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Tuesday, February 10. 2009

Vitamins

Docs have been poo-pooing routine vitamin-taking for many years. We tend to think of it as a rip-off (although I do take a daily Vit D). Studies continue to indicate their uselessness in adulthood, but the placebo effect cannot be underestimated.
Posted by Dr. Joy Bliss in Medical at 13:21 | Comments (16) | Trackbacks (0)

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I take a simple multivitamin most days, not expecting to ward off cancer but just for some help against all the things the kids bring home from school. I have to say I think it helps, I rarely even catch colds anymore, haven't had a flu in years. Of course distinguishing between a little virus and aches that I attribute to age might muddy the water a little.
#1 ricefarm on 2009-02-10 13:38 (Reply)
Most of the MD's I work with probably agree, but the placebo effect is hard to ignore. Many do, however, prescribe non-routine vitamin taking, such as folic acid, monthly B-12 injections, and supplemental D3. Others include calcium, potassium, niacin, all for specific reasons. Just today, a client asked about a new supplement ad from a major pharmacy chain, which told nothing about what it contained, only that it would promise relief from arthritis pain; I warned the client to clear this with the doc before he spent his money on it (His arthritis pain is well-controlled with minimum medication, as it is).
#2 Steve on 2009-02-10 14:02 (Reply)
It seems like a good idea to me, as a hedge against your preferred diet missing something unawares.

In the best case, you don't need it. But you don't know.
#3 Ron Hardin (Link) on 2009-02-10 15:03 (Reply)
Why do you think this is, Doc? Do people on the whole eat well balanced diets, or can our bodies make do with much smaller quantities of vitamins than recommended? Or is it something else?
#4 feeblemind on 2009-02-10 17:04 (Reply)
from the linked article:
...said multivitamins may still be useful "as a form of insurance" for people with poor eating habits.
That's one reason I take a daily multi-vitamin. And considering I buy generic-type vitamins, I end spending approximately $4.00/60 days.
Other than that, I only rarely take ibuprofen (again generic) rather than aspirin or acetaminophen, for occaisonal aches and pains.
(Man, am I boring, or what? No chronic conditions to discuss at length!)
#5 cas on 2009-02-10 18:11 (Reply)
Who stands to lose if these studies "proved" the effectiveness of vitamin/mineral supplements? So exactly how objective are the studies which seem to make a lot of physicians sustain their affections towards their BMWs, Lexus' and Mercedes?

If spending $5 on a bottle of zinc supplements helped resolve a prostate problem why spend 10 times more on some very dangerous anti-biotics...that don't work? And have to get an additional $100 for a 30 second consultation with the doc to get that Rx?

Of course, a routine office visit to a physician is also for the most part a placebo.
#6 John Hetman on 2009-02-10 19:23 (Reply)
John, You are so right about those waste-of-money trips to the doctor. Do you have PODS in your area yet? PODS stands for 'pee on disease strip'. What you do instead of go to the doctor is pee on this little strip and it changes colors and you hold it up to a little chart and the chart tells you everything you want to know from 'you have tortoise breath to you have cancer and two weeks to live'. Just amazing I'm telling you and cheap, too. You can get a three-month supple of PODS for $19.95 if you order today, and that includes S&H, and if you order by midnight, you can get a second set for half-price and S&H. The cool thing about PODS is that you use them when you want like when you're feeling a big tumor on the side of your head or if you start forgetting stuff and can't remember the name 'Alzheimer's'. It's up to you entirely and you can't beat the price for finding out something creepy in the privacy of your own home as opposed to in the cold, clinicy creepiness of a doctor's office for a hundred dollars. Are you kidding?

I LOVE TO PEE TO FIND WHAT A DOCTOR CAN'T SEE. That's the motto. Call 1-800-837-5309 today! Ask for Jenny.
`
#6.1 Meta on 2009-02-10 19:46 (Reply)
That's too damn funny for words... that's the future you're selling there. Wait for it. Love the motto.
#6.1.1 Luther McLeod on 2009-02-10 20:11 (Reply)
I'll start with a question for those who understand the workings of the medical services industry better than I do (and I have pretty constant contact with folks who live and work in that industry).

Q: How do doctors make $$ writing prescriptions in cases other than when patients come to them because they write prescriptions?

If I am unclear, I'll try to explain. I realize there are some portion, which I believe is relatively small, of doctors who's patients come to them largely because they will easily write prescriptions the patients want, perhaps rather more than they need. V-iagra, the long list of psych drugs, etc.

Having contact with pharmacy folks I am frequently amazed by the stories they tell about how many people are shoving incredible amounts of serious psych drugs down their throats. Oh, yeah, and we the taxpayers are paying for it. I presume those doctors make more money by having more patients they can dispatch quickly rather than some some prescription kickback.

So I suppose my question should be: How does a doctor who takes his craft seriously and has a reasonable ability to behave ethically, make a single $ by writing a single script? Are the writers of prescriptions for the various drugs reported to the pharm companies who then send $ to the docs? I don't think so but I could be wrong.

Now, for the more generalized topic Dr. Bliss mentioned... are we talking about ONLY vitamins or the larger group of things called "supplements"? Personally, I take an ordinary multivitamin. I have no idea if it helps but what the heck, it's cheap.

Supplements are another matter. I take a fairly broad range of those and I'm pretty convinced they help. They get somewhat expensive. Same, BTW, with prescription drugs and exercise. I won't bore folks with the details but I've gone from an unfavorable blood (primarily lipid) profile to becoming a freakin' poster child for favorable blood (primarily lipids) profile. I got HDL numbers a hot, steaming female would be proud of. But I digress....

I take two prescription drugs in "light" if not "low" dosage. For one, the following are side effects I have ZERO doubt I have experienced (there are others, a longer list, that I have not experienced):

•joint pain
•muscle cramps, pain
•unusually weak or tired

For the second, we have another somewhat extensive list of potential side effects among which I've experienced:

- Weight gain
- Feeling tired (fatigue)

Fighting against those side effects has become a daily battle that I believe I have won sufficiently to go on with the life I'd like to live.

Accomplishing that, in addition to pretty radically altering my blood profile has required a combined arms effort. And I've escalated the effort over time with improving results enough to have convinced myself that I should continue following all avenues.

I took my doctor's advice on three matters:
- quit smoking
- increase exercise (I'm no triathlete but I'm doing pretty well on this front). I was a 25 mile a week walker. Walking ain't cutting it. I don't care who tells you it is good enough, it ain't - at least not for me. You gotta sweat and suck wind or it ain't exercise.
- take the drugs he advises as prescribed/directed. The list has shrunk from four to two and the dosages have decreased because I demand "rewards" for progress.

Oh, yeah, "baby" aspirin, 2/day. Dr. ordered 1 ordinary (325mg) aspirin daily but here I disobey him and take 81mg 2x/day.

What my doctor(s) poo-poo is the supplements regimen I've developed. I've added, deleted, experimented and this is what I've arrived at. I have no evidence that any or all of it helps my blood profile or mitigates the side effects of the prescription drugs other than the fact that my blood profile is better and I feel better.

So here's the list, hammer away, tell me about the placebo effect or how I'm wasting $. All I know is I feel better:

- fish oil/omega-3. 1000mg - 1200mg, 2x daily. I go with cheapo N-aturMade C-ostco stuff here. The expensive, 3-6-9 stuff makes me feel like shit while giving me fish burps. Screw that!

- L-carnitine. 250mg/day. Somewhat difficult to find and expensive in the health food stores. I get this where I can and I lean toward the less expensive stuff. This SEEMS to me to enhance the effects of the other supplements. This is the one I'm least convinced about and I sometimes go a while without it. I keep going back 'cause I THINK I feel very slightly better with it.

- Co-Q10. Again I use inexpensive brands, typically N-aturMade. 250-300mg per day with the buld of that (150-200mg) in the AM and a smaller dose in the PM.

- C-holestOff. Look it up. I-take half the "directed dosage". Plant stanols or whatever they are. Other stuff is supposedly better but this is easy to find.

- Red yeast rice (or Red rice yeast, whatever). Half the "directed dosage"

- Metafreakinmucil. Daily. Twice. Smooths life right out, Bubba. Don't underestimate the value of that stuff.

- cinnamon (ground). Sprinkle a bit of it in the metafreakinmucil.

- M-oveFree (a glucosamine/condroitin/something else supplement). Recommended dosage.

I've built my routine up over two+ years and I'm happy with the results. I arrived at this list through "research" and trial but I no longer remember the specifics and details of why they are supposed to help.

One thing I do remember is learning that some vitamins (and supplements, I suppose) are water soluble and others are fat/oil soluble. You need to get some olive oil (and fish oil) into your diet for those fat/oil soluble thingies.

Y'all have fun now! I can get through my work day and do my exercise and my walks and hikes and ski and bike and I'm happy as a clam. That wasn't the case on prescription stuff alone. I've got aches and pains like everyone else but for a while I had pains and cramps that were stopping me in my tracks and ruining my sleep.

Placebo... maybe. Whatever works.

If this goes through now, sorry for the odd "-" here and there. The spam filter here at Maggie's gets awful ornery at times.
#7 knucklehead (Link) on 2009-02-10 21:22 (Reply)
I'm impressed. You quit smoking and are exercising regularly. And you seem dedicated to researching everything you take, so you have my admiration. Especially on quitting smoking and sticking with the exercise. Good for you.

You can order L-Carnitine online. Much cheaper than in 'nature' stores.
`
#7.1 Meta on 2009-02-11 00:11 (Reply)
Thanks for the kind words, "Meta". I used to joke that quiting smoking was "EASY" - I'd done it a dozen times or more. Giving up the weeds was among the more difficult things I've accomplished. "Cold Turkey". 2+ years and I still wanna smoke when certain triggers happen. Nuttin' to do there but grind it out Nancy Reagan style - Just Say NO. Oh well.

Exercise is the most beneficial thing. I'm pretty convinced its the only thing that actually yields real improvements in one's ability to live one's life. All the rest are just rear-guard, holding actions to try and slow the inevitable. Nuttin' wrong wit dat, just sayin'.

Of course, who to listen to and what one actually needs as far as exercise goes in no less confusing than trying to fathom the biochem of the drugs and supplements. Do you need 60%, 70%, 85% or "Max. Predicted HR" for 15, 20, 30, 40, or 60 minutes at a sesson? Is sustained and steady or intervals better? What about "PACE" - is there REALLY any benefit to pushing to "Max Predicted HR" for a steenking 3 minutes at a time? Do you need 3 sessions, 5, 7, more per week. How much aerobic vs. anaerobic? Whattaya do when shoulders and knees are too shot to be lifting weights?

Since I don't know who to put my faith in I've hybridized a schtick that seems to work for me and change it as I go. When all is said and done a 5 - 7 hr per week investment in what "Modern Hardbodies" would call moderate exercise isn't that difficult but it makes a big difference.

Sorry for climbing on the soapbox going all evangelical.

OK. What aboot the above has bothered Ol' Mag's spam censor? Didn't use any brand names I'm aware of... went easy on the foul language... As usual I'm funky with my capitalization... I'll try quoting the capped stuff and see what happens.
#7.1.1 Knucklehead (Link) on 2009-02-11 09:57 (Reply)
I read an article a hundred years ago in "Redbook" magazine. It was about dieting and exercise, and to this day I have remembered it because it was so profoundly real-life. Basically the author stated diets and exercise programs are bound to fail because, by nature, our bodies can't tolerate being denied something, and even if our bodies tolerate it to a point, sooner or later our minds will revolt. Their answer for it all, this Madison Avenue litany for dieting and exercise, was 'moderation'. That, they said, is the key to life. It sounds to me as if, as I said, you've researched and tested and worked with and without your doctors, to find what works for you. You've got the 'mind' part down so that it won't revolt, and you sound happy with your diet and supplements. You could be a poster person for that long-ago "Redbook" article.

As for the smoking... I've known several people who have quit cold turkey, the only way, and the cravings were gone after three days. The habit of reaching for a smoke took much longer to quell. But everyone of them says the 'urge' every now and then when something triggers it is a big deal. All of them do what you do.... "I do not smoke." My dad says it still gets him even after 30 years.
`
#7.1.1.1 Meta on 2009-02-11 12:35 (Reply)
"All things in moderation. Especially moderation." - WC Fields
#7.1.1.1.1 Knucklehead (Link) on 2009-02-11 15:56 (Reply)
The analytical value of being weighed, having your pulse and blood pressure checked, thumped on the back and abdomen, and feeling your ankles fo swelling every 3-4 months is a surefire way, Meta, of ensuring that you are cancer free. And free also of $100.

Which is why physicians make the worst patients--whom could they possibly trust?
#8 John Hetman on 2009-02-10 23:30 (Reply)
John. You have free will. Don't go to the charlatan.

That was simple.

`
#8.1 Meta on 2009-02-10 23:59 (Reply)
I drink about 2, 2 1/2 quarts of whole milk a day. I doubt that I need either vitamin D or calcium supplements.
#9 rightwingprof (Link) on 2009-02-11 13:20 (Reply)
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#10 e-cigarette (Link) on 2013-07-07 21:06 (Reply)

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