Sunday, February 27, 2011

What is Needed for Supplements and Vitamins

With constant messages and studies that contradict each other, it is no wonder patients are confused about vitamins and what is needed to stay healthy.  While most supplements cause no harm, except to the wallet, people do sometimes forgo needed good health habits with the erroneous assumption that they are doing the right thing by popping lots of vitamin pills.  Based on current research, here are the supplements I recommend for good preventive health:

  • Low dose aspirin (81mg).  Although a recent study did not recommend women take aspirin as a preventive medication, there are others that show its benefit for preventing heart attack and stroke in both men and women.   A recent study reported in The Lancet showed low-dose aspirin taken for 5 years or longer reduced mortality from esophageal, pancreatic, brain, stomach, colorectal, prostate and lung cancer.  If you are over age 40, I recommend one low dose aspirin a day.
  • Omega-3 Fatty Acid (fish oil).  The benefits of Omega 3 have been reported for years for depression, hyperlipidemia, heart health, ADHD, clotting disorders and even arthritis.  The newest study published in The American Journal of Cardiology, showed that patients with heart failure improved their exercise duration and left ventricular ejection fraction by taking 12 months daily Omega 3 FFA.  Yes,  you can get this by eating fish and flax seed and certain vegies, but our modern diets are deficient in Omega 3 so an extra supplement is easy.
  • Vitamin D.  This vitamin is essential for a number of body functions including bone health, autoimmune diseases, cancer,  heart disease and cognitive function.  I have no idea why there seems to be an epidemic of low Vitamin D levels in Americans, but there is. It might be dietary because we need the right mixture of amino acids to convert Vitamin D in the body.  I am still checking all patients 25 OH Vit D levels by a blood test.  If mid or high normal range, great.  If they are low, I recommend 1000 IU a day.  It is cheap and easy.
  • Calcium.  Calcium is needed for good bone and heart health, especially as we age.  Women especially may be deficient in dietary calcium unless they drink milk, eat yogurt or cottage cheese.  Any women with a family history of osteoporosis should be making sure she gets at least 1500mg of calcium per day.  One cup of cottage cheese contains 1, 300 mg calcium. Unfortunately the blood test for Calcium is not an accurate way to see if you need supplements because the body will steal calcium from bones to keep the blood level steady.  If you smoke or are a thin woman past menopause, you probably need Calcium supplements.
So what about Magnesium, CoQ10, Vitamin B, Carnitine, Biotin, Folate, Iron?  Readers, vitamins are big business.  It is estimated to be a $61 billion dollar industry in the U.S. alone.  If you don't believe me, just google a vitamin and see how many ads pop up. There is no evidence that taking these extra vitamins as additional supplements improves your health or lifeline.  

We all want to live long and healthy.  Use the money you would spend on supplements for organic fruits and vegetables. 

72 comments:

Anonymous said...

Thanks for this, Dr. B.

abnormalfacies said...

Oh, Dr. Brayer, this is brilliant & concise.

If I may contribute re: n-3s. Since research has really only shown those great benefits for EPA/DHA, it should be noted that fish/krill oil is the best source for supplementation. Plant n-3s are healthy, but I've read papers concluding that our ability to convert them to EPA/DHA is pretty low (in the ballpark of 20% efficiency).

That said, I don't discourage flax, etc. at all, but like to remind people that's not what's used in the conclusive research.

Pet Meds Discount said...

Plant n-3s are healthy, but I've read papers concluding that our ability to convert them to EPA/DHA is pretty low (in the ballpark of 20% efficiency).

Tracy M said...

I love love this post because it is so clear and filled with information. Thank you for telling us what supplements to ake and why.

Raymond Bouchayer said...

I agree with abnrmalfacies that Krill oil is the best . Any other products are , i my opinion not very safe as most of them go rancid quickly and we do not know were the fish oil came from "The gulf Coast " ?
Having Osteoporosis I have mixed feelings about Calcium as the absorption of the mineral is still unknown or Osteoporosis would be a thing of the past .
Calcium deposits itself everywhere in your body , Heart , Kidneys , lungs . If you look at older people their faces are calcified and I suspect that it effects Alzheimer's disease I am not an MD but having tried about every treatment possible for Osteoporosis I would say to slow down on the Calcium and increase the magnesium.
Dr Brayer covers a lot of Vitamins and I agree that the research is somewhat limited compared to the one done for pharmaceutical that produces all kinds of medicine that have all kinds of side effect and that it would be to the pharmaceutical advantage to make it illegal to buy vitamin .
You know placebo works and if taking vitamins makes you fell like you are doing something good for yourself , you probably are .

Steve Heilig said...

Toni -
very good.
one Q: Vit. C not mentioned, and one of the most commonly sold/used, with much conflicting info. any remarks there?

thanks,
Steve

abnormalfacies said...

Raymond,

Is there any proof that krill oil doesn't go rancid as quickly as fish oil?

The only difference I know of is that, if I recall, the EPA:DHA ratio is somewhat higher vs. fish oil. Otherwise, polyunsaturated fats all like to oxidize.

Toni Brayer, MD said...

Steve Heilig: The promise of Vitamin C in reducing disease and even preventing cold virus has not panned out. Despite numerous studies, extra supplementation has not proven to help much of anything. We get Vit C mainly from citrus ftuits, and vegies such as broccoli, red pepper, tomatoes and cabbage. People who smoke need more Vitamin C.
Vitamin C deficiency is Scurvy, not a huge problem for us anymore thank goodness.

Car Parts said...

I have mixed feelings about Calcium as the absorption of the mineral is still unknown or Osteoporosis would be a thing of the past .

KM said...

Thanks for the reminder on the low dose aspirin. Once a neurologist I used to work with recommended taking it to me, so I will ask my doctor. Your info. on the confusion of calcium amounts is helpful as well.

Obagi said...

Wonderful post!

I've been trying to become more conscious about my health. I've talked to a lot of family and friends... they keep dropping this terminology and it makes me feel stupid... it's almost like a second language!

It's funny, because I actually found your blog on a Google search while researching some of these terms. This definitely clarified a lot for me. Thanks for the education!

Toni Brayer, MD said...

Obagi, Thanks for making my day. That is why I blog.

abnormalfacies said...

Dr. Brayer,

Just wanted to let you know I went ahead with the cross-post. Thanks again!

Jim

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There are manufacturers that offer quality vitamins nutrition supplements at reasonable prices. One manufacturer even has the individual ingredients linked to relevant clinical studies. Before spending your money, be as informed as possible about nutrient products you intend to do every day.

JSTBOOK said...
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JSTBOOK said...

You may require a calcium supplement in the event you:

* Have a lactose intolerance
* Have a milk allergy
* Hate milk, milk products or calcium fortified beverages

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krill oil said...

Great list and considering omega 3. Did you try krill oil? it's 42x times more effective than fish oil so check it out. Helped me with joint pain