Another Nail in the Coffin for Vitamin Supplements

[fls]

I'd much rather get fish oil from eating fish. Works out cheaper (some fish oil pills may be cheap, but buying fish means that's a meal sorted) and fish can displace less 'healthy' foods.

Even for those who have had a heart attack, the NICE recommendation in the UK is to - by preference - get fish oil from eating fish http://www.nice.org.uk/nicemedia/pdf/CG48PuiblicInfo.pdf (p. 5). Fish oil pills are only recommended if the patient can't or won't include enough oily fish in their diet.

Well, that must simply represent the anti-supplement bias of the medical community. It can't possibly be an evidence-based recommendation.

Linda

 

[GreyICE]

There must be 1,000s of vitamins, minerals and other stuff we humans need, both known and unknown. Yet supplements only give us a handful of these. Work the rest out for yourself.

I just love how ill-educated these forums are sometimes. I myself tend to hate the suppliment nonsense, but stuff like this is just physically painful.

Go walk over to a periodic table sometime. How many things do you see there? Thousands? Hundreds?

Hmm, and how many of them are either poisonous, useless, or just not even found in measurable quantities in any food?

The vast majority of things your body needs are carbon, nitrogen, hydrogen, and oxygen, with trace elements for flavor.

Yes, it's very easy to make thousands of compounds out of a handful of starting blocks. To pretend your body looks at a carbon chain, throws up its hand, and walks off because it's not exactly the right carbon chain is just stupid beyond bearing.

Short summary:

- Your body needs many different things, depending on age, exercise, climate, health, gender, etc.
- Getting these from diet is usually preferred, simply because of the supplimental things that tend to come along and the fact that the dose is more slowly digested, and its easier to reject excess chemicals when they're not being dumped in in a pill
- If you can't get them that way, supplements are fine. Or if there's good reasons not to get them that way (what percent of your daily value of mercury do those fish contain? We've poisoned our planet, and we have to live with that)
- Gigantic dosages of vitamins that have dangerous side effects and no known effect are dangerous. And stupid. And have no effect.
- Vitamins are a good thing. More of a good thing is not better.
- Most anyone who has a general disagreement with any of the points above is a complete idiot or is selling something.

P.S. I know someone who was hospitalized on a no salt diet. He ate no salt. I can't help but wonder how many of you would think that anecdote impossible because there's nothing in your diet that you NEED beyond calories...

 

[MG1962]

Well I cant speak for other products but I can vouch for zinc. As a suppliment it does exactly what the sellers claim

 

[Lemastre]

. . . . So you have huge side effects but otherwise, they're worthless?

lolwut

This makes me wonder how a supplement that's worthless, which I assume means it has no effect, can have a side effect. If the only detectable effect is the "side" effect, then that effect becomes the principal effect by default. I guess we mean any effect other than that for which the product is ingested.

 

[Lonewulf]

This makes me wonder how a supplement that's worthless, which I assume means it has no effect, can have a side effect. If the only detectable effect is the "side" effect, then that effect becomes the principal effect by default. I guess we mean any effect other than that for which the product is ingested.

But the "principle effect" was antioxidants, wasn't it? If it's working as an antioxidant, then why is nothing else involved with the vitamin working?

 

[GreyICE]

But the "principle effect" was antioxidants, wasn't it? If it's working as an antioxidant, then why is nothing else involved with the vitamin working?

You kn ow what? We need to redefine vocabulary. There are no such things as principle effects and side effects.

There are three categories - claimed effects, documented effects, and proven statistically nonexistent with a confidence value of x effects.

 

[fls]

This makes me wonder how a supplement that's worthless, which I assume means it has no effect, can have a side effect. If the only detectable effect is the "side" effect, then that effect becomes the principal effect by default. I guess we mean any effect other than that for which the product is ingested.

It isn't the substance that is worthless. We are talking about essential vitamins and minerals and botanicals (which are the source of the majority of our drugs), after all. What would be worthless is using supplements according to non-evidence-based suggestions, which forms the bulk of this multi-billion dollar industry. And that it is unreasonable to assume that regardless of the lack of evidence "it can't hurt to try" when it comes to taking excessive doses of vitamins, because maybe it can.

Many vitamins are strictly regulated by the body, such that excess amounts are simply eliminated (e.g. through the kidneys). But rather than simply providing you with expensive pee, excess amounts of vitamins are claimed to have various therapeutic effects. Once you get past demonstrating that the vitamin (or other supplement) has an effect, whether or not you call it a side-effect or the main effect really depends upon what you were looking for in the first place.

Linda

 

[Puppycow]

The discussion so far:

El Greco: Saying that all supplements are useless is wrong

Who said that?

Well I cant speak for other products but I can vouch for zinc. As a suppliment it does exactly what the sellers claim

Which is?

 

[Puppycow]

P.S. I know someone who was hospitalized on a no salt diet. He ate no salt. I can't help but wonder how many of you would think that anecdote impossible because there's nothing in your diet that you NEED beyond calories...

I wouldn't. It's well known that salt is essential. Eating a normal, well balanced diet with all the food groups should get you plenty. He got in trouble by intentionally avoiding it to too high a degree.

 

[Puppycow]

You may be letting your confirmation bias cloud your judgment here.

Thanks for the psychoanalysis. You may be projecting!

Consider the following:

This is ONE study!!!!!!!!!

One study, in a series of reports that mostly seem to say there are limited or no benefits for most healthy people who eat a balanced diet in taking vitamin supplements. Is there even one study that says otherwise?

 

[ponderingturtle]

I agree. There is a clear anti-supplement mentality within the medical community, which is reflected on this forum.
For example, there is solid scientific evidence that Vitamins B12 and D are not well absorbed by the elderly and deficiencies of these two vitamins often occur. Yet, physicians mostly neglect to advise the elderly in their care to consider supplementing with these two vitamins.
The historical bias against fish oil and the current prevailing lazy attitude concerning recommendations for fish oil is another case in point.

And is there evidence that these suplements increase health? I remember hearing on the SGU about a study with immune system disorders where they suplemented their lack in a particular vitamin, this turned out not to be helpful that having reduced levels of that vitamin for those patients was better than the normal healthy levels.

 

[ponderingturtle]

Which is?

Contain Zinc.

Now this may or may not be helpful to people though.

 

[pgwenthold]

Radio dermatologists must not have private practices.

Wrong again. Dr Radio (Sirius 114/XM 119) is a product of the NYU School of Medicine. The hosts on the show are regularly practicing doctors in the clinics there, except they take 2 hours a week to host a radio call-in show.

Moreover, you missed the other part, that people who CALLED the show were patients taking Vitamin D supplements. Patients of other doctors. Doctors who, apparently, are prescribing Vitamin D supplements.

Among my many elderly acquaintances, who see dermatologists regularly, NONE have had a recommendation for vitamin D!

And how many need them? How many are Vit D deficient?

 

[BenBurch]

As I understood what went through the science press a few months back, almost everybody is deficient in Vitamin D who does not spend a lot of time in the sun, with the dietary supplements in milk providing only enough to avoid rickets, but not enough for healthy bones or mood regulation.

 

[dlorde]

The Cochrane studies are usually the gold standard for assessing this kind of thing, but for anti-oxidants they only looked at prevention of mortality:

Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases
Summary
No evidence to support antioxidant supplements to prevent mortality in healthy people or patients with various diseases. Previous research on animal and physiological models suggest that antioxidant supplements have beneficial effects that may prolong life. Some observational studies also suggest that antioxidant supplements may prolong life, whereas other observational studies demonstrate neutral or harmful effects. Randomised trials have largely been neutral. We need evidence from randomised trials to decide if antioxidant supplements should be used for prevention.

They also did one on fish oil for ulcerative colitis, with inconclusive results, and for dietary fish oil in asthmatics with no apparent benefits, but no adverse effects.

One problem with media interpretation of such studies is that they often over-generalise the results, so 'prevention of mortality' becomes 'overall health', which is not necessarily the same thing.

 

[GreyICE]

I wouldn't. It's well known that salt is essential. Eating a normal, well balanced diet with all the food groups should get you plenty. He got in trouble by intentionally avoiding it to too high a degree.

I'm so curious. Do you have a definition of normal and balanced? I assume balanced is a recursive definition - a balanced diet is defined as a diet that gives you everything you need, therefore a balanced diet gives you everything you need (classic tautology, true but useless). Is such a diet an average diet for the population of... the United States? The world? Vancouver?

You've thrown a lot of terms out here, and I'm not really sure they mean anything.

 

[Skeptic Ginger]

Thanks for the psychoanalysis. You may be projecting!

One study, in a series of reports that mostly seem to say there are limited or no benefits for most healthy people who eat a balanced diet in taking vitamin supplements. Is there even one study that says otherwise?

And the percentage of people who eat a nutritious balanced diet is _____ ?

It's a straw man if you think I or anyone in the medical field here is saying proper diet isn't the best option.

So are you claiming the majority of people eat all the vitamins they need and supplements are a waste of money for everyone? Or is it confirmation bias on your part that most people eat right?

 

[Skeptic Ginger]

As I understood what went through the science press a few months back, almost everybody is deficient in Vitamin D who does not spend a lot of time in the sun, with the dietary supplements in milk providing only enough to avoid rickets, but not enough for healthy bones or mood regulation.

Vitamin D in milk and iodine in salt are there based on evidence.

 

[Skeptic Ginger]

I base my vitamin decisions on an algorithm.

Are there some studies suggesting potential benefit?
No > Stop.

Yes> Are there any studies suggesting harm?
Yes> Stop.

No > Is the supplement very expensive?
Yes> Stop.

No > Are there better alternatives which would produce the same effect which one is forgoing by taking the vitamin supplement?
Yes > Stop.

No > Go for it until the evidence suggests the benefit is nil.


Of course, underlying this decision algorithm is the fact I don't believe I eat a nutritious balanced diet and to do so is more trouble than I care to invest.

 

[Orphia Nay]

http://www.ncahf.org/digest11/11-43.html

"The Medical Letter on Drugs and Therapeutics has updated its review on appropriate use of vitamin supplements. [Who should take vitamin supplements? Medical Letter 53:101-103, 2011] The article concludes:

• In healthy people living in developed countries and eating a normal diet, the benefit of taking vitamin supplements is well established only to ensure an adequate intake of folic acid in young women and of vitamins D and B12 in the elderly.
• There is no good reason to take vitamins A, C, or E routinely.
• No one should take high-dose beta-carotene supplements.
• Long-term consumption of any biologically active substance should not be assumed to be free from risk."