From: abulsari@abo.fi (Abhay Bulsari VT)
Subject: Vitamin supplements unnecessary
Organization: Abo Akademi University
Date: Wed, 30 Sep 1992 05:36:46 GMT


This one is from Ted Altar.

MORE IS NOT BETTER

It is worrisome that the FDA estimated that 40% of the American
adult population uses vitamin and mineral supplements on a daily
basis, vitamin C being the most widely consumed synthetic
nutrient.  Maybe it has something to do with the technocratic
ethos that `if a little is good for you then lots must be
better'.

Of course, this is false.  I've already posted a concern about
"vitamin D", and we also have the recent example of new research
suggesting that excess iron in the diet is a risk factor for
cardiovascular disease.

There is no know and documented advantage for healthy adults to
take vitamins, unless they enjoy seeing their urine turn a
brilliant yellow ;-)  One would do better to spend the money not
on vitamin pills but on quality, fresh fruits and vegetables,
organically grown if possible.

It surprises me to no end how very penurious people are about
spending a mere few pennies more on organic produce, but will
quite willingly waste hundreds of dollars per year on vitamin
pills or magic herbal teas.  There are no magic pills or herbs to
better health, there is only the good sense to do daily exercise
and eat a variety of quality vegetarian foods properly prepared.


THE CASE OF VITAMIN A

To take the example of vitamin A, consider this listing of
problems:
     "prolonged use of vitamin A in excessive doses can cause a
     variety of symptoms, including dry, coarse scaly skin,
     angular stomatitis, pain and tenderness of the bone,
     hyperstosis, hypercalcemia, disease syndrome of pseudotumor
     cerebri (which may produce increased intracranial pressure
     with headache, papilledema, and diplopia),
     hepatosplenomegaly, and disturbed blood clotting with
     hemorrhage.  in children, anorexia, pruritus, and failure to
     gain weight are followed by irritability, bone pain, and the
     limitation of join motion.  Large doses of vitamin A,
     furthermore, are teratogenic"  from "Council Report: Vitamin
     Preparations as Dietary Supplements and as Therapeutic
     Agents" JAMA, 1987, 257(14, April 10):1929)

Indeed, as one researcher reported,
     "the toxicity of vitamin A in early pregnancy, for which a
     safe intake level is known, is stressed.  On many grounds
     these suggested lower RDI values are preferable to the 1980
     RDA values"
          (from Olson, "Recommended dietary intakes (RDI) of
          vitamin A in humans"  Am J Clin Nutr 1987, 45:704)

While the RDA levels are 1000 ug for men and 800 for woman, Olson
recommended, for instance, that RDI levels be 700 for adult men
and 600 for women and 0 for early pregnant woman (200 for 6-9
month pregnancies; 400 for earlier lactation and 320 for 6+
months of lactation)! Olson also observed that:
     "toxic signs also appeared when 25000IU of vitamin A was
     superimposed on a vegetarian diet containing 25000IU of
     provitamin A.

If vegetarians would only stay with beta, alpha or gamma-carotene
as naturally found in a variety of vegetables and fruits, there
simply would be no worry about toxicity as the body is more able
to regulate these precursors as opposed to the pre-formed vitamin
A found in vitamin pills.

What is interesting is that the 1980 RDAs were based upon amounts
needed to (1) correct night blindness among subjects with a
vitamin deficiency and (2) raise plasma vitamin A levels to a
normal level in DEPLETED subjects.  To these amounts of the
vitamin necessary to correct deficiency symptoms was added a
generous margin of safety.

The 1980 to 1985 RDA Committee took a different approach based
upon the amounts of the vitamin needed to maintain a given body-
pool size in well-nourished subjects (I gave an example of this
approach for protein in an earlier posting).  With this approach,
recommended levels were reduced to 700 for adult men and 600 for
women, but these recommendations were NEVER OFFICIALLY accepted.
They appear, however, in the literature and are referred to as
the "recommended dietary intakes" or RDI.

The official RDA levels are also made problematic due to the wide
amount of individual differences in need/aborption/utilization.
Based on a study of adult men, the subcommittee of the 10th
edition of the RDAs chose to leave recommendations for vitamin A
at those higher than RDI levels, simply because a few subjects
appear to need such levels  There is here, however, simply a wide
variation of vitamin utilization and need.  Some individual
differences for a greater need are produced by such things like
alcoholism, pancreatic disease, liver disease, gall bladder
disease, respiratory disease, chronic nephritis, measles,
steatorrhea, measles, protein deficiency, intestinal parasites,
children under 6, and the prolonged use of cortisone or neomycin
sulfate.


THE COMPLEXITY OF INTERACTIONS

Besides the potential toxic effects of consuming too much, there
is also the interaction effects of vitamins on each other,
especially due to high amounts again.  I think this is an even
more widespread problem and one of concern for everybody.  For
example, mega-doses of vitamin C can reduce B12 absorption.
Normally, 80-90% of intakes up to 100 mg/day are absorbed by
humans, but with higher intakes vitamin C is less well absorbed.
Some other examples: large doses of A and E inhibit vitamin K
absorption or action; mineral oil and cholestyramine can reduce
absorption of the fat-soluble vitamins; excess intakes of copper
and iron have adverse effects on vitamin C nutritional status;
too much zinc, copper, iron, and absorbic acid form complexes
with riboflavin to alter its bioavailability; and so on and so
forth.

Frankly, things are so complex that the atomistic approach of
simply orally ingesting those "VITA-amins" simply ignores that
whole foods are immensely complex substances which no chemical
soup can replace.  Patients on long-term IV feeding loose weight
and begin to suffer nutritional deficiencies in spite of the
assurance of biochemists that the IV solutions are "complete".
Remember, it was not too long ago that these same dieticians and
non-holistically orientated nutritionists assured us that
reinforced white bread was equivalent in nutritional value as
whole wheat bread.  Well, we wrongly bought and eat that
tasteless white bread then, why should we now be buying so many
vitamin pills?


HIGH DOSES OF WATER SOLUBLE VITAMINS CAN INDUCE DEPENDENCY STATES
     AND WITHDRAWAL SYMPTOMS

As Alhadeff et al. report:
     "Water-soluble vitamins taken in high doses over long
     periods of time may induce dependency states, and users may
     shows signs of deficiency or withdrawal symptoms when the
     dose is lowered or the substance is discontinued.  Although
     the mechanism for this is not well understood it may be
     related to the fact that most of the water-soluble vitamins
     induce the enzymes required in their own metabolism or
     action.  It is also possible that large doses of vitamins
     promote catabolism of unneeded amounts.  All of the B-
     complex vitamins are converted in the body to coenzymes.
     High levels of coenzymes may induce the formation of their
     respective apoenzymes which may be considered binding
     proteins.  When the coenzyme level falls rapidly after
     discontinuation of high dose vitamin intake, distortion of
     metabolic pathways may occur."  (Nutrition Reviews, 1984,
     42(2):33)

As you can see, the effect is real but the reason is still
unknown.  Dependency and withdrawal of this sort has even been
found in people who grew accustomed to daily doses of vitamin C
as low as 200 mgm!  "Rebound scurvy" is the term used in the
literature to describe this phenomena of real scurvy occurring
after one stops consuming vitamin C pills.  It has even been
reported to occur in the infants of mothers who were taking C
supplements during pregnancy.  Pyridoxine withdrawal symptoms
have occurred in adults taking daily doses of only 200 mg.


OTHER PROBLEMS

Some other problems, which I will here simply list as this
posting is already getting too long, are:

     a) vitamins can mask the symptoms or signs of a pre-existing
     disease process or vitamin deficiency.

     b) vitamins interact with drugs and other vitamins

     c) use of megadoses water-soluble vitamins may be
     accompanied by the concurrent use of other, more toxic
     vitamins, like vitamin A and D.

Again, for healthy adults, vitamin pills are simply a waste of
money at best and potentially harmful at worst.  There are,
however, special circumstances and needs.  Pregnant and lactating
vegan woman, for instance, ought to take B12 and iron
supplements.  There is, however, no justification for the
indiscriminant use of multivitamins by individuals who rightly
wish to improve their health or take due precautions but are too
lazy to exercise and too foolish to eat good quality vegetarian
foods ;-)   (present company excepted of course).
-- 
A. Bulsari                                       Tel.  358 (21) 654 721
V{rmeteknik, ]bo Akademi                         Fax   358 (21) 654 792
Va"rmeteknik, A'bo Akademi   (for the non-Scandinavian screen impaired)
SF 20500 Turku, Finland                          Tlx  57 62301 AABIB SF