Are vitamins vital?

Supporters of vitamin and antioxidant supplementation and those who condemn this practice seem to inhabit a parallel universe. Straddling both makes my existence conflicted, which means my extensive daily regimen of supplements gets seriously challenged every time studies surface suggesting my pro-health choices many not be only unwise but possibly even harmful.

When recent research suggested that taking a combination of multivitamins and minerals including vitamin B6, folic acid, iron, magnesium, zinc and copper might make me die sooner, while extra vitamin E increased my risk of succumbing to prostate cancer, siding with the anti-supplement tribe seemed a better survival option.

These studies also buoyed their claims that in the first world we get all the nutrients we need from the food we eat and, unless we hang out with the alcohol-consuming demographic, are planning a pregnancy or are living in aged-care facilities, the smart money suggests we should jettison our vitamin-taking habits, as these might only jeopardise our health.

Some concerning supplements

It is difficult to appreciate that topping up with vitamins and minerals might not do us good but I did refer to the dangers of excess iron in a previous article and the destructive effects that this can have on our liver and brain cells. The problem is you might not experience the ill-effects of too much iron until it is too late, and only a blood test, not routinely performed by doctors, will let you know if your iron levels are too high.

Folic acid is another seemingly innocuous nutrient that can be extremely damaging when supplemented at the wrong time. While folic acid can protect our brains and help to prevent cancer, once cancer cells are present, it can stimulate their growth. How do you know if you have cancer cells establishing themselves in your body? This is the difficult part. You can have tests that measure DNA and chromosome damage, but this is not a direct assessment of the presence of cancer cells. Even these tests aren’t yet freely available and most doctors won’t even be aware of their existence.

Folic acid can also interfere with the activity of vitamin B12, another vital nutrient. Both these nutrients combine to lower homocysteine, a substance that can be highly toxic to the brain, setting us up to develop Alzheimer’s when it accumulates in excess. There is evidence that those with low vitamin B12 status and elevated serum folic acid are more likely to manifest impaired cognitive performance than those with low vitamin B12 status but normal serum folic acid concentrations. This could be due to the build-up of homocysteine, which can be assessed by means of a blood test, once again unlikely to be performed unless you request it.

Folic acid is found in green vegetables but health authorities in their naivety have decided all of us need to be saturated with this nutrient. In Australia, from 2009 all wheat flour used for making bread, with the exception of flour represented as “organic”, has been required to be fortified with folic acid. Some breakfast cereals also have added folic acid. All multivitamin supplements are laced with folic acid. Simply put, it’s almost impossible to avoid being drowned in this nutrient and just about every patient I measure has levels of folic acid way above the normal range. As I’ve suggested, this could be a health disaster in the making.

Zinc is another nutrient that men especially need to approach with some caution. Most of my patients appear to be zinc deficient, at least when I assess their status by means of a taste test. However, taking 40mg a day might increase the risk of copper deficiency. Copper is responsible for transporting iron around the body, which suggests that, if you’re lacking in iron, extra zinc might make this worse. Most multivitamin and mineral supplements contain at most 15mg of zinc, so you would have to take two of these daily to cause a copper deficiency, which is highly unlikely.

Daily doses of 300mg of supplemental zinc for six weeks appear to impair the immune response, but again this dosage would be impossible with current supplement levels. For men, taking more than 100mg of supplemental zinc daily or taking supplemental zinc for 10 or more years doubles the risk of developing prostate cancer. There is also evidence that men who take a multivitamin more than seven times a week and who also take a separate zinc supplement have a significantly increased risk of dying if they do have prostate cancer.

All this information segues quite nicely into research carried out by Dr Michael Fenech at the CSIRO in Adelaide, who has examined the effects of various nutrient combinations on DNA damage. He has found that excessive intakes of vitamins B2 and B5, as well as biotin and beta-carotene, are associated with increasing DNA damage. Dr Fenech makes the point that both vitamin excess and deficiency increase cancer risk and he suggests a time when culturing an individual’s cells in an environment of multiple micronutrient combinations in the laboratory will be the ultimate way to discover which teams of nutrients are needed for optimal wellbeing and for the preservation of healthy DNA.

In the balance

The fact that seemingly harmless vitamins can tamper with DNA won’t be music to the ears of the vitamin manufacturers, and Michael Fenech’s suggestion that the provision of optimal nutrients can be individualised and determined in the laboratory is not advice that can be easily used by the supplement industry. What’s even more disconcerting is German research showing that taking antioxidant supplements actually reduces longevity by interfering with the protective effects exerted by free radicals, as they switch on antioxidant defences.

The evidence would suggest that advantage lies with the anti-supplement team, however my practical experience suggests that nutrient deficiencies are not uncommon. Bring on Dr Fenech’s laboratory tests but in the meantime it all highlights the truth of the adage that you can have too much of a good thing and, before deciding on any regular supplementation, including herbs as well as vitamins and minerals, you should consult your health practitioner.

Findings true as of April 2012

 

Dr Michael Elstein is a Sydney-based anti-ageing physician and writer. He is the author of two books, Eternal Health: The Comprehensive Guide to Anti-Ageing for the New Millennium and You Have the Power: Why didn’t my doctor tell me about this?

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