Straight Talk on Vitamins and Supplements

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There is a lot of confusion about vitamins and supplements.  Here is some valuable information, and my professional perspective. 

 

Vitamins by definition are essential components to your health and physiologic function which your body cannot produce by itself.  Ideally, and historically, we get our needs through eating a healthy, balanced diet.  But according to multiple medical sources (http://www.createbalance.net/support/science/Nutritional%20Deficiencies%20Article.pdf), our foods are now missing 30-60% of the micronutrients they used to contain, when they come straight out of the ground.  Why?  Because of the change in the soil over the last couple of decades.  The soil produces a larger amount of crop, but a less nutritious quality of crop. 

So how do we make up for this deficiency?  Vitamins.  But which ones?  There is quite a spectrum of quality.   The quality and regulatory standards in the US are generally poor in comparison to those in Canada and Europe.  Processing deficiencies in product production include 1) using a lesser quality version of a given element (eg calcium carbonate instead of calcium citrate), which leads to poorer absorption and bioavailability; 2) the destruction of the elements during the production (cold processing or not?), leading to a lack of the element; 3) non-dissolving capsules, leading to an inability to absorb the elements within the product; and more. 

 

It is my opinion that everyone, not just those in developing countries or diabetics or those with chronic disease, benefits from taking vitamins and supplements.  Those who have particular health profiles will benefit even greater.

 

So it becomes a question of what level quality of vitamin is best for you.  At the lowest quality level, one might consider universally formulated supplements off of your local retail pharmacy’s shelf.  At the next step up, you could consider pharmaceutical grade vitamins.  Often times, such products are ordered either through your physician or online.  Finally, you have the option for custom-created test-based vitamins.  This has previously been a rare find, and an expensive option at that, but more recently, this has become very affordable through a particular company here in the US that has exclusive agreements with arguably the top lab in the country that performs such testing (assessing your body’s nutritional and immune status), and arguably the top lab in the continent that produces these ultra-high grade supplements (profiled for your needs, based on the lab results), and all at a very reasonable price.

In addition to these multivitamin packages, I strongly recommend fish oil and a total of 2000 IU/day of vitamin D, presuming you have not been formally tested for vitamin D.  (See my write up on vitamin D for more details on this topic.)

 

In the end, I am an advocate of vitamins.  So is the American Medical Association (go to

http://www.ncbi.nlm.nih.gov/pubmed and type in JAMA 2002; 287:3127-9 in the search field).  The question is which types and which ones are best for you?

 

For validation information, among other sites: http://www.drlam.com/gateway.asp

Vitamin D Deficiency

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Vitamins are substances that cannot be made by humans but need to be ingested in the diet in small quantities to prevent metabolic disorders. Subclinical vitamin D deficiency, specifically, may contribute to the development of osteoporosis, and is also associated with an increased risk of fractures and falls in the elderly, decreased immune function (and possibly development of autoimmune disorders, the list of which includes allergies, asthma, diabetes, thyroid disease, joint disorders, and many other conditions), bone pain, and possibly cancer (prostate, colon) and heart health. The exact mechanism and extent of impact of vitamin D deficiency on each of these considerations is unknown.

How does vitamin D deficiency occur?

  • Deficient intake or absorption: Most people in our communities are aware of our problem with inadequate sunlight exposure, as a primary cause. Other causes include inadequate amounts of dietary intake (fatty fishes, plants, milk and related products or cereals which are fortified with extra vitamin D), defective intestinal absorption (due to celiac disease, surgical excision of stomach or gastric bypass), small bowel disease (eg celiac disease, Crohns disease), and pancreatic disease.
  • Defective metabolism or increased breakdown of ingested and absorbed vitamin D due to severe liver disease or simultaneous use of anticonvulsant medications.
  • Other causes including kidney failure, rare kidney diseases and metabolic or genetic disorders.

    • Dietary Intake of Vitamin D

    Food

    IU’s per serving

    Cod liver oil, 1 tablespoon

    1,360

    Salmon, cooked, 3.5 ounces

    360

    Mackerel, cooked, 3.5 ounces

    345

    Tuna fish, canned in oil, 3 ounces

    200

    Sardines, canned in oil, drained 1.75 ounces

    250

    Milk, nonfat, reduced fat, whole, reduced fat, 1 cup

    98

    Margarine, fortified, 1 tablespoon

    60

    Cereal

    40

    Egg, 1 whole (Vitamin D is found in the yolk)

    20

    Liver, beef, cooked, 3.5 ounces

    15

    Cheese, Swiss, 1 ounce

    12

    Summary

    In the end, the exact cause of vitamin D deficiency in any given individual is unidentifiable for certain (and it may be multifactorial). Most people do not have one of the definitive medical conditions mentioned above (Crohns disease, celiac disease, having had certain stomach surgeries, pancreatic disease, severe or rare liver or kidney diseases, etc), and do not take anticonvulsant medications, which leaves only deficient dietary intake, deficient sunlight, and other speculative yet-to-be known/discovered considerations. So unfortunately, there is usually no satisfactory answer to the question of “what caused this?” But thankfully, we have treatment options and techniques to monitor progress of such treatment. And hopefully, research will make progress in the near future to help answer this question.