Vitamins, your opinions please

  1. Hepth

    Hepth 508
    Gold Member

    I know a lot of people that take vitamins, and I myself have been thinking about it. I know I need more Iron, as for the past year I have REALLY cut back on my red meat, and although I eat a lot of dark green vegetables I don't think its enough. I eventually start to get more and more tired until I change my diet back or start taking iron pills.

    I am wondering about everyone's opinions, not only in effectiveness but also in edibility. I can't seem to regularly take large vitamins, as about 50% of the time it turns in my throat (Centrum) and gets stuck.

    I'm wondering if anyone has any experience with vitamin chewables or powders. There is so much binder and filler in the pills.

    I'm looking for really maybe Calcium, Iron and Vitamin-D to increase their absorption rate. That's about it, with as little filler as possible. I'd rather it taste horrible and be chewable than some of these peanut sized pills that have no reason to be that large. I don't think I'm deficient in anything else. My wife's doctor recommended her to take something similar as her body has a resistance to iron absorption which causes hair loss if she's not taking it.
     
  2. jcsd
  3. Astronuc

    Staff: Mentor

    One could take multivitamins occasionally, and one could take the tablet with food and/or drink to avoid getting it stuck in one's throat.

    One can get most vitamins and sufficient amounts from certain foods.

    Quinoa has relatively high Fe, or otherwise beans, lentils, prunes and raisins, instead of meat.

    http://www.webmd.com/diet/features/top-10-iron-rich-foods


    Some folks overdo vitamins. Excessive vitamins are excreted and not beneficial. They should be consumed in moderation.
     
  4. Evo

    Staff: Mentor

    Before you assume you need iron, please have your doctor do a blood test to check for iron. I thought I needed iron due to being so lethargic, turns out I have too much iron and it was killing me, I now have to give blood to reduce iron levels since the body hardly excretes any iron. I have also stopped eating foods high in iron.

    As long as you don't have health issues, a multi-vitamin with the RDA of vitamins and minerals should be ok, just stay away from those mega doses, those are something that should only be given by a doctor if there is a very specific reason.
     
    Last edited: Jun 21, 2014
  5. SteamKing

    SteamKing 9,133
    Staff Emeritus
    Science Advisor
    Homework Helper

    If you find your vitamin pills hard to swallow due to their size, you might cut them in two. A lot of people have this problem.

    There is a device known as a pill cutter which can be used to cut oblong pills into two parts along the scoring in the middle of the pill.

    My neighbor had the same problem and she had one, but I'm not sure where she got hers.

    Wait... Here, you might try some of these from the pharmacy, pill cutters and pill crushers:

    http://www.walgreens.com/store/c/pill-cutters-and-splitters/ID=361561-tier3
     
  6. Student100

    Student100 589
    Gold Member

    It always amazes me at the number of people who take supplements or vitamins without first consulting a doctor for a vitamin deficiency profile. Before taking any supplement or multi-vitamin you should see a doctor. Every year while taking your supplements you should go in for a follow up, or every 3-5 years when you aren't.

    There have been epidemiological studies that show vitamins are completely safe and the best thing since sliced bread. There are also epidemiological studies that show vitamins can kill you or otherwise shorten your life. Also, if you're a post-menopausal women you should never take iron supplements unless you're anemic and seen a doctor.

    See a doctor, you might even save some money if he tells you that you don't need to take a multi-vitamin.
     
  7. Pythagorean

    Pythagorean 4,609
    Gold Member

    Hi student. Could you provide sources for all the claims in your second paragraph?
     
    1 person likes this.
  8. Evo

    Staff: Mentor

    I know he's right about post menopausal women.

    http://newsnetwork.mayoclinic.org/discussion/should-postmenopausal-women-take-extra-iron/

    And his suggestion that you see a doctor first is correct. But Pyth is right, we need to see the studies, that way people can understand the issues.
     
    Last edited: Jun 21, 2014
  9. Student100

    Student100 589
    Gold Member

    http://archinte.jamanetwork.com/article.aspx?articleid=1105975

    Heme Iron associated with increased risk of type two diabetes in women, of which several supplements are derived from.
    http://care.diabetesjournals.org/content/29/6/1370.short

    Iron stores and CHD
    http://archinte.jamanetwork.com/article.aspx?articleid=485095

    There are literally thousands of articles, for every vitamin supplement that you can think of which both show a risk or decrease in mortality.

    http://ajcn.nutrition.org/content/64/2/190.short

    Multi-vitamins reduce the risk of cancer in men:
    http://jama.jamanetwork.com/article.aspx?articleid=1380451

    Excessive use of multi-vitamins lead to advanced and fatal forms of prostate cancer in men:
    http://jnci.oxfordjournals.org/content/99/10/754.short

    No increase or decrease in mortality associated with multi-vitamin use:
    http://aje.oxfordjournals.org/content/early/2011/02/21/aje.kwq447.short

    Vitamin C and risk of coronary heart disease in women
    http://content.onlinejacc.org/article.aspx?articleid=1132452

    You can Google scholar if you want to read the thousand of sometimes contradictory epidemiological studies on supplementation.


    With that said, epidemiological studies shouldn't be used as a definite proof of causative links between vitamin/supplement use and increased or decreased mortality. RCT's are a bit better. The science is good enough however to recommend that before anyone begins taking a supplement that they see a doctor.

    Further, why buy something that you might not need unless you're aware of a deficiency? Taking vitamins blindly when most adults get what they need from their normal diet is only an exercise in burning money. If you have dietary restrictions or a condition which prevents proper absorbent of certain vitamins or minerals, then supplementation may be needed. There's no way to really know without consulting a doctor.

    FDA information regarding supplementation: http://www.fda.gov/Food/DietarySupplements/UsingDietarySupplements/ucm110567.htm
     
    Last edited: Jun 21, 2014
  10. Pythagorean

    Pythagorean 4,609
    Gold Member

    Thanks for the studies. I'm curious if you have any thoughts on the nature of the conflicts between claims that vitamins are harmless to claims that they affect mortality.
     
  11. Student100

    Student100 589
    Gold Member

    It would all be pure speculation, human physiology is complex.

    I actually looked into a long time ago when I was trying to see what supplements would be good for my workout routine. A lot of the information out there is confusing and/or misleading. That's why it best to discuss these things with a medical doctor that's up to date on all the latest research. It's also good so they can be aware of any potential drug interactions a multivitamin may have with prescribed medication.
     
  12. Evo

    Staff: Mentor

    Exactly. Do not guess or try to self diagnose. Only blood tests can tell.

    http://www.mayoclinic.org/diseases-conditions/hemochromatosis/basics/definition/con-20023606

    Go to a doctor, demand extensive blood tests, regular blood tests do not test for these fatal conditions.
     
  13. verty

    verty 1,854
    Homework Helper

    Reading the results paragraph, the association is in men taking multivitamins more than seven times per week, that is, more than recommended. Of these men, the risk of prostate cancer was highest for those with a family history of prostate cancer and those who were taking individual supplements as well, for example, beta carotene and zinc. So men who are taking multivitamins more than seven times a week along with individual probably high-dose supplements are most at risk of these cancerous complications. And as usual there could be contributory causes: high-dose users are more likely to be poor and uneducated, more likely to smoke, will eat differently, there could even be a race connection if these mega users tend to fall into one racial group.

    For example, cancer is more likely to progress further in poor populations, so the increased incidence of advanced and fatal cancers in these mega users may mean they were from poorer households and were thus less likely to seek medical help early. We also know this group is predisposed to self-medicate, so we might expect them only to seek help when it was truly at an advanced stage.
     
  14. Student100

    Student100 589
    Gold Member

    Yeah that particular study only showed a negative correlation in taking more than recommend doses of multivitamins.

    I've also read studies that suggest men who take multivitamins are more educated, wealthier and more likely to exercise though. I think most of these studies do post numerical fiddling to try to account for these factors. These studies aren't that great anyway, diets, vitamin adherence and other factors could all skew these results in statistically significant ways.

    There were some meta analysis I read yesterday that suggested a review of studies showed predominately positive effects, with something like 4% of the studies correlating to an increase in mortality and 40% have no effect on patient heath after adjustments were made. Still, talking to a physician would be the best course of action.
     
  15. DrDu

    DrDu 4,245
    Science Advisor

    After having worked 5 years in epidemiology, I can say some words on this:
    You have to read every study very carefully, not only the abstract, but especially the discussion. What kind of study is it? A fully randomized clinical study or epidemiology.

    E.g., I had at random a quick look at this study:
    Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons: the Established Populations for Epidemiologic Studies of the Elderly. K G Losonczy, T B Harris, and R J Havlik, Am J Clin Nutr August 1996 vol. 64 no. 2 190-196
    which had been cited by Student100.
    http://ajcn.nutrition.org/content/64/2/190.short

    It is an epidemiological cohort study with a cohort size of 11 178. Sounds impressive. But if you read beyond the abstract and look at table 1, only 320 persons have reported use of vitamin E and only 76 of them have died in the study period. So in fact the study is quite small for the risk factor of interest.
    Typically, a cohort study is planned so that there is some decent power to discover detrimental effects of not more than a hand full of mayor risk factors, but information on many more factors is collected. After data collection, all kinds of analyses are run on the data, after the main risk factors have been analyzed (and hopefully been published). I would suspect that the effect of vitamin E is such a secondary factor.

    Now look at the medical history reported in the group "all E" and compare with group "none". Only 2.5% of vitamin E users self reported (sic) a previous stroke as compared to 6.1% in the group of non-users. With diabetes the comparison is similar (10.3 vs. 17.1 %). Although they tried to adjust for these factors, it is to be expected that the group of vitamin E users was generally more healthy (and perhaps avoiding other risk factors) than the group of non-users, which is what they say in the discussion:
    "It is plausible that our results are due to confounding by other factors associated with vitamin supplement use, such as practice of better health habits and access to better health care by users compared with nonusers."

    They write that their result is consistent with other studies. OK. Does it add much additional evidence? Probably not.
     
    Last edited: Jun 23, 2014
    1 person likes this.
  16. lisab

    Staff: Mentor

    Hepth, gummi-bear style multi-vitamins are available now (at least in the US). If traditional pills get stuck in your throat, but your doc advises that you take them anyway, perhaps that could be an alternative.
     
  17. DrDu

    DrDu 4,245
    Science Advisor

    To me, taking vitamin mega doses seems to be some kind of pseudo-scientific superstition, which is quite widespread in the US but not so much in the rest of the world. This may be due to the strong influence of Nobel prize winner Linus Pauling, who propagated it.
    In fact, hardly anyone in developed countries suffers from vitamin or mineral deficits. If you really think you have low levels of iron, get an analysis of your blood first.
    I would also consider first other possible causes of fatigue, like e.g. thyroid hormone status.

    If you really should have low levels of iron, and don't want to take big pills, there are also many juices and syrups which contain ferrous gluconate.
     
  18. Pythagorean

    Pythagorean 4,609
    Gold Member

    My wife was prescribed iron during pregnancy, and in Alaska we were casually presribed vitamin D as there have been studues showing that D deficiency is common in the north due to limited sun exposure during the winter.

    But none of this is based on blood testing, it was meant more as a preventative measure, I assume.
     
  19. Student100

    Student100 589
    Gold Member

    I think most people prescribe to the idea that "vitamins are good for you, so more is better", however, this isn't always the case. Supplements are a billion dollar industry in the US, and over 40% of the population take some kind of supplement; which is mind blowing when you consider most don’t actually need to be taking them.
     
  20. Ygggdrasil

    Ygggdrasil 1,615
    Science Advisor

    Nature just published a news feature on this topic that discusses this issue, and it echoes advice in this thread that vitamins are probably beneficial if you are deficient in a particular nutrient but are not beneficial (and can in some cases be harmful) if you are not already deficient in that nutrient:

    The article also discusses how it can be difficult to draw conclusions from the published literature because of many confounding variables in the studies (e.g. problems with self-reporting of diets, compliance with the treatments, and differing baseline intakes of the nutrients among study participants).
     
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