By: Barry W. Ramo, MD
Cardiologist, New Mexico Heart Institute
Clinical Professor of Medicine and Emergency Medicine, University of New Mexico School of Medicine
Consulting Professor of Medicine, Duke University School of Medicine
Everyday I’m in the office, patients bring in a bag of vitamins or minerals that they have purchased at the local grocery store or alternative pharmacy. Often they tell me they want to do things naturally, like being on as few medications as possible, but don’t mind taking the mountains of pills that come from Whole Foods. It never occurs to them that the FDA nor anyone else does not regulate these materials. In my private musings, I have suggested that the SPCA look into some of them.
If you are vitamin deficient then vitamins are important. B vitamins for women who are of childbearing status are important. But for the rest of us who are not vitamin deficient, they offer no benefits and in some settings are even harmful. I believe that you should get vitamins from food because there are many cofactors in food not in pills that may be important for good health. So a vegetable-based diet, with good fats, i.e. olive or canola oil and complex carbohydrates with low ability to spike your blood sugar, makes good nutritional sense. I am pretty sure that the hot dogs at Top Dog that just opened in my neighborhood don’t fit that bill.
Vitamin A, C and E are considered antioxidant vitamins. We hear all the time that oxidants are bad. Sometimes I think I should spend all my time stamping out oxidants. It turns out that when vitamin E, vitamin B6 and vitamin A were studied to see whether or not they prevent heart attacks, cancer or strokes or even death, no study involving tens of thousands of patients ever showed a benefit. Patients who take statin drugs should not be taking vitamin E because vitamin E interferes with the effects of statins. Vitamin A for a while was considered to be a drug that could protect against lung cancer. A large study of vitamin A in smokers who were at highest risk of lung cancer was done. It turned out that taking vitamin A actually increased the risk for lung cancer.
Part of the sales pitch for vitamins is that they have an effect on the blood, which seems like a good thing. Folic acid is a good example. Several years ago, it was found that folic acid lowers the level of homocysteine in the blood. A disease call congenital homocyteinuria was associated with coronary artery disease in children and some studies found that individuals with high homocysteine levels in their blood had more heart attacks than those who did not. So after 20,000 people were studied with half taking folic acid for seven years, the researchers found that indeed it did lower homocysteine levels in the blood. That was the good news – the bad news was that having your homocysteine level lowered didn’t change your chances of having a heart attack.
The most recent study of B vitamins published in a summer 2008 Journal of the American Medical Association is the final long term study showing no benefit to taking the B vitamins in terms of heart attack, stroke or death risk.
I tell my older patients to take a multivitamin even though I am not sure it does anything. But vitamin pills aren’t natural, food is; so, if you’re looking for good health, eat food that swims or flies or grows.