I'm currently reading a book on reversing asthma. Part of this doctor's treatment involves vitamin supplements, even to the point of injecting magnesium on a weekly or monthly basis. This, along with other interventions, helps his clients who give testimonials in the book. These statements, more than once, indicate that when the patient skips their vitamins for any length of time, symptoms come back.
This, unfortunately, is all too often the case in inhaler and steroid treatment of asthma: stop using the medications and symptoms come back. The medications themselves can have powerful side effects and are quite "addicting" for the asthmatic.
It is easy to see in the above example that vitamins or minerals can be used as drugs. In fact, many nutrient preparations, especially for injection, are made in the laboratory and are understood to be pharmaceuticals. Magnesium is lifesaving in certain cardiac arrest situations. Sodium is added to water to make the intravenous saline solution, which was miraculous in saving those with dysentery when IV fluids were first invented. There are specific diseases, such as scurvy, which have long been cured or prevented by a supplement.
I would divide today's use of supplements into three categories.
The first would be assisting nutrition, which should come from a wholesome diet. Here, promoters of supplements quickly argue that obtaining a wholesome diet is near to impossible. Arguments range from soil depletion due to modern farming methods to the overuse of overly processed, hence nutrient depleted food. Adding a multivitamin and mineral or "balanced" one-a-day type supplement would provide a solution here. Or would it?
One has to question the efficacy of multivitamins for general nutrition. Vitamin C from rose hips, for example, is a 27 nutrient complex, and that's only the known ingredients. Pure vitamin C then might not supplement the lack of complex compound in natural food. Taking the multitude of vitamins, minerals and other compounds out of whole bread and adding several vitamins back for "enriched" bread is more of a marketing ploy and commercial requirement than good nutrition.
The second use of vitamins has been for prevention. Vitamin D added to milk to enhance calcium absorption and prevent rickets is an older example. So is the addition of iodine to salt to prevent thyroid goiter. More recently, we have seen calcium added to orange juice.
In reality, the availability of foods has improved to the extent that these forms of mass supplementation are questionable as to true need. Perhaps, if one never eats fish, sea vegetables or other iodine rich foods, one should buy iodized salt.
In addition, mass supplementation is not always reliable. A survey I personally know of on the East Coast measured toxic levels of vitamin D in random samples of milk. Mass fluoridation of water supplies still is controversial, although generally accepted
Finally, the preventative uses don't always pan out. Complex caratenoids in yellow and orange vegetables apparently have effects on cancer prevention that pure beta carotene does not always demonstrate. Once again, for prevention as in general nutrition, we get back to whole foods as a better choice.
The third use of supplements would be in the treatment of disease, and here their usage has much in common with pharmaceuticals. B-12 supplemetation for pernicious anemia. Calcium to slow osteoporosis. B vitamins to lower homocystine in the blood and prevent heart disease. More controversially, vitamin E to treat angina. The difference between therapy and prevention often centers on a mass quantity of vitamin needed, often, not always, through a special delivery system like injection. Vitamin E doses, for example, do not occur in foods at the 200 to 1,000 unit amounts found in vitamin preparations. Vitamin C doses of three to six grams a day often are difficult to obtain from food. Therefore, pronounced antioxidant effects from nutrients might require supplements.
Classifying a supplement as "therapeutic" usually also indicates that we have studied the effects and tested the therapy. We also can usually measure results in the patient. But in many newer proposed uses of supplements, we only have a partial understanding of dosing and effects.
Unfortunately, and this is something to always keep in mind, published research on supplements in general has continually lagged behind what is published and promoted about pharmaceuticals. Vitamins are widely made by various types of companies, and expensive development for therapy does not fit standard American business models for developing drugs. Often, we are left with health food store literature, which is someone's viewpoint about the research that is "somewhere out there." We often are trying to trust a reliable company -- hoping the supplement contains what it claims -- and, once again, experimenting on ourselves.
We probably should at least demand and ensure that companies can prove the content of their products.
For M.D.s, in trying to sort all of this out, a big problem is the lack of training in clinical nutrition. Most general M.D.s read the New England Journal of Medicine; relatively few read the American Journal of Clinical Nutrition. This is because the latter tends not to be "mainstream medicine." Also, clinical testing that is done often is not found in the most popular journals. It might take 10 or more years before an initially proven therapeutic or preventative effect is accepted.
M.D.s worry about the occasional toxicities of certain supplements. Vitamins D and A can be toxic to internal organs and tissues in larger doses. Vitamin B-6 in large doses can lead to peripheral nerve damage. Too much zinc can raise fat levels in the blood and actually lower immunity. Large doses of selenium might be cancer-promoting instead of cancer-preventing. Thus, like drugs, supplements sometimes have a therapeutic "window" between efficacy and toxicity.
I personally recall talking with a customer in a health food store who was ready to buy an expensive protein concentrate, complete with all of the amino acid building blocks in high concentrations for the purpose of building muscle while weight lifting. I quietly pointed out that large protein loads might be toxic to his kidneys, certain isolated amino acids are toxic to renal function, and that a lean meat such as turkey would give him more protein than needed for body building. He saved $40. I lost my usual discount on purchases that day.
Recently, I came across an unusual concept related to all of this in a text on healing with whole foods. This idea was that supplements are usually treating conditions of excess rather than deficiency. In other words, in the absence of a clinical deficiency, remember scurvy, vitamins are making up to some extent for our excessive lifestyles.
Excessive meat consumption impairs calcium absorption, so calcium can be replaced along with cutting down on meat in the diet. Many drugs deplete minerals at the cellular level. This cellular stress might be partly alleviated by supplements. But what supplements temporarily compensate for in terms of nutrition, prevention and long-term healing ultimately might require a change in lifestyle. This will involve a lot of attention to whole food, exercise, emotion and spirit. But we also will have to pay attention to the excesses created in our surrounding environment. Exposure to 20,000 to 30,000 marketed organophosphate pesticides while only 20 to 30 -- about .1 percent -- have been tested adequately for human toxicity is an example that comes to my mind.
In fact, with our chronic exposure, often beyond our will or intent, to toxic environments, many have argued that the antioxidant vitamins like C, E, selenium and caratenoids have become a daily necessity.
As always, this type of argument is based on some knowledge, although total understanding of supplements remains a complex problem. A single vitamin can be involved in multiple reactions in the human body. Vitamin C generally is not toxic, although it might temporarily cause diarrhea. Do we, however, always want to stimulate the multitude of chemical reactions that this vitamin is involved in or does our body naturally demand a rest from pushing all equations in one direction? Do we simply cover up deeper problems, so that symptoms come back when supplements are stopped?
Regardless of these issues, at some point, given that many symptoms don't fit our disease models, and given that many degenerative and chronic diseases are on the increase, we will try to fight back. Keeping caution and knowledge in mind, vitamins, minerals and supplements in general have become one part of a personal, individualized arsenal against bad health.