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Tuesday, October 11, 2011


I am sure everyone is buzzing about the fallacious news stories from the last couple of days that are telling you taking vitamins is risky for your health.  Every time I hear reports on these studies I get mad.  I get more so when I hear the local ABC outlet news anchor say she does fair and balanced reporting.
If her reporting was fair and balanced she would include the following information from Mitch Stargrove an ND I have known over some years:
It is not advisable to make a causal statement of excess risk based on these observational data..." Without proper accounting of and informed choices for form, dose, combination, sequencing of nutrients this data says little of clinical consequence. Moreover, the fundamental premise of natural medicine is personalized and evolving care in concert with a healthcare professional trained and experienced in nutritional therapies. All contemplated supplement usage should be discussed with primary care providers, such as (licensed) naturopathic physicians, who are trained in their appropriate, prudent and proper usage. Lastly, reliance of foods, i.e., fruits and vegetables, is not what it used to be. Solid research shows that the nutrient content of commercially grown foods sold in the USA has declined markedly over the past 30 years; presumably due to industrial/petrochemical agribusiness practices and priorities. Other problematic factors have been mentioned by previous responses to this alarmist declaration which reveals a hostile and prejudiced posture in the conventional medical world that does not serve the patient's best interests nor the methodology of science and discovery.

The only concern I have fore vitamins used by people over 40 is iron unless the person is clearly anemic.  Iron is known to be a higher risk of heart attack in this age group.

Zinc is important for immune support and endocrine health.  If elevated Copper is usually low.  Too much copper is a risk but reputable supplements know the safe limits.

Magnesium is good for the brain and nervous system just like the B vitamins.  Magnesium is usually deficient especially if you are using Rx drugs. 

Many forms of calcium are not well absorbed and yet this "study" tells you to take it.

If you need help deciding on your supplements we offer this service through our Health Forensics programs. Email us for more information.

I'll continue taking my vitamins, Thank you!

From Natural Products Insider

Then consider this from MedPage Today

Readers Say Vitamin Levels Should Be Checked Yearly

By Chris Kaiser

Cardiology Editor, MedPage Today
Published: October 07, 2011
Processed foods, mineral-depleted soil, overcooked vegetables, increased stress levels -- all of these increase the chances of having a vitamin deficiency, according to a vocal majority ofMedPage Today readers who commented on last week's poll.
We asked readers if and when patients should be assessed for vitamin deficiencies. Of the more than 2,200 votes, 69% said that patients' vitamin levels should be assessed at least annually.
"I cannot remember how many patients have been rescued from dementia and psychosis by B12, especially when I have a geriatric focus," said one doctor, who also touted vitamin D, calcium, fish oil, and thyroid testing. "Everybody deserves a look about once a year."
But once a year was not enough for some (9% said every visit) and too much for others. One cardiologist said he or she tests vitamin levels every six months with a "pick up rate over 25%." Another commenter said that yearly testing seems too frequent. "Getting a baseline every five years with additional testing as needed seems better."
We received several anecdotal accounts about vitamin deficiency being caught, but only when the patient requested the test.
"I was diagnosed with severe insufficiency of vitamin D and only had it tested because I requested it," said one woman, who added that her mother and daughter were subsequently found to be vitamin D-deficient.
"I have just been rescued from severely low vitamin D levels, and my daughter has been found to have low vitamin levels as well. I wish my doctors had been checking levels all along," noted another MedPage Today reader.
And another expressed similar exasperation. "It was not until I was diagnosed with osteoporosis that I had a vitamin D 25-OH test, and found out that despite being outside every day, my level was insufficient. By then it was too late. I am very disappointed that my physician did not order this inexpensive test years ago. Now, I have asked for a B12 test as well."
One woman's B12 deficiency mimicked multiple sclerosis and she went through a battery of tests before a neurologist ordered vitamin testing for her.
"It baffles me that insurance companies aren't pushing for annual vitamin testing, because so many conditions can be resolved with proper vitamin supplementation," wrote one woman, who also was found deficient in vitamin D after she requested the test.
The comments also parsed the meaning of "recommended daily allowance" (RDA). Most agreed that the RDA is not meant to prevent disease states but more to support optimum health.
"The original purpose of RDAs was to specify the amounts of various micronutrients needed by the 'average' person to guard against deficiency disease; the fact that a person does not have scurvy or anemia doesn't mean she/he is getting enough vitamin C or B12, respectively, to be as healthy as possible," wrote one commenter.
But what is the root cause of vitamin deficiency? "We need to start with nutrition," was how one physician simply put it.
Others, as well, chimed in with the notion that vitamin deficiencies and chronic diseases are symptoms of malnourishment, which is symptomatic of poor eating habits.
As expressed by one European, "Ultimately, there is simply no substitute for a healthy diet. Sadly, American diets often lean toward processed foods, which tend to be low in nearly every (micro)nutrient other than sodium."
"Healthy eating is almost nonexistent today," said another commenter. "Processed and modified foods simply are not as nutrient-dense as their counterparts were perhaps 20 years ago."
And, as usual, we had at least one post worthy of going in the X-file.
"I wonder how much this 'concern' is being driven by yet more EU 'directives' banning the sale of 'natural' additives and supplements," this commenter wrote. "Whilst the profession should remain wary of too close an 'association' with what is considered as 'Big Pharma,' we should also remain acutely aware of signs and symptoms of deficiencies which have been known and recognized for centuries. The prescribing decisions must always be made as a result of knowledge, not some bureaucratic nonsense from an invisible and unaccountable back-room mandarin with several bees in his bonnet and 'fees' to be earned!"

And now the meaningless study -

Dec 27, 2009
NEW YORK (Reuters Health) – An analysis of "real-world" clinical data indicates that vitamin E, and drugs that reduce generalized inflammation, may slow the decline of mental and physical abilities in people with Alzheimer's ...

Dietary Supplements Linked to Higher Death Risk

By Todd Neale, Senior Staff Writer, MedPage Today
Published: October 10, 2011
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
In postmenopausal women, the use of several common vitamin and mineral supplements was associated with an increased risk of death, researchers found.

After adjustment for multiple potential confounders, use of multivitamins and vitamin B6, folic acid, iron, magnesium, zinc, and copper supplements was associated with greater all-cause mortality through 19 years of follow-up (HRs 1.06 to 1.45), according to Jaakko Mursu, PhD, of the University of Eastern Finland in Kuopio, and colleagues.

Use of a daily calcium supplement, on the other hand, was associated with a lower risk of death (HR 0.91, 95% CI 0.88 to 0.94), the team reported in the Oct. 10 issue of the Archives of Internal Medicine.

"Based on existing evidence, we see little justification for the general and widespread use of dietary supplements," they wrote, citing a body of literature generally supporting no association with mortality, with some suggestions of harm. "We recommend that they be used with strong medically based cause, such as symptomatic nutrient deficiency disease."
"We cannot recommend the use of vitamin and mineral supplements as a preventive measure, at least not in a well-nourished population," they wrote. "Those supplements do not replace or add to the benefits of eating fruits and vegetables and may cause unwanted health consequences."
Taking dietary supplements to improve health and prevent diseases is widespread, with about half of U.S. adults using one or more in 2000, according to Mursu and colleagues. Annual sales top $20 billion.
The long-term impact of supplementation is unknown, however, and some studies have suggested a relationship between supplements and increased mortality.
As Rita Redberg, MD, of the University of California San Francisco, wrote in an editor's note, "manufacturers are not required to disclose to the FDA or to consumers the evidence they have regarding their products' safety, nor must they empirically back up claims of purported benefits."
In light of this uncertainty, Mursu and colleagues examined the use of vitamin and mineral supplements among 38,772 postmenopausal women participating in the Iowa Women's Health Study. The mean age of the women at baseline in 1986 was 61.6.
The participants reported their use of supplements in 1986, 1997, and 2004. The percentage who reported using at least one supplement daily increased from 62.7% to 85.1% during the study. In 2004, more than one-quarter of the women (27%) said they used four or more.
The most commonly used supplements were calcium, multivitamins, vitamin C, and vitamin E.
Through 2008, 40.2% of the women died.
After adjustment for demographics, dietary and lifestyle factors, comorbidities, and use of hormone replacement therapy, the following supplements were associated with a greater risk of death during follow-up:
  • Multivitamins: HR 1.06 (95% CI 1.02 to 1.10)
  • Magnesium: HR 1.08 (95% CI 1.01 to 1.15)
  • Zinc: HR 1.08 (95% CI 1.01 to 1.15)
  • Iron: HR 1.10 (95% CI 1.03 to 1.17)
  • Vitamin B6: HR 1.10 (95% CI 1.01 to 1.21)
  • Folic acid: HR 1.15 (95% CI 1.00 to 1.32)
  • Copper: HR 1.45 (95% CI 1.20 to 1.75)
Absolute increases in risk ranged from 2.4% with multivitamins to 18% with copper.
After multivariate adjustment, use of calcium supplementation was associated with a lower risk of death (HR 0.91, 95% CI 0.88 to 0.94). The absolute risk reduction was 3.8%.
To account for the multiple comparisons made, however, the researchers set a P value of less than 0.003 to establish significance. Only the increase associated with multivitamins, calcium, and copper remained significant using this threshold.
"However, many of the additional statistical tests were confirmatory, strengthening confidence that findings were not explainable by chance," Mursu and colleagues noted.
In particular, the findings related to iron and calcium remained consistent when the analysis was restricted to follow-up from 1986 to 1996, from 1997 to 2003, and from 2004 to 2008.
In addition, the mortality risk associated with iron supplementation increased in a dose-response fashion.
The relationship was not significant for doses of 200 mg/day or less, but was significant for a dose of 201 to 400 mg/day (HR 1.35) and for a dose of 400 mg/day or more (HR 1.57).
"Iron is suggested to catalyze reactions that produce oxidants and thus promote oxidative stress," the authors noted, acknowledging that they did not examine possible mechanisms in the current study.
"However, we cannot rule out the possibility that the increase in total mortality rate was caused by illnesses for which use of iron supplements is indicated," they wrote. "Chronic disease, major injury, and/or operations may cause anemia, which is then treated with supplemental iron. However, we could find no evidence for such reverse causality."
In their commentary, Bjelakovic and Gluud said that "one should consider the likely U-shaped relationship between micronutrient status and health," with risks associated with both insufficient and excessive intake.
"Therefore, we believe that politicians and regulatory authorities should wake up to their responsibility to allow only safe products on the market," they wrote.
Added Redberg, "A better investment in health would be eating more fruits and vegetables, among other activities. Because commonly used vitamin and mineral supplements have no known benefit on mortality rate and have been shown to confer risk, this article has been given our 'Less Is More' designation."
Mursu and colleagues noted that their study was limited by the possibility of residual confounding and changes in supplement use during the study, the inability to exclude the chance that some supplements were taken in response to symptoms or clinical disease, the lack of data on nutritional status or detailed information on the supplements used, and the study sample comprised of white women, which limits the generalizability of the findings.
The study was partially supported by grants from the National Cancer Institute and the Academy of Finland, by the Finnish Cultural Foundation, and by the Fulbright program's Research Grant for a Junior Scholar.
One of Mursu's co-authors is an unpaid member of the scientific advisory board of the California Walnut Commission.
Bjelakovic and Gluud reported that they had no conflicts of interest.

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1 comment:

kaney said...

Vitamin D is an exiting vitamin that has received renewed interest in the research community. Its mechanism of action is being unraveled and it has been shown to have effects not only on calcium absorption but also wider effects on the body including prevention of cancer. In the last decade the sun safe message has been getting through to people, but as a side effect of this Vitamin D deficiency has now become more common.