Vitamins are deadly! This is the claim of a recent study that has caused panic among the health conscious who use them every day.
Now medical professionals have hit back, calling the study flawed. Their message is that vitamins work, in moderation - and for prevention. They point out that latest reports prove that vitamins don't kill.
Fears about vitamin and antioxidant supplementation were fuelled by a review article published in the Journal of the American Medical Association in February which suggests that betacarotene, vitamin A and vitamin E may increase mortality, while potential impacts of vitamin C and selenium on mortality needed further study.
The review article, "Mortality in Randomised Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-analysis" (Bjelakovic et al), was released locally by the SA Cochrane Centre, a unit of the Medical Research Council. The populist press picked it up and published the article "Death by Vitamins".
"Saying that vitamins are deadly is irresponsible. There is enough research to prove otherwise," says pharmacist Brent Murphy, director of Solal Technologies and specialist in the research of complementary medicines.
"The research was not properly understood. The majority of clinical trials included in this meta-analysis focused on secondary prevention. These antioxidants were being used by patients who were sick - people who had, for example, suffered a heart attack. They were taken to prevent future heart attacks - often to the exclusion of prescription medications.
"If you put your faith in these three antioxidants to heal you if you have had a heart attack, and chose not to take your medications as a result, you're in for a nasty surprise. They benefit healthy people for protection, not sick people for treatment. The risk of death increased because people used these antioxidants instead of conventional medicines rather than in combination."
Chairperson of the Health Products Association of Southern Africa and Sportron, Dr Alan Tomlinson, believes reports implying that vitamins could kill are "badly misleading".
"The safety of vitamins has been well documented. Not one death was caused by vitamins in 2005, according to the most recent statistics available from the US National Poisoning and Exposure Database. The report of the American Association of Poison Control Centres, published in the journal Clinical Toxicology, shows zero deaths from multiple vitamins, any of the B vitamins, vitamins A, C, D or E, or any other vitamin."
Dr Denice Smit, Research and Development Manager at Vital Health Foods, writes in her Risk Assessment of Complementary and Traditional Medicines, "Dietary supplements pose a lower risk than insect stings, lightening strikes, poisonings and many other seemingly unlikely causes of fatalities."
In her statistical comparison of frequent causes of death in the US, dietary supplements rank lowest at 0.0001 percent, whereas preventable medical misadventure is 2.40 percent and properly prescribed and used drugs, 5.18 percent.
The meta-analysis in question has been criticised by numerous authorities in the field of complementary and alternative medicines, including Dr John Hathcock of the US Council for Responsible Nutrition (one of the world's leading authorities on the safety of vitamins and minerals), Prof David Richardson, scientific adviser to the UK Council for Responsible Nutrition and Dr Derek Shrimpton, scientific adviser to the European Federation of Associations of Health Product Manufacturers.
The study authors themselves acknowledge that their results are in conflict with observational studies that have shown beneficial effects of supplemental antioxidants as primary prevention in healthy populations. They also admit not knowing what the actual causes of death may have been in the individuals in the trials.
Tomlinson, who believes the meta-analysis was poorly constructed and gives the wrong impression about the safety of vitamins and minerals, says he is "dismayed at the parameters used in the research designs. The study included vitamins at well above recommended levels. It is well known that just about any substance taken in excess can be harmful."
"One should never elevate vitamins and minerals to a godlike status and overdose on them hoping for a miracle," warns Murphy, "because eventually the pendulum will swing in the opposite direction and you could start having side-effects and blame the supplements. High doses of vitamin A and B3 can cause liver damage and high doses of B6 can damage the nervous system."
This article was originally published on page 27 of Tribune on June 24, 2007
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"Saying that vitamins are deadly is irresponsible. There is enough research to prove otherwise," says pharmacist Brent Murphy, director of Solal Technologies and specialist in the research of complementary medicines.
"The research was not properly understood. The majority of clinical trials included in this meta-analysis focused on secondary prevention. These antioxidants were being used by patients who were sick - people who had, for example, suffered a heart attack. They were taken to prevent future heart attacks - often to the exclusion of prescription medications.
"If you put your faith in these three antioxidants to heal you if you have had a heart attack, and chose not to take your medications as a result, you're in for a nasty surprise. They benefit healthy people for protection, not sick people for treatment. The risk of death increased because people used these antioxidants instead of conventional medicines rather than in combination."
Chairperson of the Health Products Association of Southern Africa and Sportron, Dr Alan Tomlinson, believes reports implying that vitamins could kill are "badly misleading".
"The safety of vitamins has been well documented. Not one death was caused by vitamins in 2005, according to the most recent statistics available from the US National Poisoning and Exposure Database. The report of the American Association of Poison Control Centres, published in the journal Clinical Toxicology, shows zero deaths from multiple vitamins, any of the B vitamins, vitamins A, C, D or E, or any other vitamin."
Dr Denice Smit, Research and Development Manager at Vital Health Foods, writes in her Risk Assessment of Complementary and Traditional Medicines, "Dietary supplements pose a lower risk than insect stings, lightening strikes, poisonings and many other seemingly unlikely causes of fatalities."
In her statistical comparison of frequent causes of death in the US, dietary supplements rank lowest at 0.0001 percent, whereas preventable medical misadventure is 2.40 percent and properly prescribed and used drugs, 5.18 percent.
The meta-analysis in question has been criticised by numerous authorities in the field of complementary and alternative medicines, including Dr John Hathcock of the US Council for Responsible Nutrition (one of the world's leading authorities on the safety of vitamins and minerals), Prof David Richardson, scientific adviser to the UK Council for Responsible Nutrition and Dr Derek Shrimpton, scientific adviser to the European Federation of Associations of Health Product Manufacturers.
The study authors themselves acknowledge that their results are in conflict with observational studies that have shown beneficial effects of supplemental antioxidants as primary prevention in healthy populations. They also admit not knowing what the actual causes of death may have been in the individuals in the trials.
Tomlinson, who believes the meta-analysis was poorly constructed and gives the wrong impression about the safety of vitamins and minerals, says he is "dismayed at the parameters used in the research designs. The study included vitamins at well above recommended levels. It is well known that just about any substance taken in excess can be harmful."
"One should never elevate vitamins and minerals to a godlike status and overdose on them hoping for a miracle," warns Murphy, "because eventually the pendulum will swing in the opposite direction and you could start having side-effects and blame the supplements. High doses of vitamin A and B3 can cause liver damage and high doses of B6 can damage the nervous system."
This article was originally published on page 27 of Tribune on June 24, 2007">
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