11:01 am ET
Nov 21, 2013


For Better or Worse, Vitamins Are Medicine, Too

    • This is a mistaken notion. It's amazing that someone with all his credentials cannot understand a simple concept. Vitamin supplements are chemically identical to the vitamins found in food. Thus they cannot be patentable like medications. Medicaltions are isolated chemicals, like vitamins supplements can be, but there is a twist. To become patentable, and therefore owned by a company, the medication has to be novel. In order to do this a chemical change has to happen that changes the structure in order for it to be "novel". So the vitamin supplement is chemically identical to the one in food but the medication is not chemically identical to anything found in nature. It has been restructed to become patentable. If Dr. Sotos believes only unhealthy people get medications I believe he is very mistaken.

    • "For better or worse," most conventional doctors can only think within the tiny box they've been indoctrinated in (google/bing "2 Big Lies: No Vitamin Benefits & Supplements Are Very Dangerous by Rolf Hefti").

    • However, modern medicine treats most disease as if it were a drug deficiency. Vitamins for healthy people? You can maintain a modicum of health without vitamin pills, but not a state of optimal health. The idea of getting all needed nutrients from food is folly since the 5-servings of plant food per day effort fell flat and didn't lower the risk for heart disease and cancer. Nor has the 9-13 servings of plant foods a day been shown to do that. For discussion sake, let's say the only people who need vitamin pills are smokers, diabetics, women in pregnancy who have high nutrient demands, growing children, people who eat processed food diets, alcohol drinkers, adults who don't make sufficient stomach acid to absorb vitamins from food properly, and those who take vitamin-depleting drugs. Who is left? The vitamin E study cited only found vitamin E was not effective, it did not meaningfully increase risk for death. Most large studies involving vitamins provide no instruction to individuals because they provide population data. Individuals aren't an average of the whole. With 70+% of Americans deficient in vitamin D, ~40% deficient in B12, another 70% likely deficient in vitamin B1, ~40% have a shortage of magnesium, nearly 100% (except vitamin users) do not consume optimal amounts of vitamin C, and probably 70% are deficient in zinc and most do not consume the daily allowance for vitamin E, it is inconceivable an MD would be oblivious to all this. Vitamin pills are safer than tap water, table salt and aspirin. You don't need to read the fine print like pharmaceuticals. If there were two doors and behind door #1 were unlabeled drugs and behind door #2 were unlabeled vitamins, and you had to take 10 pills from either door #1 or door #2, which one would you pick, the vitamins or the drugs?

    • Can you please provide credible evidence for your statement:

      "vitamin B12, can cause harm by obscuring the diagnosis of a disease."

      Thank you.

    • ALM, I am also concerned by the statement “vitamin B12, can cause harm by obscuring the diagnosis of a disease.” News Flash Mr Sotos...Pernicious Anemia is a disease.
      I get it though...doctors make more money when they have pts who have continuous follow up appointments, x-rays, EKG's, antidepressants, sleep studies, nerve conduction testing....why would you want simply give them a cheap B12 supplement that makes the majority of the symptoms clear up?
      I think maybe you should be more clear, or do more research before you step on the toes of people who fight hard every day to get their disease recognized as just that...a disease. There's nothing more to keep looking for, the answer is in the B12

    • ALM and LV - I join the ranks of non-believers in this statement "Even a vitamin having no known toxic effects at any dose, e.g. vitamin B12, can cause harm by obscuring the diagnosis of a disease". I too would like credible proven evidence for this statement.

      The only disease I am aware of that it could obscure a diagnosis of is Pernicious Anaemia. And the treatment for Pernicious Anaemia is....oh yes, that's right, B12.

      For better or for worse...in the case of PA patients...this would definitely be a case of for worse due to the misguided ill-informed actions of many GPs who have no idea how to treat this condition and I suspect that you have no idea of how much this vitamin is needed by PA patients or how much we have to battle to receive appropriate treatment.

      I look forward to seeing the evidence to back up your statement.

      Best wishes

      A PA patient who has had to resort to self injecting due to the failure of a GP to treat PA according to symptoms, even ignoring the guidelines in the BNF Section 9.1.2.

    • Re: B12. Consider a patient with borderline macrocytosis from folate deficiency. Very commonly a physician's suspicion for the disease is triggered by the MCV. B12 in supraphysiological doses can reduce the MCV, driving down the index of suspicion and thereby delaying diagnosis.

      Consider this, too: the more time your physician has to spend worrying about and discussing your vitamin use, the less time s/he will spend on your real problem. Doctor visits still average just a bit longer than 15 minutes, so if s/he spends one minute on this, that's about a 6% drop in attention elsewhere.

      By the way, giving folate (a vitamin) to someone who is deficient in vitamin B12 can worsen the neurological disease caused by the B12 deficiency. Giving beta carotene (a vitamin) to smokers *increases* mortality.

      Many vitamins has toxic effects in high enough doses even in "healthy" people. B6, A, D, and K come immediately to mind. Be careful out there.

      Thanks for reading.

    • I have PA, and I also have a folate deficiency...by supplementing with both, my neurological symptoms have greatly reduced. (B12 is used in the production of the myelin sheath surrounding the nerves, btw) It should be standard to test for both deficiencies at the same time. The "6%" of my doctors attention being on my vitamins, saved my life. If we would have began the process there, I would have also saved thousands of dollars not to mention reduced the amount of damage that has been done. The "real problem" is that PA is not recognized as a problem, therefore people are suffering and that is nonsense.

    • I do agree with you that some vitamins are dangerous, and that care must be taken when considering taking them, especially during pregnancy. I just don't think that the medical profession should be dismissing PA as a disease and suggesting that by taking B12 we are causing more harm to ourselves.

    • Please tell me which disease diagnosis can be masked by B12 supplementation? I can't conceive of one myself.

      Also, you state that vitamins can do harm. Could you please supply evidence of this? My understanding is that very few deaths in the US(or anywhere else for that matter) are attributed to vitamin supplementation per annum: something in order of less than 10. If one compares this number to the accepted figures for mortality caused by iatrogenic harm, i.e. those killed by drugs and other treatments prescribed by their doctors, a number in excess of 200k per annum, it seems to me that claiming vitamin supplementation can be harmful is ridiculous.

      The main problem that people experience when supplementing with vitamins, minerals and other substances is lack of knowledge: appropriate quantities of the full spectrum of vitamins and minerals are required and should be tailored to the needs of the individual. Some people require more vitamin B12, D or C than others. Yet more people must take the active forms of vitamin B9(folate) or vB6 because they have genetic issues in converting folic acid into the active form and similarly with vitamin B6.

      Sadly, conventional doctors themselves are ignorant of the appropriate uses of supplementation and are not best placed to advise their patients on the subject.

      Finally, the idea that time can be wasted on discussion of vitamin deficiencies in a consultation when that time could be better spent, no doubt, discussing which drugs could be used to suppress symptoms of whatever is ailing a patient is most amusing. I discovered, unfortunately late in life, that all of the various illnesses and symptoms I'd experienced in more than four decades were caused by vitamin deficiency. During those four decades I was unnecessarily operated upon, had numerous other medical procedures and consumed a small fortune in drugs which did no more than suppress my symptoms and likely added new ones.

      No. What people need to do is discuss their supplementation requirements with a knowledgeable doctor who will guide them to proper, rude health.

    • Yes, giving rapid B12 can be a problem, but in practicum if you practice with any sense of your patient you will already know who is folate or B12 deficient and act accordingly.

      I am looking forward till some "expert" comes on the WSJ stage and start talking about hormones. Maybe some venture capitalist for a drug firm will whine how estradiol need more regulation and how testosterone should only be sold as cyprionate.

      JS all the things you cite as examples are so common in the naturopathic and integrative wold that I don't even bother asking students about it.

      Smoker: beta carotene, yes, make it simple.

      Folate and B12: learned it before pre-med and so did you I surmise.

      Otherwise, what about detracting from REAL issue, HAHAHAHAHAHA

      How many NH patients who are on Reclast, Boniva or what have you did I see with Vitamin D level of 6 or so. Aggressive replacement and more out and everybody recovers. The pharm drugs will harden the bones and INCREASE fractures. Isn't that what your own studies say?

      Again, when will Mc Cain and Hillary ram through a "Vitamin&supplement act". we need another distractor, right? The only ones who get hold of them in the future will be the wealthy elite on the black market. Others will be locked up and fare worse than registered sex offenders.

      Welcome to corporate medicine, the evil beast that keeps biting.

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