Saturday, December 21, 2013

Vitamins: To Take or Not?

Any place that sells health supplies generally has a large vitamin/supplement section, and at any given time, there will be several people standing around this area trying to determine what to buy. Is this necessary? Are the millions of Americans spending billions of dollars being misguided?

Depending on diagnosis, it is not uncommon for people with chronic conditions to be deficient in certain vitamins, and therefore may need supplementation. But, do you need a multi vitamin? If so, what kind? What about other vitamins?

This week, two new studies found no evidence that taking vitamins protected men’s brains or helped those who have had a heart attack. In the Annals of Internal Medicine editorial concerning these studies, the following was noted, "Evidence is sufficient to advise against routine supplementation."

Some groups of people do benefit from supplementation. These include:
-    * Folic acid for women planning a pregnancy to reduce the risks of a neural tube defects (e.g. spina bifida)

-     *  People on a vegan diet may benefit from vitamin B12 supplements

-     * Those on long-term restrictive weight loss diets or people with malabsorption problems, such as diarrhea, celiac disease, cystic fibrosis or pancreatitis.

Some vitamins do not work, such as:
-     * Vitamin supplements do not help to prevent cognitive decline in healthy older adults. Canadian Medical Journal July 9, 2013 

-       * Ginkgo biloba does not slow down cognitive decline in older adults.

-       *Taking Vitamin C will not prevent a cold.

Some vitamins can be harmful:
-      *  For people with HIV, taking St. John’s Wort to combat depression can reduce the effectiveness of several types of anti=HIV drugs by more than 50%.

-       * Vitamin E, considered to be a promising tool for cancer prevention, turned out to have the opposite effect. Men who took vitamin E were 17% more likely, not less, to develop prostate cancer.

-       * After years of telling women to take calcium, in February, the US Preventive Services Task Force recommended that postmenopausal women refrain from taking supplemental calcium and vitamin D. Not only did it not prevent fractures in healthy women, but several studies linked it to an increased risk of heart attack and death from cardiovascular disease.

Because people with chronic conditions may have a real need for vitamins and supplements, consider the following:

• To learn more about the various types of vitamins and supplements, check out Mayo Clinic Drugs and Supplements.  This is an easy site to understand what works, as they use a grading system of A-F with A being strong scientific evidence for this use and F being strong scientific evidence against this use.

• Tell your medical provider what vitamins/supplements you are taking.

• Condition specific organizations, (e.g. American Diabetes Association) are good places to learn what’s being tried in terms of supplements for your particular condition. 

• The best way to give your body the vitamins and minerals it needs is through diet. That noted, depending on condition, medications you are taking, and in the case of vitamin D- where you live, you may need certain supplements. Discuss this with your provider.

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