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Vitamin Supplements: Magic pills or Placebos?

8 Nov. 2011 Posted by Hannah Mich in vitamin supplements, vitamin D, vitamins, micronutrients, eating healthy
vitamin supplements, vitamin D, vitamins, micronutrients, eating healthy

It seems like vitamins are becoming like eggs in that one-minute we are told to consume them the next minute we are told to avoid them. Some warn of their dangers, while others praise vitamin supplements for their extraordinary health benefits. So, what do you do: take vitamin supplements or avoid them all together?

Let us start with some basics. Vitamins are micronutrients that are naturally present in unprocessed foods – vegetables, fruits and whole grains. In processed foods, such as cereals, vitamins and minerals are often lost, and, therefore, must be artificially put back into the food, also called food fortification. We know of 13 vitamins, which include A, B1, B2, B3, B5, B6, B7, B9, B12, C, D, E and K.

Vitamins are either water-soluble or fat-soluble. The B vitamins and vitamin C are water-soluble, which means they dissolve easily in water and are not stored in the body. Instead, they are either used or excreted. Fat-soluble vitamins, A, D, E and K, on the other hand, are absorbed and stored easily in your fat. Water-soluble vitamins may become depleted more easily than the fat-soluble vitamins, while fat-soluble vitamins can build up to excessive amounts in your body. Your body regulates these vitamins very well, however, to avoid such imbalances. It is often an abnormal diet, illness, high-stress and, in rare cases, inappropriate consumption of vitamin supplements that can lead to such imbalances.

Eating fresh fruits and vegetables, and whole grains is the best way of obtaining the necessary vitamins in your diet. Vitamin B12 and D are two exceptions. Bacteria produce vitamin B12 and the best source for B12 is controversial. Although, some believe meat is a better source than vegetables, fruits and grains. Vitamin D is produced when your skin is exposed to sunlight. Furthermore, a healthy active lifestyle with low stress levels and adequate sleep can also help prevent vitamin deficiencies. So, if you eat a healthy diet, why would you need to consider taking vitamin supplements?

  • Fruits, vegetables and grains contain less micronutrients, or vitamins, than what they contained 70 or more years ago due to poor soil quality.

  • Fruit and vegetables lose their nutrients quickly after they are harvested. So by the time they are harvested, transported, purchased, [cooked] and eaten, they could have lost 50 to 80 percent of their nutrients

  • The absorption rate, or metabolism, of vitamins varies from person to person. Although foods may have 100 percent of the required vitamins, you may only absorbed a fraction of that amount.

  • Due to limited researcher and guidelines, you may have an unknown deficiency in a particular vitamin, which your body may not be able to correct through diet alone.

  • An unexpected illness or sudden increase in stress can result in a depletion of your vitamins, such as vitamin C, which a healthy diet alone may not be able to fully combat either.

  • Even the healthiest eaters have days where they do not consume enough vitamin rich foods.

With all of this said, it is clear that a vitamin supplement can potentially bridge the gap between our bodies’ needs and the lack of micronutrients in our diet. Therefore, proper vitamin supplementation may be used as a form of preventative care. For example, adequate vitamin D consumption can help reduce your risk cardiovascular disease, chronic fatigue and breast cancer. Additionally, adequate amounts of vitamin C can help boost your immune system, and adequate amounts of vitamin B9, or folic acid, can help protect your heart, improve brain function and prevent neural tube birth defects. So what are the current concerns about vitamin supplements?

  • Overdosing, especially with the fat-soluble vitamins

  • Paying for something that may be excessive, which your body will just excrete. You may have heard that vitamin supplements just give you “expensive pee.”

  • Many vitamin supplements exceed the recommended daily allowance, or RDA

  • Taking vitamin supplements does not improve your overall health and may actually increase your risk of illnesses and diseases

Let’s address each one of these points separately to determine their validity. First, you can become ill if you overdose on vitamin supplements. For example, too much vitamin C can cause mouth sores. You are more likely, however, to overdose on fat-soluble vitamins than water-soluble vitamins. Fortunately, stopping your vitamin supplementation regiment normally alleviates symptoms and causes no long-term damage. The risk of overdosing on vitamin supplements is low, with dying from an overdose being unheard of. The American Association of Poison Control Center reported in 2009 that there are no known deaths from overdosing on vitamin supplementations. If you follow the directions on the bottle and consult your physician, your chances of overdosing on vitamin supplements and experiencing adverse side effects are extremely low. This is partly due to the fact that we do not absorb 100 percent of the vitamins in the supplement.

In fact, the absorption rate of vitamins from your food may be higher than vitamins in supplements. The absorption rate of vitamin supplements in the form of pills and capsules may be as little as 10 and 20 percent, respectively. This poor absorption rate greatly inhibits the effectiveness of vitamin supplements. Further research is needed to improve the absorption rate of vitamin supplements, but like our natural vitamin sources vitamin supplements may still not be 100 percent absorbable. This may be one way our body ensures we do not overdose of these micronutrients. Taking vitamins with a meal and drinking little fluids during the meal may help to improve absorption. As we breakdown, absorb and use vitamins, they eventually make their way into our urine.

This poor absorption rate explains, in part, why many vitamin supplements contain more than the recommended daily allowance, or RDA. Another reason for this higher amount is that some believe the research supports additional dietary amounts. Vitamin D is a great example of this. New research has implicated that adults can consume up to 10,000 international units a day of vitamin D without any adverse side effects. The RDA for adults has now been increased from 400 to 600 international units. Daily “mega-doses” of vitamin D that range between 1,000 and 10,000 international units may help improve symptoms associated with depression, fibromyalgia and cardiovascular disease.

Some studies, on the other hand, show that certain vitamin supplements may have no health benefits or worse may be detrimental to your health. In October 2011, research was published claiming vitamin supplementation increased mortality. This has brought the safety of vitamin supplements into the forefront again. Data from the Iowa Women’s Health Study was used in this recently published research. There are serious flaws, however, with this research, including uncontrolled variables, age of the subjects, and the fact that data is from self-reported questionnaires. There are also studies supporting the health benefits of vitamin supplements when taken appropriately. For example, an evidence-based review of vitamin D published in 2009 in the “Journal of the American Board of Family Medicine,” reported that vitamin D supplementation may reduce the risk of cancer, osteoporosis and cardiovascular disease. Looking at the conflicting information from these studies means we need more research, and need to start asking and answering questions that are contributing to the conflicting data. Questions that need to be explored more include,

  • Who performed the research? Is there a conflict of interest?

  • What flaws or limitations exist within the studies?

  • Who will benefit the most from vitamin supplements?

  • At what point does someone have a vitamin deficiency or is at risk?

  • How prevalent is vitamin deficiencies in the United States?

  • What is the best source for vitamins?

  • What are the absorption rates of vitamins from both supplements and foods?

  • What is the benefit to risk ratio of taking vitamin supplements?

  • What are the safest and most appropriate RDA of vitamins? Do we need to re-evaluate?

  • What diagnostic tests are best in detecting vitamin levels?

In order to know whether vitamin supplements are safe and effective, we need to answer the important questions listed above. If we proceed with business as usual with the current holes and assumptions in vitamin research, we are likely to undermine the real benefits and miss the potential dangers. To determine if you could benefit from vitamin supplements, consult your physician or a naturopathic doctor. And remember that fresh fruits, vegetables and whole grains in your diet need to be your primary source for micronutrients, such as vitamins.

Call To Action: 

Talk with your physician or naturopathic doctor about vitamins
Stay up to date on recent vitamin research
Be critical of articles and research

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References: 

http://www.nutritionsecurity.org/PDF/NSI_White%20Paper_Web.pdf
Nutrition Security Institute: Human Health, the Nutritional Quality of Harvested Food and Sustainable Farming Systems

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727181/pdf/kwp167.pdf
American Journal of Epidemiology: Use of Supplements of Multivitamins, Vitamin C, and Vitamin E in Relation to Mortality

http://www.scientificamerican.com/article.cfm?id=soil-depletion-and-nutr...
Scientific American: Dirt Poor: Have Fruits and Vegetables Become Less Nutritious?

http://www.time.com/time/health/article/0,8599,1880145,00.html
Time: Eating Your Vegies: Not As Good For You?

http://cancerres.aacrjournals.org/content/53/18/4230.full.pdf
Reduced Risk of Colon Cancer with High Intake of Vitamin E: The Iowa Women's Health Study

http://www.charlespoliquin.com/ArticlesMultimedia/Articles/Article/713/F...
Flawed Iowa Women's Health Study Used to Discredit Supplements: Don't Believe It!

http://www.internalmedicinenews.com/index.php?id=514&tx_ttnews%5Btt_news...
Some Vitamins and Minerals Supplements May Be Harmful

http://www.jabfm.org/content/22/6/698.full.pdf
Journal of the American Board of Family Medicine: Vitamin D: Evidence-Based Review

http://www.gaia-health.com/articles401/000412-poison-control-report-herb...
Poison Control Reports: Not a Single US Death Caused by Supplements, Herbs, or Vitamins

http://www.sciencedaily.com/releases/2010/12/101207191447.htm
Vitamin Supplements Reduce Deaths Caused by Measles and Diarrhea, Study Finds

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2020807/pdf/nihms-21502.pdf
Vitamin A intake and the risk of hip fracture in postmenopausal women: the Iowa Women's Health Study

http://cancerres.aacrjournals.org/content/53/18/4230.full.pdf
Reduced Risk of Colon Cancer with High Intake of Vitamin E: The Iowa Women's Health Study

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamins/
Harvard School of Public Health: The Bottom Line

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