VITAMIN RECOMMENDATIONS:
As a rule, I do not recommend much in the way of supplemental vitamins routinely for healthy adults. I certainly do not recommend herbal supplements generally.
The reasons and criticisms of supplementation are simple:
1. The data for supplementation is, at best, mixed, and at worst, there may be negatives for supplementation. There is little to no scientific evidence of the benefits of vitamin supplementation, except for specific disease states, which I will list below. Yes…vitamins in their natural forms in foods are beneficial as per studies, but isolated as specific supplements, and that data is not present or convincing.
2. The production of vitamins and supplements may be suspect. Regulation of their production is not FDA sanctioned, which means you are depending on the good graces of the manufacturer to provide the supplements in the quantities that are mentioned and to confirm that the process of production are safe and without tainting from potentially toxic byproducts or contaminants. Given the concerns about production in foreign countries, I feel there is legitimate reason for concern.
3. There may be negatives from significant vitamin supplementation. The logic is as follows: Cancer cells grow at a faster rate than normal cells. To grow quickly, cells require the ‘building blocks’ of cell growth, of which vitamins are a key element. Providing supplementation of needed materials would seem to benefit cancer cells more readily than normal cells, as the cancer cells are growing fast and uncontrolled, while normal cells area growing slower and in a controlled manner.
4. Vitamin and supplement peddlers are focused mostly on profit as their ultimate motive and thus will see the benefits of their products preferentially, as opposed to their negatives. They are not objective in any manner.
5. The advertisements for vitamins depend on testimonials and ‘hearsay’ commentary, and rarely involve legitimate scientific validation When science is invoked, it is generally done so in a non-rigorous context and conclusions from such are suspect and uncertain.
Legitimate Supplementation:
• Calcium and Vitamin D in the setting of osteoporosis
• Vitamin B-12 supplementation in Pernicious Anemia (this must be given as an injection since the oral medication is not well-absorbed in patients who are deficient)
• Iron Supplementation in the setting of iron deffiiciency anemia
• Lutein in the setting of Macular Degeneration
• Vitamin E in the setting of fatty liver (400-800 units daily)
Possible legitimate supplementation:
• Omega 3 fatty acids may be helpful in heart disease, atrial fibrillation, high cholesterol. (1000-3000mg daily)
• Glucosamine Chondroitin in the setting of osteoarthritis if the knees, hips, and hand joints (1500mg daily)
• Co Enzyme Q10 in the setting of treatment for cholesterol with statins (may deplete this vitamin) 10-100mg daily
• Milk Thistle may be useful in liver disease (200mg total per day in divided doses…3x per day)