Dr. Saunders recently wrote a long article about everything you always wanted to know about vitamins and supplements (but we’re afraid to ask). Today we’re posting Part I: Too much of a good thing…
Hilda is in her eighties and very active with no medical problems. She came to see me with a two-page list of vitamins and supplements that she was taking. It turns out she gets a magazine that’s really a catalog with advertising for a supplement company that promises a longer life. Each month there is an article on a supplement that they sell, why it’s important and why theirs is better. She buys it almost every time. I asked her what she does all day. “Either I’m reading about vitamins, buying vitamins, organizing vitamins or taking vitamins. I take over a hundred pills every day!” As we went over her list, she didn’t remember why she was taking most of them.
Because vitamins and other nutrients are required for life and health, it’s easy to become anxious about which ones to take. Many, like Hilda, just take everything to “cover all their bases.” There are many multi-vitamins that say they contain every nutrient “from A to Zinc.” As more research is done, more nutrients are added. These aren’t necessarily “vitamins” or nutrients that are required for life, but they are found to perform important functions in the body. For example, less than ten years ago the colors of foods were being studied as possible nutrients. For many years it was known that the yellow and orange colors, called carotenes, were important parts of vitamin A, but now many more colorings are added. You can now buy the red color of tomatoes, or lycopene, and the purple color of berries and grapes, called xanthenes. You’re told this is essential to prevent AMD (age-related macular degeneration) or blindness. Nobody wants to go blind so when they learn about it, they’re willing to immediately buy it. Can vitamins do harm? Yes, of course. Excess water-soluble vitamins are very easily disposed-of by the body. The kidney can excrete huge amounts of vitamin C, or any of the B-vitamins so these don’t cause toxicity.
Some have said that vitamin C in large doses can cause diarrhea, but this is just a secretory diarrhea that happens if it isn’t fully absorbed in the small intestines – when the acid (ascorbic acid) gets in the colon it gets expelled quickly. Fat-soluble vitamins, on the other hand, (A, D, E, K) are stored in the liver or the fat in the body and can build up to toxic levels. Vitamin A is the classic toxic vitamin because of the very large amounts found in arctic animals and people have died from eating the livers where the vitamin is stored. It takes very large amounts to be toxic. What we need, really, is balance, more than amount. Most vitamins aren’t just one chemical entity, but rather a spectrum of compounds that each perform a slightly different function. Any one of the compounds may prevent deficiency disease, but it takes all of them to be healthy. For example, vitamin E isn’t just the chemical dl-alpha-tocopherol contained in most supplements, but rather a spectrum of alpha, beta, and gama tocopherols, as well as a series of tocotrienes. Foods that contain vitamin E will have some or all of these forms in varying quantities. Vitamin A is similar. We see retinoic acid used in supplements, when natural vitamin A is a whole series of carotenoids and retinoids. Some can be converted to other forms, but most have to be ingested. Vitamin C isn’t just ascorbic acid, but rather this chemical with a group of flavanoids to potentiate it. This is now being understood with most nutrients. One study in Scandinavia used a group of smokers, half of which took large amounts of beta-carotene. What was found after several years was that those ta