"Energy" pills

Factual Questions
1

My nephew picked up some energy pills at his gym. Looking at them they are almost exclusively Vitimin’s B and C (actually no caffeine, much to my surprise.)

My gut says that if you aren’t defficient in these vitimins, the pills will do nothing for you. But he swears they give him a boost. Is this all psychological or is he really getting an energy boost? I do know that my B vitimins seem to give me a boost in the morning and if I forget them I’m a little sluggish all day, but due to some health issues my doc says that I have some malabsorbtion and so I expect that I am somewhat defficient.

2

IMHO Placebo effect or would that be affect (someone stole my Elements of Style ).

This might be a a slight hijack but I think Jack and the beanstalk could easily be rewritten with him trading the cow for magic pills instead of magic beans. Patent medicine is as popular as ever. People will never learn that there is not a pill for every condition. It’s what my wife believed and she has been ashes in a jar for two years now.

3

Sorry about being on the soapbox in the previous post, I lost track of what forum I was in, please forgive me.

Now, a factual answer for a real question. My doctor told me that most vitamin supplements taken via pills go straight through the body and are eliminated in urine. My doc is big on eat right, get exercise, do the right thing and things will probably work fine.

4

I see several issues here and you’ve pointed out at least one of them.

My gut says that if you aren’t defficient in these vitimins, the pills will do nothing for you. But he swears they give him a boost.

Obvious possibility - his diet is deficient in these vitamins and taking them does give him a boost. The fact is that B vitamins are used by the body in the metabolism of carbohydrates, fats, and proteins and it is at least possible they really are giving him a boost.

Health isn’t simply the lack of disease. Just because you don’t have beriberi doesn’t mean that you have the B vitamin levels necessary for optimum health. There’s a big difference between feeling like crap and feeling great and if taking a B vitamin makes the difference between me feeling like crap and me feeling great, then I’d say I was deficient in B even if I wasn’t actually “diseased.”
*
My doctor told me that most vitamin supplements taken via pills go straight through the body and are eliminated in urine.*

Anything eliminated in the urine is coming from the bloodstream so the body is absorbing the vitamins in supplements exactly the same way it absorbs the vitamins in foods. There are larger issues involved such as the fact that vitamins are coenzymes and fresh foods also tend to have the enzymes they work with along with the vitamins and so if you are deficient in the enzymes the vitamins work with, the vitamins aren’t going to do much, but that doesn’t change the fact that anything coming out in your urine was first absorbed by the body and circulated throughout.

I think the following illustrates what the doc is getting at but it also suggests he may be wrong.

I take a B complex every morning. Some days my urine is a bright yellow for a couple of hours afterwards and on those days I figure “Ok, I guess I didn’t need much of that” but on other days, my urine doesn’t show any trace of the tell-tale yellow and on those days I figure that I did need it because my body is hanging on to it. Oh yeah, I eat the same thing for breakfast every day so the color/no color thing isn’t due to food combination effects in my gut. I’m fully aware that there might be other reasons than use/non-use to explain the color/no color deal but it at least suggests that some days I really am using those supplemental vitamins.

Please be sure your brother doesn’t think “If some is good, more is better” when it comes to these supplements. Excess B complex can cause calcium deficiency, for example, so one needs to be prudent at least and being educated is even better.

The human body is incredibly complex and is constantly changing. Aspirin, for example, kills some people and doesn’t do squat to others so I am not willing to accept the one answer fits all idea when it comes to these sorts of issues.

5

[QUOTE=daffyduck]
Excess B complex can cause calcium deficiency, for example, so one needs to be prudent at least and being educated is even better.
[/QUOTE]
There is some medical history of using injections of vitamins B to perk up the hung over or sleep deprived.
I can’t find a decent reference to the practice, but perhaps KarlGauss knows more?

6

[QUOTE=Squink]
There is some medical history of using injections of vitamins B to perk up the hung over or sleep deprived.
I can’t find a decent reference to the practice, but perhaps KarlGauss knows more?
[/QUOTE]

Not to speak for the good and esteemed KarlGauss, but vitamin therapy is mostly bogus, unless you are deficient in the vitamin in question. And 99.999% of folks in the US are not. No normal person following the U.S. Dietary Guidelines is in any danger of vitamin deficiency.

7

[QUOTE=Qadgop the Mercotan]
…but vitamin therapy is mostly bogus…
[/QUOTE]
Agreed, but I remember seeing a couple refs to B shots being used as I described by the military, back in the 40’s or 50’s.

8

[QUOTE=Squink]
Agreed, but I remember seeing a couple refs to B shots being used as I described by the military, back in the 40’s or 50’s.
[/QUOTE]

An infusion of thiamine (vitamin B-1) is usually given to alcoholics going thru detox, as they may have an absolute deficiency of vitamin b-1. Combine that deficiency with calories via IV (dextrose infusions) and you get permanent neurological damage.

This approach got adopted into regularly giving alcoholics vitamin b-1 pre-emptively, and a lot of heavy drinkers seemed to adapt it as a part of their post-partying routine.

I am unaware of any reputable authorities making claims that B vitamins will ‘energize’ anyone.

9

[QUOTE=Khadaji]
Is this all psychological or is he really getting an energy boost?
[/QUOTE]

If you take enough vitamin B3 in the form of niacin but not niacinamide, you can sometimes cause capillary opening that results in a flush which at lower levels can feel energizing but at higher levels is just kind of hot and itchy.

10

I seem to recall something about energy drinks, some w/o caffene on their label, but do actually contain caffene, but don’t have to list it because caffene is part of another ingredient which naturally contains caffene. I do n’t know if these pills fit into this, but it’s something to watch.

A obvious (but fictional) example of the above would be a ingredient list of:
Water, sugar, instant coffee, polysorbatol-80, …

Where though caffene is not listed, there is caffene in instant coffee. IIRC Sometimes multiple ingredients contain caffene.

11

[QUOTE=kanicbird]
I seem to recall something about energy drinks, some w/o caffene on their label, but do actually contain caffene, but don’t have to list it because caffene is part of another ingredient which naturally contains caffene. I do n’t know if these pills fit into this, but it’s something to watch.
[/QUOTE]

Guarana, perhaps?

12

[QUOTE=Qadgop the Mercotan]
Not to speak for the good and esteemed KarlGauss, but vitamin therapy is mostly bogus, unless you are deficient in the vitamin in question. And 99.999% of folks in the US are not. No normal person following the U.S. Dietary Guidelines is in any danger of vitamin deficiency.
[/QUOTE]
I eat a fairly balanced diet; rice, vegetables, some animal protein, pasta, fruit and vegetable juices, little or no processed foods (does store bought whole wheat bread count?) and take a multi-vitamin every day. Is the vitamin unnecessary? I mainly take it to cover my bases, as it is not always possible to eat on a regular schedule. Sometimes Gatorade and a bannana is lunch. (I work a construction type job.)

13

[QUOTE=Contrapuntal]
(does store bought whole wheat bread count?)
[/QUOTE]

I would count this as processed, why would you exclude this? and why the ‘store bought’ qualifier? And for that matter pasta.

14

[QUOTE=Contrapuntal]
I eat a fairly balanced diet; rice, vegetables, some animal protein, pasta, fruit and vegetable juices, little or no processed foods (does store bought whole wheat bread count?) and take a multi-vitamin every day. Is the vitamin unnecessary? I mainly take it to cover my bases, as it is not always possible to eat on a regular schedule. Sometimes Gatorade and a bannana is lunch. (I work a construction type job.)
[/QUOTE]

As the doctor has said, “No normal person following the U.S. Dietary Guidelines is in any danger of vitamin deficiency” and I certainly won’t argue that point. 99.999% of folks in the US do not have vitamin deficiency diseases so if your question is if you need to take a multi-vitamin to avoid vitamin deficiency diseases, the answer is an unambiguous no.

If your question is if there are any possible benefits from vitamin supplementation, I think the answer is a pretty clear maybe.

A report from the University of Maryland Medical Center on Vitamin C (cite ) illustrates the problem.

Low levels of vitamin C have been associated with a variety of conditions including hypertension, gallbladder disease, stroke, some cancers, and atherosclerosis (the build up of plaque in blood vessels that can lead to heart attack and stroke; conditions that are caused by atherosclerotic build up are often collectively referred to as cardiovascular diseases). Eating adequate amounts of vitamin C in the diet (primarily through lots of fresh fruits and vegetables) may help reduce the risk of developing some of these conditions. There is little evidence, however, that vitamin C supplements can cure any of these diseases.

So is taking vitamin C going to cure your cardiovascular disease? No way. But they do recommend you get “adequate amounts” to help prevent developing these diseases in the first place. Why don’t they just say that adequate amounts will definitely help? Because they don’t know for sure. Low levels of C are associated with these diseases; nobody is saying that low levels cause these diseases. It’s way too complicated to make such a simplistic statement. But, clearly, Vitamin C does more than prevent scurvy.

Further down in the report, they recommend you get between 500mg and 1000mg of vitamin C a day. Now we’re cooking.. now we have some numbers to work with. Ok, let’s get eating!

Let’s say you put a half cup of fresh strawberries on your morning cereal, eat an apple at lunch, have an orange for a snack, and have a spinach salad with dinner. You’re doing better than most, I’ll bet, but you’re still only up to about 150mg of C and that is only 30% of the minimum recommended amount for optimum health. You only need 60mg a day to meet the RDA, so we know you’re in no danger of developing a vitamin deficiency disease like scurvy, so that is something, but the good folks over at the University of Maryland Medical Center think you should do better and I’m inclined to agree with them, especially since the report I cited is linked to from the USDA Dietary Guidance pages. We’re not talking about hucksters or people making extravagant claims or people trying to sell you something. We’re talking doctors who study this stuff every day and they recommend you get eight times the RDA for vitamin C. They also recommend you get it in foods, but that isn’t as easy as it sounds. It can be done, but it requires exceptional effort and most of us aren’t going to eat seven oranges a day.

Needless to say, we’ve only scratched the surface with this little illustration about vitamin C. Once you start looking at all the other vitamins, minerals, and enzymes known to be important for good nutrition, it actually starts to get complicated.

So, are there valid reasons why supplementing with a multivitamin might be a good idea? Read the available literature from reputable sources and decide for yourself. I’m no doctor, but I read a lot of what doctors who study nutrition full time have to say and I take one. YMMV and no offense intended to others who feel differently, but for my money (literally) there is enough literature available from reputable sources to suggest that vitamin supplementation isn’t automatically foolish.

15

[QUOTE=daffyduck]
Further down in the report, they recommend you get between 500mg and 1000mg of vitamin C a day.
[/QUOTE]

No they don’t. What they actually say is:

Emphasis added.

and

The “studies” they mention, and whether the conditions in the Uses section are actually prevented or treated by high doses of Vitamin C are matters the article is, in general, somewhere between indifferent and highly sceptical of.

In fact the article doesn’t say anywhere that there is any strong evidence that there is any benefit at all of intake of Vitamin C above the USDA dietary level of up to about 90mg depending on age and sex.

16

[QUOTE=kanicbird]
I would count this as processed, why would you exclude this? and why the ‘store bought’ qualifier? And for that matter pasta.
[/QUOTE]
Maybe I’m wrong. I a thinking of foods that are made from whole ingredients, such as whole wheat flour versus whit flour, cheese versus ‘cheese food,’ etc.

17

[QUOTE=Qadgop the Mercotan]
Not to speak for the good and esteemed KarlGauss, but vitamin therapy is mostly bogus, unless you are deficient in the vitamin in question. And 99.999% of folks in the US are not. No normal person following the U.S. Dietary Guidelines is in any danger of vitamin deficiency.
[/QUOTE]

Sure. But Doc, few dudes follow the US Dietary Guidelines. Vitamin Supplements are useful to a variety of the population, as these cites show:

“The response rate to vitamin supplements supports the notion that metabolic evidence of vitamin deficiency is common in the elderly, even in the presence of normal serum vitamin levels. Metabolite assays permit identification of elderly subjects who may benefit from vitamin supplements.”

(Pregnant women with HIV, warning PDF)
http://www.dr-rath-foundation.org.za/pdf-files/jan05/document_h.pdf

http://edrv.endojournals.org/cgi/content/abstract/22/4/477
Vitamin D deficiency is common in the elderly, especially in the housebound and in geriatric patients. The establishment of strict diagnostic criteria is hampered by differences in assay methods for 25-hydroxyvitamin D. The synthesis of vitamin D3 in the skin under influence of UV light decreases with aging due to insufficient sunlight exposure, and a decreased functional capacity of the skin. The diet contains a minor part of the vitamin D requirement. Vitamin D deficiency in the elderly is less common in the United States than elsewhere due to the fortification of milk and use of supplements. Deficiency in vitamin D causes secondary hyperparathyroidism, high bone turnover, bone loss, mineralization defects, and hip and other fractures. Less certain consequences include myopathy and falls. A diet low in calcium may cause an increased turnover of vitamin D metabolites and thereby aggravate vitamin D deficiency. Prevention is feasible by UV light exposure, food fortification, and supplements. Vitamin D3 supplementation causes a decrease of the serum PTH concentration, a decrease of bone turnover, and an increase of bone mineral density. Vitamin D3 and calcium may decrease the incidence of hip and other peripheral fractures in nursing home residents. Vitamin D3 is recommended in housebound elderly, and it may be cost-effective in hip fracture prevention in selected risk groups.

"A meta-analysis of 12 randomized trials of vitamin supplements to lower homocysteine levels was carried out to determine the optimal dose of folic acid required to lower homocysteine levels and to assess whether vitamin B 12 or vitamin B6 had additive effects. This meta-analysis demonstrated that reductions in blood homocysteine levels were greater at higher pretreatment blood homocysteine levels and at lower pretreatment folate concentrations. After standardization for a pretreatment homocysteine concentration of 12 µmol/L and folate concentration of 12 nmol/L (approximate average concentrations for western populations), dietary folic acid reduced homocysteine levels by 25% (95% confidence interval [CI]: 23 to 28%) with similar effects in a daily dosage range of 0.5 to 5 mg. Vitamin B 12 (mean 0.5 mg) produced an additional reduction in blood homocysteine of 7%, whereas vitamin B 6 (mean 16.5 mg) did not have any significant effect. Hence, in typical populations, daily supplementation with both 0.5 to 5 mg folic acid and about 0.5 mg vitamin B 12 would be expected to reduce homocysteine levels by one quarter to one third (from about 12 µmol/L to about 8 to 9 µmol/L). Large-scale randomized trials of such regimens are now required to determine whether lowering homocysteine levels by folic acid and vitamin B 12, with or without added vitamin B6, reduces the risk of vascular disease. "

Research during the last 5 years has made it clear that people who do not take folic acid supplements are at increased risk for functional folate deficiency, which has been proven to cause spina bifida and anencephaly and also has been associated with an increased risk for occlusive cardiovascular disease. The overriding folate policy issue is how to increase dramatically the folate consumption of 75% of the population who are now consuming 0.4 mg of folic acid in a supplement. The most expeditious way to increase consumption is through fortification of a food staple. Public health programs are also needed to educate people about the vital importance of increased consumption of folic acid vitamin supplements and of food rich in natural folates. It is urgent that fortification of cereal-grain products be implemented now. The level proposes by FDA would accomplish some prevention, but much more prevention would occur if the fortification were 2.5 times that level. Fortification at the higher level would prevent about 1000 spina bifida and anencephaly birth defects each year and perhaps as many as 50,000 premature deaths each year from coronary disease. Available data have not demonstrated that increasing consumption of folic acid by 0.1 to 0.25 mg of folic acid a day is harmful. If a policy needs to be established on the assumption that people who take vitamin supplements could be harmed, a good policy option ia available; require that all folic acid vitamin supplements also contain 0.4 mg of vitamin B-12"

Vitamin B12 deficiency is estimated to affect 10%–15% of people over the age of 60, and the laboratory diagnosis is usually based on low serum vitamin B12 levels or elevated serum methylmalonic acid and homocysteine levels.

http://www.springerlink.com/content/lt26654g0873p83h/
The efficacy of calcium (Ca) in reducing bone loss is debated. In a randomized placebo-controlled double-masked study, we investigated the effects of oral Ca supplements on femoral shaft (FS), femoral neck (FN) and lumbar spine (LS) bone mineral density (BMD), and on the incidence of vertebral fracture in vitamin-D-replete elderly. …Thus, oral Ca supplements prevented a femoral BMD decrease and lowered vertebral fracture rate in the elderly."

We conclude that in elderly postmenopausal women with spine fractures and selfselected calcium intakes of < 1 g/day, a calcium supplement of 1.2 g/day reduces the incidence of spine fractures and halts measurable bone loss.

Here’s a PDF on “what vitamins do I need Doctor?”
http://www.direct-ms.org/pdf/nutritionGeneral/WillettVitamins.pdf
“Given the greater likelihood of benefit than harm, we conclude that a daily multivitamin that does not exceed the RDA make sense for most adults… A multivitamin is especially important for women who might become pregnant; for persons who regularly consume one or two alcholic beverages a day; for the elderly…; for vegans…; and for poor urban residents, who may be unable to afford adequate intakes of fruits and vegetables”. To that I’ll add: “those who just plain *don’t * eat a balanced diet.”

Oddly, dudes who do take supplements are less likely to need them that those who don’t! :eek: :
http://jn.nutrition.org/cgi/content/abstract/135/7/1782
*Use of dietary supplements may be one of a number of health-related behaviors that cluster together. The current study investigated the underlying diet, health-related characteristics, and behaviors of users and nonusers of dietary supplements in a longitudinal study of health. Participants (n = 1776) completed a 5-d food diary including information on dietary supplement use (vitamins, minerals, and nutraceuticals) at age 53 y. Sociodemographic information and data on smoking, alcohol, and physical activity were obtained along with anthropometric measurements, blood pressure, and a blood sample (nonfasting subjects). A significantly greater percentage of women reported supplement use compared with men (45.1 vs. 25.2%). Supplement use was associated with lower BMI, lower waist circumference, higher plasma folate and plasma vitamin B-12 concentrations, nonsmoking, participation in physical activity, and nonmanual social class in women and with plasma folate concentrations and participation in physical activity in men. Nonsupplement users tended to be nonconsumers of breakfast cereals, fruit, fruit juice, yogurt, oily fish, and olive oil and had lower dietary intakes of potassium, magnesium, phosphorus, iron, and vitamin C even after adjustment for sociodemographic and behavioral factors. Overall, supplement users tended to differ from nonsupplement users on a range of health-related behaviors and health status indicators, although there were fewer significant associations in men. Similarly, dietary supplements users tended to have underlying diets that, were healthier and those taking supplements may be the least likely to need them. These results support the notion of a clustering of healthy behaviors and cardiovascular risk factors, particularly for women. *

But yeah, The good Doctor Qadgop is right- it’s more important and better for you to eat right than pop a pill. However, OTOH I agree with Drs. WC Willett, MJ Stampfer *et al, * in that a moderate priced and moderate potency multivite “makes sense for most adults”. YMMV. Consult your personal Physician. Eat right, get some sun and fresh air, excercise, get a physical. No pill can really substitute for those.

18

Getting back to the OP, what are the actual ingredients of the pills? They may be sugar pills with some vitamins added, in which case the kid could be experiencing a mild sugar rush.

19

[QUOTE=Little Nemo]
Getting back to the OP, what are the actual ingredients of the pills? They may be sugar pills with some vitamins added, in which case the kid could be experiencing a mild sugar rush.
[/QUOTE]

The two ingredients that jumped out at me were vitamins B and C. I am pretty sure I would have recognized any sugars, even the hidden ones. But I don’t have the pills anymore, so I can’t say for sure.

20

All this about whether or not vitamin supplementation is helpful is sort of secondary - it seems pretty unlikely that vitamins are causing anyone to get a rush of energy. Isn’t it a ton more likely that it’s just the placebo effect? It’s not really necessary to invent elaborate, unlikely fantasies about miniscule quantities of sugar causing a rush when the placebo effect is much more likely.

I’ve heard this before. But I’d be cautious if I were you about who I’m getting my information from. Your link is to a quack website.