Thursday, February 27, 2014

To V(itamin) or not To V(itamin)....that is the question.

People are coming in totally confused about whether they should take a vitamin supplement or not.  I dont blame them....even the medical community is clueless about nutrition.  It boils down to that,,,,nutrition. Average medical school student spends no time learning about food except cholesterol is bad because Dr Oz said so.  It used to be important in curriculum about 30 years ago but now so much else is squeezed into 4 year that some "non essential" stuff had to be dropped.  No problem....we will save the education for residency.  Oops, no one to teach it to residents except the attending physicians who were trained 20 years ago when nutrition was dropped.   No problem, make it mandatory CME (seminars required 1 time every 7-10 years) training to keep private practice docs updated.  Oops, most docs attend the lectures but stuff the literature under the pile of bills and charts when they get back to the real world.
When doc tells you to eat a balanced diet, you should ask the doc what s/he eats.   When the doc tells you to exercise, you should ask him/her what they do to keep fit.
Dr Klein and associates on the SELECT trial concluded vit E (in alpha tocopherol form) and selenium (in L-methionine selenium form) were associated with an increase in prostate cancer risk for men.  The doses studied were the measurements found in common over the counter vitamins (400IU and 200Mcg respectively).  So the conclusion of Dr Klein is dont take it if you have a history of prostate cancer and he went on to say in an interview....dont take the supplement at all.. The information is good but the they only studied the intake of one type of tocopherol.  Vitamin E in nature comes in 8 forms (my favorite natural sources are almonds, sunflower seeds, kiwi and mangoes).  If you take it there should be a balance of mixed tocopherols and tocotrienols.  The cheapest synthetic  to produce is listed as dl tocopherol - the most abundant form normally found in tissue and blood is d alpha tocopherol.  There is good evidence for Vit E aiding in Alzheimers and Parkinsons disease.  So end of the day, change your nutrition to include a mostly plant based whole food diet.  It you are just starting out a lifestyle change and want to include a supplement or two to provide building blocks to repair the long standing damage accumulated, ok to take a vitamin but you should read labels and empower yourself with the research (google scholar or pubmed) but also know how to interpret the data (www.drweil.com gives Andy's  translation for "layman" of up-to-the-minute research).  The idea will be eventually to get off everything once you have maximized on nutrition and lifestyle.   (in my DrRic 12 Weeks to Change I suggest adding different supplements every few weeks while also self empowering with reading and seeking reliable sources of information to develop your person plan for change)
By the way, as typical for statistical healing, one way to know which supplements you may benefit from (everyone lacks a different level of nutrition) is to get a blood test for every vitamin you are about to take and make sure you "really need it".  Medicare/Medicaid is the insurance of choice for the highest risk people in the US and it Does Not Cover vitamin blood tests.  So I can get substandard blood tests and 'tease out" an opinion from a CBC and CMP (the basic blood all docs order) and say "looks like your blood system is normal so continue current eating pattern".  Kinda like getting an xray of the chest on a tobacco user and saying "all normal-no cancer" so you can continue smoking!!! ......or.......telling an obese person "your annual cholesterol and glucose is normal " so dont change your weight!!!!  My head is spinning from all this dis-empowering research....I'm going hiking....but first I take my "prostate cancer inducer".

 ( ...note: the vit E is lower than the SELECT study but selenium is same  Nice knowing you!!)