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Old 01-07-2010, 01:31 PM
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Article: Do Vitamins Do Any Good?

Do vitamin supplements really do any good? - By Emily Anthes - Slate Magazine

Quote:
Deciding what to eat for dinner can be mind-bending. How do we keep track of the ever-evolving recommendations for what to put on, and leave off, the plate? Red meat might cause cancer! But don't replace it with tofu—soy concoctions might be carcinogenic, too! Don't even try to figure out where carbs stand this week. And the verdict on coffee, chocolate, and alcohol changes faster than you can order a mocha martini.

Vitamins—with their promise to bridge the gap between the nutrients our bodies need and those they get—have always seemed reassuringly simple: Just pop a multivitamin and let your body soak in those extra nutrients. But not any longer. During the past few years, study after study has raised doubts about what, if any, good vitamins actually do a body. They could even pose some real medical risks.

Half of all American adults take some sort of nutritional supplement. But research on a wide variety of patient populations and medical conditions has failed to find much evidence that multivitamins, the most commonly used of the lot, prevent major chronic diseases in healthy people. The most recent knock came this spring, when a study of more than 160,000 post-menopausal women, published in the Archives of Internal Medicine, found that the all-in-one pills did not prevent cancer, heart attacks, or strokes and did not reduce overall mortality.

Individual vitamins and minerals haven't fared much better under scientific scrutiny, with research debunking some of the reputed benefits of vitamin B6, calcium, niacin, and others. In 2006, the National Institutes of Health convened an independent panel of experts to evaluate the evidence that vitamins could prevent chronic disease. The scientists ultimately issued a report stating that studies "do not provide strong evidence for beneficial health-related effects of supplements taken singly, in pairs, or in combinations."

The news on antioxidants, the darlings of the vitamin menagerie, is even more troubling. These compounds, which include vitamins A, C, and E, selenium, beta carotene, and folate, fight free radicals, unstable compounds thought to damage cells and contribute to aging. But not only do antioxidant supplements fail to protect against heart disease, stroke, and cancer; they actually increase the risk of death, according to a 2007 analysis of research on more than 232,000 people, published in the Journal of the American Medical Association, as well as other studies.

Exactly why they might increase mortality is unclear, but doctors at prominent research institutions—including New York's Memorial Sloan-Kettering Cancer Center and Seattle's Fred Hutchinson Cancer Research Center—have highlighted some unsettling connections between supplemental antioxidants and an increased risk of a variety of cancers. Popping certain kinds of antioxidant pills can feed latent cancers growing in the body, for instance, and reduce the effectiveness of chemotherapy. These observations make a certain intuitive sense, since vitamins and minerals play an important role in the replication of healthy cells—why shouldn't they be doing the same for cancerous cells? (Feeding mice a diet poor in antioxidants, on the other hand, can actually help shrink their brain tumors.) Scientists are also beginning to suspect that the body may actually need free radicals—which help kill cancer cells, ensure optimal immune function, and regulate blood sugar, among other things—so we shouldn't necessarily be mopping them all up.

The list of worrisome findings goes on, but it doesn't seem to have put a dent in the $25 billion supplement industry. Sales are not only robust but rising in the United States. Doctors still recommend multivitamins as part of basic preventative care. Despite the demonstrated risk, as many as 80 percent of cancer survivors swallow a daily dose, according to a study published in the Journal of Clinical Oncology in 2008.
Vitamins have a powerful psychological hold over us. As precautionary health measures go, supplements are easy. Compare the two seconds required to swallow a pill with the constant vigilance necessary to exercise and eat right. And the fact that vitamins are available without a prescription makes them seem safe—even though it probably makes them less so, since they're not regulated by the FDA and manufacturers are not required to prove that they're effective at treating disease.

But the risk-benefit calculus has changed. We know more about the risks, and it's clear that there's also less potential benefit. During the early 20th century, diseases like scurvy and rickets were common until researchers began to isolate compounds in food—which became known as vitamins—that could altogether cure these ailments. It must have been remarkable to see devastating diseases alleviated with common foodstuffs.

During an era when many people legitimately had nutritional deficiencies, placing your bets on a multi might have been reasonable. But today, of course, actual deficiencies are much less common. Our salt, milk, flour, juice, cereal, and more are all fortified with extra nutrients, and a 2009 study published in the Archives of Pediatrics and Adolescent Medicine suggests that most of the kids who end up taking vitamins in the United States today don't actually need them.

If vitamins are useful for anything, it's probably for tapping into our old friend the placebo effect. In a 2008 survey, 38 percent of doctors confessed to recommending vitamins because they believed the pills could promote health purely through the power of positive expectations. Consider a famous 1975 study designed to probe whether vitamin C supplements alleviated colds better than a placebo, an inert lactose tablet. It turned out that it didn't matter much which pill the subjects were actually taking. What mattered was what they thought they were getting: Those who believed they were taking vitamin C had fewer and milder cases of the sniffles than those who believed they were just swallowing lactose. That would be reason enough to pop a supplement—there are worse things than deceiving yourself into better health—if it weren't for the emerging evidence that the pills might be capable of causing real harm.

That's not to say that vitamins aren't important. Vitamins are critical to all sorts of bodily functions, and we have to get them through diet because our bodies can't make them on their own. The Office of Dietary Supplements at the NIH recommends that we get certain levels of a variety of kinds of vitamins, and that recommendation is sound. But encouraging us to get a complete suite of vitamins is not the same as suggesting that we get them by popping a pill.

In fact, the reports littering the ODS site seem to converge upon the same point: There is some good news for supplements, but it's extremely limited. The 2006 NIH panel, for instance, concluded that postmenopausal women should probably take calcium and vitamin D to safeguard their bones; that pregnant women should keep taking folate; and that adults with age-related macular degeneration, an eye disease, should take a combination of antioxidants and zinc. But beyond that, the panel's strongest recommendation was that scientists conduct further research on the risks and benefits of vitamins. For every study that turns up disconcerting vitamin side effects, there seem to be two more that conclude that we simply don't know enough yet about supplements to make evidence-based recommendations.

Until we do, we should stop treating supplements like health candy and more like prescription meds, to be used only when there's a demonstrated need. Doctors should create individualized regimes, tailored to a particular patient's deficiencies. As for the rest of us, we can put the pills back on the shelf and save our cash for one of those martinis.
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Old 01-09-2010, 11:31 AM
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I was wondering what supplements I should start taking since my immune system is down from getting off of my meds (mainly prednisone) and I have been sick for over a month. I just started doing research on what type of supplements to start taking to help my immune system. After reading this though, it is so amazing how people can spin information. I read so many supplements stating to be so benefiscial and I was wondering which ones would actually work. I am kinda back to square one after reading that article.
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Old 01-10-2010, 12:09 AM
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Until we do, we should stop treating supplements like health candy and more like prescription meds, to be used only when there's a demonstrated need. Doctors should create individualized regimes, tailored to a particular patient's deficiencies. As for the rest of us, we can put the pills back on the shelf and save our cash for one of those martinis.
Doctors aren't always the most knowledgeable about supplements - pharmacists are very knowledgeable about this. They are a very underused resource IMO.
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Old 01-10-2010, 01:26 AM
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Interesting language that this article uses...that vitamin supplements "do not prevent disease".

This article is a little too vague to sway my opinion, honestly. There's a lot of "ifs" and "maybes" flying around. I'll still be taking mine
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Old 01-10-2010, 01:38 AM
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Originally Posted by mesalomanic View Post
There's a lot of "ifs" and "maybes" flying around. I'll still be taking mine
I agree.
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Old 01-10-2010, 06:40 AM
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I haven't read the article but after studying plenty of biochem nutrition I will say that a balanced diet is the way to go.
Vitamin absorption, especially from a multivitamin pill, is tricky; it doesn't happen the way we imagine it does, it's never 100%. Some vitamins share the same transporter (imagine a car that can carry only one person at a time from point A to point B), some are absorbed faster because the body needs them asap, some are peed because there is too much of them (Vit. C is the best example), so on and so forth.
I personally never recommend supplements to healthy individuals. Most of the time I recommend them to my HIV+ clients, to alcoholics, to people who smoke, and to people who have deficiencies from one reason or another (absorption issues, etc.).
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Old 01-10-2010, 07:07 AM
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I used to take vitamins everyday...until I realized that when I took vitamins I was actually sick MORE often. Perhaps it is just a coincidence, but I haven't been sick in three years, which is about when I said goodbye to supplements. Eating healthier is the way to go!
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Old 01-10-2010, 09:51 AM
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I've never taken a multi-vitamin, simply because I try to make sure my diet is good so I get all of the nutrients I need that way. They say that's the best.

I do take an assortment of different vitamins like D because here in Washington, we rarely get enough D from natural sources.
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Old 01-10-2010, 10:39 AM
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Originally Posted by all4oldchevys View Post
I've never taken a multi-vitamin, simply because I try to make sure my diet is good so I get all of the nutrients I need that way. They say that's the best.

I do take an assortment of different vitamins like D because here in Washington, we rarely get enough D from natural sources.
^Yup, I take Vitamin D now too. Recently from a stress fracture, my doc checked my Vit D level in my blood and it was low...but now since I've been taking the vitamin I honestly see a difference in my skin, its healthier all the way around I also take a multi-vitamin and Calcium now too...I used to hate taking vitamins, but now its a must for me per my doc
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Old 01-10-2010, 10:41 AM
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I take a multi, since I probably don't eat enough to get a good variety (and I have a milk allergy, which predisposes me to calcium issues)...I figure it's better than nothing.
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Old 01-10-2010, 11:43 AM
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Are there any diary products that you can tolerate? Some people can tolerate skim milk, yogurt (some of the sugar is converted to lactic acid), and some cheeses.

Diary is definitely not the only source of Ca. As a matter of fact they now fortify orange juice, cereals, and soymilk with Ca. Don't forget that you can have Lactaid.

Broccoli, kale, pinto beans, lettuce, sardines, white tuna, and salmon with edible bones are also good sources of Ca.
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Old 01-10-2010, 12:15 PM
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^none Casein is my allergen, and they put it in freakin EVERYTHING (not just dairy)...even most fake cheese! Luckily my allergy is mild, but I can still feel it when I've slipped up. Basically I get cold symptoms and feel very tired/spaced out/down.
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Old 01-10-2010, 03:50 PM
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i take a prenatal still (nursing)...but i have one that is without calcium.

we're testing to see if calcium in synthetic for (ie pills) is causing my friggin' kidney stones.

i get calcium from dairy and other food sources. i'm allergic to all seafood (shellfish and fresh-water) so dairy is my primary source.
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Old 01-10-2010, 04:08 PM
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^ I have kidney stones also and my doctor told me to take magnesium and drink lemonade, the kind with real lemon juice in it. That helps to prevent the formation of kidney stones. They haven't been able to determine what mine are made up of, so for now, that's what I do.
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Old 01-10-2010, 04:10 PM
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I was told the same, plus to cut back on red meat and salt. I know for sure I have calcium oxalate stones, but one they removed they thought could have been uric acid stone; it crumbled when they did the ureteroscopy.
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Old 01-10-2010, 04:42 PM
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Yes.
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Old 01-11-2010, 09:50 AM
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^none Casein is my allergen, and they put it in freakin EVERYTHING (not just dairy)...even most fake cheese! Luckily my allergy is mild, but I can still feel it when I've slipped up. Basically I get cold symptoms and feel very tired/spaced out/down.
You really should do some weight training for your bones!
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Old 01-11-2010, 09:58 AM
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Originally Posted by pianochica View Post
^none Casein is my allergen, and they put it in freakin EVERYTHING (not just dairy)...even most fake cheese! Luckily my allergy is mild, but I can still feel it when I've slipped up. Basically I get cold symptoms and feel very tired/spaced out/down.
Yeah... unfortunately not much you can do but read all labels and stay away from processed foods. Whole Foods (probably other places as well) sells vegan cheese with no casein (of course, it's vegan), give it a shot; mozzarella actually melts!
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Old 01-11-2010, 10:11 AM
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^yup, I've tried that stuff and it's pretty good...unfortunately no Whole Foods in the area where I go to school, so I try to stock up on trips home. The Kroger here did have a different vegan product but it tasted funny...
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Old 01-11-2010, 10:22 AM
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i take a prenatal still (nursing)...but i have one that is without calcium.

we're testing to see if calcium in synthetic for (ie pills) is causing my friggin' kidney stones.

i get calcium from dairy and other food sources. i'm allergic to all seafood (shellfish and fresh-water) so dairy is my primary source.
I hope this helps...

Apparently dietary oxalate is a cause; it's not clear if dietary calcium plays a role in stone formation; there may be a positive correlation between coffee intake and kidney stones.
In a 2002 study (Borghi et al) -- a normal calcium intake, decreased Na and animal protein showed reduced stone formation events compared to low calcium intake.
Williams et al (2001) showed that high intake of dietary calcium decreases the risk of oxalate stones, supplements may increase the risk.

Try to reduce the amounts of oxalates in your diet if you can... High amounts are found in spinach, strawberries, rhubarm, beets, nuts, chocolate, coffee, black tea, cola, beans, soybeans, and beets. Vit. C is a precursor of endogenous (i.e., stuff produced by our bodies) production of oxalates therefore mega-doses of vit. C may hurt you.
Also, oxalate absorption may be blocked by magnesium carbonate or cholestyramine...

I want to add that some individuals are simply predisposed to stone formation (although males more than females), some medications (diuretics, protease inhibitor indinavir), excessive use of Vit. D supplements, and urinary tract infection may increase the risk of stone formation.
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Old 01-11-2010, 10:56 AM
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Alina, you have brought a lot of very useful information to the table. Thanks.
My diet is very high in Oxylates, calcium is a very tricky mineral.
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Old 01-11-2010, 02:07 PM
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Brody,
No problem at all, happy to help (when I have time ).
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Old 01-11-2010, 02:10 PM
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eeeek. Apparently my diet is very high in oxalates never had a kidney stone though...from seeing my friends' experiences, I wouldn't wish them on my worst enemy (ok, maybe on my worst enemy I would, lol...)
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Old 01-11-2010, 02:14 PM
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Originally Posted by aluhall View Post
I hope this helps...

Apparently dietary oxalate is a cause; it's not clear if dietary calcium plays a role in stone formation; there may be a positive correlation between coffee intake and kidney stones.
In a 2002 study (Borghi et al) -- a normal calcium intake, decreased Na and animal protein showed reduced stone formation events compared to low calcium intake.
Williams et al (2001) showed that high intake of dietary calcium decreases the risk of oxalate stones, supplements may increase the risk.

Try to reduce the amounts of oxalates in your diet if you can... High amounts are found in spinach, strawberries, rhubarm, beets, nuts, chocolate, coffee, black tea, cola, beans, soybeans, and beets. Vit. C is a precursor of endogenous (i.e., stuff produced by our bodies) production of oxalates therefore mega-doses of vit. C may hurt you.
Also, oxalate absorption may be blocked by magnesium carbonate or cholestyramine...

I want to add that some individuals are simply predisposed to stone formation (although males more than females), some medications (diuretics, protease inhibitor indinavir), excessive use of Vit. D supplements, and urinary tract infection may increase the risk of stone formation.
I have read all this; my problem is that the only high oxalate foods I really eat is chocolate, and that's really mainly ice cream and in shakes.

My dad has passed a few stones, as has my brother. After I'm done nursing, my nephrologist wants to do a full analysis (I had one done and my calcium level was slightly elevated, but my parathyroid levels were normal). I may have to be put on medications if we can't get these under control. I currently have 6-7 left (4 in one kidney, 2-3 in the other). One is quite large; we did lithotripsy and they think they zapped a few, but we're not sure.

Urologists treat them, but they really don't get into prevention; that's why I'm consulting a nephrologist. I refuse to live in fear; every time I feel a twinge I start worrying. Yeah, this coming from someone who had six unmedicated, natural births.

Kidney stones suck.
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Old 01-11-2010, 02:14 PM
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Yikes! I didn't mean to alarm anyone; some individuals are predisposed to certain conditions, some are not.
Have a balanced diet, drink plenty of water, slow down with soft drinks, don't smoke, get plenty of sleep, don't drive over the speed limit... and you'll live to 150, you'll be ok.
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