Campus Chronicle

Issue date: 8/4/08 Section: Pulse

Dr. George

Q. There are many vitamins and supplements out there. I know that Centrum is almost comprehensive in the minerals I need. But there are also natural ones available. What supplements do you recommend, if any at all?

A: This is a real hot button issue, with a billion dollar industry and many users passionately committed to them. However, being a skeptic, I want to see objective scientific research to back up claims. I'm not talking about testimonials that some brand of saw palmetto is needed for the health of my prostate, which incidentally, isn't even ill. Believable scientific research is only done by parties who have no agenda, financial or otherwise, that might lead to a bias. I trust the National Institute of Health (NIH), American Dietetic Association (ADA), and the Federal Drug Administration (FDA). They really don't benefit one way or the other if a given treatment is shown to be effective, pure quackery, or somewhere in between. Not everyone trusts these agencies (including conspiracy theorists who feel the government lied about the Kennedy assassination and UFOs). I just have more confidence, knowing that these agencies aren't trying to sell me vitamins.

According to the NIH and ADA, with the exception of a relatively small group of special needs people, supplemental vitamins and minerals produce primarily expensive urine. The NIH and ADA state that if a person in this country consumes a varied diet anywhere near normal, they will have more than adequate amounts of every necessary vitamin and mineral that we know to be required. There is even wiggle room for Twinkies and Big Macs, as long as they don't comprise the bulk of your diet.

How then, is there an entire industry of apparently legal products "approved" by the Federal Drug Administration (FDA) you ask? It has to do with the difference between FDA approval of a drug, and a vitamin or nutritional supplement. A drug must, to get FDA approval, be shown to be both safe, and effective at whatever it claims. A nutritional supplement must be shown to be merely safe (at normal doses). FDA approval says nothing about effectiveness of them. In fact, FDA approval of a nutritional supplement must carry the warning "This product is not intended to treat, diagnose, mitigate, prevent, or cure disease". That sounds to me to be the equivalent of saying, "This product doesn't do anything to benefit your health."

Understandably, people have always had a desire to believe in miraculous potions to cure our ills. There was the Fountain of Youth of Ponce de Leon. Much later, Dr. Feelgood's Magic Elixir claimed to cure baldness, cancer, insomnia, lumbago, and whatever else ailed you. 50 years ago, many doctors advocated monthly B12 shots for middle aged patients who were tired and lacked the pep of their youth. Usually with any of these potions, there was a claim, outright or implied, of an improvement in sexual desire and performance. Alcohol and even cocaine were ingredients that offered short term boosts of energy in some of them to go along with the placebo effect they offered.
That is not to say that people with certain medical conditions (people without any exposure to the sun may need vitamin D, for instance) never benefit from supplements. Good studies have shown that pregnant women have a lower rate of neural tube defects in their babies, with the addition of the vitamin folate. People with malabsorption syndromes, alcoholics, chronically ill, and those with a variety of unusual medical conditions may require certain vitamins and minerals. They are the exception to the rule, according to NIH and the ADA.

Not all doctors feel as I do. There are many health care professionals who recommend vitamins under the "can't hurt, might help" philosophy. The problem with that is that vitamins are very expensive. If that same money were used to provide good healthy food…

For the great majority of us, eating a diet high in varied fruits, vegetables, whole grains, and lean meats will more than provide everything you need to run your fastest, jump your highest, and be the best you can be. Just go easy on the Snickers bars and Cheetos.

Dr. George is an Emergency Room physicians with the University of Illinois at Chicago's Medical Center.

As with all medical advice, consult your physician before beginning any regimen or if symptoms persist for more than five days.

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