How To Stay Out of Trouble When Taking Dietary Supplements
by Bill Sardi
In this modern era when the usage of dietary supplements is popular and growing (U.S. supplement sales rose 7 percent to $11.5 billion in 2012, and are forecasted to reach $15.5 billion by 2017), and there is a strong upsurge in the use of vitamin D (up from $40 million in 2001 to $425 million in 2009), calcium ($177 million sales in 2012) and polyphenols (green tea catechins, grape seed proanthycyanidins, red wine resveratrol, curcumin from turmeric spice, silymarin from milk thistle, many others), unguided use is resulting in many avoidable side effects. (Herbal supplement sales were $5.3 billion in 2011.)
Don’t get me wrong. Dietary supplements antagonists unwaveringly pitched against dietary supplements are sure to misquote what I am saying and launch their "I told you so" reports.
Dietary supplements are safer than tap water, aspirin, vaccines and even table salt. Poison control center data confirms dietary supplements are safe.
The side effects I’m talking about usually cause supplement users to back away from their use. But there are also some long-term threats posed by improper supplement use that are not so apparent in the short term and need to be addressed.
The above-mentioned supplements, when used skillfully, are at the center of a self-help health revolution that surely will reduce mortality rates and hold promise to prolong the healthspan of many millions of Americans. However, their improper use often emanates from over-enthusiast use and the mistaken notion that more is better.
A key problem is that even supplement-savvy physicians are not well trained in the use of dietary supplements. Many supplement users don’t disclose what they are doing to their family physician for fear of being subjected to ridicule. One survey revealed about a third of supplement users don’t inform their doctors of the dietary supplements they use, but the real figure is probably much higher.
Unfortunately medical school usually leaves physicians with common biases against dietary supplements. Some of these misconceptions are: vitamin A can be toxic to the liver – yes, but mostly among alcoholics and patients with pre-existing liver disease; vitamin C causes kidney stones – based on contrived science; vitamin D can induce hyper-calcification – yes, but at doses in excess of 1 million units in the animal lab; vitamin E can over-thin the blood – disproven by modern studies; magnesium induces diarrhea – yes but it is an effective laxative, and it induces loose stool, not expulsive diarrhea.
When it comes to nutritional supplements, doctors can be generally categorized as dumbbells, (even though supplements have a high rate of use among health professionals) whose entire scope of nutritional expertise often doesn’t extend beyond the recommendation of an aspirin tablet, a Centrum multivitamin and a calcium pill.
I may be a relentless advocate of dietary supplements, but they aren’t totally without side effect and safe at any dose. It is unconscionable to think that the supplement industry is in some cases mistakenly circling its wagons to blindly defend dietary supplements largely because of the income stream they now generate. Calcium supplements are the biggest example.
Calcium pills: yea or nay?
My argument against supplemental calcium for post-menopausal women first appeals to common sense.
I ask women who no longer have monthly cycles, as they began to approach menopause they developed a nutrient shortage of ________? They usually answer "calcium."
I say no, let’s do this again. As menopause sets in you develop a deficiency of _______ ? They have no clue. They look at me dumbfounded.
So I answer it for them: "estrogen."
"Oh, ya, the ovaries stopped producing hormones," they say. Seems obvious, doesn’t it?
And estrogen sends a signal to hold calcium in bone. Lose that signal and it doesn’t matter how much calcium you pour into your body it will leach out and be deposited in your arteries, stiffening them like a statue.
The more bone that is lost, the more that arteries are progressively diseased. That is why a growing number of published studies now say supplemental calcium increases the risk for mortal heart attacks! High dietary consumption of calcium (1400 mg) coupled with calcium supplements has been found to increase the risk for death from all causes by 257%. Supplemental calcium below 500 mg didn’t pose a risk.
Supplement industry in denial
The supplement industry is in denial over this. The Council For Responsible Nutrition, which represents supplement makers, refers to the Institute of Medicine recommendation for women over age 50 to consume 1200 mg of calcium. But that number is the amount of calcium from the diet plus supplements. The typical American diet provides 800-1200 mg of calcium. So only small amounts of supplemental calcium are needed, if at all. The problem is the inability to retain calcium in bone, not a lack of intake.
Furthermore, since the loss of calcium from bone is not being addressed, this is why supplemental calcium is like pouring calcium into a barrel with a hole in its bottom.
So what modern medicine has done since frightening women away from hormone replacement therapy is to increase the risk of hip fracture by 55%.
What happened in the aftermath of advice to avoid hormone replacement therapy was that alternative therapies (bone hardening drugs) were recommended which pose some of the same health risks as estrogen. Some investigators think modern medicine took one step forward and two steps back when it backed away from estrogen replacement. Bottom line, estrogen replacement therapy is as safe as what has been recommended as an alternative.
Health authorities now concede that restrictions on hormone replacement therapy are not supported by the original data used to make that recommendation.
Estrogen replacement not only helps retain bone integrity but also inhibits deposition of calcium that stiffens arteries.
In lieu of estrogen replacement, fearful women who don’t want hormone therapy, may opt for use of weak plant estrogens like resveratrol (rez-vair-ah-trol), known as a red wine molecule, that is 1/7000th the strength of natural estrogen but acts like estrogen to retain calcium in bone.
Women can supplement their diet with all of the calcium, magnesium, vitamin D, strontium, and other bone enhancing nutrients they want, but unless the estrogen signal is replaced to hold calcium in bone, bones will continue to wither.
Vitamin D and vitamin K are effective anti-calcifying agents that may be helpful, but they do not replace estrogen.
Use of supplemental vitamin D and K help to reduce bone fractures. Vitamin D in higher doses than have been recommended may be needed. Both vitamin D and K not only aid in retaining bone strength, but also help maintain elastic (un-calcified) arteries.
Bottom line: Don’t fall for all the sales pitches to drink more calcium-rich milk or take calcium pills, even if given by your doctor.
Another tip for women facing bone loss and accompanying loss of physical stature – without sleep, bone is lost. Women with low estrogen levels report many sleepless nights. This points to the importance of another hormone, melatonin. When animals had their pineal glands removed, which secrete melatonin, their bones rapidly withered. Sleep is of great importance for bone health. Nighttime is when the bones repair and rebuild. The ideal time to take bone supplements is at bedtime and a melatonin tablet may be a beneficial addition to your bone-building regimen. Some bone-enhancing dietary supplements now provide low-dose calcium with vitamin D and melatonin with the recommendation they be taken at bedtime.
Vitamin D: balance it with vitamins A and K and calcium/ magnesium
Millions of Americans have begun to take vitamin D pills given an upsurge of published reports that low vitamin D levels are linked to a number of maladies.
I was recently interviewed on a nationwide radio program and received many inquiries about leg spasms, toe curling and foot cramping. I wondered what could be causing these muscle cramps.
I can remember, as a teenager, returning from a day at the beach and experiencing the worst charley-horse cramps in my leg muscles. A day in the bright sun had produced high vitamin D levels that increase the utilization of muscle-constricting and relaxing minerals such as calcium and magnesium. An imbalance of these minerals can produce excruciating leg and foot cramps.
Having adopted vitamin D3 pills into my daily supplement regimen I began to experience leg cramps and my toes began to tighten and curl in bed. I found a low-dose calcium/magnesium supplement helped relieve this problem. Maybe a reduction in the dose of supplemental vitamin D will also eradicate these muscle cramps.
Another lesson I learned about vitamin D is that it is stored in the liver as a fat-soluble vitamin along with vitamin A and vitamin K. Too much vitamin D can impair liver storage of vitamin A. I don’t consume butter or other vitamin A-rich foods on a regular basis, mostly relying on my diet and supplements to provide vitamin A converted from beta carotene in carrots, squash, etc.
As time passed I experienced two eye infections within a short period of time. I had never had an eye infection in my lifetime. My eyelids were also sticky when I awoke in the morning. I gave this some thought and wondered if I was getting enough vitamin A to produce mucin that coats the surface of my eyes. Mucin serves as a barrier against infection.
So I laid my vitamin D pills aside and began to take cod liver oil as a natural source of vitamin A and my sticky eyelid problem disappeared and I have not had another eye infection. I now supplement my diet with vitamin A-rich cod liver oil two days a week and vitamin D 5 days a week.
By the way, cod liver oil provides such a miniscule amount of vitamin D that it cannot be relied upon as a source of this vitamin.
It’s also important to know that all of the alleged side effects of high-dose vitamin D appear to emanate from a shortage of vitamin K. So vitamin K2 supplements are suggested as a way to balance these fat-soluble nutrients. Some vitamin D formulas now include vitamin K.
Bottom line, balance out your vitamin D with vitamins A and K....
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