Why you should not listen to your doctor in regards to supplements
If you are interested in smart supplementation to complement your diet and healthy lifestyle do not listen to your medical doctor on supplement suggestions. This statement is not meant to disparage physicians. I have worked and continue to work with the best of the best what I call physician pearls.
In truth, medical doctors simply have no knowledge or training in nutrition science. If you take a look at the Harvard Medical School curriculum you would not find one nutrition course – NOT ONE.
I was on Dr. Radio XM / Sirius this past Wednesday, commenting on my opinion of the SELECT clinical trial that recently showed that Vitamin E causes an increase risk of prostate cancer. The co-host, a medical physician, was asked if he would recommend his patients to consume vitamin E supplementation and, to paraphrase, he said he would not based on the new information from the SELECT trial. I cringed. Not only was I uncomfortable with his response but I then realized that many other physician’s share this sentiment and would discourage their patients from consuming this seemingly helpful nutrient.
When I was asked the same question I responded, I would not recommend synthetic alpha tocopherol to any patient at 400 IU a day because it clearly promotes cancer. In fact, you cannot find alpha-tocopherol in any over-the-counter supplement store. I would, however, recommend mixed tocopherol with gamma tocopherol as is found in nature.That’s right, the most abundant dietary type of vitamin E is gamma- tocopherol along with lesser levels of the other family member: alpha, beta and delta tocopherols. (Jiang et al. 2001).
The host of the show, then asked a peculiar question; why would the government pay $130 million to study a synthetic form of vitamin E?
I have written one the “facts of vitamin E and prostate cancer” in several forums (also here and here) but it’s worth sharing with you my response to this potentially provocative question.
Why is alpha-tocopherol studied for prostate cancer?
In 1985, the alpha tocopherol beta cartotene trial (ATBC) was initiated to see if these two nutrients protected smokers against lung cancer.
The ATBC study ended in 1994 showing no protective effects in the group consuming alpha-tocopherol and a higher incidence of lung cancer in the beta-carotene group. As a side observation the researchers noticed a 32% decrease in prostate cancer among those taking alpha-tocopherol.
The amount of alpha-tocopherol consumed by the ATBC participants was 50 units a day.
Since it was the alpha-tocopherol type of vitamin E used on the ATBC clinical trial – The SELECT trial, (alpha tocopherol, selenium study for the prevention of prostate cancer) began in 1999 using 400IU of alpha-tocopherol of vitamin E in one of the four “arms.” For more details on the design of this study go here.
Why 400 IU? I really don’t know but this amount is 8 times the amount of alpha-tocopherol used in the ATBC study. Researchers have reported that it could be dangerous to take high levels of alpha-tocopherol vitamin E without also consuming gamma-tocopherol (Christen et al. 1997).
S0 not only did they use a synthetic form of vitamin E in the SELECT trial but they also used an astronomical amount as well – 400 IU. Common over-the-counter usage of vitamin E is 400 IU of MIXED tocopherols (not only alpha tocopherol) a day.
The SELECT trial was set up for failure right from the beginning. This was likely not intentional of course, but this is what it is.
Another recent supplement study mis-intrepeted – the Iowa women’s health study
Lastly, this past week several other anti-supplement headlines hit the media waves: Your multi-vitamin may be killing you and vitamins may increase death risk in older women from Shape magazine and USA today, respectively – referring to the Iowa Woman’s Health study.
Lets partially dissect this study. The Iowa Woman’s Health study assessed the use of vitamin and mineral supplements in relation to total mortality in 38Â 772 older (post menopausal) women.
The Iowa Women’s Health Study concluded: In older women, several commonly used dietary vitamin and mineral supplements may be associated with increased total mortality risk; this association is strongest with supplemental iron. In contrast to the findings of many studies, calcium is associated with decreased risk.(Mursu et al. 2011)
The study initially suggested that women who supplemented with vitamins C, D, E and calcium had significantly lower risks of mortality; of course you or I did not see this anywhere.
In addition, no naturopath, nutritionist and, I think, no medical doctor would recommend iron to non-anemic post menopausal woman. Excess iron consumption can be toxic in men and women who ceased menstruation. Furthermore, the Iowa Women’s Health Study used questionnaires to gather data ”this is an important difference because questionnaires are unreliable in accurately capturing information.
What should you do?
Growing up my dad use to say, Son, in life you always need a good lawyer , a good doctor and a good car mechanic. I would replace the car mechanic with a good naturopathic physician , all biasness aside and nothing against car mechanic’s.
Naturopathic physician’s take 2 years of Nutrition -a cornerstone of clinical training as described in the University of Bridgeport School of Naturopathic Medicine curriculum.
There are also medical doctors who are nutritionally oriented – many whom are members of the American College of the Advancement of Medicine (ACAM).
I hope this helps clear things up a little in regards to all the hype around supplement toxicity.
Have a great weekend.
In Optimal Health,
Christen S, et al. gamma-tocopherol traps mutagenic electrophiles such as NO(X) and complements alpha–tocopherol: physiological implications. Proc Natl Acad Sci U S A 1997 Apr 1;94(7):3217-22
Jiang Q, et al. gamma-tocopherol, the major form of vitamin E in the US diet, deserves more attention. Am J Clin Nutr. 2001 Dec;74(6):714-22.)
Albanes et al., Alpha-Tocopherol and beta-carotene supplements and lung cancer incidence in the alpha-tocopherol, beta-carotene cancer prevention study: effects of base-line characteristics and study compliance. J Natl Cancer Inst. 1996 Nov 6;88(21):1560-70.
Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR Jr. Dietary Supplements and Mortality Rate in Older Women: The Iowa Women’s Health Study. Arch Intern Med. 2011 Oct 10;171(18):1625