I need to talk to sensible people (like you folks) about dietary supplements

In My Humble Opinion
81

RDA for women over 50 years old is 1200 mg daily. Most of the time when people talk about taking a calcium supplement they are not referencing a multivitamin that also has a little calcium but taking a separate pill. 600 to 1200 are common amounts. 500 mg is not pretty large. It’s pretty modest.

The cited study did not test with vitamin D coadministered. It might be protective but this study does not inform on it.

The article cited gives a broader backdrop of studies that are not all consistent, the uncertainty as things currently stand. Other studies find that it is getting total intake over 1400 mg a day that is the potential problem. But more so if that happened with supplements than by diet alone. Thing also is that is a narrow window from what is RDA for the population.

https://www.bmj.com/press-releases/2013/02/11/risk-cardiovascular-death-doubled-women-high-calcium-intake

Results showed that during 19 years of follow-up, 11,944 women (17%) died: 3,862 of these (32%) died from cardiovascular disease, 1932 (16%) from heart disease and 1100 (8%) from stroke. Highest rates of all-cause, cardiovascular and heart disease were observed among those with a dietary calcium intake higher than 1400mg/day. In addition, researchers observed higher death rates among women with an intake below 600mg/day.

Women who had a higher dietary intake of calcium exceeding 1400mg/day and also used supplements had a higher death rate compared to those not taking supplements. Women with a high dietary calcium intake (>1400 mg/day) were more than twice as likely to die compared with women with a 600-999mg/day calcium intake.

The researchers explain their findings by suggesting that diets very low or very high in calcium can override normal homeostatic control causing changes in blood levels of calcium.

The researchers conclude that high calcium is associated with “higher all-cause and cardiovascular mortality rates” and so to prevent fractures in the elderly emphasis should be placed on individuals with a low intake of calcium rather than increasing the intake of those already consuming satisfactory amounts.

A little bit extra, less than half the RDA for the group, just in case, may not be a good idea. Unless your intake from food is very low. And better to increase food source intake if you can. And if good intake already? 300 mg more may get over that level.

Individuals have individual issues, like poor absorption. Again not advising anything to any specific person.

82

Interesting about men and iron. My husband takes an iron supplement on medical advice due to low platelets (seems to be idiopathic - which to you as a doctor means “we don’t know the cause” but to me as a civilian, means “your body is being an IDIOT”).

And yeah, I know you aren’t talking about me specifically :smiley: - my supplements are taken with the knowledge of my doctors, and because of my specific situation.

As an example of relative vs absolute risk: I’m BRCA1+. Among the better-known risks (breast and ovarian cancer), I have double the regular risk for endometrial cancer.

DOUBLE??? OH NOOOOOOO. Until you learn that the general population risk is 2%. So my risk would be 4%.

As it happens, I did yank the uterus along with the tubes and ovaries - while 4% was a risk I was willing to take, at my age without having developed it yet, the type I was likely to develop was more aggressive (serous) and often required chemo even at stage 1. The chemo was what decided me. My odds of developing it were low, but the issues if I did anyway seemed to be too rough.

83

When we have difficult medical conditions the supplements and vitamins we need to add can be quite complicated.

It’s such an individual thing. You really can’t follow another patients advice for yourself.

@Roderick_Femm is doing it the right way. Researching as best they can.

I’m wary of these things like ashawaganda and willow bark. Heck, I’m wary of chamomile tea.

I would really be deep diving if I thought I needed it.

I thought one time I needed to be on St. John’s wort. I looked into it as far as I could. Ask my doctor who said she wasn’t sold on it but try it. I did.

Next day I noticed some spots in my legs. Soon, I looked like a kid with Chicken pox. Funny thing St.Johns wort can do this if you go out in the sunlight. It was no where in the literature I read that this was a possibility.

You gotta be careful.

84

I remember “calcified’“ being on the report from a CT angiogram I had last year - and “calcified plaques” were noted in several places.

Without knowing ANYTHING about the mechanism of how this happens, it doesn’t seem outrageous that there might be a connection with supplements.

Luckily my own calcium score, while some plaques were found, was in the mild range.

85

I’m shooting from a sore hip here, but wouldn’t calcium deposits inflame joints as well?

86

And was I suggesting a separate Calcium Supplement? Nope. B12 and D- maybe, and sure a normal daily multivite. Large dosages of most supplements (Vitamin C seems to be okay if you do not go into MEGA doses) are something one should discuss with their medical practicioner, which i have said over and over.

It is basically impure aspirin, and since not pure or better yet buffered- it can be very hard on your stomach. Unless you cant get aspirin there is no reason to take willow bark.

87

Maybe I got confused by the fact you responding to this -

In context of this -

But okay. Still stands that it may be that even the 300 mg in a multivitamin is enough to push someone with adequate calcium intake into a range of possible harms.

Again, some lack of certainty. And reading more also unclear on the supplemental iron harms in men. Pretty solidly so if you are a male diabetic but not so much so otherwise.

88

When discussing supliments, it is important to remember the ‘Placebo Effect’.

If you believe that it is working, it probably is. It is a real phenomenom. If you think it is helping you it may well be helping, even if it has no real medical or nutritional value.

Placebo - Wikipedia

89

My understanding Placebo is harmless.

These vitamins, minerals and supplements CAN be detrimental.

It behooves you to do your own research, if doctors orders don’t convince you of their efficacy or safety.

90

Aren’t these two statements at odds? Or has “doing your own research” not yet been debunked?

91

Maybe. But you gotta do your best.

Shit happens.

92

Very true!

For what it’s worth, the vitamins I take don’t contain calcium. Many multivitamins don’t contain much iron either (mine don’t).

93

Yeah, just like I said back in post #2.

Rohin Francis’ video that I cited is well worth seeing. His point is that if a “placebo” works for you, then it has value.

94

I remember, during the “calcium craze” of the mid 1980s, there were reports of (mostly) women getting kidney stones because they were taking way more calcium than they needed.

95

I can’t believe St. John’s wort is legal to sell OTC. (It’s actually RX-only in some countries.) It has so many drug interactions, especially with oral contraceptives.

96

So, there are a few things to unpack in your op

  1. do these supplements work?
  2. are they safe?
  3. if it’s worth getting, where do i get the real thing, not overly contaminated?

First, the placebo effect is real. Especially for pain. If something helps your pain, it is helpful. It might also be dangerous, though.

Glucosamine seems to have a pretty good safety record. If you are eating quantities of turmeric found in food, that also has a decent safety record.

MSM is apparently GRAS (generally recognized as safe) and generally well tolerated in doses up to 4 grams daily.

I’ve never heard of boswellia extract and have no clue about it.

But remember that anything that’s biologically active/effective can have side effects. That includes pure placebos, although they tend to be less dangerous than actual drugs. Be on the lookout for unwanted changes in your health after taking something new.

Also, make sure your doctor knows what supplements you are taking, and how much. Both because doctors are supposed to be on top on health research and new findings, and also because a lot is supplements that are generally safe have known interactions with drugs you might need for other stuff.

A friend’s father was an arthritis doctor. He had lots of patients with pain, and there was a limited amount he could do to help them, in many cases. A lot of them used supplements and other “alternative medicine” treatments. His philosophy was to only intervene if the stuff was either dangerous or grossly expensive. If patients came in wearing a lot of copper bangles (a then-popular treatment for arthritis, with zero support as anything but a placebo) he figured it might be helping them and wouldn’t do any harm.

I don’t know how to get good quality supplements. Consumers report once rated a bunch and found that the ones that claimed to adhere to some external standard generally did, even though that claim had no legal weight. I like to buy vitamins from major brands that have a stake in not getting a lot of bad press. I seem to have 3 bottles of vitamin D, all different brands (something both my doctor and my husband’s doctor have told us to take, so we go through a lot of it) “Nature Made” has strongest claims on the label. (USP verified) But I’ve obviously not followed my own advise. The others are both major brands found at major shops, though.

97

Thank you for your very organized discussion. This product is from the same family of trees that is the source of frankincense. The specific tree is called Boswellia Serrata, the tree family is Burseraceae. A lot of it comes from India and that region, you can find brands that at least say they are manufactured in the US (even if the ingredients come from elsewhere).

This is one of my questions, how long before one might notice side effects. Especially side effects that rely on accumulation of a substance in the body over time.

They do always ask what I’m taking, and I tell them, but they don’t ask how much. Fortunately, most of my doctors are in a network that has a patient portal where I can put that stuff down for all of them to see.

I don’t have a lot of confidence that the MDs and PAs that I’m seeing are actually on top of health research and new findings, though. None of them have said anything so far.

98

It seems to work for me. Studies are all over the place- some say “no results” other show mild help with joint pain. My Doctor said- “if it works for you- great!”. But folks- dont expect a miracle.

I however have a new and very strong recommendation. If you do not have a regular Doctor to discuss this with (or even if you do) read this months Consumer Reports. It sorta says i am wrong but right over multi-vites: they are iffy on them for everyone, but do suggest them for ages 60+.

They do not mention any dangers from Calcium.

here is a Calcium study-

https://www.tandfonline.com/doi/full/10.2147/CIA.S157523

Calcium is an important integrative component of the human body and critical for human health. It has been well established that calcium intake is helpful in the prevention and treatment of osteoporosis, which has become one of the most serious public health problems across the world. However, community-dwelling adults with and without osteoporosis are rarely concerned or even not aware of the potential side effects of high or inappropriate doses of calcium intake. Some recent studies have revealed that excessive calcium intake might increase the risks of cardiovascular diseases. The purpose of this article was to review the health benefits, costs, and consequences of calcium supplementation on osteoporosis/osteoporotic fractures, cardiovascular events, kidney stones, gastrointestinal diseases, and other important diseases. In the end, we suggest that calcium supplementation should be prescribed and taken cautiously, accounting for individual patients’ risks and benefits. Clearly, further studies are needed to examine the health effects of calcium supplementation to make any solid recommendations for people of different genders, ages, and ethnicities.

And folks “doing your own research” has a certain stench after morons used it to not get Vaccines or used anti-malaria drugs to cure Covid. Youtube, talk radio , politicians and TV are not Research.

Talking to your doctor, and if you must- articles on Google Scholar are real research. Published articles in peer reviewed trusted journals.

99

That reminds me, first of all, of my grandmother (1915-2007) who read about cider vinegar being good for arthritis in a supermarket tabloid, and asked her doctor if she could use it. He told her, “Sure, give it a try” so she would add a spoonful to her meals. My parents couldn’t taste the difference, and she swore it worked. Even if it was the placebo effect, it was harmless.

I also worked at the grocery store with a woman whose late mother had long battled psoriasis, and a friend who sold Shaklee products suggested a certain type of their vitamins. Again, her doctor said, “Give them a try” and to everyone’s surprise, not only did her psoriasis clear up, when she stopped taking them for whatever reason, it did not come back.

100

Just saw this thread. Maybe I missed it, but the above question may have been neglected in responses.

This Sloan-Kettering link is 11 years old, but sounds right to me:

How do I know if a dietary supplement contains what the label says it contains?

I take Vitamin D3 due to a history of deficiency and low quality evidence that it slows progression of chronic leukemia I have. And I look on the label for USP.