What supplements do you take and why?

[YK]

YK, I don't see how the levels of vitamin D are irrelevant.
Results won't be seen with comparing two groups with low levels, especially when the levels are right next to each other.

Talker, take an epidemiology and stats class. Since the internet can't always convey the attitudes, I am going to clarify that I am recommending this in a sincere and non-condescending way. You're young and you want to be in charge of your health for the rest of your life - it would benefit you greatly if you'd get the principles of medical literature appraisal down.

The quoted study was a case-control study, it is an observational epidemiologic study. It did what it was intended to do - observe that in studied subsets lower vit D was associated with higher cancer rates. Even if the second comparison group had normal vit D and lowest cancer rates, the conclusion wouldn't have been that normal vit D (or supplementation thereof] protect from cancer; the conclusion would've been just the same - low vit D is associated with higher rates of cancer, and that's it. There is a very long distance between correlation and causation; not that it never happens - in fact, the idea of those studies is to find such strong associations that causation becomes very likely.
The distance from observation to causation to proving the effectiveness of intervention is much longer though.

We (as in medicine) go through this stuff all the time. What you see is what has been brought up in a mainstream media - vit D, vit E, whatever. What you don't see is a myriad of measurable substances, chemicals and particles that come up in research all the time. CRP, Mycoplasma antibodies, metalloproteinases, can't keep up with all of that. And then the same discussion happens all over again: is it a causative offending substance, or is it just a marker, and would intervention directed at that substance be effective.

 

[WildVolley]

As a comparison, this is a level of discussion that I am accustomed to, the cancer data is taken just as an example, to contrast with cancer "data" above:
...

Your literature review matches my current understanding of the vitamin D issue. Some intriguing evidence, but hardly conclusive of anything yet. I believe better studies are probably underway.

The double-blind study with old people did find a statistically significant reduction in fracture risk, so that's nice, but no statistical difference on mortality.

Given the potential benefit in fracture risk reduction from vitamin D supplementation, why would you as a physician not run vitamin D tests?

 

[ollinger]

I suspect environmental risk factors are far more a concern than nutritional, at least with respect to vitamins, where the correlations really are difficult to interpret. My brother in law and his wife bought a weekend house some years ago and he spent nearly every weekend for a few years gutting it and rebuilding inside, tearing down walls, building new ones, doing floors, plumbing, everything on his own. His rotary saw was constantly in use. Last year he was diagnosed with adenocarcinoma of a nasal sinus, a rare malignancy that happens to be about 1000 times more common in woodworkers, thought to be due to exposure to the wood dust. The prognosis is that he will likely succomb this year.

 

[r2473]

^^Wow!! You're kidding me!!!! That really sucks Ollinger.

I will for sure be buying a good quality mask for my future sanding, etc projects!!!!!!

 

[YK]

Given the potential benefit in fracture risk reduction from vitamin D supplementation, why would you as a physician not run vitamin D tests?

I wasn't very clear about this: if the question at hand was in regards to skeletal benefits, i.e. clinical vit D deficiency with rickets, osteomalacia, osteoporosis, or fracture prevention, I would. These problems however are not within the scope of my practice so I don't.

What I meant to say was that I do not run those tests on the patients who, in my opinion, shouldn't be tested or take it for the indications that I can't support. If they started on their own, they are free to pay for the test out of the pocket and interpret the results themselves. If they were started by another physician, it is his/her responsibility now. This is a general position, not restricted to vit D only.

 

[WildVolley]

I wasn't very clear about this: if the question at hand was in regards to skeletal benefits, i.e. clinical vit D deficiency with rickets, osteomalacia, osteoporosis, or fracture prevention, I would. These problems however are not within the scope of my practice so I don't.

What I meant to say was that I do not run those tests on the patients who, in my opinion, shouldn't be tested or take it for the indications that I can't support. If they started on their own, they are free to pay for the test out of the pocket and interpret the results themselves. If they were started by another physician, it is his/her responsibility now. This is a general position, not restricted to vit D only.

OK. That makes sense. Just wanted clarification.

 

[LuckyR]

That's right folks. No profit in the supplement industry. Nothing to see here. Move along.

(Thanks Orrin )

As you know I didn't say there was no profit (nice try). But if the supplement industry funded the quality and size of studies that the pharmaceutical folks do, yes, there would likely be much smaller profits.

 

[LuckyR]

To answer the second part of the question: medical community does. All these cries about magic potions and physiologic theories don't go unnoticed and independent researchers do try to scrape funds to get those studies going. The HOPE trial was one of big medical trials, and the study group managed to piggy-bag vitamin E on top of the ramipril for a two-by-two factorial design 'cause vitamin E was so sexy then. Vit D, that has been mentioned here ad nauseum, has been studied ad nauseum, as far as I am concerned. CoQ10 in heart failure was studied by cardiology groups, etc.
So, the medical community, that has been accused here in turning a blind eye to supplements, is the one that actually moves some science here.
The supplement industry wouldn't do that. One reason is what you mentioned - difficulty of holding a patent and capitalizing financially on one individual product. The second reason is no less important: proving that vitamins and supplements work in healthy populations would be a scientifically and statistically nearly impossible feat, such studies would either be non-feasible or doomed to find no benefit from a get-go.



That is a correct to an extent, there is a number of historically based therapies. The big difference is that medical community is making and has made huge strides towards transparency about it. Go and pull up any American College of Cardiology practice guidelines, and you'll see that each recommendation will have a letter attached to it, A, B or C. A is a sufficient evidence from multiple randomized trials. B is a limited evidence from single, randomized trial or other nonrandomized studies.
C is based on expert opinion, case studies, or standard of care. We're trying to be as honest about limitations of our knowledge and as explicit about what backs our recommendations as we can, and that applies to everything that gets studied - drugs, procedures, or supplements.

Glad you agree with me. The highlit phrase is a different way of implying that the size, quality and number of the supplement studies are dwarfed by those funded by the pharmaceutical industry.

 

[Fee]

Haven't kept up with the 21 pages of this thread so I'll just answer the original question. I'm now taking Country Life Chewable Adult Multi, one per day. It was recommended by my chiropractor and I'm in such a horrible state right now that I put aside my general distrust of supplements in the US (no regulation) and bought them. He wants me to take 2 per day, but I'm only taking one, with food and plenty of water (they taste icky). Hate the neon urine, just reminds me of how much is wasted.

My chiro uses Sacro Occipital Technique, not the usual spine cracking method.

 

[YK]

Glad you agree with me. The highlit phrase is a different way of implying that the size, quality and number of the supplement studies are dwarfed by those funded by the pharmaceutical industry.

I don't know if number of studies is less - I just provided a reference for 17 studies on vit D and cancer alone with vast majority published after 2006, not counting vit D and cardiovascular disease, vit D and immunity, vit D and mortality etc. However, the quality and size of most studies certainly remains to be desired, for the reasons we already discussed above. Another reason that has not been mentioned is that the drug company can't hope to bring a new product to the market without presenting a compelling evidence - so their hand is forced, so to speak. Incidentally, this is a reason why R&D costs for a single medication reach several hundred million dollars. Supplement producers are not required to provide such rigorous evidence, so they don't.

 

[r2473]

Haven't kept up with the 21 pages of this thread so I'll just answer the original question. I'm now taking Country Life Chewable Adult Multi, one per day. It was recommended by my chiropractor and I'm in such a horrible state right now that I put aside my general distrust of supplements in the US (no regulation) and bought them. He wants me to take 2 per day, but I'm only taking one, with food and plenty of water (they taste icky). Hate the neon urine, just reminds me of how much is wasted.

My chiro uses Sacro Occipital Technique, not the usual spine cracking method.

What's wrong?

(You can answer with what's right if that would be shorter)

 

[Fee]

What's wrong?

(You can answer with what's right if that would be shorter)

Ummmm. Shoulder injury led to inactivity led to weight gain led to more inactivity and unhappiness about the weight gain and the shoulder injury is still unresolved. Paying attention to proper diet and nutrition kind of flies out the window when frustration rules your day. Is that vague and specific enough?

 

[r2473]

What's wrong with your shoulder?

(Running is fun by the way. Don't need a healthy shoulder for that.)

 

[Fee]

What's wrong with your shoulder?

(Running is fun by the way. Don't need a healthy shoulder for that.)

My chiro doesn't want me running right now or even walking on the treadmill. He might change that at tomorrow's visit. I can't run for more than 60 seconds anyway, I'm too weak and out of shape.

It seems no one knows what is wrong with my right shoulder. When I lift my arm up, the back upper right side of my neck hurts, and my back teeth on the right upper side of my mouth. Yes, lifting my arm makes my teeth hurt. It's gotten to the point where I can sit up in a chair and move my shoulder backwards and my teeth will hurt, I don't even have to lift my arm.

 

[r2473]

Sounds like a lack of vitamin D

Well, hopefully someone can figure out how to fix you. Have you had any big machines take expensive pictures of it?

Doesn't it seem like a "nerve thing" instead of a "muscle / tendon / ligament thing". That's what your description sounds like.

It's either that or your postural alignment is off. Are your teeth in line with your shoulder?

 

[Fee]

My MRI was negative. Probably need another x ray to rule out bone spurs. I have limited range of motion backwards, hard time putting my hand on my hip, cannot reach my lower back at all. Pain in my bicep or tricep with certain movements. It's still a muscle/tendon/ligament thing, but there might be a nerve/impingement thing too. I'm stalling on my doctor's appointment for a week or two, I'm sure he's going to recommend surgery and I just don't want to go there yet.



Anyway, not sure how I feel about these supplements I'm on. I feel better in some ways, the same in others. Just read a review of this product on Amazon and one woman said she can 'feel them in my bloodstream within ten minutes'. Yeah... okay...

 

[r2473]

I just read in Pacific Lefty's thread that you've been having this pain for a year? And its getting worse? Even with rest and rehab?

I'll have to agree with your assessment. It sucks.

Well, best of luck with your next doctors visit. If surgery is required, I hope you are as happy with the outcome as Pacific Lefty seems to be with hers.

 

[Fee]

thank you. I hope so too, right now I just want to cry.

 

[Talker]

Talker, take an epidemiology and stats class. Since the internet can't always convey the attitudes, I am going to clarify that I am recommending this in a sincere and non-condescending way. You're young and you want to be in charge of your health for the rest of your life - it would benefit you greatly if you'd get the principles of medical literature appraisal down.

The quoted study was a case-control study, it is an observational epidemiologic study. It did what it was intended to do - observe that in studied subsets lower vit D was associated with higher cancer rates. Even if the second comparison group had normal vit D and lowest cancer rates, the conclusion wouldn't have been that normal vit D (or supplementation thereof] protect from cancer; the conclusion would've been just the same - low vit D is associated with higher rates of cancer, and that's it. There is a very long distance between correlation and causation; not that it never happens - in fact, the idea of those studies is to find such strong associations that causation becomes very likely.
The distance from observation to causation to proving the effectiveness of intervention is much longer though.

We (as in medicine) go through this stuff all the time. What you see is what has been brought up in a mainstream media - vit D, vit E, whatever. What you don't see is a myriad of measurable substances, chemicals and particles that come up in research all the time. CRP, Mycoplasma antibodies, metalloproteinases, can't keep up with all of that. And then the same discussion happens all over again: is it a causative offending substance, or is it just a marker, and would intervention directed at that substance be effective.

YK, I understood the study.

I also understand that you feel there are no studies strong enough to consider that people need to increase their vitamin D levels or even have them tested.

I feel confident enough in the current research so that's just a personal preference, it's good enough for me.

Just keep an open mind is all I ask on the matter then.

 

[YK]

I also understand that you feel there are no studies strong enough to consider that people need to increase their vitamin D levels or even have them tested.

Incorrect. There is a clinical Vit D deficiency that's pretty common in third world countries, there is osteoporosis prevention and treatment, there is this data on fracture prevention, I believe there is data on mortality reduction in old institutionalized women, need to look it up again. There are good studies and historic data.
There are people with malabsorption due to GI pathology who will develop frank deficiencies of most nutrients and vitamins. I don't even need studies to supplement, pun intended, a common sense.

It is when you start bringing in alleged benefits for which the data is weak, heterogenous and conflicting that I start being apprehensive.


Ladies and gents, I am pretty sure I made more posts in this thread over last few days than I did since old TW's message board was replaced with this one some 8 years ago. Therefore I exhausted my quota for the next decade. Enjoy your supplements when you feel like it, be critical of governmental institutions at all times, promote the ideas of free spirit and thinking, and keep hitting tennis courts whenever you can. The latter will do more good to your health than all others combined, unless you get tennis elbow, athlete's foot or callous hands. Tennis elbow has been discussed here and elsewhere in detail, and for athlete's foot and calluses I suggest to look at urine therapy, scroll down to mid-segment on "Public Figures" http://en.wikipedia.org/wiki/Urine_therapy.

Cheers.

 

[Talker]

Incorrect. There is a clinical Vit D deficiency that's pretty common in third world countries, there is osteoporosis prevention and treatment, there is this data on fracture prevention, I believe there is data on mortality reduction in old institutionalized women, need to look it up again. There are good studies and historic data.
There are people with malabsorption due to GI pathology who will develop frank deficiencies of most nutrients and vitamins. I don't even need studies to supplement, pun intended, a common sense.

It is when you start bringing in alleged benefits for which the data is weak, heterogenous and conflicting that I start being apprehensive.


Ladies and gents, I am pretty sure I made more posts in this thread over last few days than I did since old TW's message board was replaced with this one some 8 years ago. Therefore I exhausted my quota for the next decade. Enjoy your supplements when you feel like it, be critical of governmental institutions at all times, promote the ideas of free spirit and thinking, and keep hitting tennis courts whenever you can. The latter will do more good to your health than all others combined, unless you get tennis elbow, athlete's foot or callous hands. Tennis elbow has been discussed here and elsewhere in detail, and for athlete's foot and calluses I suggest to look at urine therapy, scroll down to mid-segment on "Public Figures" http://en.wikipedia.org/wiki/Urine_therapy.

Cheers.

You won't know if there's a defiency if it's not tested.

As you mentioned earlier, vitamin D isn't dangerous.

If the studies are false, then your patients taking it won't lose anything except a few dollars.

If studies are true then a percentage of them will die because you won't test them or suggest the supplement.

The end result is that having them tested and taking the supplement can only end up saving lives or nothing happens.

With the number of studies out there, a number of doctors are taking the most favorable approach with the chance of saving thousands of lives each year.

Just think about this approach, only good can come from it.

 

[sureshs]

Excess of Vitamin D is also dangerous.

 

[YK]

You won't know if there's a defiency if it's not tested.

As you mentioned earlier, vitamin D isn't dangerous.

If the studies are false, then your patients taking it won't lose anything except a few dollars.

If studies are true then a percentage of them will die because you won't test them or suggest the supplement.

The end result is that having them tested and taking the supplement can only end up saving lives or nothing happens.

With the number of studies out there, a number of doctors are taking the most favorable approach with the chance of saving thousands of lives each year.

Just think about this approach, only good can come from it.

Geez, Talker, you won't let me out of this thread.

Clinical deficiency state, or disease, that I referred to above, is not the same as low vitamin D level. Clinical disease due to vit D issues implies low vit D levels; low vit D levels do not mean diseased state, nor correction of low vit D state means you'll prevent the disease, until proven so . We already went over this 3-4 times, other than bone/skeletal problems, the evidence for benefits of vit D supplementation is lacking.

I never said vit D wasn't dangerous, I said it wasn't a poison. Suresh said twice in this thread that high levels are dangerous. In that very brief that I posted there is piece of observational data suggesting increased risk of cancer associated with high vitamin D levels, something that I alluded to as a U-shape relationship. Did you notice it?

You idea of vitamin D supplementation for masses, while very humanistic, is conceptually wrong. It is not a win-win situation, as you portray it, you either benefit or nothing happens. You have to avoid high levels and vit D toxicity, so now you have to have regular blood tests and dose adjustments as vit D levels in any individual are variable and dependent on adipose tissue and sun exposure. So now an "innocent cheap supplement intake" becomes a lifelong medical management problem, with concerns for toxicity, expenses of recurrent blood test, discomfort of vein sticks - all based on what, few retrospective observations? Waste of healthcare dollars, if you ask me, but everybody feels great 'cause we're doing something, "omg, your D levels are low, but fear not, we'll take care of that, and we'll watch it like a hawk as long as you live".

 

[Talker]

Geez, Talker, you won't let me out of this thread.

Clinical deficiency state, or disease, that I referred to above, is not the same as low vitamin D level. Clinical disease due to vit D issues implies low vit D levels; low vit D levels do not mean diseased state, nor correction of low vit D state means you'll prevent the disease, until proven so . We already went over this 3-4 times, other than bone/skeletal problems, the evidence for benefits of vit D supplementation is lacking.

I never said vit D wasn't dangerous, I said it wasn't a poison. Suresh said twice in this thread that high levels are dangerous. In that very brief that I posted there is piece of observational data suggesting increased risk of cancer associated with high vitamin D levels, something that I alluded to as a U-shape relationship. Did you notice it?

You idea of vitamin D supplementation for masses, while very humanistic, is conceptually wrong. It is not a win-win situation, as you portray it, you either benefit or nothing happens. You have to avoid high levels and vit D toxicity, so now you have to have regular blood tests and dose adjustments as vit D levels in any individual are variable and dependent on adipose tissue and sun exposure. So now an "innocent cheap supplement intake" becomes a lifelong medical management problem, with concerns for toxicity, expenses of recurrent blood test, discomfort of vein sticks - all based on what, few retrospective observations? Waste of healthcare dollars, if you ask me, but everybody feels great 'cause we're doing something, "omg, your D levels are low, but fear not, we'll take care of that, and we'll watch it like a hawk as long as you live".

Thanks for the response, I thought I lost you.

There's several problems here.
Once you have your blood tested for vitamin D and supplement to correct it the numbers won't change dramatically even with changes in the seasons.
This can be verified through organizations that do the blood testing.


Toxicity only happens in very rare cases and will be found out through the blood testing in the beginning.
The relationship between blood levels and vitamin D intake is not linear, it takes quite a bit to reach toxic levels and only in very rare cases would that ever happen, the blood test will always find this after a short amount of time with consistent supplementation.

Then there is the cost, you can have blood testing done in the beginning, find the level your at with the dose your taking and that's it.
Your blood levels won't just start going up unexpectantly, there won't be a lifelong management problem.

Doctors are prescribing 50,000 IU a week regularly now as they have gone over the studies and found this amount (7,000 IU a day) have had next to zero problems with toxicity while bringing the levels up to where so many studies have agreed to be effective for so many areas, increasing daily.

Though the studies aren't the best there are so many and most of them pointing in the same direction with very few showing anything negative.
After all, in some parts of the world people are getting 20,000 IU a day by being in sunny climates, no problems there for centuries.

Looking at it from another way, sunscreen, working indoors and limiting sun exposure have cut down dramatically the vitamin D produced and levels have fallen off. Many people are walking around with very low levels with no symptoms, they have to be tested. The other solution is just take about 2,000 IU a day and that probably won't be enough but would be safe as getting 5 minutes of sun a day in the summer.

I did see your U shaped comment, I disagree with that fully but didn't want to pick apart every sentence I could, that's not my purpose.
Many studies have found reduction of cancer( some more than others) to be reduced at generally over 40ng/ml and the number increasing at levels go up.

There's not much more that I could say, I'm hoping you'll look into it further, you're in a great position to help quite a few people from my perspective.

Hopefully you can stop by and post now and then, all viewpoints are appreciated.

Talker

 

[kevin-af]

Looks like vitamin D has been hi jacking the thread. Good thing it's knowledgeable info, thx for sharing.

Please allow me to step back a bit and share my supplements consumption in the initial format. DISCLAIMER: I happen to be a rep for Ace Supplements Inc. which make the product listed below. However, the following is only my opinion as a tennis and fitness geek.

1) What you are taking. Be as specific as possible. I know that some sources are better than others for the same supplement. List anything you consider a "supplement". Herbs, spices, aspirin, protein powder, special recovery drinks. Whatever you consider a supplement to be.

2) Why you take what you are taking. Are you trying to reduce your blood pressure? Are you taking a fiber supplement to try to get the daily recommended amount (which is damn hard from diet alone). Even if you are taking an aspirin for heart health, include that.

3) How much are you taking? What are your doasages?

4) How often do you take these?

5) List any benefits. This can be anything from listing blood pressure test results to having better bowel movements to simply feeling better or having more energy.

6) If you are really on top of things, list products that you want to take but are not avaliable for one reason or another. Again, why you would take it, etc.

7) Any other useful information you can think of

1) I take the following: Whey proteins, AceFormula (Glucosamine, Chondroitin, Lutein, Leucine, Iso-leucine, L-valine, Alpha lipoic acid, Vitamin C, B5, B6, Folic acid, B12, Stevia) and L-Glutamine

2) a) I consume the whey proteins when I do not have time to eat an appropriate meal. I recognize real food is better but sometimes you just do not have time for it!
b) I take aceformula mostly for the fast recovery and the reflexes improvement. I do a lot of sports and being sore is just not an option for me.
c) I take the Glutamine before going to bed if I have been to the gym lifting weights.

3) all of them are 1 scoop (proteins: 21g, aceformula: 6g since it is very concentrated, L-glutamine: 5g)

4) a) I take the proteins usually once a day, rarely 2.
b) I take AceFormula every time I slip my tennis shoes on, meaning approx. every other day.
c) 1-2 times per week, depending what workout I am on.

5) see 2)

6) As a nutrition geek, I do take a supplement when I know it is good for me, life is too short to wait! Companies are rarely out of stock since it is for most of them their bread and butter.

I am a firm believer that every individual need a different supplementation and dietary plan. Depending mostly on the activities he/she performs and also a bit on his/her body phenotype. This is where I predict the supplement market will shift towards in the near future.

7) see 6)