Month: February 2018

Vitamin Supplements — Cure-All, or Snake Oil?

By Mark A. Kelley, MD |2/15/18
Founder, HealthWeb Navigator

Vitamins and other over-the-counter supplements are extremely popular in the United States. In fact, it’s estimated that Americans spend $21 billion on these products every year—a few billion dollars more than NASA’s entire annual budget.

Over the last century, there has been extensive research to understand the importance of vitamins and minerals in maintaining good health. Essential vitamins and minerals are chemicals that our bodies cannot manufacture on their own. Usually they’re introduced to our bodies by the food we eat.

There are some great stories surrounding the discovery of certain vitamins and minerals. Three centuries ago, sailors on long voyages often became very ill, many of whom died. The cause was lack of vitamin C in their diet, a condition known as scurvy. To provide vitamin C, these sailors were given limes to eat on the voyage. Miraculously the condition disappeared.

Another example comes from the early twentieth century, when patients were mysteriously dying from anemia despite an adequate diet. Studies showed that they lacked a protein that is necessary to absorb vitamin B12. When the patients were given vitamin B12 by injection, their anemia vanished.

Over time medical science has learned much more about how vitamins and minerals keep us healthy. Yet even in this era of health supplements, the average person still wonders, “What should I be doing to maintain good health?”

Below, we’ll look at a few of the consensus recommendations for vitamin use based on clinical studies to date.

Are Vitamins and Supplements Necessary?

For a healthy person, a well-balanced diet will supply the necessary minerals and vitamins. A balanced diet should include fruits, grains, vegetables, protein, and some dairy products. These foods have the right nutrients that our bodies are designed to absorb to keep us healthy.

Folic acid supplement during pregnancy has been shown to reduce neural tube (spinal) defects in infants. This major advance may save many infants from a lifetime of disability.

Strict vegans may need vitamin supplements. A completely vegetarian diet may lack vitamins B12 and D, and the patient may require oral supplements to correct these deficiencies. The same approach applies to anyone on a poor or restricted diet.

Vitamin D may require some supplement. Vitamin D is necessary for bone growth and strength and comes from two sources. The first is from food, and the second from our skin, which produces vitamin D in response to sunlight. Low vitamin D levels can be seen in patients whose diets are poor or who rarely go out in the sun. For this reason, many experts advise oral vitamin D supplements for older patients who may be at risk for osteoporosis or bone fracture.

Multivitamins are safe, but usually aren’t necessary. Patients with poor diets or digestion may benefit from multivitamins or other supplements. However, for an average person, the consensus is that these products are unnecessary. Nonetheless, multivitamin doses are generally modest and likely won’t harm healthy patients who want to use them within the usual recommended doses.

Beware of high doses of certain vitamins. High doses of the following vitamins can cause lasting damage to your health:

• Vitamin A: Birth defects, osteoporosis, increased cardiac mortality

• Beta-Carotene: Lung cancer

• Vitamin C: Kidney stones

Based on current research, there is no evidence that supplemental vitamins or antioxidants prevent or improve the outcomes of cancer or cardiac disease.

Vitamin and mineral supplements can sometimes be helpful. But for those of us who take prescription medications, they can also cause dangerous interferences. This field is complex, and the science behind it is constantly evolving. Before taking any supplements, it is wise to consult your physician and discuss what is best for you.

A Permanent Vaccine for the Flu?

By Mark A. Kelley, MD |2/5/18
Founder, HealthWeb Navigator

The current flu season is the most severe in nearly a decade. In a typical year, influenza causes 3 to 5 million cases of severe illness, and anywhere from 290,000 to 650,000 deaths around the globe.

But this year may be even more worse because the flu vaccine has been only 10-20% effective in preventing the flu—less than half its usual protection.

The flu virus mutates rapidly, so creating an effective vaccine is largely a game of chance. The process requires scientists to decide in advance which strains they think will be the most prevalent each flu season. That decision determines how the flu vaccine is manufactured, a process that takes about six months.

This year the H3N2 virus emerged unexpectedly. It is particularly nasty and tends to be more resistant to flu vaccines.

The flu virus, particularly type A, can also blend its genes with other viruses, including those infecting animals like pigs and birds. These changes produce new surface coatings on the virus, which pose a major challenge for our body’s defenses. If our immune system recognizes a virus from a previous infection or vaccine, it can quickly kill it. However, new forms of the virus are hard to recognize and can make it difficult for the immune system to react quickly. Such a delay can be deadly if it allows the infection to gain a foothold.

Compared to vaccines for polio, smallpox, and measles, the current flu vaccine falls considerably short:

• It offers limited protection that changes year to year.

• It does not provide lifelong immunity.

• It is unlikely to protect against more dangerous strains of flu like the 1918 pandemic that killed 50–100 million of the world’s population.

Can we produce a better and more effective flu vaccine? The short answer is yes—but only if we have the will to do it.

Scientists have known that certain parts of the flu virus do not change their genetic profile. These areas hide from our immune system. A more effective vaccine would expose and target those areas so that our immune system can always recognize the virus and eliminate it. Other approaches include reengineering some of our own cells to look like the flu virus and making the immune system better prepared to reject it.

These and other innovations are aimed at developing more effective and predictable protection against the influenza virus. Although it will likely take years and considerable funding to develop, the costs are paltry compared to the estimated $8.4 billion in lost productivity every year in the U.S. resulting from the flu. A new vaccine that uses modern technology and offers better protection would be a bargain.

Influenza has plagued mankind for centuries. Every winter, this disease reappears around the world. It may spread even more rapidly with population growth, international travel, and urbanization.

There are reasons to be optimistic about a new vaccine. In this era of “precision medicine,” the science of virus biology has advanced far beyond the 70-year-old technology used for the current vaccine. If the nations of the world choose to accept this challenge, we may be able to protect millions of people who suffer or die from influenza every year.

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