House Calls / Dr. Michael Schwartz
Recent studies have created controversy regarding the benefits of vitamins and supplements. Several reports suggest that certain vitamins may actually be harmful for some patients. This contradicts previous studies which have shown many benefits from these substances.
Most physicians agree that if a patient already has an adequate level of a vitamin or nutrient, then additional ingestion of such nutrient may not provide additional benefit. However, this assumes that a patient has a healthy diet, has normal absorption of these substances and does not have an underlying disease which requires higher doses of these medicines.
Some vitamins are fat soluble (vitamin A, D, E and K) which can accumulate in the body leading to toxicity; some are water soluble (vitamin B and C), and excess ingestion is excreted by the body.
Vitamin A and beta-carotene play a role in vision, skin health and immune function. This vitamin is found mainly in liver, potatoes, carrots and broccoli. Vitamin A deficiency can cause night blindness, skin dryness and even increase the risk of certain infections. Smokers, however, should avoid Vitamin A and beta-carotene as this may increase risk of certain cancers including lung and colon.
Vitamin D is actually a hormone, meaning it can be produced by our body when exposed to sunlight. Some studies suggest that D may lower the risk of certain cancers, reduce the risk of heart disease and actually increase life-span. Additionally, it may play a role in improving fertility and is essential in bone health. However, excessive Vitamin D intake can result in nausea, weakness and kidney failure.
Vitamin E, found in certain nuts, fruits and vegetables, plays a role in neurologic function and acts as an antioxidant in protecting cells. Although thought to decrease mortality, studies have not supported this as a benefit. However, new research suggests that high doses of vitamin E may improve function in patients with Alzheimer's disease.
Tracey Godwin-Randolph, a certified therapeutic neurological and exercise specialist, is cautiously intrigued by the study, "It is important to understand that the use of vitamin E at higher amounts should only be taken under the direct supervision of a physician as it can cause some undesirable side effects such as increased bleeding, nausea and blurred vision."
Ms. Godwin-Randolph also expressed that while the use of Vitamin E does not slow the progression of the disease, patients taking the vitamin had an increased ability to function when it came to daily living.
"In almost every observational study, where test subjects were physically active as opposed to their non-active counterparts, the mental function of the physically active group was much higher," she said. "Non-active groups began to experience mental decline at early ages."
Vitamin K is most commonly derived from greens and vegetables. Deficiency may result in bone loss and an increased risk of bleeding. Research is being conducted to evaluate if vitamin K reduces the risk of heart disease, Alzheimer's disease and certain cancers.
Vitamin B includes many different subsets including folate, thiamine, riboflavin, niacin, pantothenic acid, biotin, pyridoxine and Cyanocobalamin. These vitamins play a role in cellular metabolism. Deficiency can lead to anemia, confusion, fatigue, cracking of the lips and skin changes. Grains and vegetables contain many of these vitamins. Deficiency is commonly found in the elderly due to poor absorption.
Vitamin C, found in many fruits and vegetables, is important in wound healing and immunity. Some studies suggest that vitamin C shortens the duration of colds. However, other studies suggest that supplemental vitamin C does not have an effect on overall health.
There are numerous ongoing studies currently examining the potential benefits of many other supplements. For example, co-enzyme Q10 may help decrease muscle cramps in patients taking cholesterol drugs; probiotics and enzymes may improve digestion; and fish oil and Omega 3 fatty acids may lower cholesterol and improve circulation.
A unique and innovative supplement currently used by hundreds of thousands of people is OPC-3 (oligomericproanthocyanidins). Studies suggest that this supplement can decrease pain, minimize allergy symptoms and lessen chronic fatigue. Dennis Franks, the executive vice-president of Market America (a national distributor for nutraMetrix advanced line of nutraceuticals, including OPC-3) confirms that more than 200 studies have been published on the efficacy of OPC-3.
"It is the single most important ingredient in my supplemental regimen," he said. "It decreases inflammation, improves circulation, is great for skin, and acts as a super antioxidant maximizing the effectiveness and duration of Vitamin C and E."
Mr. Franks also advocates that individuals electing to take supplements should consider how vitamins are absorbed by their bodies.
"If you can take a quality dietary supplement in an isotonic form [equal to body fluid content], then you have the best opportunity to have the nutritional content delivered where your body can best absorb it and ultimately use it."
Many physicians who have reviewed the new studies believe that the recommendation to stop vitamins is irresponsible. There is obviously a great concern that patients who need certain vitamins will stop taking them. Given that initial medical studies are frequently refuted by subsequent studies, patients and physicians should never rely on one study alone to determine the best course of action. Furthermore, many patients who feel better while taking vitamins should continue to take them. However, remember to always consult with your physician to determine if any of these medications are contraindicated with prescriptions you may be already taking.