Another witnessing to your being mistaken. Even our ongoing CME tests have regular questions on these subjects … you can depend on one every so often with a presentation that will be acrodermatitis enteropathica, skin findings characteristic of zinc deficiency … but really the only utility I’ve had of knowing about it is getting that question correct!
In actual practice? Bloodwork for vitamin levels are rarely useful to me other than in special circumstances, such as medical conditions of poor absorption. Or severe lacks.
Don’t worry though. Consumers want supplements. MAHA thinks they’re great. Much better than actually consuming a healthy overall nutritional pattern. There is money being made and the corporations that own the physician groups would rather be in on the cash cow.
My cynicism aside there are some supplements that should be considered potentially effective medicines with low risk profiles that are sometimes being recommended but sometimes not.
For example lavender oil turns out to actually be a reasonable option to treat anxiety, in some cases, as weird as that sounds.
Unfortunately most claims regarding supplements have no good evidence for either safety or efficacy and as noted may contain stuff not listed on the label.
Better to be excessively skeptical than not skeptical enough.
I know my doc watches my potassium and iron. I’ve never heard them say anything else about other levels in bloodwork. I’m sure you are 100% correct.
Yes, there are good doctors and those doc that cookie cutter you and rush you out. Maybe the nurse find you pamphlet.
I’m not dissing doctors. I know some very good ones who I trust my life to.
My point is, if you want this looked into as deeply as our OP does it behooves them to find a doctor who specializes in it. If Google or other research fails it’s time to go into another way.
I hear this a lot from credible sources so I believe it to be true. In my case I apparently have a Vitamin D deficiency so both my PCP and cardiologist recommended a supplement, though they disagree on how much I should take. I’m going with the lower number suggested by my cardiologist because too much can lead to kidney stones, since it’s associated with calcium buildup (normally a good thing).
But on the subject of the thread, I choose to take the Vitamin D in the form of a multivitamin formulated for men over 50, because … why not? It has at least one ingredient that I actually need, in just about the right amount, and many others that may or may not be helpful. Who knows what else I may be short of that no one has noticed?
I belive it’s an OTC gummie of maybe 1200mg that was recommendedby her PCP. Not sure how often she takes it as I have not directly responsible for setting up her meds for quite some time.
She also had low sodium issues as well at one point and took supplements for that. Sent her to the ER one time when she visited my home. She is 94 now and in a nursing home, and doing quite well physically. Mentally is another story.
My sister wrote this to me the other day, as she is pushing various supplements at me:
“doctors have no training in nutrition or nutrients unless they are interested for their own reasons and search out the info for themselves”
For background, she is a retired nurse who worked for the last 20 years or so of her career exclusively in the OR of her local community hospital. I suspect most of the doctors she has come in contact with in the course of her work were surgeons.
Many of those who claim “doctors are ignorant about nutrition” really mean “doctors are skeptical about claims for the dietary supplements I promote/sell”.
QFT. If you are eating even a poor industrialized western diet, it’s more than likely you are getting all the vitamins you need from your food anyway and wont have any deficiencies - if you eat heathy then the risk is even less. The whole “just in case” blanket does not seem to be supported in the studies. If your doctor has recommended Vitamin D for something, you can get that specific supplement by itself without needing to consume un-needed other substances that you may be paying for just to be excreted (or worse).
And if you really question the expertise of doctors on this, there are specialists readily available for consultation in nearly every corner of the world from the smallest berg to the biggest city - pharmacists - just go talk to the one in your neighborhood rather than searching online.
On the other hand, it does seem to be true that the training in nutrition for medical doctors is sparse, considering how important nutrition is to general and specific health issues.
Searching for information on this topic, there is of course a lot of garbage and fluff. I did find articles in general-interest magazines (Time and US News) that talked about it, and one from a publication called The American Journal of Clinical Nutrition (however it seems to me their funding is suspect, being mostly companies that sell food products). I did find one article from 2019 in The Lancet that had a world-wide focus, and they had this conclusion:
“Our analysis of these studies showed that nutrition is insufficiently incorporated into medical education, regardless of country, setting, or year of medical education. Deficits in nutrition education affect students’ knowledge, skills, and confidence to implement nutrition care into patient care. A modest positive effect was reported from curriculum initiatives.”
What seems to me most likely to be true is that it depends on the type of doctor. I would, perhaps naively, expect an endocrinologist to be more aware of nutrition issues than, say, a urologist.
I have given multiple different supplements a try over the years. Since they’re an expense and since I get tired of chug-a-lugging more pills than George Jetson’s breakfast, I don’t continue anything that doesn’t clearly seem to benefit me. I do the usual daily multivitamin, I add in an extra 500mg vitamin C because I don’t eat a balanced diet, chromium picolinate helps with my blood glucose levels, and I supplement magnesium glycinate. Nutrition aside I’m also taking a few other over the counter supplements that are supposed to help with mood and sleep, which seem to be some help.
I can accept that for most healthy people, multivitamins are generally useless, but I have trouble with the “can be harmful” bit because there are just so many potential confounding factors in a study like the one cited.
For example, is there some health or dietary concern that prompts many people to take multivitamins that correlates with reduced longevity but has nothing to do with the multivitamin itself being a causative factor? I can cite myself as an example of that. I like to think (probably wrongly, but who knows) that multivitamins may help compensate to some extent for an inadequately balanced diet, especially for someone who isn’t a fan of fruits and vegetables.
I take a slightly different take on the “can be harmful” bit.
My fear is that some people feel a bit less concerned about eating a decent nutrition pattern under the belief that it isn’t as important to eat a real food diet with vegetables and fruits because of the mistaken belief that their multivitamin is there as just in case insurance.
That’s a valid concern and I pretty much cited myself as an example of that. I’m not about to make major changes to my diet or lifestyle but I sort of intermittently pay more attention to what I buy. There are some healthy things I like – salads, green grapes, sweet corn (not the best veggie, but better than none). If I consider my diet to be more or less a given regardless of what supplements I do or do not take, I think it’s safe to consider multivitamins to be at least harmless. And I’m not 100% convinced that they don’t have some utility, especially with a less-than-perfect diet.
I tried taking a multivitamin several years ago. The B vitamins in it made me throw up because I already had plenty of those in my system.
A friend of mine recommended MSM for some joint pain I was having. Taking it made my joint pain worse. Doing some research I found out that was because I’m allergic to sulfa drugs and guess what the S in MSM stands for. I looked on the brand website and there wasn’t word one about the supplement containing sulfa or that people allergic to sulfa shouldn’t take it. Why? Because they didn’t have to mention that.
When I was on chemo over the summer, my liver numbers cratered. My oncologist said there had been a study about milk thistle helping liver function for breast cancer chemo patients. I tried the brand she recommended and my liver numbers went back to normal. When I had to wait for the next bottle to come in (I didn’t order it soon enough), the numbers went back down. New bottle, numbers back up. I kept taking it until I was finished with chemo.
Lesson: take your doctor’s recommendation on supplements, not anyone else’s.
No offense to your sister or any nurses reading this, but I’ve found many nurses to have their own ideas about things which they don’t know enough about. Certainly not all, or even a majority, but enough that I’ve been really surprised by it.
The statement as you’ve written it sure sounds like a person who’s “done her own research”. And I’d be surprised if an OR doc discussed their nutrition training with an OR nurse over the course of their OR interactions.
That’s pretty frightening (as another person allergic to sulfa).
How did you determine which specific ingredient(s) made you vomit?
The stuff you are more importantly and highly likely missing eating crap is all the other stuff than the vitamins. Not just fiber either but hosts of various phytonutrients that do us all so much good.
As with any other profession, there are competent nurses and the other sort. I know two who swear by apple cider vinegar as a magic elixir and another who is a proponent of “alkaline” water.
