Vitamin Primer, From A to K

Although vitamin supplements are a multi-billion dollar industry, medical and nutritional experts urge patients to balance their diets with whole foods for optimal health.

In 2009, the American Botanical Council’s Quarterly Journal estimated that sales of herbal supplements in the United States reached $5 billion. Consumers are the target.

Vitamin supplements are a complex topic, requiring a good background in disease prevention, nutrition and physiology. Factor in research showing it is often unclear whether supplements make a difference in pill form, the topic can have your head spinning.

“The double-edged sword of it is that in medicine, we like to have double-blind, randomized placebo-filled trials, “ said Kirk G. Voelker, a board certified internal medicine physician practicing critical care and  pulmonary medicine, in Sarasota. "We simply don’t have those when it comes to vitamins,” he said.

Expert Advice

According to Kathryn Allen, Director of Nutrition Therapy at the H. Lee Moffitt Cancer Center, it’s a question of balance.

“When we eat foods in combination with one another, they have a more powerful impact that when purified and taken out of context.”

Tinkering with the balance of nutrients doesn’t always yield a “more is better result”.

Mega-Dosing

Many Americans take higher doses of specific supplements thinking they’re dosing their body with extra protection against disease. Yet studies show that any vitamins taken in high doses can possibly cause harm and in some cases merely travel through our bodies will little absorption.

Others may actually accelerate the growth of cancer cells. One such example is folic acid, which when given to children with leukemia, causes the disease to proliferate.

Plainly stated, vitamin supplements are an unregulated industry. Many pharmaceutical companies stand to make great profits, since they invest little to no funding into research and development or randomized trials, as required with medications.  

Become a wary consumer

No one drug, vitamin or herb will cure all ailments. And not all “herbal” treatments or supplements are as clean as one might assume. So it takes some effort on our part.

For example, some supplements are compounded from the root, some from the blossom and some from the leaf, said Allen. That’s why you may only be guessing at the potency. However, some guidelines have been established by our government:

RDA (Recommended Dietary Allowance) established by the precursor of the FDA, equates to the amounts of a vitamin or mineral you need to stay healthy and prevent nutritional deficiencies.

UL (Tolerable Upper Intake Level) is the maximum amount of daily vitamins and minerals you can safely take without risking serious side effects (or an overdose). For certain nutrients, the higher you go above the UL, the greater the risks.

DV (Daily Value) used by the FDA, this number is the amount of a vitamin or nutrient needed for optimal health from a 2,000 calories-a-day diet.

Essentially the RDA and DV allow us to estimate how we can estimate inclusion of the maximum amount of nutrients we need to prevent disease.

It can be confusing to sift through the enormous amount of information becoming available to consumers. For example, the RDA of vitamin D for a 60-year-old is 600 international units (IU). Yet the National Osteoporosis Foundation recommends 800-1,000 IU.

And while the Institutes of Medicine has created a table listing the RDA for each vitamin, it is unclear which level is too high or low, without a specific exam or diagnosis, and in some cases, testing.

But experts also say an increasing amount of research into nutrients shows we are still developing ways to identify ideal amounts for people based on their personal history and disease processes.

“People intuitively want a pill to cure something, but the benefits come from doing the hard work,” cautions Voelker. ”A tweak in our diet and adding in exercise is likely more helpful to all of us,” he said.

Allen cautions against taking a vitamin as an intended cure.

“If you’re taking a vitamin as a supplement” she said, “that’s one thing. But if you’re taking it like a medicine, you need to seek professional guidance.”  

The best disease defense, says Allen, is a diet rich is fruit, vegetables, multi-grains and Omega3s.

Research has indicated that certain vitamins may also reduce inflammation. Keep in mind, it is somewhat challenging to determine what amount you may need. It's still not clear whether taking any of the vitamins listed below will reduce your risk for diseases linked to inflammation.

Vitamin A: found in whole milk, cod liver oil, organic eggs, spinach and some fortified foods. Beta-carotene is also found in carrots and many colorful vegetables that can be converted to vitamin A in our bodies. Yet it gets a bit overwhelming when you realize not everyone can easily convert beta-carotene into vitamin A.  As an antioxidant, it is protective against harmful substances called free radicals, which can damage DNA. Researchers believe this may lead to cancer and other diseases.

• Vitamin A deficiency has been linked to inflammation in the intestines, lungs, and skin.
• For some people, taking vitamin A supplements may reduce inflammation that contributes to conditions such as rosacea, acne, inflammatory bowel disease, and lung cancers.

Since it’s difficult to list vitamins you may consider taking without knowing your specific situation, here are some that have been identified with potential effects on chronic inflammation:

Vitamin B6: found in beef, turkey, vegetables. Because it is water-soluble, your body constantly eliminates this vitamin, so replenishment is essential.

The research:

• A deficiency may increase your risk for heart disease. Studies show those lacking this vitamin have higher levels of C-reactive protein (CRP), a marker of inflammation linked to heart disease.  
• B6 deficiencies may increase inflammation associated with rheumatoid arthritis. It is theorized that inflammation caused by rheumatoid arthritis can deplete the body's vitamin B6 stores. Some believe vitamin B6 supplements daily may counteract the deficiency, yet researchers say there's no conclusive evidence it will actually reduce inflammation.

If you find this a bit confusing, you should. The act is that research and medicine is a constantly evolving field.

Vitamin C: found in citrus fruits, it helps produce collagen, which is the essential building block of skin, cartilage, ligaments, and blood vessels. It also helps protect against harmful substances that contribute to disease. Classified as an antioxidant, studies suggest it has some anti-inflammatory benefits. Those at risk for deficiency include infants fed  evaporated or boiled milk, smokers and those around smoke, those with certain chronic diseases (such as end-stage renal cancer) and those eating a diet with limited variety..

The research:

• Taking vitamin C supplements may significantly lower CRP levels according to the latest research. It is unclear that having lower levels of CRP translates to a lower risk for heart disease.  

Vitamin D: works with calcium to strengthen bones, may protect against inflammation. Found in fish, liver, beef, egg yolks, and some fortified foods. Vitamin D is also produced in the body when skin is exposed to certain amounts of sunlight.

The research:

• Vitamin D deficiency has been linked to inflammatory diseases, including rheumatoid arthritis, lupus, inflammatory bowel disease and Type I diabetes. It has not been proven that taking Vitamin D supplements decreases the risk of these diseases and may in some cases increase levels of inflammatory markers in otherwise healthy patients.
• We do not know yet whether taking vitamin D supplements can actually lower cancer risk.

Vitamin E: found in certain nuts, seeds and green leafy vegetables, it is classified as an anti-oxidant, it has anti-inflammatory properties sources include nuts, seeds, and green leafy vegetables.

The research:

• Vitamin E comes in several different forms so be a savvy consumer. Some forms MAY help prevent heart disease and some breast cancers by slowing the release of inflammatory substances.
• Alpha-tocopherol also might be effective for easing lung inflammation related to allergies. However, because studies were conducted on animals, it's unclear whether the results translate to humans.

Vitamin K: found in green vegetables (asparagus, broccoli, kale, spinach), plays a role in coagulation (blood clotting).

The research:

• Getting more vitamin K can reduce levels of inflammatory markers throughout the body.

While much of this data is confusing, it may offer some background.

To illustrate how confusing this can get, it’s wise to note that Vitamin K is often confused with Potassium, which is essential to normal cardiac function. Yet to illustrate its potency sodium pentothal is injected during capital punishment, Potassium is also injected to stop the heart. That is why knowing what effect a substance could have on your body – especially in tandem with other substances, is essential before undertaking any changes.