Vitamin Drinks Risk Serious Harm


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Are Vitamin Drinks a Bad Idea?

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from New York Times

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Free full report below

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I need time to write about so many exciting things I am seeing in my practice, but this is always lurking. Children and athletes are at most risk for growing toxicity from overdosing on supplements. This has yet to be studied. Not just from vitamin drinks but daily vitamins pills too.

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IV Infusion clinics are the rage now popping up all over London. The very luxurious price alone would convince most people that the more they pay, the better it feels. Did it begin in Hollywood? Surely La Jolla will be soon.

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I see so much of the excess. My thoughts are often on the harm of vitamins and supplements and I’ve posted here, here, here, here, here, here, here, here, here, here about their risk to brain, peripheral nerves, heart, hypertension, cancer, interference with chemotherapy and cardiovascular medications, and in some cases risk to every cell of the entire body.

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$18 Billion a year business in the U.S

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This is an $18 billion a year business in the U.S. which explains why, since the 1970’s, Congress shot down the FDA’s authority to regulate dietary supplements and nutrients that could be fortified. Of course, congress restricts and excludes trade of European supplements that have proven scientific value. Usually this would be called unfair trade, but ….

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Forgive me for being superfluous to point out that those who bring in one bottle with 30 ingredients astonishes me. Centrum Silver I’m thinking of you. How much titanium, molybdenum, chromium and zinc do we need every day to go with its toxic doses of B6 and the proven harmful Vitamins A and E? What is so completely lacking in the diet? How easy is this on seniors with reduced capacity to metabolize medications? No studies, thanks.

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I favor several important vitamins for key reasons based on blood work, but known essential supplements seem to lost on many. Zinc is everywhere. This is rarely tested in a patient. Who has ever once tested most things in Centrum Silver? Could the popularity be due to bombardment or with unproven labeling or endless aisles of bottles?

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This is a rich person’s game.Typically female, unless guys are hiding or avoiding them.

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There are those who drag behind them truck loads of large suitcases bursting with expensive supplements. They need to stop the cause of their problems that is in those bags. They may link bags together with cabling like a train or walk back several times to pull in more and more.

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Stop all of them. That is the treatment. That and a long, long drug holiday to wash them out of the system. Eat a basic healthy diet in moderation and always exercise. There is then hope to re-establish equilibrium. Who could swallow that many pills every day and have any room left for food?

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But I digress.

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The Report – free full text.

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An examination of the nutrient content and

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on-package marketing of novel beverages.

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Risks

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46 novel beverages tested

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“there is little evidence that consumers stand to benefit

from the micronutrients most commonly found in these products.”

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But aiyee!!! the problems.

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At long last, after billions spent on vitamin drinks, the risks are addressed by Valerie Tarasuk, lead author of the study. She is nutrition science professor at the University of Toronto faculty of medicine. I quote extensively from the New York Times but recommend the entire article.

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“A nationwide study carried out by the National Institutes of Health in 2012 found that Americans who take vitamins and supplements were already getting large amounts of nutrients from their food, and on top of that they had the lowest prevalence of vitamin deficiencies to begin with. The study found that supplement use put these people at increased risk of potentially excessive consumption of folic acid, calcium, iron, zinc, magnesium and vitamins A, C and B6.”

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 “…for much of the general population today, there is no scientific justification for a high intake of vitamins and minerals, said Mara Z. Vitolins, a registered dietitian and professor of epidemiology and prevention at Wake Forest Baptist Medical Center.”

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“When consumed in excess, some water-soluble vitamins like B and C are excreted in the urine [unless toxic to nerves and kidneys, those of you who develop nerve pain and kidney stones from them]. But fat soluble-vitamins – including A, D, E and K – accumulate in tissues, posing potential risks.”

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“These fat soluble vitamins are very stable,” she said. “They’re not released in the urine. If you are over-consuming them, you can raise your levels gradually over time and get into trouble with liver function. You have to be very careful with them.”

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Authors should warn be even more cautious when you lose weight, the fat and that giant stash must somehow get out or what harm will they all cause next?

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“Data from clinical trials have highlighted clear risks from excess. A large study published in JAMA in 2009, for example, looked at clinical trial data on more than 6,000 heart disease patients who were treated daily with either B vitamins or placebo over a seven year period. The study found that those who were given folic acid and B12 had higher mortality and cancer rates.”

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“In 2012, a review of 78 clinical trials involving 300,000 people that was published in the Cochrane Database found that antioxidant supplements like beta carotene, vitamin A and vitamin E actually increased mortality. A year later, the United States Preventive Services Task Force concluded that there was “limited evidence” that taking vitamins and minerals could prevent cancer and cardiovascular disease.”

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“The task force noted that two clinical trials had found “small, borderline” reductions in cancer incidence in men who took multivitamins. But the group also said there was good evidence that high doses of antioxidants could cause harm.”

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No one could ever be funded to study the untold combinations of a single bottle that contains 30 ingredients. Studies require placing humans at risk long term, not a quick look at test tubes or a few mice.

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The majority who have finances for these products are often among the best fed in the world if not the the most prosperous.

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If you have read this far, you are not the person lumbering to push these truckloads of supplements ahead like Sisyphus.

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Know hope.

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That readers will read.

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Is there any hope with congress?

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Do not overlook the A, B, C’s

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Balancing the harms, the staggering 90% less atrophy has been shown in areas typically harmed by Alzheimers in the OPTIMA study (Oxford Project to Investigate Memory and Ageing) at Oxford University, March 2013, when they looked at persons with mild cognitive impairment (MCI).

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They looked at brain MRI changes in 156 volunteers before and after two years after placebo vs certain doses of B vitamins. No one has tested these doses long term for toxicity. I would never recommend their dose of B6 that has known toxicity to brain and peripheral nerves, see my post here. And they hold a patent on this vitamin regimen, making the protocol potentially suspect.

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It has been shown a few years before, that size of the hippocampus tends to predict Alzheimers to some extent.

 

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We know that those with Major Depressive Disorder and those with chronic low back pain have been shown to develop brain atrophy and memory loss. It would seem essential to test these vitamins again on those groups and replicate the study on mild cognitive impairment, with placebo controlled double blind testing. Again, caution, B6 can be toxic.

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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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Vitamins and Herbs – Risks and Benefits


Most doctors have little if any training in vitamins and supplements

except as they relate to their specialty.

My field of neurology concerns itself with metabolic and nutritional diseases more than most areas of expertise, and I have an interest in several vitamins because of research related to major causes of mortality in the United States.

During the period I taught at a cancer center, I was concerned that research protocols may be misleading as these supplements were not accounted for, however since that time in the mid 90’s, I’m glad that public interest has pushed this field into the fore.  Major cancer centers now have active research in Complementary and Integrative Medicine (CAM) because there are risks and benefits, and some have significant herb-drug interactions as discussed below.

Check your vitamins and supplements for toxicity

Because of the growing science on toxicity, usefulness, and drug interactions, if you use vitamins, review each one carefully with your physician and with the websites listed in the column on your right. Some “vitamins” are simply brand names that have over 20 different vitamins, minerals and various ingredients.  This means you must review each one for current research benefits and risks.

At special risk for vitamin deficiencies are those who have highly restricted diets, abdominal resection, intestinal conditions, colitis, Celiac Disease, gastric bypass, HIV, or the elderly.

Pregnant women have special needs that are essential not only for their own health but to reduce the risk of neurological defects in the fetus.  It is essential in their case to work closely with their obstetrician, especially if morning sickness prevents them from taking their daily supplement.

Resources

One of the best resources I have found is Memorial Sloan Kettering Cancer Center’s Herbs and Botanicals, also linked on the column at right.  Their website is updated frequently with an excellent review of the literature.  It is hosted by a senior physician who has specialized in the field for decades and is actively involved in research at their center as well as NIH.

MD Anderson Cancer Center’s Complementary/Integrative Medicine Education Resources website andColumbia University’s Rosenthal Center for Complementary and Alternative Medicine are two others, but there are other resources on the web and books that are excellent.

Recipe for Rum Soaked Salmon with Apple Ginger Puree is found here.

VITAMINS & SUPPLEMENTS

Vitamin D has become a major research topic in recent years.  It may play a more important role than any listed below.   I have written separately on it and its controversy in greater detail.  Please refer to the last post by scrolling down.

Fish Oil

Omega 3 Fish Oils are polyunsaturated fatty acids that are essential for health yet cannot be made by the body.  Unless you eat several servings per week of fatty fish or wild salmon, not farmed salmon, it is one of the most important supplements that any adult of any age can take.  They are needed for building cell membranes in the brain but our body does not make them.   Fish oil helps your lipid profile by reducing triglycerides as much as 45%.  It reduces platelet clotting, lowers risk of heart attack and cardiac arrhythmia, and is an important anti-inflammatory reducing pain for many particularly those with arthritis.  One of thebest references on Omega 3 Fatty Acids is by  Dr. Frank Sacks, Professor of Cardiovascular Disease Prevention, Department of Nutrition, Harvard School of Public Health.   He mentions high doses “are used to treat depression. New studies are identifying potential benefits for a wide range of conditions including cancer, inflammatory bowel disease, and other autoimmune diseases such as lupus and rheumatoid arthritis.”

One high quality fish oil, Lovaza, has been approved by the FDA and is prescription only.  Fish oil and cod liver oil available over the counter should be checked for adequate dosages of EPA and DHA that will vary with your needs as determined by your lipid profile, and should be purified to remove cholesterol, dioxin, PCB’s and other pesticides.

Co-Enzyme Q10 is also called CoQ10.  CoQ10 is present in every cell of the body which is why it is also called ubiquinone.  It is important in the electron transport chain to produce intracellular energy.

Statins deplete CoQ10. Vitaline’s CoQ10 product has been used in NIH funded trials for cardiovascular, neurological and brain disorders. Two mitochondrial disorders have been shown to benefit from Co-Q10: migraine and Parkinsons Disease.

My preferred manufacturer is Vitaline because of their research with NIH which requires that they validate and verify dosages.  Their website discusses other advantages and gives guidance on dosages that have shown benefit for various conditions. They offer a discount of 25% if you request scheduled delivery every 3 months.  Use the code code DEF25.  Their product is in the form of wafers that are about the size of a quarter and are very easy to break into 2 or 4 with your hands.

Vitamin B supplements in the elderly may help reduce the risk of dementia and B12 deficiency may result in neurological conditions such as peripheral neuropathy, dementia, hematologic and psychiatric disorders, Subacute Combined Degeneration of spinal cord & brain, increased fracture risk, and may increase the risk of cardiovascular diseases.  A good B complex vitamin is not likely to harm and may benefit.    The best source of all is food:  leafy green vegetables, beans and peas.

Thiamine (Vitamin B1) in high doses of 300 mg per day may reduce kidney disease in type 2 diabetes and may prevent early diabetic cardiomyopathy (heart disease).  As many as 70% to 90% of people with diabetes, both type 1 and type 2, are thiamine deficient.  The research is still a little early to draw firm conclusions.  It is being done by Charity Diabetes UK which finds that thiamine works by helping protect cells against the harmful effects of the high blood sugar levels.”

Vitamin A is associated with a 45% risk of hip fracture.  There are four major adverse effects of high levels: birth defects, liver abnormalities, reduced bone mineral density that may result in osteoporosis, and central nervous system disorders.

Vitamin E may actually increase mortality and there are significant risks to its use including increased risk of some cancers.  Several studies were reviewed by one of the foremost science writers, Jane Brody, in the New York Times on March 23, 2009.  It does not reduce the risk of cardiovascular disease, stroke, dementia, mild cognitive impairment, and there is no evidence that it slows the progression of macular degeneration.  In thePhysicians’ Health Study II it has been shown to actually increase the risk of hemorrhagic stroke since it decreases the clotting tendency of blood.

Vitamin C was recently shown to markedly increase the growth of cancers. It’s healthy for them too.  It blunts the effect of cancer drugs by as much as 30 to 70% depending upon the drug tested.

Zinc may prevent the absorption of copper which is necessary for the brain and spinal cord thus resulting in progressive neurological conditions.  Herb-drug interaction reduces the bioavailability of some antibiotics, tetracycline and fluoroquinolones.  Intake of 100-300 mg/day may result in chronic toxicity including copper deficiency, depressed immune function, headache, chills, fever, and fatigue.  It concentrates in the prostate and consumption of more than 100 mg per day may increase risk of prostate cancer.

It may be useful for tinnitus and for short term use to reduce symptoms of the common cold when used topically or in lozenges

HERBS & BOTANICALS

Don’t forget seeds, beans and whole grains that help digestion and keep the system moving!

This is a very brief summary of a few of the more commonly used herbs.  Please refer to Memorial Sloan Kettering Herbs and Botanicals website for detailed information on risks and benefits.

Arnica – a topical anti-inflammatory may help sprains and osteoarthritis.

Aloe Vera – apply immediately after sunburn or burning the skin to prevent blister formation

Chamomile – calming sedative, may use for intestinal colic or gas

Cat’s Claw – anti-inflammatory activity may be caused by the inhibition of TNF-alpha production.  It may be useful for refractory oral ulcers of unknown etiology in persons with HIV/AIDS that have not responded to other known remedies.

Echinacea may shorten the duration of common cold, useful in sinusitis, and respiratory infections.  Because of the lack of standardization of various products, I recommend a high quality organic liquid product by HerbPharm. Avoid use in autoimmune conditions, Multiple Sclerosis, HIV/AIDS.  “Echinacea was shown to stimulate phagocytosis, enhance mobility of leukocytes, stimulate TNF and interleukin 1 secretion from macrophages and lymphocytes, and improve respiratory activity… both in vitro and in vivo.”

Goldenseal is anti-inflammatory, antimicrobial with activity against pathogens such enterotoxigenic E. coli and V. cholera that may be useful for bacterial sinusitis and respiratory infections.   Warning it may prolong the QTc interval in persons with heart disease or those on methadone and it is contraindicated in persons with hypertension.  A high quality organic liquid product is made by HerbPharm.

Medicinal Marijuana is a vast subject. I would be happy to schedule time to discuss its medical use with you. Refer here for some of the known research and patient information.

Red Yeast Rice, a naturally occurring statin, the same as Lovastatin, often used in China.   Make sure your doctor knows this and monitors liver function.  Statins may cause severe muscle and joint pain that may potentially lead to rhabdomyolysis (sudden death of muscles), kidney failure, vasculitis, lupus-like syndrome, and many other symptoms, however most people tolerate them without side effects and they have dramatically reduced the incidence of heart attacks and stroke.  They may also reduce the risk of dementia including Alzheimer’s type dementia.

Turmuric (Curcumin) – may alleviate irritable bowel syndrome and ulcerative colitis.  There is a suggestion of improved cognitive performance from epidemiology studies but studies show no benefit for Alzheimer’s Disease.  Avoid use if you have gallstones.  It may inhibit the action of some chemotherapy drugs, such as used for breast cancer, but may be beneficial for certain cancers and other chemotherapy drugs.

Wheat grass– a natural source of vitamins and minerals (Chlorophyll, Vitamins A, C, E, K and B-complex, Iron, Calcium, Magnesium,  Selenium,  Amino acids); may have antioxidant effects.

Willow Bark – contains salicin, the precursor of aspirin.

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The material on this site is for informational purposes only.

It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

To Find My Home Page, click here:  

Welcome to my Weblog on Pain Management!

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