How safe are vitamins?
Dr. Dimitris Tsoukalas, MD
President of The European Institute of Nutritional Medicine E.I.Nu.M
American College for the Advancement in Medicine
A question that seems to confuse the public as well as healthcare professionals more than any other is: is it safe to take vitamins and other micronutrients such as minerals and amino acids?
The words 'Recommended Daily Allowance' (RDA) are printed on all dietary supplement formulations and sometimes also on food labels.
I believe it is vitally important to precisely answer the following questions so as to know exactly were we stand in regards to vitamins and other food supplements:
• What exactly does RDA mean?
• What happens if one takes more than the Recommended Daily Allowance? Is it harmful to health?
• Does regular vitamin intake overtax the kidneys and liver?
The History of Dietary Standards
The history of dietary standards was recorded and published for the first time by Dr. Isabella Leitch in 1942. The terms 'Recommended Daily Allowance' appear for the first time in the scientific treatise she wrote.
The first official provision on the subject of the human diet was made in 1835 by the British Parliament. It required the addition of lemon juice to a sailor's diet as a measure to prevent scurvy.
However, the first true dietary recommendation was made in 1862, at a time of economic crisis, by Dr. Edward Smith. Smith was asked by the Royal Council to determine the minimum amount of food a person needs to avoid starvation. Through measuring the amounts of carbon dioxide and nitrogen eliminated from the body in people working at a treadmill, Smith calculated that a man performing manual labor needs a minimum of 80 grams of protein and 2,800 calories per day. This was the first time a dietary standard was based on scientific measurements.
During the 19th century, the generally accepted idea was that a diet containing proteins, sources of energy (fat, carbohydrates) and some minerals was adequate. Only through discoveries made in the 20th century did it become understood that food contains other vital elements.
At the time of World War I (1914-18) suggestions were made regarding the amount of food to be given to soldiers. Diseases due to dietary deficiencies had been known for some time by then and foods that prevented them were called 'protective foods'. The British authorities recommended the addition of milk to a child's diet and greens for all ages.
Following the start of the Great Depression in 1929, special committees were formed to collect information regarding the needs of the human body in minerals and vitamins. In 1933, the first quantitative dietary recommendation was made that included vitamins and minerals (Sherman-Stiebeling). In 1939 Sherman said that these recommendations were minimum values and that they should be increased by 50% so as to include persons for whom the earlier recommendations may not be ade.
During the World War II similar but broader recommendations were drafted, which included more minerals and vitamins, with the purpose of establishing the minimum values of nutrients intake in times of war.
The Present Situation
As can be seen, historically all dietary recommendations were made based on the minimum amounts of micro- and macronutrients required to avoid starvation and the onset of defficiency diseases.
These recommendations were later used as a basis for legislative provisions in the field of supplements and nutrition. They are, however, the minimum quantities required by the human organism to stay alive during times of food shortage. And here lies the crux of the matter: contemporary recommendations are the same (in some cases they are even lower) than those dating from 1933.
Today we live in an era of abundance where food is available in quantities never before imagined (at least for part of the world's population). Unfortunately these are essentially nutrition-empty foods. They provide one with harmful calories while not even coming near the minimum required quantities of micronutrients.
The explosive increase in chronic health conditions and autoimmune diseases, as well as the declining health levels of the entire population is the result of these deficiencies.
• What is Man's natural diet?
• What was the nutrient content of foods when Man appeared on Earth?
In truth, we do not know the answers to these questions. What we do know for certain is that our diet is poorer than what it was only thirty years ago by a factor of ten.
It has become imperative to take supplements, along with a balanced diet, to make up for our food's departure from its natural state.
Accordingly, the daily intake of a good multivitamin and vitamin D has become an integral part of the dietary pyramid as issued by the Department of Nutrition of the Harvard School of Public Health.
Safety of Vitamins
Over the last few years the number of scientific papers and popular articles naming the health benefits vitamins and other supplements has been on a steady increase (e.g. vitamins D and K, Q10, antioxidants, multivitamins).
And yet, in the minds of many there are still questions regarding the safety of taking supplements.
• Are too many vitamins bad for my liver or kidneys?
• Am I at risk of allergy?
• Do I have to take a break from vitamins from time to time?
• Does the organism develop a tolerance to vitamins?
The concern over burdening the liver and kidneys stems from the identification of vitamins with drugs. Drugs indeed severely burden both liver and kidneys because they are xenobiotic compounds that the organism must eliminate.
The term 'xenobiotic' describes chemical compounds that should not be present in the organism; compounds that are foreign (xeno-) to life (biotic). They can be either water-soluble or fat-soluble, which means that they can be dissolved in water or fatty substances respectively, just like paints (watercolors vs oil paints).
Water-soluble compounds are eliminated directly by the kidneys while fat-solubles must first be converted into water-solubles before they can be eliminated. This conversion process takes place in the liver mainly, in a complex of 500 enzymes called P450, that requires the presence of a great number of vitamins and minerals to function properly.
As can be seen easily, not only are the liver and kidneys not burdended by vitamins and minerals but they actually need them to do their work in eliminating the toxins that burden the organism.
Oil-soluble vitamins (vitamin A, D, E) may accumulate in the organism, although it is unlikely, and for this reason their administration in therapeutic dosages must be done under medical surveillance so that their levels can be monitored and any deficiency or excess quickly ascertained. No toxic threshold has been found for vitamin K, although is an oil-soluble.
As far as vitamin D is concerned, it is practically impossible to reach the toxic threshold. One would have to take over 50,000 IU per day for months on end before the first signs of toxicity would appear! The same goes for vitamin Ε.
The intake of vitamin A should be limited to 10,000 IU per day during pregnancy. Furthermore, it seems that in higher amounts vitamin A reduces the effectiveness of vitamin D. This is why big supplement companies have either greatly lowered the amount of vitamin A in the content of their multivitamins or removed it altogether.
It is an interesting fact that many people feel safe when taking pharmaceutical drugs but are afraid of the possible side effects of vitamins. The facts of the matter are that the number of vitamin-induced deaths is zero, even following a deliberate poisoning attempt. On the other hand, the death toll among hospitalized patients from the side-effects of correctly prescribed pharmaceutical treatment is 106,000 per year in the USA alone.
It should be pointed out that the supplements and hormones taken by athletes for performance enhancement purposes do not come under the heading of vitamins or micronutrients. Those are not natural substances that can be ingested to supplement one's diet but pharmaceutical compounds which are directly linked to health risks.
According to data published in the USA by the CDC: 60 billion doses of vitamins administered in 2010 did not result in a single death and the same goes for the previous twenty-seven years. According to the Council For Responsible Nutrition, dietary supplements are safe, beneficial and controlled by governmental agencies in each country.
Detection of Nutrient Deficiencies
Thanks to the extremely rapid progress made in the field of laboratory testing, metabolic tests are now available at a cost lower than that of the usual checkup. The information they provide to the physician, however, is of much greater value as it shows the individual's true needs at any given time.
Analyses so obtained make it possible for the medical doctor to administer vitamins and other micronutrients according to the individual's specific deficiencies, and this with complete safety (personalized medicine).
The implementation of these techniques on a large scale will radically change the way we view prevention and treatment as it makes it possible to take steps long before the appearance of symptoms. We are effectively talking about a medical approach that is broadly applicable and which is oriented toward the detection of causes rather than the mere relief of symptoms.
To your health!
References:
Leitch, I. (1942) The evolution of dietary standards. Nutr. Abs. Rev. 11:509-521
History of Nutrition Standars
New RDAs
onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.2008.00102.x/full http://www.vitamindcouncil.org/about-vitamin-d/what-is-vitamin-d/vitamin-d-toxicity/
www.orthomolecular.org/resources/omns/v05n04.shtml
en.wikipedia.org/wiki/Vitamin_poisoning#cite_note-5
www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamins/
jama.ama-assn.org/content/279/15/1200.full
President of The European Institute of Nutritional Medicine E.I.Nu.M
American College for the Advancement in Medicine
A question that seems to confuse the public as well as healthcare professionals more than any other is: is it safe to take vitamins and other micronutrients such as minerals and amino acids?
The words 'Recommended Daily Allowance' (RDA) are printed on all dietary supplement formulations and sometimes also on food labels.
I believe it is vitally important to precisely answer the following questions so as to know exactly were we stand in regards to vitamins and other food supplements:
• What exactly does RDA mean?
• What happens if one takes more than the Recommended Daily Allowance? Is it harmful to health?
• Does regular vitamin intake overtax the kidneys and liver?
The History of Dietary Standards
The history of dietary standards was recorded and published for the first time by Dr. Isabella Leitch in 1942. The terms 'Recommended Daily Allowance' appear for the first time in the scientific treatise she wrote.
The first official provision on the subject of the human diet was made in 1835 by the British Parliament. It required the addition of lemon juice to a sailor's diet as a measure to prevent scurvy.
However, the first true dietary recommendation was made in 1862, at a time of economic crisis, by Dr. Edward Smith. Smith was asked by the Royal Council to determine the minimum amount of food a person needs to avoid starvation. Through measuring the amounts of carbon dioxide and nitrogen eliminated from the body in people working at a treadmill, Smith calculated that a man performing manual labor needs a minimum of 80 grams of protein and 2,800 calories per day. This was the first time a dietary standard was based on scientific measurements.
During the 19th century, the generally accepted idea was that a diet containing proteins, sources of energy (fat, carbohydrates) and some minerals was adequate. Only through discoveries made in the 20th century did it become understood that food contains other vital elements.
At the time of World War I (1914-18) suggestions were made regarding the amount of food to be given to soldiers. Diseases due to dietary deficiencies had been known for some time by then and foods that prevented them were called 'protective foods'. The British authorities recommended the addition of milk to a child's diet and greens for all ages.
Following the start of the Great Depression in 1929, special committees were formed to collect information regarding the needs of the human body in minerals and vitamins. In 1933, the first quantitative dietary recommendation was made that included vitamins and minerals (Sherman-Stiebeling). In 1939 Sherman said that these recommendations were minimum values and that they should be increased by 50% so as to include persons for whom the earlier recommendations may not be ade.
During the World War II similar but broader recommendations were drafted, which included more minerals and vitamins, with the purpose of establishing the minimum values of nutrients intake in times of war.
The Present Situation
As can be seen, historically all dietary recommendations were made based on the minimum amounts of micro- and macronutrients required to avoid starvation and the onset of defficiency diseases.
These recommendations were later used as a basis for legislative provisions in the field of supplements and nutrition. They are, however, the minimum quantities required by the human organism to stay alive during times of food shortage. And here lies the crux of the matter: contemporary recommendations are the same (in some cases they are even lower) than those dating from 1933.
Today we live in an era of abundance where food is available in quantities never before imagined (at least for part of the world's population). Unfortunately these are essentially nutrition-empty foods. They provide one with harmful calories while not even coming near the minimum required quantities of micronutrients.
The explosive increase in chronic health conditions and autoimmune diseases, as well as the declining health levels of the entire population is the result of these deficiencies.
• What is Man's natural diet?
• What was the nutrient content of foods when Man appeared on Earth?
In truth, we do not know the answers to these questions. What we do know for certain is that our diet is poorer than what it was only thirty years ago by a factor of ten.
It has become imperative to take supplements, along with a balanced diet, to make up for our food's departure from its natural state.
Accordingly, the daily intake of a good multivitamin and vitamin D has become an integral part of the dietary pyramid as issued by the Department of Nutrition of the Harvard School of Public Health.
Safety of Vitamins
Over the last few years the number of scientific papers and popular articles naming the health benefits vitamins and other supplements has been on a steady increase (e.g. vitamins D and K, Q10, antioxidants, multivitamins).
And yet, in the minds of many there are still questions regarding the safety of taking supplements.
• Are too many vitamins bad for my liver or kidneys?
• Am I at risk of allergy?
• Do I have to take a break from vitamins from time to time?
• Does the organism develop a tolerance to vitamins?
The concern over burdening the liver and kidneys stems from the identification of vitamins with drugs. Drugs indeed severely burden both liver and kidneys because they are xenobiotic compounds that the organism must eliminate.
The term 'xenobiotic' describes chemical compounds that should not be present in the organism; compounds that are foreign (xeno-) to life (biotic). They can be either water-soluble or fat-soluble, which means that they can be dissolved in water or fatty substances respectively, just like paints (watercolors vs oil paints).
Water-soluble compounds are eliminated directly by the kidneys while fat-solubles must first be converted into water-solubles before they can be eliminated. This conversion process takes place in the liver mainly, in a complex of 500 enzymes called P450, that requires the presence of a great number of vitamins and minerals to function properly.
As can be seen easily, not only are the liver and kidneys not burdended by vitamins and minerals but they actually need them to do their work in eliminating the toxins that burden the organism.
Oil-soluble vitamins (vitamin A, D, E) may accumulate in the organism, although it is unlikely, and for this reason their administration in therapeutic dosages must be done under medical surveillance so that their levels can be monitored and any deficiency or excess quickly ascertained. No toxic threshold has been found for vitamin K, although is an oil-soluble.
As far as vitamin D is concerned, it is practically impossible to reach the toxic threshold. One would have to take over 50,000 IU per day for months on end before the first signs of toxicity would appear! The same goes for vitamin Ε.
The intake of vitamin A should be limited to 10,000 IU per day during pregnancy. Furthermore, it seems that in higher amounts vitamin A reduces the effectiveness of vitamin D. This is why big supplement companies have either greatly lowered the amount of vitamin A in the content of their multivitamins or removed it altogether.
It is an interesting fact that many people feel safe when taking pharmaceutical drugs but are afraid of the possible side effects of vitamins. The facts of the matter are that the number of vitamin-induced deaths is zero, even following a deliberate poisoning attempt. On the other hand, the death toll among hospitalized patients from the side-effects of correctly prescribed pharmaceutical treatment is 106,000 per year in the USA alone.
It should be pointed out that the supplements and hormones taken by athletes for performance enhancement purposes do not come under the heading of vitamins or micronutrients. Those are not natural substances that can be ingested to supplement one's diet but pharmaceutical compounds which are directly linked to health risks.
According to data published in the USA by the CDC: 60 billion doses of vitamins administered in 2010 did not result in a single death and the same goes for the previous twenty-seven years. According to the Council For Responsible Nutrition, dietary supplements are safe, beneficial and controlled by governmental agencies in each country.
Detection of Nutrient Deficiencies
Thanks to the extremely rapid progress made in the field of laboratory testing, metabolic tests are now available at a cost lower than that of the usual checkup. The information they provide to the physician, however, is of much greater value as it shows the individual's true needs at any given time.
Analyses so obtained make it possible for the medical doctor to administer vitamins and other micronutrients according to the individual's specific deficiencies, and this with complete safety (personalized medicine).
The implementation of these techniques on a large scale will radically change the way we view prevention and treatment as it makes it possible to take steps long before the appearance of symptoms. We are effectively talking about a medical approach that is broadly applicable and which is oriented toward the detection of causes rather than the mere relief of symptoms.
To your health!
References:
Leitch, I. (1942) The evolution of dietary standards. Nutr. Abs. Rev. 11:509-521
History of Nutrition Standars
New RDAs
onlinelibrary.wiley.com/doi/10.1111/j.1753-4887.2008.00102.x/full http://www.vitamindcouncil.org/about-vitamin-d/what-is-vitamin-d/vitamin-d-toxicity/
www.orthomolecular.org/resources/omns/v05n04.shtml
en.wikipedia.org/wiki/Vitamin_poisoning#cite_note-5
www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamins/
jama.ama-assn.org/content/279/15/1200.full
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