Don’t Throw Out Those Vitamins Just Yet.
I have been repeatedly asked my opinion of an editorial piece that was published in the Annals of Internal Medicine today that has been reported on by news outlets such as NPR and the New York Times. Before you panic and scoop all or your vitamins into the trash, allow me to offer some persepctive on these findings.
First, you have to understand the plight of the lowly vitamin/mineral in the scientific literature. You see… these substance are natural and unowned. There is no multi-billion dollar patent on Vitamin C or Magnesium. Therefore, there is no real incentive to spend millions and billions of dollars proving they work. In fact the opposite is true. There exists a considerable interest in proving that they don't work. If you are a pharmaceutical company who holds one of these multi-billion dollar patents, you want to do everything in your power to prove the freely available stuff is garbage. So you hire a doctor as a prostitute to take out the competition. What's in it for medical journals? Well, they make their money by reprinting articles and selling those to drug companies. They want to stay in their good graces so it biases the types of studies they publish. So if you are a journal liiiiiiike…. The Annals of Internal Medicine, for example, you want drug company business, so you join the campaign.
So how do they do it? There are a few tactics that are used to give therapies like vitamin and mineral supplementation a black eye.
1. Don't publish studies that show their efficacy. These journals are very selective about what they print. It's not all about the best science; its about publishing what sells or supports a paradigm. Think of it like the National Enquirer. They have an image to uphold so they are selective about what they publish.
2. Studies on vitamins/minerals are purposely done with non-physiological doses or using the wrong form of the vitamin/mineral. A great example of this is Vitamin D as described by Alex Vasquez, DC, ND, DO in a 2005 paper on the topic. In this example he exposed a study for using doses of vitamin D (800 IU) to compare against another therapy. A therapeutic dose would be more in the ballpark of 4,000 IU. This is either done on purpose or by people who have no idea what proper doses of nutrients are to receive a therapeutic response.
3. They attempt to expose the "dangers" associated with supplementation. In the editorial they conclude with this statement, "…β-carotene, vitamin E, and possibly high doses of vitamin A supplements are harmful." There is no context provided for this statement. These are all substance that occur naturally in healthy foods like vegetables and fruits. Can vitamins be harmful? Yes, in some circumstances. Nonetheless, they have a relatively supreme safety record when compared to drugs. Here are the numbers: In 2004 vitamin overdose was reported in 62,562 individuals, resulting in 3 deaths. How does this compare to drugs? Well we really only need to look at one number… the number 19. What is that? Every 19 minutes an American dies from a drug overdose according to the CDC. It is just irresponsible to use a word like "danger" to describe vitamin/mineral supplementation when the alternative is killing as many people in an hour as vitamins/minerals are supposedly killing in a year.
Furthermore, the article focuses on a narrow subset of diseases using reference material from their own journal to make their point. One of the studies they published admittedly had a high dropout rate and could not produce conclusive results. If they couldn't find studies to support the use of vitamin supplementation then the only logical explaination would be that they didn't look very hard. A statement like, "With respect to multivitamins, the studies published in this issue and previous trials indicate no substantial health benefit." is ludicrous. It demonstrates an obivous disingenuity or lack of education on the role of vitamins and minerals in human health.
They overstate the claimed potential of vitamin supplementation, stating that they do not "prevent death". Well what does? What clinician is telling their patients that as long as they pop a daily multivitamin they will live forever? Ridiculous. They pereptuate an underproven paradigm that human health depends on successful monotherapies. Excuse the big words… A monotherapy is the concept that you have 1 disease and use 1 treatment for 1 cure. That is almost never the way it works. If you were to ask a doctor: Why do people get cancer? There is no simply answer to that. Thus, there is no simple therapy that will prevent or cure cancer. Vitamins and minerals are effective as therapies when they are part of a personalized, lifestyle focused approach to treatment. This means what you eat, how you move, how you handle stress, how toxic is your environment, etc. Give a bottle of multivitamins to a chain smoker and they will probably still get lung cancer. I don't think you could find a single expert that would tell you that all you need is a bunch of Vitamin X and you will live forever. If this is the case then I join with the authors of the study in saying, "Enough is Enough!".
If you have questions about the usefulness of vitamin/mineral supplementation find someone with actual nutrition training. You would be surprised to find out that this is often not even your primary care doctor who had around 25 hours of nutrition education during med school.
The fact is that we get less nutrition from food than we ever have. We need these vital nutrients to be healthy. Cancer and cardiovascular disease aren't the only diseases out there (and by the way there are research studies that show vitamins/minerals reduce risk factors for these diseases). There are many conditions that are reversible with proper nutrition and lifestyle. This is not vitamin supplementation alone. It is a total approach. Telling people to "stop wasting money" on vitamins is a definite step backwards and an invitation to develop long-term effects of vitamin insufficiency. Some of this deficiency is even caused by the medications they would likely support for chronic disease.
In short… this editorial is a cheap sham. The purpose was to score the headlines you have seen today. The goal is to get people (you) to stop using the competition's (nature) product. I hope you don't fall for it.