EDITOR’S NOTE: In her column Beyond Rx, Andrea Wong, a 4th year Doctor of Pharmacy (PharmD) candidate from the University of Waterloo, and a very new member to the Manitoulin community, will be exploring topics on health and wellness, medical advances, and everything in between in the pages of this newspaper.
The ABCs of Vitamin A, B and C
Part I: Multivitamins
by Andrea Wong
One of the most popular questions I get asked are about vitamins and other mineral supplements. So should a generally healthy adult on no medications need to take a daily multivitamin supplement? According to the current research, vitamin supplements are not necessary as most Canadians are not deficient. Most nutrients are available through a well-balanced healthy diet. Whole foods are a great source of nutrients. However, processed and packaged foods such as cereal, grains, and bread are also fortified with additional vitamins so vitamin intake is usually more than what we realize and more than we need. Therefore, supplementing certain vitamins and minerals at high dosages could possibly be dangerous. Some vitamins are water soluble and others are fat soluble. Excess water soluble vitamins such as B, C, and folate will pass through the body and excreted in the urine. These vitamins will not build up in your system and a colleague of mines has always just called this phenomenon “expensive urine.” On the other hand, fat-soluble vitamins such as A, D, E, and K will build up in the body over time and can be potentially dangerous.
A study done for the US Preventive Services Task Force on multivitamins and single or paired vitamins in more than 400,000 participants showed no clear benefit of supplements on all cause mortality, cardiovascular disease or cancer. In the Physicians’ Health Study II, the results were mixed. There were modest reductions in cancer and cataracts but no effects against cardiovascular disease or declining mental function. Based on these studies, there remains no clear evidence that multivitamins are useful for overall or long-term health. However, there are also certain populations that can benefit from a multivitamin or certain single supplements. For example, folic acid supplementation is crucial in women looking to get pregnant to prevent spinal birth defects. In people who are at high risk of developing advanced age-related macular degeneration (AMD), a certain combination of vitamins known as the AREDS formulation can reduce the risk of developing AMD by 25 percent and help preserve vision.
Whether or not someone requires vitamins are really dependent from person to person depending on their gender, age, diet, medical history, and concurrent medications and therapy. The decision whether or not you should supplement should be discussed with your healthcare provider to ensure there are no interactions and you are getting the proper supplement for your needs. As there can be interactions with vitamins, natural health products, and other supplements with prescription medications, it is always a good idea to bring a copy of your medication list with you with both prescription and over-the-counter medications and vitamins you are taking to your health appointments.
Although the evidence behind multivitamins may not be strong, other health recommendations such as eating a healthy diet, maintaining a healthy weight, and reducing the amount of sodium, sugar, and saturated and trans fat have proven benefits. A healthy lifestyle goes far beyond what a pill can offer as other nutrients such as fiber and phytonutrients are found in foods but not pills. Next week, Part II of the series ‘The ABCs of Vitamin A, B and C’ will discuss the basics of healthy eating and nutrition.
