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Vitamins: Your questions answered

 The vitamin and mineral supplement industry is worth billions of bounds, but few people are really clear about which - and how much - nutrients they should take in pill form. We put some searching questions to our resident expert, Dr John Briffa.

Is taking vitamin C necessary?

Vitamin C is one of the most beneficial substances known to man. It has myriad biological effects and plays a role in many body processes, such as immune activity, wound healing, protection from pollution and smoking, and a reduction in the risk of cataract.

Should we always stick to Recommended Daily Allowances?

Not necessarily. The RDAs, established more than 50 years ago, represent the level of nutrients needed to prevent deficiency diseases. For instance, 60mg of vitamin C (the RDA) is deemed to be the amount of this nutrient we need to consume each day to keep us from getting scurvy. In practice, RDAs are of little relevance for many reasons.

To begin with, the RDAs take no account of individual circumstances. Requirements for nutrients can vary according to genetic makeup, sex, age, levels of stress, activity levels, alcohol consumption, pollution, smoking, the use of prescription medications, pregnancy and menopause.

Generally, the levels of nutrients required to achieve these important health-giving effects are way in excess of the pitifully low RDAs.

Isn't it true that the whole supplement industry is all about money?

The manufacturers of nutrient supplements are no doubt in the business of making money. However, I do not believe that the motivation for the industry as a whole is entirely financial. It is clear that the nutritional supplement industry provides products to the public which often have very significant health-giving properties. Natural remedies are generally very safe and often help where conventional medicine has failed.

Wouldn't we be better off simply eating a healthy diet?

A healthy diet is the cornerstone of any nutritional approach to health. However, intensive farming methods and processing have stripped our food of much of its vital nutrient content. Many of the foods we eat today are nutritionally lacking. Even if we eat a 'healthy diet', it is virtually impossible to get the amounts of nutrients we need for optimal health.

Another reason why supplements may be advised is when it is not practical to obtain a nutrient from the diet at the levels required to achieve a particular effect.

An example of this is vitamin E in the prevention of heart disease. Studies have shown that taking 100-200 IU of vitamin E each day reduces the risk of heart disease by about 40 pc. It is, however, virtually impossible to consume this quantity of vitamin E through diet alone.

Another example is folic acid, which is recommended by doctors at a dose of 400mcg per day for pregnant women. To get this quantity of folic acid via the diet is impractical, which is why the medical profession recommends supplementation in this instance.

I am often asked whether people need to take supplements. My answer is that no one needs to take supplements. However, if an individual is interested in preventing illness and optimising their health, supplements can have a useful role to play.

Is there any evidence that people live longer or are any healthier taking handfuls of supplements every day?

Yes. Numerous scientific studies demonstrate that nutrients can be effective in treating a wide range of conditions. It is important to remember that, while we know people do not get sick because of a lack of prescription medication, nutrient deficiencies are quite often an important factor in disease.

Don't most vitamins just pass straight through the body, in effect, money down the drain?

The body will generally dispense with what it doesn't need and nutrients are no different in this respect. Excess nutrients are removed from the body, often through the urine. Yet a significant proportion of nutrients that are consumed are retained by the body and go on to play a vital part in all bodily processes. Even the nutrients that are expelled will exert some effect as they pass through the body.

Point by point, how do you answer charges that: Too much vitamin A causes birth defects, dry skin, scaly skin, headaches, fatigue, painful bones and loss of appetite?

Vitamin A in excess may give rise to all the symptoms listed here. However, the smallest daily supplement generally considered to generate any risk of birth defects is 25,000IU per day. To be on the safe side, it is recommended that pregnant women should take no more than 10,000IU of vitamin A per day.

With regard to the other problems associated with vitamin A usage, the scientific literature shows that vitamin A is safe in adult men and postmenopausal women at a dose of 30,000 IU per day. This is about ten times the dose of vitamin A found in multivitamin and mineral supplements.

Too much vitamin D leads to high blood calcium, headache and appetite loss?

Vitamin D plays an essential role in the absorption of calcium from the gut and may therefore help prevent osteoporosis and other conditions. The toxic effects of vitamin D have been found only at doses which exceed 2,000IU per day in adults. Again, this is about ten times the dose of vitamin D found in multivitamin and mineral supplements.

Too much vitamin E can thin the blood and may be dangerous for those on certain medications?

Vitamin E is a natural blood thinner. In fact, it is this effect which probably accounts at least in part for vitamin E's beneficial effect in the treatment and prevention of heart disease. Certain medications, notably warfarin, also thin the blood and this effect may be enhanced by taking vitamin E. For this reason, it is generally advised that individuals on warfarin or other anticoagulant medication do not take vitamin E.

Too much folic acid can disguise a deficiency in B12 with potentially serious neurological consequences?

It is true that folic acid supplementation may mask the symptoms of B12 deficiency. Nerve damage can result, which may not be responsive to the B12 supplementation. It is an established part of natural health dogma that folic acid is given either with B12, or as part of a B-complex supplement containing B12. It is conventional doctors who tend to advise use of folic acid on its own.