vitamin K2-induced apoptosis of myeloma cells. Haematologica. 2006 May;91(5):613-9.
    Furumoto K, Inoue E, Nagao N, Hiyama E, Miwa N. Age-dependent telomere shortening is slowed down by enrichment of intracellular vitamin C via suppression of oxidative stress. Life Sci. 1998;63(11):935-48.

    ....A miniscule sampling of available research (generated by a 5 minute web search.

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    1. Yes, there are thousands of studies showing some intermediate measurable effects of all kinds of drugs and supplements. But this doesn't mean they are proven to be effective in prolonging health or life in healthy people.

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    2. Dr. deMaine, I respect your opinion and your blog.
      However, since I've had cancer twice, the most recent bout being stage 4 (10 years in remission), I'm not sure if you would/could define me as a "healthy person". At any rate, I have been taking at least 15-20 supplements (not daily, but in loose rotation) throughout those 10 years, and attribute my survival and health to them, as I was told by the oncologist that my chances were slim.. But here I am to sing the praises of resveratrol, vitamin C, quercetin, fish oil, vitamin D3, curcumin, ginger, astaxanthin, and the the many others I've been taking without any negative effects all those years. I just got back from walking 4 1/2 miles, which I try to do every other day. Maybe I'm extremely lucky, or maybe the placebo effect is so strong it saved my life. But I'm not going to stop taking vitamins and supplements--no matter how much negative press about supplements is periodically disgorged by the medical establishment.
      Thanks for your time.

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    3. Congratulations on being a cancer survivor. I've actually gone through that also and am doing well. I'm truly happy that your regimen in working for you and I wouldn't change a thing!

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  4. Thank you for your kind words and the very best to you.
    We are fellow travelers on this road.

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  5. It all boils down to this. One can't medicate or supplement oneself out of a medical problem one ate oneself into. A case in point is Dr. Pauling. He believed that high intake of ascorbic acid would protect him from heart disease. Must have, because he died from prostate cancer at the age of 93.

    In truth, population studies seem, by design, to be incapable of furnishing definitive answers in terms of telling us how effective supplements can be. Why? Because, biochemically and physiologically, response to therapeutic doses of a chemical of any sort, be it drug or supplement, is highly individualized. In addition, the concentration of trace minerals, fatty acids, amino acids, and vitamins in food varies with soil quality as well as with what was done to the food in the interval between harvest and mealtime. Modern farming, livestock feeding, food processing, and food manufacturing practices have made food quality extremely problematic. So much so that the public feels obliged to chuck down approximately 28 billion dollars worth of supplements. Really, only through individual experimentation can anyone tell whether a supplement is helpful or harmful.

    On a hopeful note, the biochemistry branch of science has furnished some answers where inflammation is concerned. Excerpt from Page 191 of “The Modern Nutritional Diseases: and How to Prevent Them” by Fred and Alice Ottoboni:

    “BIOCHEMICAL LESSON: The significant point is that good health depends on regulating the D5D enzyme. High insulin levels due to dietary sugar and starch and high dietary omega-6 to omega-3 ratios,stimulate the D5D enzyme, and move the biochemical set point from normal toward inflammation. On the other hand, control of dietary sugar and starch, reduction of LA [linoleic acid, an omega 6 FA that is common in US diet in oils such as safflower, grapeseed, soybean, etc, and putatively 'bad' - PHE ed] in the diet, and a daily supplement of fish oil to provide EPA will inhibit the D5D enzyme so that the appropriate amounts of both proinflammatory and anti-inflammatory eicosanoids are produced. Keep in mind that all of the eicosanoids, both the so-called good and bad, are important. The body is designed to use eicosanoids with opposing effects to control vital functions. In a state of optimum health, the good and the bad eicosanoids balance one another.”

    I've experienced the truth of the above. My intake of omega-6 has been excessive for most of my life. As I approached retirement age I began to lose mobility due to leg pains. Fortunately, in November 2009, I heard NIH scientist Bill Lands mention in a lecture that a 28 gram, one ounce serving of peanuts contains 4,000 milligrams of omega-6. I stopped eating peanut butter sandwiches for lunch and my leg pains subsided within two months. A year or so later I noticed that I no longer had gingivitis. More recently, my blood pressure returned to normal (113/58) and my LDL cholesterol dropped about 30mg/dL. Over the past 4 years I've regained much of the strength and stamina I had lost thanks to overly high omega-6 consumption. Isolated incident? Maybe not. I've warned others about excessive omega-6 intake in general and excessive peanut butter intake in particular. A brother-in-law shed his peanut butter habit a few months after I did and reports a dramatic improvement in his health. I've been researching the omega-6 hazard, as I term it, ever since and what I've been finding out paints a grim picture. Google - "David Brown omega-6" for more details.

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  6. I have st 4 breast cancer ++- and find supps help me thrive. Drs and people say i don't look like I'm cancer sick. I took supps of herbs, homeopathics, vits for decades and never needed a dr. I had a remedy for any ailment. It helped me thru all the toxic cancer treatments so far. One thing i found is that biased studies use synthetic lab created supps so they test ineffective. Use only natural forms and learn their names. Your health depends on it. The synthetic chemicals in our products, air, and water is altering our immune system and growing our cancer DNA from over active hormones. Also causing weight gains.

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  7. In 1911 Funk obtained an alcoholic extract of the outer husk of rice which cured beri beri. This was thought to be a vital amine introducing the name vitamine. The "e" was later dropped to read "vitamin".
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