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Should we be taking Vitamin Supplements?

May 9, 2020. Andy Horide, Osteopath

Scurvy, Rickets and Pellagra are all caused by being deficient in certain vitamins. There is no question that vitamins are essential for us, not just to prevent these conditions but to live.

The market for vitamin supplements is expected to be nearly half a billion in 2021 in the UK, we seem to love our supplements (although just for reference we currently spend more than double that on chocolate).

Myself, I’ve delved in and out of taking vitamin supplements. There is something that makes you feel good when you take a vitamin in tablet form; like you doing something proactive about your health.

A question I’ve asked myself and I’m sure most of us who take vitamins supplements have thought about is – Do I really need to be taking these?

History of Vitamins

The first thing I remember at school when being taught about vitamins was that sailors (I imagined pirates) would get scurvy often, this was due to a lack of vitamin C in our diet.

Reading a little further past my primary school education, it amazed me to find that 50% of sailors during the age of the sail died due to scurvy. A Scottish surgeon in the Royal Navy, James Lind, proved that scurvy can be successfully treated with citrus fruit in 1753.

It still took the British Navy 40 years to take this finding seriously. Gilbert Blane persuaded the British Royal Navy to routinely give lemon juice to its sailors. Between 1779 and 1794 the naval sick rate improved from 1 in 2.45 to 1 in 4, and the death rate from 1 in 42 to 1 in 86. Between 1794 and 1813 the naval sick rate fell from 1 in 4 to 1 in 10.75 and the death rate from 1 in 86 to 1 in 143.

I found a great paper by Jeremy Hugh Baron that stated:
‘It was then possible for the British Navy to blockade French ports for years at a time, winning the Napoleonic War by sea power. Of all the means which defeated Napoleon, lemon juice and the carronade gun were the two most important.’

Over a hundred years later a Polish biochemist by the name of Casimir Funk (what a name!) has been credited to be the first to formulate the idea of vitamins.

In 1911 Casimir published a paper that examined how people became resistant to beriberi if they ate brown rice over the fully milled version. He isolated the substance responsible for this effect. As this substance had something called an amine group and seemed vital to prevent beriberi, he called it a ‘vital amine’, these two terms were combined later on to form the word vitamin. The substance he found would go on to later be known as vitamin B3 (niacin), he postulated the existence of various other vitamins such as B1, B2, C, and D.

Since Casimir’s discovery of vitamins, subsequent scientists have built on his work to discover the remainder. It has led to hundreds of health reforms and has eliminated many diseases that used to be commonplace. There is no question that vitamins are vital and essential for our life, but do we need them in today’s world?

Vitamin deficiency on the rise?

Here are some figures from NHS digital UK:

In 2017-18 there were 284,901 admissions for scurvy, vitamin D deficiency, gout and other maladies this was up by 24 per cent on the year before.

Many of these conditions on the rise go hand in hand with economic inequalities and child food poverty has been linked to the UK’s rising rates of malnutrition and obesity.

There were 101,136 admissions last year where vitamin D deficiency was a primary or secondary factor in the admission, a rise of 34 per cent in a year.

So by looking at the data, the answer to the question is yes (in some diseases). So does this mean we should be out buying vitamins for us and our families? As always, the answer to this is unlikely to be black or white.

My problem with Vitamin Supplements

When I say ‘vitamin supplements’, my gripe actually lies with the supplement companies that manufacters the supplements. The core problems, I feel come, down to is due to regulation, efficacy and testing or lack of.

In the UK, the majority of supplements are considered to be foods and are therefore regulated under established food laws by the Food Standards Agency and the Department of Health (FSADH).

This means that anyone can start producing supplements and do not need prior approval from the Medicines and Healthcare Regulatory Agency (MHRA) before producing or selling their product and there is no requirement for supplements to be licensed. Supplements sold in the UK are not subjected to the same scientific scrutiny as medicines and are not as strictly regulated.

Most importantly, supplements are not tested for product safety, quality and efficacy before they hit the shelves because there is no legal obligation for supplement manufacturers to take part in testing products.

To further illustrate this concern, there is a growing body of research which indicates that many supplements sold in the UK may be contaminated with “banned” and often dangerous substances.

A 2004 study tested 634 supplements purchased in 13 countries from 215 different suppliers. 94 (14.8%) contained anabolic androgenic steroids, 18.8% of which were purchased in the UK.

Another study in 2008 found that 10% of supplements and weight loss products purchased and tested in the UK were contaminated with steroids and/or stimulants.

A more recent study tested 24 products sold in fitness shops in the UK. Of the 24 products tested, 23 contained steroids including known anabolic agents.

I would always advise that, if you are going to buy a product, make sure you go to the company’s/manufacturer’s website and make sure they are third-party tested.

Are we doing more harm than good?

There are two types of vitamins: water-soluble and fat-soluble.

Water-soluble vitamins are easily absorbed by the body which doesn’t store large amounts. The kidneys remove those vitamins that are not needed.
Fat-soluble vitamins are absorbed into the body with the use of bile acids, which are fluids used to absorb fat. The body stores these for use as needed.

The body always wants to create equilibrium or homeostasis. So having buckets full of a good thing isn’t always a good idea. Either way, your body has to correct any imbalance. So if you take too many water-soluble vitamins like B1, B2, B6, C, etc, your poor kidneys have to work extra hard to flush these out of your system.

Fat-soluble vitamins like A, D, E, and K are stored in your fat. So if you have been taking excess supplements for years, there may be a huge amount of these vitamins being stored in the fat around your body. When you decide your new year resolution is to join a gym and lose weight; this fat gets broken down for energy while running on the treadmill. These vitamins could be being released in vast amounts throughout your body.

There are studies to back up that vitamin supplements might not be good for us:

A study of vitamin E and beta-carotene found that these didn’t reduce the incidence of lung cancer, with beta-carotene actually increasing death rates from lung cancer and heart disease.
Unfortunately, more recent studies don’t paint a better picture; the use of dietary vitamin and mineral supplements in older women increased their risk of dying.

Vitamin E is thought by many of us to be an anti-cancer agent, surely taking too much is better than too little. Unfortunately, a study found that vitamin E supplementation significant increased rates of prostate cancer in healthy men.

Back to the question

Experts are still deciding what the optimal recommended daily intakes (RDI) of vitamins are, these can vary country from country. For example, research indicates that 50% of people with higher than normal levels of vitamin D have this because of their genes.. So we still need to learn why this is the case, and this could affect RDI values of vitamin D in the future.

Vitamin D is classed as a hormone due to its signalling ability and role in regulating our physiology and behaviour. We don’t think taking something to increase our testosterone levels to incredibly higher than normal levels is a good idea. So we shouldn’t think differently with regard to vitamin D.

This is where the problem lies (for me), we don’t have a full picture yet of how and to what extent vitamins at certain dosages affect the body. Over time these will become more accurate. This is why I don’t understand why certain vitamin supplements contain 150% of the RDI or even 200% of RDI, I found these amounts after a quick search on popular products from Holland and Barrett.

This is something else to consider, as vitamins are condensed down in pill form, you can easily consume too much without knowing. In foods, it can be incredibly hard to get similar quantities of vitamins. Taking vitamin supplements is not risk-free – in 2015 a study found that, in America, 20,000 people visit the emergency department due to taking dietary supplements.

I think of vitamin supplements and whether I should take them or not, in a similar way to whether I should take a certain type of medication. Undoubtedly supplementing with vitamins is essential for certain people, for example, people with anaemia who take iron and people who suffer from Osteoporosis taking vitamin D or calcium. This is not something these people have decided to take on a whim but from advice from a licensed medical professional.

Here is an example of all the vitamins you would need and in the RDI ranges needed on a plate. This surprised me how little it is, I feel that many of us have got an image that we need to eat enough spinach that could fill up two suitcases. It’s about picking the right foods, this is what’s important.

So, in my opinion, for the average person out there, I would say save your cash and don’t bother taking supplements. Stick to a healthy and varied diet and you will get all the vitamins your body needs without putting any undue stress on it.

I hope you’ve all enjoyed the article. Well done if you managed to get to the end of it, it’s been a long one.

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