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Taking Vitamins and Mineral Supplements

By Jeffrey Sterling, MD January 22, 2019

Introduction

This Straight, No Chaser discusses the use of vitamins and mineral supplements.

placebo effect in supplements
If any of you are familiar with the hit comedy The Big Bang Theory on CBS, you may recall this scene from one of the first episodes featuring the genius, physicist and would-be Noble Prize winner and the ditzy, would-be actress:

  • Sheldon (as Penny selects vitamin supplements): Oh boy.
  • Penny: What now?
  • Sheldon: Well, there’s some value to taking a multivitamin, but the human body can only absorb so much, what you’re buying here are the ingredients for very expensive urine.
  • Penny: Well, maybe that’s what I was going for.
  • Sheldon: Well then you’ll want some manganese.

The Prevailing Medical View on Widespread Use of Supplements

My views on these things have migrated over the years, and although I’ll share it with you, I still defer to the standard of care on medical matters. That standard is based on an editorial from the prominent medical journal Annals of Internal Medicine. In short, the findings of the editorial, based on a review of relevant recent literature and covering approximately half a million individuals are that taking supplements and multivitamins to prevent chronic diseases is a complete waste of money. Pointedly, the title of the editorial is “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.” In other words, the vast majority of uses of vitamins and minerals are unwarranted and constitute a waste of your well earned dollars.

Here are a few points that reflect the prevailing opinion on supplements.

  • Physicians have every reason to embrace improvements in medicines and technology when they exist and no reason to shoot down them down when they’re effective. If there was evidence of widespread supplement use, you’d be hearing about it from your physicians.
  • Your individual opinions, anecdotes and personal experience do not constitute medical fact. Just because you felt better or believe your memory seemed to have improved after taking a certain pill doesn’t mean the cause of your improvement was the pill.
  • There is a phenomenon called the placebo effect that explains more than you’re willing to admit. It’s more or less “the power of positive thinking.” The placebo effect is a measurable, observable, or felt improvement in health or behavior not attributable to an administered medication or invasive treatment. Even though placebos are not active medicines, they seem to have an effect in about 1 out of 3 patients. This is thought to represent the body mobilizing to address the concern for which you decided to take the pill. In this example, vitamins aren’t placebos because they actually have an effect on the body. However, the improvements you’re experiencing aren’t directly attributable to those pills.

But you love them…

More than half of all adults in the United States take a multivitamin and/or additional supplements, including those touted to prevent cancer, heart disease and boost memory.
“The (vitamin and supplement) industry is based on anecdote, people saying ‘I take this, and it makes me feel better,’ said Dr. Edgar Miller, professor of medicine and epidemiology at Johns Hopkins University School of Medicine and co-author of the editorial. ”It’s perpetuated. But when you put it to the test, there’s no evidence of benefit in the long term. It can’t prevent mortality, stroke or heart attack.”

The vitamin and supplement industry rakes in nearly $12 billion annually, according to the researchers, with multivitamins its most popular product.

Try Diet Instead Unless Told Otherwise

With that, allow me to again extol the virtues of a good diet.

  • Most everything you’re looking for in a bottle can be obtained by a healthy diet. This is especially true with generous servings of fruits and vegetables.
  • It is a fair point to make that a large number of us do not engage in a healthy diet, so much so that a multivitamin would be beneficial. Of course, that begs the question “If someone is not compliant with the direction to eat health foods, why would you presume they’d be compliant taking a multivitamin daily?” These pills are not inexpensive. Your better course of action is in spending that money on healthier food choices.
  • It is appropriate to note that if you are suffering from a nutritional deficiency, you will benefit from a vitamin supplement. Of course, the deficiency would have diagnosed by your physician, and the supplement would have been recommended by your physician. Short of that, in most cases, you’re allowing your fears to be played upon.

Finally, and this is where I’ve migrated, if you simply have the money to spread (or burn as the case may be), and you choose to view supplement use as akin to an insurance policy, there’s usually no harm (medically speaking) to your doing so. I am an advocate of your taking any positive step forward for your health. I just wish you’d do so in an evidenced-based manner. This would be in your best medical – and financial – interests.

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