The case for multivitamins.

I have a Berocca every day, and I have found that I tend to avoid a lot of the 'bugs' that fly around our office. It could be coincidence, but I'll stick with it.

There are alot of interactions between vitamins and some minerals. You certainly do not absorb as much from supplements and yes many people probably do not need to take them! Evidence from athlete testing has shown that they are excreting alot of water soluble vitamins and there is a risk of overdose with fat soluble vits. I do not think people treat them with enough respect - I say that as I see so many pts taking them! I am a dietitian and do not take any and none of my family do either!

Hi ally,

I appreciate what your saying that a well balanced nutritional diet should be sufficient to obtain all the vitamins we need, and I for one wholeheartedly agree, but do modern manufacturing methods not destroy some of the goodness in our food.

What I mean is food, such as fresh fruit and vegetables do lose some of their nutritional goodness the longer it is stored and transported from its place of origin. Also, as someone who advocates cooking meals from scratch to obtain the best from my food, I know this isn't always possible for some people, and pre-packed and ready-made meals are often the preferred choice, but often these products are low or void of essential mineral and vitamins, so for these people I think that a multi-vit would be of benefit to their overall health.

What are your thoughts on what I have said?

Nigel

interesting point but it is really only the vits like C , folate etc that may be reduced and perhaps zinc if soil levels are delpleted. The problem is that unless you get your diet analysed you just do not know whether you may be at risk. One problem is that people may be taking multiple supplements and then there may be a risk of overdose.

I think alot of people are taking them as an insurance policy !

The DRV for Vit C is only 40 mg/day after about 200mg you just pee it out !

Hi Ally.
It isn't just the diet that needs analysing, as you know blood tests are required too.

I found deficiencies in my Vit's after recent blood tests, that meant I was prescribed Vit B12 and I was told to increase Potassium intake. Banana's and Coffee helped with that. I am like you prefer to get all my Vit's from my food and drink, avoid taking supplements of any sort.

If you do need to take any Vit's etc then it should only be after a proper evaluation by a qualified Dietician and/or GP. I agree too many people are taking stuff they don't really need and can probably do without. Filling the 'coffers' of Health Food firms and depleting those of the people who can least afford it.

Ken

Hi ken - yes you are right problem is GPs often will not do a screen!

Another problem is calcium as blood levels do not show osteoprosis - but a dexa scan does. I have seen several young people in my clinic with osteoporosis recently!

Allyx

What about the evidence that the majority of people who live as far North as we do are deficient in vitamin D? Especially those with darker skins.
Whenever a population of people is tested, the majority are deficient. Not just one or two.
In fact rickets is a real problem in some populations.

I have lived in the UK all my life and have been tested over the last twelve years.......I have never had a Vit D deficiency........I think that is due to having a really good diet and plenty of fresh air and sunshine.....when it's about !

Vitamin D is a fat-soluble vitamin. This means you don't need it every day because any of the vitamin your body doesn't need immediately is stored for future use. Most people should be able to get all the vitamin D they need from their diet and by getting a little Sun as far as I am aware.

As for Rickets, that is a disorder that affects children, causing poor development of the bones in the skeleton. Rickets was common during Victorian times but nowadays, the condition is rare. Rickets in adults is known as osteomalacia (soft bones).

Ken.

Check your figures #Ken. Rickets is no longer rare. It was in my childhood.
Hana

Hana.
I did....according to the NHS that is the information. Maybe they are wrong....I don't know. I can only go on what they put in front of me. If you have some other source I would be grateful if you could post it here. We can compare notes !

An extract from the NHS website.......28/1/2010

How common is rickets?
Rickets was common during Victorian times but mostly disappeared in the western world during the 1940s, thanks to the fortification of vitamin D in everyday foods such as margarine and cereal.

There has been a reported increase in cases of rickets in the UK in recent years. Children from Asian, African Caribbean and Middle Eastern origin are at higher risk because their skin is darker and they need more sunlight to get enough vitamin D.

Other risk groups include children who were born early (prematurely) and those on certain medicines that interfere with vitamin D. However, any child whose diet does not have enough vitamin D or calcium can develop rickets.

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Ken

cugila said:

If you do need to take any Vit's etc then it should only be after a proper evaluation by a qualified Dietician and/or GP. I agree too many people are taking stuff they don't really need and can probably do without. Filling the 'coffers' of Health Food firms and depleting those of the people who can least afford it.

Ken

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Again, I wholeheartedly agree with what Ken has said above, last year when I changed my diet I asked for a professional opinion from my dietitian at the diabetes clinic, thankfully alll was fine. I have mentioned this before, but I was told to take a high-strength cod-liver oil by my gp, after having a few problems with legaments in my knee, and although I took it in a low-dose capsule form for the last 20+years, I switched to the liquid high-strength and have not had a problems since, maybe coincidental, but I am almost certain its due to the oil.

Good discussion so far!

Nigel

There were some newspaper articles about vit D deficiencies and rickets earlier in the year. This NHS article puts them into context.

http://www.nhs.uk/news/2010/01January/P ... -rise.aspx

han - rickets was prevelant in times of famin and now is common in ethnic groups.

People are making sweeping statements about Vit D without much real evidence - I had mine done out of curiosity and it was normal!

More on vitamin D deficiency.

How common is vitamin D deficiency?

It is very common. Research suggests that in the UK around 2 in 10 adults, and 9 in 10 adults of South Asian origin, may be vitamin D deficient. Most people don’t have symptoms and are unaware of the problem.

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http://www.patient.co.uk/health/Vitamin ... ciency.htm

"More than 50% of the adult population [in the UK] have insufficient levels of vitamin D and 16% have severe deficiency during winter and spring," they say. "The highest rates are in Scotland, Northern Ireland and northern England. People with pigmented skin are at high risk as are the elderly, obese individuals and those with malabsorption."

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http://www.guardian.co.uk/society/2010/ ... deficiency

Graham

Not all supplements are has harmless as manufactures etc would have us believe, there are a fair few that are water soluble that the body is able to excrete excesses, but there are some that the body can’t sort out if overdosed...

Take some of the B vitamins, with some of these, when overdosed can cause tingling and pain very similar to the effects of neuropathy?
Back along, research linked Vitamin D deficiency played a factor in fall risk of the elderly... Around 18 months ago, a lot of PCT’s decided to use this to implement a cart blanch implementation of preventive prescription of Adcal-3 (combination of Vitamin D and calcium supplement) to the elderly who they perceived to be at risk (mainly elderly people who required care either in the home or residential) good thing one might think... The problem is that when Adcal-3 can cause liver/kidney damage so a regular blood test to check function is required... And in a cart blanch situation has proven that there not really any change if falls amongst this group... It’s only really beneficial to those that do have a deficiency, but if not it could be more harmful that good for them...

I myself prefer to obtain my nutrients by eating a varied diet, and if for any reason my body can’t/doesn’t adsorb the correct amount, then it’s for the doctor to deem this is so, and with consultation with my HCP decide what is best way forward for me...

I find it strange though, to take a multiply vitamin supplement, because it’s suggested that 2 out of10 adults might be deficient in Vitamin D! How is shoving other vitamins and other nutrients going to rectify the lack of Vitamin D??

Supplement do need regulating because you will always get those who will not only use them to support a unhealthy diet/eating habit, and those who believe that if you double the recommended dose, that it will be twice as good!! Landing themselves in some dangerous territory indeed one way or another...

jopar said:

I myself prefer to obtain my nutrients by eating a varied diet, and if for any reason my body can’t/doesn’t adsorb the correct amount, then it’s for the doctor to deem this is so, and with consultation with my HCP decide what is best way forward for me...

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In theory this would be a great idea but many people have problems getting their vitamin levels tested by GPs. I asked my GP and was told that vitamin testing is 'alternative medicine'.

I got some of my vitamin levels tested privately and found I was deficient in several important vitamins/minerals (A,D and Magnesium - all of which have been demonstrated in the literature to be problematic for diabetics). I have a balanced diet as stated by NHS dietician.

I find the idea that vitamin testing is 'alternative' to be worrying as there are numerous publications (search on Pubmed if you're interested) that show that Type 1 and Type 2 Diabetics have abnormally low levels of certain vitamins compared to normal controls. If doctors don't bother to test us to identify deficiencies then how can they say it's not a problem?

As for the vitamin D evidence, the original report stating that over 50% of the population is D deficient was published in the British Medical Journal in 2010

http://www.bmj.com/cgi/content/extract/ ... 11_1/b5664

Goji - GP is talking rubbish. How did they test levels?

ally5555 said:

Goji - GP is talking rubbish. How did they test levels?

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Hi Ally

Thanks for your reply.

A private doctor requested the blood tests. The vitamins levels were taken using blood samples (and handled correctly/covered up from the light - I watched the phlebotomist). Tests were serum Vit A, 25-Hydroxy-D and Magnesium.

I have read in the literature that diabetics and patients with hypothyroidism have problems converting Betacarotene into Vitamin A. Also Vitamin D deficiency has been shown to be associated (not causative mind) with autoimmune diseases like Type 1 Diabetes and Autoimmune thyroid disease. I couldn't understand why this would be seen as 'alternative'. :?

Do you think the reason patients don't get tested is simply about cost? I could understand that as the NHS is very overstretched.

Ally from time to time your warn that reduced carb results in low fat consumption & corresponding deficiency of fat soluble vitamins.

I take a basic multivit & min supplement, as I understand that our soil is now depleted & deficiencies are possible. What problems should I look out for from excess of Vs & Ms?