One of my patients reported taking 50 different health supplements, spending hundreds of dollars each month on them. Patients frequently inquire about which vitamins they should take. There is no denying the benefits of iodized salt in improving thyroid health for the population, and fortifying milk with vitamin D in the 1930s effectively eliminated rickets. However, it’s worth noting that these specific interventions are targeted to reduce morbidity in the presence of nutritional and sun exposure deficiency. It’s crucial to understand that vitamins are categorized as fat-soluble and water-soluble. Fat-soluble vitamins can accumulate in the body and potentially lead to toxicity.
Vitamins are essential organic compounds that our bodies require in small amounts for various biochemical processes. They play critical roles in maintaining health and supporting numerous bodily functions, including energy production, immune function, bone health, and cellular repair. There are two main categories of vitamins based on their solubility: fat-soluble vitamins (A, D, E, K) and water-soluble vitamins (B vitamins and vitamin C).
We recently reviewed a paper published in the Journal of the American Medical Association by Erikka Loftfield et al. in our class, which examined the association between multivitamin use and mortality risk across three prospective studies. The paper highlighted that one in three U.S. adults uses multivitamins primarily for disease prevention. In 2022, the U.S. Preventive Services Task Force reviewed data from randomized clinical trials on multivitamin supplementation and concluded that there is insufficient evidence to determine whether regular use of daily multivitamins provide benefits or pose harms in terms of mortality risk in the general population.
This study included nearly 40,000 participants with a median age of 61 years. Around 40% of these participants were never smokers, and a similar percentage had a college education. Approximately half of the participants were women. The findings indicated that multivitamin use was not associated with reduced all-cause mortality; individuals who took multivitamins did not exhibit a lower risk of death compared to those who did not regularly take multivitamins.
Importance of Vitamins:
Vitamin A: Essential for vision, immune function, and skin health.
Vitamin D: Crucial for calcium absorption, bone health, and immune system modulation.
Vitamin E: Acts as an antioxidant, protecting cells from damage.
Vitamin K: Necessary for blood clotting and bone metabolism.
B Vitamins: Includes thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folate (B9), and cobalamin (B12). They are involved in energy metabolism, red blood cell formation, and neurological functions.
Vitamin C: Important for collagen synthesis, wound healing, and antioxidant defense.
Common Vitamin Deficiencies and Their Consequences:
- Vitamin D Deficiency: Can lead to weakened bones (osteomalacia in adults, rickets in children) and increased risk of fractures.
- Vitamin B12 Deficiency: Causes anemia, neurological symptoms like numbness or tingling, and can lead to irreversible nerve damage if untreated.
- Vitamin C Deficiency: Results in scurvy, characterized by weakness, gum disease, and skin problems.
- Vitamin A Deficiency: Impairs vision (night blindness) and weakens the immune system.
Iron and Folate Deficiencies: Contribute to anemia, resulting in fatigue, weakness, and reduced oxygen-carrying capacity of blood.
Should I Take a Specific Vitamin?
The decision to take specific vitamins should be based on individual health needs and deficiencies. While supplements can be beneficial for correcting deficiencies diagnosed by a healthcare professional, taking excessive amounts of vitamins without a specific medical indication can be unnecessary and potentially harmful.
Evidence on Multivitamin Use:
Research, including studies like those published in the Journal of the American Medical Association, indicates that regular multivitamin use does not significantly reduce mortality risk or prevent chronic diseases in the general population. Multivitamins are often marketed for disease prevention, but randomized clinical trials have not consistently shown clear benefits.
Specific Considerations:
Iodine Supplementation: Taking iodine supplements in the absence of a functioning thyroid gland (such as after thyroidectomy) is not beneficial and can potentially worsen thyroid function in certain cases.
Selective Vitamin Use: Vitamins should ideally be supplemented only when there is a diagnosed deficiency or a specific medical need. In otherwise healthy individuals with balanced diets, additional multivitamins or supplements do not provide added health benefits and may even lead to unnecessary costs or health risks.
In conclusion, while vitamins are crucial for health, indiscriminate use of supplements is not recommended. It’s important to consult healthcare providers for personalized advice regarding vitamin intake, ensuring any supplementation is based on evidence-based guidelines and tailored to individual health needs.
(Endocrine class project with Dr. Oreoluwa Sowunmi, Dr. Hadeel Alkayed, Dr. Ibrahim Folorunsho, Dr. Loretta Amoako, Dr. Stephen Gbekor, Dr. Ezike Lynda, Dr. Agbo Emmanuel Uchenna, Dr. Olayemi Akanmode and Dr. John Ubah)
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