I
am an Endocrinologist, a medical doctor whose specialty is studying and taking
care of people with hormonal imbalances.
Very
early on in my student days in London, I was taught: you correct the situation,
when there is a deficiency, try to normalize the hormonal levels, do the same
when there is an excess of hormones.
I
am also a student of Medical History and I had read that when Konrad Roentgen
discovered X-rays, it was thought of as a panacea and people were given
radiation treatment for back aches, acne among other things.
Many
of the hormones secreted by our bodies are potent and while we give them as a
supplement or medication, we only give them people who are deficient in such
hormones. There was a fashion at one time to give thyroid hormones to overweight
women, trying to justify with the clinical observation that hypothyroid women
when given thyroid hormones they were deficient in, lost weight. Giving excess
thyroid hormones or testosterone or any hormones when you give to people who
truly do not need them can only lead to health problems.
Cortisol
is a good hormone and we know the myriad of side effects : hypertension, thin
bones and thin skins, diabetes
These
hormones or minerals have been judiciously used and benefited millions of
people around the world, but only when taken appropriately.
The
same applies to Vitamin and Mineral supplements.
There
are medically indicated situations when these are necessary and beneficial:
Folic acid supplement to prevent neural defects in the foetus. A new study,
Prenatal Vitamin Use Lowers
Risk for Autism Spectrum Disorder in Vulnerable Families
Brings
hope to many of the affected families of Autism Spectrum Disorder
When
there is documented Vitamin D deficiency (the numbers would be in single
digits) or calcium deficiency, supplementation is warranted. In my travels I
have seen the benefits of sporadic vitamin supplementation when the population (country,
isolated region) has been deprived of food or does not have sufficient food, or
a population becomes too dependent on food cooked outside or in fast food
restaurants. While we recognize that the American diet may be deficient in
certain minerals, such as Calcium or Iodide, but we recommend that mineral
replacement be natural and through food, not tablets.
Vitamin
and Mineral industry in the USA is worth billions of dollars..
The
big 5 spenders in Vitamins and supplements are
Top 5
UnitedStatesUS$4,630m
I have always felt that this behemoth of an industry was built
on the false promise that, if a little is good, more should be only better, so
that you can take 500% of the required amount of the mineral in a tablet and
“feel” better.
Of course, a broader spectrum of individual ingredient and its
purported huge benefits also fill the store shelves:
Co Enzyme Q 10
Individual amino acids
I feel that these supplements (unless indicated as explained
above) are not panaceas of health but a waste of money and in many cases may
actually harm you. If I suspect a mineral deficiency, on clinical grounds, such
as a young woman taking a very small amount of Thyroid hormone, may be due to
Iodide deficiency, I ALWAYS recommend that the nutrient or mineral be obtained
naturally through food. I was very reluctant to prescribe high dosages of
vitamin D being advocated (almost every one had Vitamin D deficiency because
the normal levels were artificially raised).
The new entry into this circus is PROBIOTICS. And you would see
its prescription more and more as we learn the science of Microbiome.
Microbiome is as diverse as a thick jungle and the Probiotics tablets are just
like few leaves in that canopy, plus the fact that the probiotics do not reach
where they are supposed to be effective.
Forbes magazine September 2018
Do You Buy Probiotics? New Study Says They May Not
Work For You And May Even Be Harmful
Science Daily:
Probiotics are found in everything from chocolate
and pickles to hand lotion and baby formula, and millions of people buy
probiotic supplements to boost digestive health. But new research suggests they
might not be as effective as we think. Through a series of experiments looking
inside the human gut, researchers show that many people's digestive tracts
prevent standard probiotics from successfully colonizing them. Furthermore,
taking probiotics to counterbalance antibiotics could delay the return of
normal gut bacteria and gut gene expression to their naïve state. The research
publishes as two back-to-back papers on September 6 in the journal Cell.
So
it was very gratifying for me to read an article published today , thousands
and thousands of people and their habits and whether or not vitamin and mineral
supplement did anything to their health or longevity?
Nutrients from food,
not supplements, linked to lower risks of death, cancer
SUMMARY
AND COMMENT | GENERAL MEDICINE
April 18, 2019
Dietary Supplements Aren't Associated with
Lower Mortality
|
|
Daniel D. Dressler, MD, MSc,
SFHM, FACP reviewing Chen F et al. Ann Intern Med 2019 Apr 9
But adequate intake of
nutrients from food confers health benefits.
Many U.S. adults report taking dietary
supplements, despite no evidence of benefit. In a prospective cohort study,
investigators evaluated the effects of dietary supplements and nutrient
intake from foods and supplements on mortality in ≥30,000 adults who
participated in the U.S. National Health and Nutrition Examination Survey and
were followed for ≥6 years.
Fifty percent of participants used
dietary supplements. In analyses adjusted for demographics, habits, and
comorbid conditions, use of dietary supplements was not associated with lower
mortality. However, people who did not maintain at least adequate intake of
vitamins A and K, magnesium, and zinc from foods (according to Institute of
Medicine standards) had excess risk for death. Excessive calcium intake
(≥1000 mg daily) from supplements was associated with
significantly higher relative risk for cancer-related death (1.5 additional
deaths per 1000 person-years). Excessive vitamin D intake (≥10 µg [400 IU]
daily) from supplements in people without vitamin D
deficiency was associated with significantly higher relative risk for death.
|
COMMENT
In this study, researchers went to
great lengths to accurately calculate participants' vitamin and mineral
intake (distinguishing nutrient sources) and to assess mortality outcomes. Findings
mirror those of other large cohorts and a systematic review, supporting
findings that adequate vitamin and mineral intake from foods leads
to positive outcomes, with little or no additional benefit from
supplements. Whether the excess mortality associated with calcium and
vitamin D supplementation reflects residual confounding in this
observational study is unclear, but clinicians might want to share these
findings with patients who routinely take these supplements.
|
|
Commentary from Tufts
University (long) for those who wants to know the nitty gritty of the research:
Adequate intake of certain nutrients is associated with a
reduction in all-cause mortality when the nutrient source is foods, but not
supplements, according to a new study. There was no association between dietary
supplement use and a lower risk of death.
In addition, excess calcium intake was linked to an increased
risk of cancer death, which the researchers found was associated with
supplemental doses of calcium exceeding 1,000 mg/day. The study was published
on April 9 in Annals of Internal Medicine.
"As potential benefits and harms of supplement use continue
to be studied, some studies have found associations between excess nutrient
intake and adverse
outcomes, including increased
risk of certain cancers," said Fang Fang Zhang, M.D., Ph.D., associate
professor at the Friedman School of Nutrition Science and Policy at Tufts
University and senior and
corresponding author on the study. "It is important to understand the role
that the nutrient and its source might play in health
outcomes, particularly if the
effect might not be beneficial."
The study used a nationally representative sample comprised of
data from more than 27,000 U.S. adults ages 20 and older to evaluate the
association between dietary supplement use and death from all causes,
cardiovascular disease (CVD), and cancer. The researchers assessed whether
adequate or excess nutrient intake was associated with death and whether intake
from foodversus supplement sources
had any effect on the associations.
For the association between nutrient intake and the risk of
death, the researchers found:
· Adequate intakes of vitamin K and magnesium were associated with a
lower risk of death;
· Adequate intakes of
vitamin A, vitamin K, and zinc were associated with a lower risk of death from
CVD; and
· Excess intake of calcium
was associated with higher risk of death from cancer.
When sources of nutrient intake (food vs. supplement) were
evaluated, the researchers found:
· The lower risk of death
associated with adequate nutrient intakes of vitamin K and magnesium was
limited to nutrients from foods, not from supplements;
· The lower risk of death
from CVD associated with adequate intakes of vitamin A, vitamin K, and zinc was
limited to nutrients from foods, not from supplements; and
· Calcium intake from
supplement totals of at least 1,000 mg/day was associated with increased risk
of death from cancer but there was no association for calcium intake from
foods.
In addition, the researchers found that dietary supplements had
no effect on the risk of death in individuals with low nutrient intake.
Instead, the team found indications that use of vitamin D supplements by
individuals with no sign of vitamin D deficiency may be associated with an
increased risk of death from all causes
including cancer. Further research on this potential connection is needed.
"Our results support the idea that, while supplement use
contributes to an increased level of total nutrient
intake, there are beneficial
associations with nutrients from foods that aren't seen with supplements,"
said Zhang. "This study also confirms the importance of identifying
the nutrient source when
evaluating mortality outcomes."
The study used 24-hour diet recall data from six two-year cycles
of the National Health and Nutrition Examination Survey, through 2010. For each
nutrient, the daily supplement dose was calculated by combining the frequency
with the product information for ingredient, amount of ingredient per serving,
and ingredient unit. Dietary intake of nutrients from foods was assessed using
24-hour dietary recalls. Mortality outcomes were obtained for each participant
through linkage to the National Death Index through December 31, 2011, using a
probabilistic match.
The authors note some limitations, including the duration of
dietary supplement use studied. In addition, prevalence and dosage of
dietary supplement use was
self-reported and so is subject to recall bias. Residual confounding may play a
role in the observed associations.
MORAL OF THE STORY
DO NOT TAKE ANYTHING IF YOU ARE NOT DEFICIENT IN IT, BECAUSE OF
THE PROMISE OF SOMETHING GOOD MIGHT HAPPEN, USUALLY JUST THE OPPOSITE MIGHT
HAPPEN.
As Michael Pollan would say: EAT FOOD
As an example
9 iodine-rich food
sources that can help prevent a deficiency.
· Seaweed.
..
· Cod. Cod is
a versatile white fish that is delicate in texture and has a
mild flavor. ...
· Dairy. Dairy products
are major sources of iodine, especially in American diets (12). ...
· Iodized
Salt. ...
· Shrimp.
...
· Tuna.
...
· Eggs.
...
· Prunes.
