Sick of Supplements

Vitamin E, multivitamins, B vitamins...this week, they're all over the news.  Again.  And as Rick opines in this week's podcast, sometimes we think we talk too much about 'nutritional supplements,' but we also feel that there's got to be some voice of sanity.  So this week's blog will cover three studies, two from JAMA and one from Archives of Internal Medicine.  Let's start with the negative studies first.

Older women may be at higher risk of death if they take multivitamins, iron, or a couple of other supplements.  That's the Archives study, and it looked at women enrolled in the Iowa Women's Health Study beginning in 1986.  Almost 42,000 women aged 55 to 69 years!  These participants were surveyed using questionnaires (notoriously poor means of gathering data, btw) at baseline, 1997 and 2004.  Predictably the number responding at each follow-up declined, but here's what they found:  multivitamins, B6, folic acid, iron, magnesium, zinc and copper were all associated with an increased risk of death.  Interestingly, calcium supplements were associated with a decreased risk, and that is counter to other studies we've previously discussed linking calcium supplements with greater heart disease and heart attack risk.  Hmmmmm.  Rick is quick to point out that like all observational studies that rely on surveys, there's much we don't know about other conditions these women may have had and causes of death. 

A study in JAMA concludes  that vitamin E does indeed increase the risk of prostate cancer.  That's according to a study of almost 36,000 men begun about a decade ago and representing an average of 7 years of follow-up.  While the increased risk was fairly modest, it wasn't seen with selenium supplements or a combination of selenium and vitamin E.  So what's so dangerous about E?  It's hard to say, but danger with regard to cancer promotion also seems to be true in cigarette smokers and lung cancer incidence.  Such results appear to shoot the theory of antioxidants and cancer risk reduction in the foot.

The one positive study this week with regard to supplements was the folic acid/folate study, also in JAMA, and language acquisition in offspring of women who took these B vitamins.  Women who were studied took folate before, during or after pregnancy or didn't take the supplement at all.  While we've known for some time that spina bifida is reduced in children whose mothers use folate, now we know that delays in language acquisition are also reduced.  As I opine in the podcast, this supports the addition of folate to some prepared foods in this country. 

What Rick and I conclude is that vitamins and supplements, like almost all of medicine, clearly cannot be viewed with a one size fits all approach, and in this case it sure seems like a lifespan kind of issue.  At some points in the lifespan vitamins and supplements may have a beneficial effect, while at others they're not only not helpful, they can be harmful.  Now to fall back to that old refrain, what's needed now is more research. And that's great job security for someone.

The remaining study for this week was in NEJM, and was also good news:  the relationship between Barrett's esophagitis, an inflammation of the esophagus sometimes seen in people with gastroesophageal reflux or GERD (aka, heartburn) and esophageal cancer isn't as robust as we once thought.  Until next week, y'all live well.

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{ 7 comments… read them below or add one }


roger l alvarez June 13, 2014 at 7:27 am

I am currently taking a GNC Diabetic Support Dietary Supplement the following amount per serving % Daily Value:

Inositol 10 mg
Silica 4 mg
Boron(as Hydrolyzed Protein Chelate) 2 mg

Blood Glucose Support

alpha-Lipoic Acid 25 mg
Cinnamon Bark Powder (Cinnommum cassia) 25 mg
Bitter Mellon Powder (Momordica charantia) 50 mg
Fenugreek Seed Powder (Trigonella foenum-graecum) 50 mg
Gymnema sylvestre Extract 25 mg
Vanadium (as Sodium Metavadanate) 10 mg

Circulatory and Cardio Health Blend

Ginkgo biloba Leaf powder 10 mg
L-Arginine 25 mg
Choline(as Choline Bitartrate) 10 mg

Eye Health Support
Lutemax 2020 Lutein 3 mg
Zeaxanthin (as Zeaxanthin Isomers) 600 mcg
Hyaluronic Acid (as Sodium hyaluronate) 2 mg

Antioxidant Rejuvenation Blend

Astaxanthin 50 mcg
Lycopene 950 mcg

Muscle Support Blend

L-Glutamine 80 mg
AL-Carnitine 10mg
L-Leucine 10 mg

My blood sugar level as per my blood work order by my PCP shows a level of 5.8 or .8 over the border limit of 5.7

Should i be taking this dietary supplement to lower this 5.8 level or not.

Thank you,

Roger L. Alvarez


Elizabeth Tracey June 19, 2014 at 1:46 pm

Dear Roger,

Thanks so much for writing. Unfortunately, Rick and I have seen no data to support the use of supplements in someone with good nutritional and functional status and are unfamiliar with a supplement strategy to lower blood sugar. Your best source would be your diabetes expert. What we have reported many times is that many supplements are water soluble so you simply excrete the amount your body doesn't need, and the fat soluble ones can build up in fat stores and possibly cause an issue if you lose weight. Hope this helps.


Buy generic viagra March 13, 2012 at 2:00 am

Agus is not alone in his frustration. Other experts liken buying vitamins to flushing money down the toilet. In some cases, they mean it literally: If the body gets more of certain vitamins than it needs, it often excretes the excess in urine.

That doesn’t stop Americans from spending about $28 billion a year on dietary supplements, including vitamins and herbal supplements.


Lukas May 20, 2012 at 6:46 am

I just found out I have type II diabetes and I'm coneictllg all the good sense information I can to attack it on all fronts. Thanks for posting this interview and really good questions for the doctor. I am taking all of the things you talk about in this video chromium, magnesium/calcium, alpha lipoic acid. MSM, too. I really like the idea of using a cinnamon stick in the tea. And may I say, you are a great host. I'm going to check out your site.


Amy Marshall October 28, 2011 at 3:13 pm

So, I'm curious. I have a friend who's been taking extra vitamin D and says it's totally improved her immune system. So then I think, I'll take some extra D, too. Should I not? Should I see my dr first? I feel like any study with old people is going to show that whatever they do increases risk of death because, well, WE ALL DIE. I mean, breathing causes you to die, at that point. I mean, if vitamins are so unhealthy, why are they so abundantly available OTC?


Elizabeth Tracey November 7, 2011 at 9:55 am

The great news is you can get your vitamin D level tested with a simple blood test and see whether you might benefit from supplements and how much you might consider. All the best.


Asha May 20, 2012 at 2:26 pm

A low carb diet decreases the need to take any medciation. High carbohydrate diet only imposes a need for insulin to suppress high blood glucose levels. Proteins and fats do not rise blood sugar levels while ANY carbohydrate does cause blood sugar spikes . See-Diabetes Diet, Dr. Bernstein's Low-Carbohydrate Solution, Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S., FACCWS.Hope helps

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