Rekha V Shah, MD, MD(H)
There is so much contradictory information in the media, it is easy to
become confused about the value of vitamins, minerals and other supplements.
We hear multivitamins are good for us one day and the next week we learn
from the newspapers or television that we should not take them as they
can be harmful.
Vitamin E Fails to Stop Progress of Alzheimer’s
"Patients were randomly assigned to groups receiving Aricept, vitamin
E and placebo versions of those substances, and then observed over a three-year
period ended in January 2004... While the findings for Aricept are less
than definitive, she said, the study provides clear-cut evidence that
vitamin E is ineffective in the prevention of Alzheimer’s."
Nutrition experts contend that all we need is what’s typically found
in a routine diet. Industry representatives, backed by a fascinating history,
argue that foods don’t contain enough, and we need supplements.
Fortunately, many excellent studies have now resolved the issue... On
October 10, 2011, researchers from the University of Minnesota found that
women who took supplemental multivitamins died at rates higher than those
Two days later, researchers from the Cleveland Clinic found that men who
took vitamin E had an increased risk of prostate cancer. “It’s
been a tough week for vitamins,” said Carrie Gann of ABC News...
These findings weren’t new. Seven previous studies had already shown
that vitamins increased the risk of cancer and heart disease and shortened
lives. Still, in 2012, more than half of all Americans took some form
of vitamin supplements.
Why, then, is the whole idea of vitamin and nutrient supplementation so
Vitamins and minerals are the essential nutritional elements required by
every chemical reaction in our body to function properly. Studies performed
on the general population
shows widespread deficiency of multiple nutrients.
Nutrients like magnesium, zinc, folate, vitamin D, vitamin B, control and
affect multiple chemical reactions in our bodies. They are required for
us to make the enzymes which enable our bodies to manufacture essential
proteins at body temperature (in the lab, much higher temperatures are
usually required, temperatures not compatible with life). These nutrients
are essential for the formation of neurotransmitters, regulation of DNA,
the production of energy, for proper function and methylation (detoxification)
of hormones, getting rid of toxins, for proper health of the blood vessels
and their lining - the endothelium. The list goes on...
For example as much as 82% of population in 2006 was deficient in vitamin
D – with deficiency levels defined as less than 20 mg%. Fish oil deficiency is also highly significant, associated with multiple
diseases ranging from metabolic syndrome and diabetes to heart disease,
Crohn's disease and even memory impairment and Alzheimer's dementia. These nutrients are critical for cellular function, brain function, proper
regulation of blood sugar, reduction of inflammation and pain etc. Deficiencies
are implicated in the development of metabolic syndrome and the ongoing
epidemic of Type 2 diabetes.
Our Standard American Diet (SAD) is low in greens, beans (legumes, pulses),
and high in chronic stress, together with our over-consumption of coffee
and alcohol, makes us prone to deficiencies of vitamins like folate, cofactors,
minerals like magnesium, manganese, molybdenum etc. These deficiencies
can cause muscle cramps, headaches, constipation and bloating, anxiety,
depression, disturbed sleep, dry skin hair and nails, frequent colds,
allergies, and again list goes on and on.
From reports of beriberi in Asia in 2600 BC, to night blindness in 19 century
soldiers, the effects of vitamin deficiency and toxicity have led physicians
and scientists to search for these vital molecules and its function.
While multiple deficiencies may be required to generate frank deficiency
disease, and replacement of more than just one nutrient at a time may
be required for health, it is quite clear that insufficiency of nutrients
may lead to problems related to less obvious physical dysfunction. One
cannot overlook nutrient deficiency as a possible cause of a patient’s
signs and symptoms. Individual need for vitamins is based not only on genetic code for physiologic
activity, but also on conditional need for increased vitamin and minerals
nutrients in body. Increased need may arise from toxic overload, with
subsequent increased use of nutrients for detoxification. In the presence
of intestinal bacterial imbalance (called, in the functional medicine
community, dysbiosis) our intestinal bacteria may not be producing the
nutrients we need, because their population has been altered by stress
due to physical, mental or emotional trauma, and antibiotics given for
The functional medicine practitioner looks at every clinical situation
from the patient-centered point of view. Who is patient who has this particular
condition? What are the stressors in that patient's life? What is
the patient's cellular health? How are the rest of the patient's
organ systems functioning? And where is the root cause of the patient’s
To give you an example, inflammation is a common thread in conditions like
hypertension, heart disease, osteoarthritis, rheumatoid arthritis, cancer, diabetes,, and much more. So in order to treat those conditions, we must investigate
the cause of the inflammation.
As we saw inflammation is one of the reasons among many that can cause
nutritional deficiency. It's a Catch-22 situation, since nutritional
deficiency can also predispose to having inflammation. You can't treat
one without treating the other as well.
Functional medicine is more than a step-by-step approach. It is conceptual guide, a way of
putting all the pieces together in a puzzle. Optimal gastrointestinal
function is important in proper handling of nutrients, vitamins, minerals.
The gut, after all, is the Center of our vitality and health.
Organic food, free of pesticides and non-GMO (genetically modified, bioengineered)
is the ideal medicine we can offer our body.
Nevertheless, there are times when the deficiencies are so severe that
the right type and amount of vitamins, minerals, and supplements are needed
for improving conditions and symptoms.
Rekha Shah, MD, MD(H) practices integrative medicine at the Arizona Center for Advanced Medicine
with a focus on gastrointestinal conditions. Dr. Shah is board certified
in Gastroenterology and Internal Medicine, as well as in Medical Acupuncture.
She is licensed in the state of Arizona by both the allopathic Medical
Board and by the Board of Homeopathic and Integrated Medicine Examiners.
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