The People's Perspective on Medicine

Why Won’t the Vitamin Wars Ever End?

Doctors disagree as to whether or not people should take nutritional supplements. The vitamin wars continue to rage. Should you be taking extra vitamins and minerals?

Experts still cannot agree about vitamin and mineral supplements. Many health professionals maintain that they are a total waste of money and could be dangerous. Others say that vitamin insurance is essential for good health. Back in 2002 we wrote that “the vitamin wars are over.” We were sorely mistaken. The controversy over vitamin supplementation has only become more intense with time.

The Vitamin Wars Persist

Since the mid-20th century, health professionals have disagreed about the value of taking vitamins and minerals. One group, often personified by Nobel Prize winner Linus Pauling, advocates for supplements. The other group maintains that people get all the nutrients they need from their food and that pills are a waste of time and money.

On June 19, 2002, the Journal of the American Medical Association published a recommendation:

“that all adults take one multivitamin daily”

(JAMA, June 19, 2002).

This was based on evidence that suboptimal vitamin intake puts people at risk for chronic diseases.

Doctor Is Adamant: Vitamins Pills Are Worthless:

That did not put the issue to rest, however. The vitamin wars continued, with some experts arguing as did “Orac” commenting on ScienceBlogs in 2013:

“I remember during medical school that more than one of my faculty used to have a regularly repeated crack that the only thing that taking vitamin supplements could do for you was to produce expensive pee. My first year in medical school was nearly thirty years ago now; so it’s been a long time. During the nearly three decades since I first entered medical school, I have yet to see any evidence to persuade me otherwise. If you eat a well-rounded diet, you don’t need vitamin supplementation.”

The Latest Review from Cardiology:

This reaction from health professionals is not uncommon. A recent review of studies examining vitamin supplements to prevent heart disease found that only folate or B-complex vitamins with folic acid slightly lowered the risk for cardiovascular disease or stroke (Journal of the American College of Cardiology, June 5, 2018).  This meta-analysis of prior studies did not show that multivitamins, beta-carotene, calcium, selenium or vitamins C or D prevent heart disease.

Television commentators, including doctors, were quick to dismiss the value of vitamins. Headlines announced that the vitamin wars were over: vitamin and mineral supplements are useless.

What Is a Well-Balanced Diet?

If Americans generally ate a well-balanced diet, that would pretty much finish the argument. But we don’t.

Nutrition Action recently noted that:

“half the population gets less magnesium than experts recommend”

(Nutrition Action, June 2018)

That’s because rich sources of magnesium such as pumpkin seeds, black-eyed peas, tempeh, soy beans, sunflower seeds, flaxseeds, wheat germ, prickly pear, spinach, Swiss chard and quinoa are not staples of the American diet.

Who Needs Extra Nutrients?

Even experts who think most people should not take supplements admit that there are many Americans who need them, however. Women who are pregnant, patients with celiac disease, vegans and people who have had bariatric surgery likely need supplements.

Tens of millions of people take medications that deplete the body of essential nutrients. PPI-type acid-suppressing medications and diabetes drugs containing metformin can lower vitamin B12 levels. Blood pressure pills containing diuretics could lead to suboptimal amounts of potassium, magnesium and zinc.

Vitamins and Cancer:

We find it truly astonishing that the vitamin skeptics always ignore one of the best and longest studies of vitamins ever conducted. The Physicians’ Health Study II was a “large-scale, randomized, double-blind, placebo controlled trial” involving nearly 15,000 male doctors. In other words, this was a gold-standard study.

The results:

“Compared with placebo, men taking a daily multivitamin had a statistically significant reduction in the incidence of total cancer (multivitamin and placebo groups, 17.0 and 18.3 events, respectively, per 1000 person-years…”

“Conclusion: In this large prevention trial of male physicians, daily multivitamin supplementation modestly but significantly reduced the risk of total cancer.”

If this were an expensive drug we suspect that many physicians would be prescribing it with enthusiasm. Even a modest reduction in cancer is important.

Vitamin D vs. Cancer:

There has been considerable evidence over the decades that low levels of vitamin D are associated with an increased risk of various cancers. The latest evidence was published in the Journal of the National Cancer Institute (June 14, 2018).

NPR summarized the results:

“‘For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,’ says Marji McCullough, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin Dabove the range deemed ‘sufficient,’ had a 22 percent lower risk, she says.

“The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn’t have cancer.”

In their own words the researchers state:

“Higher circulating 25(OH)D was related to a statistically significant, substantially lower colorectal cancer risk in women and non–statistically significant lower risk in men. Optimal 25(OH)D concentrations for colorectal cancer risk reduction, 75-100 nmol/L, appear higher than current IOM [Institute of Medicine] recommendations.”

People’s Pharmacy Perspective on the Vitamin Wars:

We do not understand why health professionals continue to fight the vitamin wars. What is it about nutritional supplements that makes so many physicians cringe? Tens of millions of Americans are deficient in both vitamins and minerals. Many of these deficiencies are triggered by commonly prescribed medications. Here is a link to our free Guide to Drug and Nutrient Interactions.

If you would like to learn more about medicines that interfere with nutrient levels, we recommend the book, Fortify Your Life: Your Guide to Vitamins, Minerals, and More, by Dr. Tieraona Low Dog. It is published by National Geographic Books.

You may also be interested in our recent interviews with Dr. Low Dog and Dr. JoAnn Manson. They offer differing perspectives on the value of vitamin and mineral supplements and who can benefit. It is Show 1124. Here is a link.

Share your own thoughts about vitamin and mineral supplements below in the comment section.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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One thing that’s happened as I’ve become “older:” my appetite is greatly diminished! I have no problem with this as I believe that digesting food creates many toxic byproducts (which is consistent with the idea that eating very little food increases longevity!).

That said, of course I also believe in the importance of nutrients! But it’s simply impossible for me to ingest enough food to provide the nutrients I need. I basically eat a big salad, a power shake, and maybe one other small thing all day. And usually I have to stuff even those things down my throat cuz I’m absolutely not hungry. People say, “5 servings of this, 4 of that (etc.) per day…” Well, fat chance of that! No way! So I do take supplements, lots of them, always with food, and I’ll keep taking them.

I have been taking CO Q 10 and grape seed extract for more than 15 years. The grape seed has eliminated my bleeding gums and my joint stiffness I was starting to feel. Grape seed aids connective tissue, as in gums and joint cartilage. I also take Omega 3 oil twice a day and my AM stiffness is gone and my cholesterol is under 200 with great HD levels.

It is also a blood thinner which has an impact on clotting and therefore cleaner arteries. Doctors had me go off omega 3 before even minor surgery because MDs now recognize its blood thinning properties. It is clear than supplements do have a beneficial impact on health, but should be thoroughly researched before taking.

You said “experts cannot agree about vitamins and mineral supplements”, in my opinion that is because the medical experts do not desire you to be healthy. Vit. and min. products show no destructive side effects as Dr. prescription products do.

Remember, sick people are a gold mine to the medical and Pharmaceutical industry and the medical profession. I have just turned 85 and have never used prescription medicine, but use homeopathy and other alternatives.
“Let your food be your medicine, and your medicine be your food”

When I was in college, (Pharmacy School by the way), I developed some gum problems. A professor told me to take Vitamin B Complex with 500mg of Vitamin C.

After two or three days I had less pain and no bleeding. If I stopped the vitamins it came back. I tried just plain Vitamin C 500mg and that worked without the stomach ache I got from the B-Complex.

To this day 50 yrs later Vitamin C and hydrogen peroxide work well to maintain what my dentist calls “great tissue”.

I continue to enjoy your column. Thank you.

There is such a thing as vitamin toxicity, which is essentially getting too much of a good thing (I learned the hard way). But I still believe in supplementing my diet. I have a blood condition which necessitates avoiding added iron in my diet. I found a multi vitamin that does not contain iron. Most of the other ingredients do not exceed the USRDA maximum limits. My point is, I believe it’s better to not exceed the USRDA if you want to take supplements.

There is not one answer because we are complex beings. But the power of vitamin supplements should not be underestimated. Once I went to an integrative physician, I have found supplements to be an important part of my life. Not only did I finally get diagnosis for the many issues contributing to my extreme fatigue I had had for years but supplements were a helpful solution in a safer form. From the obvious things like treating Vitamin D deficiency, to many issues that have not been mentioned. Low serotonin, sleep issues, and low energy. They should be prescribed with care, using quality products in prudent amounts. They have helped me function better and heal. I have now cut back and take only those I feel I cannot be the best me without. I have chronic conditions that will not go away, and they help me live a better life. The problem is that there are few professionals that understand how this can work for real benefit. But more and more doctors are getting into this field because the body wants to heal and there are natural things, as well as necessary Rx, that are a safer option for healing.

I have had bouts of burning mouth syndrome 2X in the last 4 years. I am a long time user of triamterene for HBP. Traditional medicine could not help me. My internist literally threw up his hands & said, “I can’t help you”. After much research, I found a vitamin & mineral recommendation by the former director of OSU’s Center for Integrated Health. I followed it. It worked.

I recently had a 2nd bout of BMS. This time the causes were multiple. I have the herpes virus & had been eating a lot of peanut butter and nuts. I was using teeth whitening products which aggravated my mouth. I caught a terrible cold & my mouth got much much worse. I ended up seeing an ENT who diagnosed a B12 deficiency (but this could’ve happened earlier) based on the appearance of my tongue & silent GERD. GERD & herpes are also causes of BPS. I am following a GERD food plan and added lysine to my vitamin & mineral regimen.

Many foods have vitamins and minerals added so studies may be skewed because of this. All I know is that at this stage of my life, vitamin & mineral supplements are a necessity for a good quality of life.

Thank you for the opportunity to share my experiences.

I am an older lady, 81. I have taken vitamins all my life. I was raised by a family who used naturopaths and chiropractors instead of medical doctors; never saw an MD til I was pregnant with my first child. Most had vitamins for sale but I buy mine from drugstores or Walmart.

At one time I had a boyfriend who was a chiropractor and he told me that for years he thought vitamins were a waste of money but had changed his mind, don’t know why. He died of melanoma at age 62.

All I can say is I’m much healthier than most of my friends, take allergy pills but that’s all. Family members as well live into their late 80’s and 90’s. Healthy food is of course the key and there’s no lack of good food these days, it just takes some changing of eating habits; eat very little fast food or processed meats, cook from scratch. If working, cook on weekends to have food ready when you get home every day.

The AICR (American Institute for Cancer Research) as well as my own oncologist state absolutely no vitamin supplementation as both a means of preventing cancer and also preventing recurrence. Thought you might have mentioned that in your article- that said it is best to follow the guidelines recommended by your own health care provider, who has knowledge of the particulars of your situation. My own feeling is that we tend to want a quick fix, eating a mostly plant based diet with lots of variety is everyone’s best bet when possible !

I can only tell you, I take no meds….none….but supplement daily with a multi, and others. I am 81 years old. Play Pickle Ball six days a week, bridge four times a week, Mah Jong twice weekly,…well, you get the picture. I give my supplements total credit for my good health and well being….and no, it is not because of my gene pool!

Yes, you’re right – why are we still having this conversation. Remember Rachel Carson’s book, ‘Silent Spring’? Since then, US corporates have decimated the nutritional value of the soil in which food is grown. Since then, perhaps shortly after, the meat industry decided they had to increase profits and began injecting growth hormones into cattle to get them to market faster. Surely you know all this and still think there isn’t a problem? The corporates make you ill and then prescriptions are geared to ‘make you better’, but they mostly don’t. Vicious cycle. But mostly, look at the science of biologists and nutritionists, especially those who are not in the pay of pharmaceutical companies. Dr Mercola, for instance.

Here in France, I live in a ‘no pesticide, no GMO’ zone; in fact all of Europe has a BAN on US agricultural products for safety reasons. Trump is trying to over-turn this so that we too can be as unhealthy as most Americans.

I have no doubt that judicious vitamin supplement saved my life. I had a serious diagnosis of metastazised prostate cancer. eventually I came off treatment offered (as it would have ended eventually in disaster) and used supplements and life style measures alone. That was 14 years ago.

Nutrients have been depleted from the soil by over farming. Consequently, the food is not as nutritious. I believe that good quality supplements are beneficial for most people.

I have Lyme disease with at least 4 co-infections, and if it wasn’t for supplements, I’d be dead now. I have an almost normal life except for my meds and supplements, and doctor appointments. I feel human again since going on all these extra supplements! Anyone who doesn’t believe in supplementation has never been sick or needed meds to survive. They need to study the people like ME!!!!!

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