Question about vitamin pills

[Maastricht]

DSeid, B12 deficiency is a real thingand massively underdiagnosed. This Dutch meta studysaid 5 to 10 percent of people got too little B12 in their diet. Spanish, too. As the symptoms of B12 deficiency are vague, and easily confused with psychosocial problems, while treatment is cheap, simple and effective, I say such opinions as yours are both incorrect and not constructive.

Vitamin B12 (cobalamin) properties
Good for: Making red blood and the formation of the nerves.
Signs of deficiency: Tiredness and fatigue, tingling and numbness in hands/feet, memory problems and anaemia.

I myself got my blood values checked before my gastric bypass surgery. I was way too low in B12, despite eating healthily. Too much, but healthy.
Then I had the surgery and took my gastric multivitamin every day. In the year after surgery, I had three blood tests done and my my B12 value was finally normal.

[Qadgop_the_Mercotan]

@dzero

Technically, everything is subject to debate. If you choose to be overly literal in your reading of my posts, there’s not much I can do about that.

Meanwhile there is a great deal of appropriate debate about Vitamin D’s role in many disease processes.

I know this to be true, as I’ve attended a number of medical conferences where debate was ongoing, and presented data to other physicians about some of the controversies and questions.

[dzero]

@Qadgop_the_Mercotan

Meanwhile there is a great deal of appropriate debate about Vitamin D’s role in many disease processes.

I know this to be true, as I’ve attended a number of medical conferences where debate was ongoing, and presented data to other physicians about some of the controversies and questions.

I guess at this point I should quote myself for the sake of clarity.

@dzero

There is a huge amount of evidence that proves even subclinical deficiencies in Vitamin D can cause or contribute to a host of problems. This is not subject to debate. I you read the article and check the sources you will see why.

http://www.sciencenews.org/view/feature/id/332009/title/The_power_of_D_

Of course in the case of D, you simply have to spend more time in the sun. But what if that’s not an option? And if we are just finding all of these things out about the importance of Vitamin D, then why shouldn’t we at least be open to the possibility that it may apply to other substances as well? It is a valid working thesis if nothing else.

If one reads the article, it will be clear that while there may not be a raft of placebo controlled studies regarding the role of D in various biological systems and functions, there is a tremendous amount of evidence that it is in fact involved. This is what is not subject to debate. I believe that anyone who actually read the article would have seen that, but that is just my opinion.

I will apologize for the word “prove” in that quote. That did amount to overstating the case I wanted to make - assuming that your standard of proof is something akin to placebo controlled human studies. But it’s also my opinion that one must consider the importance of acting on certain health-related information sooner rather than later. If it appears that the importance of a particular nutrient will in fact be born out after rigorous testing, then even though the tables may turn and one’s assumptions will ultimately be invalidated, the odds are against that outcome. In addition, to the extent that ones assumptions are in fact validated, it is likely that there will be many important benefits gained in the interim.

[Jackmannii]

In addition to risks associated with supplementation with specimen vitamins (i.e. vitamin E), associations have been seen between multivitamin use and prostate cancer as well as breast cancer.

I agree that other components of fruits and vegetables (i.e. fiber, certain antioxidants and other compounds) make them superior to vitamins alone as a nutritional source. What is far less defensible is the claim that the vitamins themselves are somehow different whether they come from fruits and vegetables or from a supplement. Maybe in some cases they work better in combination with other chemicals found in fruits and vegetables, or less well. To assume that combinations in fruits and vegetables are automatically superior is to fall into the trap of so many alt med/natural foods enthusiasts, who often think that nature is designed specifically to benefit human beings.

[DSeid]

Jackmannii, I would however take the position that the packaging of real foods that we evolved eating is likely to be superior. (“Likely” as a default, but not necessarily.) This is not thinking that nature is designed to benefit us, but that we evolved to thrive within the real world eating real foods (i.e. we are the puddle that formed a shape to fit the hole, not the other way around).

dzero, I think we can agree on your last post and I perhaps reacted a bit strongly. Vitamin D deficiency right now is the trendy thing in medicine. That it is involved with much more than had been previously understood is pretty solidly established, but what should be the level to label someone as deficient, what role diet and/or supplements and what role moderate sun exposure should play, and whether or not supplementation has an impact on a wide variety of conditions, are all very much works in progress, and subjects of very active debate. Many are very wary, having lived through hype with A, C, and E, only to find that supplements were more likely causing harm than good.

Maastrricht, please note that your first cite confirms my point that a doctor even having someone consider B12 shots is a reason to suspect you may be dealing with a quack. Basically the role of B12 shots was historically for pernicious anemia, an autoimmune disorder which leads to poor absorbtion of B12 and shots may still used initially for that I believe. About one in 7,500 get pernicious anemia and most of those people are over 60. So while I admit as a pediatrician I don’t see any of them, I’d still call one in 7,500 rare enough to be rare. Other than that one condition B12 shots are given, generally, by quacks.

For some reason your other links are not working for me. But I accept your statement of what they say. And? 5-10% do not get RDA. Probably worse for D and E and a few others. Many eat lots of crap and not enough real food. How often does that lack of recommended target intake cause problems and does how does that inform on the question of the superiority of getting vitamins from real foods in a varied diet?

I’ll also refer to this WebMD review. Yes, specific conditions (like pernicious anemia, celiac, inflammatory bowel diseases, or bariatric surgery) and lack of dietary sources can result in B12 deficiency. The rest (the vast vast majority) of us “get more than enough B12 from eating meat, eggs, milk, and cheese.”

[Jackmannii]

@DSeid

Jackmannii, I would however take the position that the packaging of real foods that we evolved eating is likely to be superior. (“Likely” as a default, but not necessarily.) This is not thinking that nature is designed to benefit us, but that we evolved to thrive within the real world eating real foods

While basically agreeing with this, I’ll be enough of a pedant/pissant to mention that the type of fruits and vegetables mankind evolved with through much of history are quite different from the hybrid sorts (and exotic items) that you pick up at the market these days.

Personally, I only forage in the fields and forest (old growth, of course) for my plant intake so I am an exception.

[iftheresaway]

If I can expand the question a bit, what about the juice brands like Odwalla or Naked, where the juice is made up of nothing but ground up fruits, veggies, greens, etc. (Here I’m referring specifically to juices like Naked’s Green Machine, which is 100% juice. There may be other juices in either company’s lineup which are less beneficial.)

While you’re definitely not getting the fiber that whole fruits and veggies would get you, what about the vitamins & minerals? Is anyone aware of research done on these kids of juices (as opposed to multi-vitamins)?

[panache45]

I can see how a well-balanced diet would work for someone with no dietary restrictions. But for those of us on restricted diets, we’d have to spend all day calculating the content of every bite we take.

I’m overweight, so have to be on a low-calorie diet.
I’m diabetic, so can’t have many high-glycemic-index carbs.
I have hypertension, so have to cut back on sodium.
I have aortic stenosis, so have to cut back on caffeine.
And if I have too much protein, my kidneys get clogged.
And to avoid other kidney problems I have to limit my calcium intake.

When I behave myself and only eat foods I’m supposed to be eating, I need to take several supplements in order to get what I need. It’s only when I “cheat” that I can get what I need from food. But most days are a compromise, sticking more or less with a healthy diet, but eating various amounts of food I shouldn’t be eating . . . varying both qualitatively and quantitatively from one day to the next. There’s no way I can keep track of the entire nutritional content of everything I eat on a given day. It’s a lot more practical to augment my diet with the supplements I need most, the ones I’m probably not getting enough of in my diet.

[DSeid]

@Jackmannii

… the type of fruits and vegetables mankind evolved with through much of history are quite different from the hybrid sorts (and exotic items) that you pick up at the market these days…

And a fair 'nuff comment that. But that said kale, sweet potatoes, cauliflower, oranges, berries, nuts and seeds, meats, fish, fowl, so on … are a lot more like the wide variety of foods our adaptable omnivorous ancestors scrounged up than is a Centrum … or than is a Big Mac!

panache45, high nutrition foods tend to be low calorie, low glycemic and low sodium. Caffeine need not be part of a “well-balanced diet” (even if I’d have a hard time living without it). And it is not difficult to to have a very well balanced diet that has a modest amount of protein and of calcium. Really, I have a hard time imagining what you are cheating with that does not actually make it harder to meet nutritional goals! (Most “cheat” foods are low in vitamins, minerals, phytochemicals, etc.)

iftheresaway, while I am sure there are some great phytochemicals in there, Green Machine is still mainly jacked up apple juice. A bottle (and let’s face it, they call the bottle to be two servings but most people drink the whole thing) is 280 calories and 56 grams of sugar. I don’t know of any specific research. I’d guess better than taking a vitamin and not as good as eating some fruit.