Doctors Don’t Like Vitamins!

An apple a day keeps the doctor away (and the shrink at bay)? Yes – but it’s got to be a real apple and not the substitute from the local drugist(!) in the form of a multi-vitamin-multi-mineral-multi-health pill.

Evidence is mounting, that vitamin and mineral supplements do have adverse health effects. The latest on the list are calcium and vitamin E.
So far it has been believed(!) that vitamin E and selenium supplementation lower risk for prostate cancer (in men!). However, when early results after 3 years from a large controlled trial showed no fewer cases but even an excess risk for prostate cancer, the trial had to be halted.

A new study now includes data from another 3 years of follow up. The overall risk of prostate cancer was markedly elevated by 17 % in the group that had been taking 400 IU of vitamin E per day (JAMA 2011 Oct 12; 306:1549).

After 3 years of vitamin E supplementation and another 3 years without vitamin E but with observation and follow up it was confirmed that vitamin E raises risk for prostate cancer. The risk was mitigated though, if at the same time selenium supplements (200 mcg) were taken.

The message has been broadcast several times already – at least on our modest page in this funky little magazine: do make sure you eat enough vitamins, but do not buy them in a drugstore (much better word for a chemist) but at your local greengrocer.
In the same context I would like to cite a recent meta-analysis that showed that calcium raises cardiovascular risk – angina and heart attacks that is.
After 6 years of taking 1000 mg of calcium, be this with or without vitamin D, risk for myocardial infarction, angina or stroke were up by 20 % as compared to non-users (BMJ 2011 Apr 19;342:d2040).

The relatively simple explanation seems to be that raised blood calcium levels promote vascular calcification by the abrupt change after supplement ingestion.

The consequences for us medics at the moment are, to discourage calcium supplementation in patients who have risk factors or even manifest cardiovascular disease. AND: rather than taking high-energy-calcium-tablets do increase calcium intake through food sources (milk and dairy products).
Naturally there are limits to these conclusions in cases of disease and malabsorption and chronic illness – but that’s where we feel competent and do appreciate to be consulted.

However grandfatherly it may sound – not everything new is progress. There is nothing wrong with good old Mother Nature.

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