Should you take vitamin supplements or are they a waste of your time and money experts disagree about the value of vitamins this is the People's Pharmacy with Terry and Joe grade and. This week a new study published in The Journal of the American College of Cardiology we viewed the risks and benefits from taking vitamin and mineral supplements for cardiovascular disease prevention and treatment we'll discuss the results of this med analysis and why the headlines may be misleading Dr to him Manson one of the country's leading vitamin researchers shares her perspective on supplements You'll also hear from Dr Cerrone low dog author of fortify your life your guide to vitamins minerals and more coming up on the people pharmacy we take your questions about vitamins 1st the news. In the People's Pharmacy health headlines the long term use of anti-depressant medications as been associated with weight gain an epidemiological study published in the b.m.j. Tracked nearly 300000 people for more than a decade those taking anti-depressant medications were more likely to a put on pounds than matched controls who were not taking antidepressants people who started at normal weight were more likely to become overweight if they took an anti-depressant Well those who were overweight at the outset were more likely to become obese this risk became apparent during the 2nd and 3rd year on the medications the author suggests that the widespread use of antidepressants might be an important factor contributing to increasing body weight an editorial in the same issue points out that the increased risk is modest $11.00 per 100 person years of follow up among people taking antidepressants compared to $8.00 per 100 person years for people not taking the drugs but because so many people take antidepressants this could add up to extra pounds for thousands of individuals that should not keep people from taking the medications but it should make both doctors and patients vigilant about this potential adverse reaction. Many people striving to lose weight turn to a low carb diet to try to jumpstart the process instead they try to get most of their energy from fat or protein sources for years dieticians have been worrying that a high protein diet might put too much strain on the kidneys or the heart now there's research from a long running Finnish study demonstrating that eating a lot of protein from animal sources may indeed increase the chance of heart failure findings from the quote b.-o. Ischemic heart disease risk factors study were published in circulation this epidemiological study followed $2441.00 middle aged men for 20 plus years at the start of the study the men filled out dietary diaries for 4 days those who reported eating the most animal protein appeared more likely to develop heart failure during the follow up the link was not that strong However people who got most of their protein from plants had only a small increase in risk of heart failure it was not statistically significant we'll need more research to understand this connection better but in the meantime it seems a prudent man will limit his intake of meat in milk fish and eggs were not associated with an increased risk of heart failure does it make sense to take vitamin pill a new systematic review looked at 179 recent studies of commonly used supplements to see whether any of these pills help to ward off heart disease they found that none of the 4 most popular supplements had any impact on cardiovascular disease these were multi vitamins vitamin d. Calcium and vitamin c. The data revealed that folic acid and b. Vitamin complex supplements containing folic acid were associated with a slightly reduced risk of stroke on the other hand different b. Vitamin Niacin is often taken at high doses of up to 3 grams a day. When it's taken together with a staten the risk of premature death increases by about 10 percent the author suggests that we should avoid taking Niacin together with the staten to lower cholesterol aside from niacin and high dose antioxidants they didn't find that supplements harm people but they also don't appear to help much instead the scientists strongly urge people to focus on healthy dietary patterns with an increased proportion of plant foods in which many of these required vitamins and minerals can be found people who experience a t.i.a. Also known as a transient ischemic attack or a minor stroke are often put on anti-clotting drugs such as Plavix an aspirant that's because people who experience such blood clots in their brains are at a significantly greater risk for a serious stroke a new study shows that a combination of clopidogrel the generic name for Plavix together with aspirin significantly reduced the risk for a blood clot in the brain the downside however was that this combination increase the risk for haemorrhage aspirin alone did not provide quite as much protection from stroke is the combination therapy but it only had half the risk for hemorrhage and that's the healthy news from the People's Pharmacy this week. Welcome to the people pharmacy I'm Terry Graydon I'm a medical anthropologist and I'm Joe Graydon I'm a pharmacologist do you take vitamins or minerals tens of millions of Americans swallow supplements such as ascorbic acid vitamin d. Calcium or magnesium every morning with breakfast or such vitamin and mineral supplements a waste of time and money a med an analysis just published in The Journal of the American College of Cardiology concluded that most vitamin and mineral supplements are ineffective at preventing or treating cardiovascular disease the authors noted one exception b. Complex vitamins with folic acid might reduce the risk of strokes the headlines were quick to didn't announce the value of vitamins one stated most popular vitamin supplements are essentially useless another can concluded that vitamin and mineral supplements provide no health benefit pretty sweeping What do you think our lines are open for your calls and questions share your thoughts or ask a question about vitamins at 888472 the read 366 You can also e-mail us radio at People's Pharmacy dot com The number again 888-472-3366 Joining us to present one side of the vitamin controversy is Dr Joanne Manson She's one of the country's leading vitamin researchers and chief of the division of Preventive Medicine at Brigham and Women's Hospital in Boston She's also a professor of medicine and the Michael and Lee Bell professor of women's health at Harvard Medical School. Welcome back to the people star Missy Dr Joanne Manson It's great to be back with you Dr Manson Americans love vitamins and dietary supplements tens of millions of us swallow pills every day but you've been quoted in a fascinating article in The New York Times saying that there's no conclusive evidence that dietary supplements prevent chronic disease in the average American. While there have been a few studies that have produced positive results they haven't been strong enough to recommend supplements to the general American public can you explain to our listeners why you came up with those conclusions Well the research that's been done has not shown clear benefits of vitamin supplements for healthy populations especially well nourished populations so there are no professional societies that are recommending that everyone take multi-vitamins or individual vitamin mineral supplements However they're still of value for some subgroups within the population either by life stage such as during pregnancy during infancy and also those who have specific health conditions such as Ostia process. Maybe we could just review very briefly what some of those health conditions would be and what sorts of vitamins or minerals people ought to be looking at will during pregnancy it is important to have adequate Foluke acid and to take a prenatal vitamin and it's actually important to begin even before pregnancy because very often women won't know that they're pregnant and till several weeks or even months later and then some of the birth defects can already have occurred so we do recommend if you're planning a pregnancy or you're not taking reliable birth control and you might become pregnant to take at least a multivitamin which will have some folic acid and once you know about the pregnancy to take prenatal vitamins that will have a little extra folic acid as well as many of the other vitamins that are important to have during pregnancy so that's one group that should be taking these vitamins because there is a reduction in risk of neural tube defects certain birth defects when these of vitamins aren't consumed documents and there might be some other group that would benefit from specific vitamin or mineral supplements can you tell us a bit about that please so in addition to the life stage pregnancy infancy is a period when supplementation can be important especially for breastfed infants there's a recommendation for vitamin d. And iron in people who have undergone Barry Actrix surgery bypassed Ester bypass surgery or other types of surgery where there may be affects on the stomach in the intestines and the absorption of certain vitamins might be diminished it is recommended to to take supplements and other conditions include Crone's diseases. Other forms of inflammatory bowel disease or silly activities where there may be reduced absorption of several vitamins and minerals and with age related macular degeneration there is a specific formulation that may be of benefit in reducing the progression of this disorder and that includes some and tax it in vitamins and think in copper so there are some ideas ease of vitamins that may be helpful for people who have been diagnosed with macular degeneration and then those who are on certain medications such as proton pump inhibitors messed for him and may benefit from taking vitamin b 12 and some other vitamins and minerals and certainly it's important to discuss with your doctor your use of the supplements because there may be adverse interactions with some prescribed medications as well. That demands and you have suggested that the enthusiast I'm over vitamins is outpacing the evidence is it this enthusiasts and that's driving so many Americans particularly older Americans to take vitamins and minerals I think there's a lot of enthusiasm about popping a pill and magically having health benefits and unfortunately it doesn't tend to work that way very often popping these pills will provide very little benefit and can even confer risk so it's important to know whether there's any research suggesting that there will be benefits and often not to be wasting money if there are no benefits because it can add up over time taking vitamins every minerals every single day long term so there are some groups that will benefit so we don't want to suggest that it's not of value to any segments of the population that are Manson you mention the term well nourished and I think that's really critical when it comes to making decisions about supplements. Or the American diet is not renowned for being terrific and I'm just wondering if we don't have an awful lot of folks who are not well nourished too may need supplements to make up for their crappy diets which of course is is not an excuse to continue eating bad food but you know what I'm talking about I do know what you're talking about and in fact if there are diets that may be deficient in some of these essential vitamins and minerals and especially if people are eating a lot of processed and refined foods as opposed to the whole foods that can be a problem in terms of the stripping of these essential vitamins and minerals However there really isn't evidence that in the general. Us population there will be benefits from taking high doses of beta carotene or vitamin e. We did see a promising result for multi-vitamins in the physician's health study trial where there was a modest reduction in the risk of cancer by an 8 percent reduction overall in the risk of cancer and we are in the process of doing a 2nd trial to see if these results can be replicated in a study that includes women so try to replicate in men also look in women to see if there is a benefit of multi vitamin supplement Taishan in reducing cancer risk but to date the u.s. Preventive Services Task Force and many of the professional societies do not recommend routinely taking multi-vitamins or individual vitamin mineral supplements for the general healthy population but you do make an important point about whether people are truly well nourished and whether they may be missing some essential vitamins and minerals and it is possible that certain diet said restricted eating patterns will lead to some deficiencies we certainly would support people taking a multi-vitamin if they have concerns about this and hedging their bets it is a form of insurance but for many people it's just not necessary and the cost will add up over time. Dr Manson thank you so much for talking with us on The People's Pharmacy today thank you it's great talking with you you've been listening to Dr Joanne Manson She's one of the country's leading vitamin researchers and she's chief of the division of Preventive Medicine at Brigham and Women's Hospital in Boston She's also professor of medicine and the Michael and Lee Bell professor of women's health at Harvard Medical School and show Dr Manson mentioned that she's running a clinical trial she's actually in charge of I think 3 or maybe 4 clinical trials of vitamins Well here's a question for you Do you take vitamins and minerals do you think they're helpful or a waste of money tell us why the number is 888-472-3366 you can e-mail us radio People's Pharmacy dot com You can also reach us on Twitter we're at People's Pharmacy that number again 888-472-3366 Joe we've got e-mail from Marcia she says most of us eat a Western diet so I'm guessing most of us need supplements I admit to my share of junk food I don't eat plants and beans all day I wish I did but I don't so I take supplements hoping it makes up for the shortcomings in my diet Well yes I'm not sure we would endorse a crappy diet on the other hand if you are eating fast food eating on the run not eating all those fruits and vegetables and nuts green leaf fees maybe some vitamin insurance make sense. I do have to tell you that I was very glad Dr Joanne Manson mentioned celiac disease because a lot of people who have celiac disease and have cut back on gluten may still not be getting all the nutrients they need because of the damage to their small until exactly they cannot absorb the nutrients as well and therefore supplements. Very helpful after the break we'll talk with Dr Trani Lo dog she's one of the country's leading experts on the science behind dietary supplements she will offer a different perspective on the value of vitamins are you getting all the vitamins you need from food do you have a question about your medications and how they may affect your vitamin and mineral requirements give us a call again our phone number is 888-472-3366 if our lines are for you can send us an e-mail radio it People's Pharmacy dot com 884723366. You are listening to the People's Pharmacy with Joe and Terry great. On the next hearts of space the creative rhythms and techno Tronics spaces of downtown boat handy music a surprise signs of life Mark Hartman lemon grass Martin non-static and more I'm Stephen Hill a program called hyperbolic on the next talks of space. This is Nancy Whitman host of Nancy's bookshelf here on North State Public Radio each way got talked to local regional and national writers about their works with fiction nonfiction no Portree Kenyan when says it 10 o'clock and you might just hear about a new novel you didn't even know you wanted to read. Welcome back to the People's Pharmacy I'm Joe great and I'm Carrie great and if you'd like to purchase a cd of this show you can call 807322334 it's Show number 1124 or you can visit our Web site people Pharmacy dot com The People's Pharmacy is made possible in part by Red x. Industries makers of utterly smooth creams and lotions that moisturize deeply to make dry skin feel soft and smooth the number is 803457339 The website is utter cream dot com We're talking today about vitamin supplements when do pills make sense do you think vitamins and minerals have had a positive effect on your health or do you think such supplements are a waste of money our lines are open at 888-472-3366 You can also send us e-mail radio at People's Pharmacy dot com The number 888-472-3366 you just heard from Dr Joanne Manson of heard for a different approach we turn now to Dr Ciarniello dog she's one of the leading experts an integrative medicine and a founding member of the American Board of integrative medicine she's chaired numerous panels on botanicals and dietary supplements for the United States Pharmacopeia Dr Low dog was director for the 1st interpret fashionable fellowship and integrate of Health and Medicine and is the founding director of the medicine lodge Rance ranch She is author of fortify your life your guide to vitamins minerals and more Welcome back to the people spire Missy Dr to around and. Thank you it's a joy to be here. Dr Low dog I have to tell you that there was an article not too long ago in The New York Times titled older Americans are hooked on vitamins and the message was basically yeah you don't need vitamins I mean we're taking way too many you don't need them it's all a waste of time it's all a waste of money they may actually cause problems and a lot of older people especially are taking vitamins so what are your thoughts on the vitamin supplement controversy. Well I think it's been going on a long time we've been having a you know a controversy over whether bite multi-vitamins are useful or they're harmful and they're very polarizing camps Unfortunately I think that one of the issues is that when we're talking about a multi-vitamin that really doesn't mean anything some of these multi vitamins are very very high potency with hundreds of the percent of the daily value in them others are very basic multi vitamins that you know have 50 to 70 percent of most of the nutrients that are really designed to fill any gaps I think one of the problems that I have with the messaging while I agree you know we don't want people taking handfuls of supplements is that a lot of older people are at greater risk for nutrient deficiencies thing younger people you know when we get into the older of the old and the oldest of the old many of them have you know less income it's harder for them to get around and go shopping many of them have poor oral health you know alterations in their taste and smell they don't eat as well you know loss of appetite also the greatest burden of chronic diseases borne by people who are older which you know can impair immune system change their metabolism you know increasing the body's need for specific micronutrient So while I understand the controversy I think that it's not a helpful message to assume that you know all 75 year old people are getting everything and they they need in their diet because micronutrient deficiencies are known and they're not uncommon as people age how would we have a way of assessing whether a given 75 or 80 or even 90 year old person is missing out on those micronutrients that they may need or whether they're actually doing all right. So for many nutrients micronutrients testing can be done one of my issues with a lot of the studies that have been done the multi-vitamin studies and nutrition studies are that they did not gather baseline data and then also track those levels of those particular nutrients throughout the trial so a good example was a study called the Women's Health Initiative where they gave calcium and vitamin d. To the women in this arm and they wanted to see if there was a different in fractures Now overall most women in the United States don't get a sow's ear milligrams of calcium a day which is what we recommend but in this study in the control group women averaged about a 1000 milligrams of calcium a day 1st is the group that was getting a supplement so there were was what we call a null effect there didn't show any benefit from taking calcium but the people in the study the women in the study in the control group were getting lots of calcium so that study would have been much more useful if we were measuring you know parathyroid hormone you know way of actually measuring calcium status or measuring vitamin d. At baseline and yet many patients many people who are in their seventy's can get a b 12 test they can get a magnesium testified and the you can even get a mega 3 index and you can begin to see who might need certain nutrients is one of the fatal flaws in a lot of the studies is not getting baseline data on what the nutrient level was at the beginning in the middle and at the end and comparing your groups so you know and this is clinicians doctors nurse practitioners have to have more training in how to identify nutrient deficiencies and I actually think we need more research to determine what the optimal ranges for key micronutrients and older adults right I mean I think we need to look right now the daily value. Is and that you know are for 4 years and up and then you've got this vague you know 51 and older I think we really need to look at what is an optimal range not just an average but what is the best range for people to be and for optimal cardiovascular and cognitive health so testing is available is just not widely done and when we get articles like this it basically just cements in that people are not deficient in a trance they shouldn't take supplements and then nobody gets tested it's a problem. A lot of people want to know well should I be taking a little extra vitamin c. Should I be getting b. Vitamins What about minerals like magnesium but oftentimes their doctor says you don't you don't need a blood test you don't need to be assessed just a well balanced diet. Well the problem is that especially amongst older people many of them don't eat a nutrient dense diet for all the reasons that I just mentioned also many of them are on medications like Metformin for diabetes proton pump inhibitors statens direct x. For blood pressure many of these drugs themselves actually the plate or increase the need for certain micronutrient So I think it's it's a bit of a myth to say just eat a balanced diet because many people don't and it can be harder to do as you get older I mean I see this with my own parents who are in their late eighty's that it just gets harder for them to shop harder for them to cook. They used to say a tea and toast diet that many old people used to have because because they will limit what they're consuming so I think that you know I'm intrigued by these new apps that they are that are becoming available that we find are more accurate than dietary recall so you take a picture of everything you eat you know everything you put on your plate everything you eat you take a picture of and you upload it into the app and because we're capturing so much more data now we're actually getting a lot better handle on the nutrients calories you know fat etc that are in what people are actually eating I think in the future we're going to have far better nutrition studies that are going to be able to really help us determine you know who made the more risk than others but right now I would just say since nobody's testing Don't overdo the multi vitamins or the extra vitamins but taking something. Taking a multi that contains 50 to 70 percent of most nutrients excluding things like you know iron which many older people do not need and should not be taking but taking something that's a very basic multi vitamin I think and until somebody is doing testing helping you partner with us taking one of these is probably a pretty good insurance for getting the nutrients you need I would remind us all that you know the Institute of Medicine suggests people over 50 should either take it be 12 supplement or make sure they're they're eating foods fortified with the 12 because it becomes harder and harder to get the 12 as you get older from your diet so about 15 percent of those over 70 years of age in the United States we know are b 12 deficient a recent study in Germany found that almost 27 percent of people ages 65 to 90 were deficient vitamin b 12 so those are big numbers considering what deficiency of the 12 can cause so I think we need more testing I think we need better studies and I think people have to advocate for themselves because at this point what I said you've got people that think everybody needs lots of supplements you've got people that don't think anybody needs them and I think the truth is far more complex and nuanced than either one of those extreme positions Dr Karen and thank you so much for talking with us on The People's Pharmacy today. Thank you you've been listening to Dr tyranny low dog Her book is fortified your life your guide to vitamins minerals and more she's founding director of Medicine Lodge ranch and a founding member of the American Board of Integrative Medicine Dr Low dog led the fellowship program founded by Dr Andrew Weil at the University of Arizona Center for Integrative Medicine for many years and Terri I'm really glad that she mentioned testing because a lot of the studies really don't know what the baseline is well Exactly and we've got an e-mail from Elliot in New Jersey he says it would be enlightening if when you visited your doctor's office they would immediately do a test to determine your levels of vitamins and minerals that way there'd be an analysis of what you need. He says this is never done because vitamins and minerals are not seen as important only medications are the answer this is absurd and dangerous Well now it's time for you to join the conversation our lines are open at 888-472-3366 if our lines are full and they are at the moment you can e-mail us radio it peoples Pharmacy dot com Terri where we going 1st we go to 3 Lakes Wisconsin penny Welcome to the people spot missing Hi Thanks for taking my call and I want to thank you for your show and I also want to think Dr Low Doug who share a lot of my thoughts a lot better than I was going to I'm sure but I think there is a big danger in telling people of any age that vitamins are unnecessary a waste of money and I wanted to share some life experiences that. I've had a lot of injuries and illnesses throughout my life and I don't know what I would have done without people like you who. Sent me on the right path to getting better the I don't do well on medicines typical medicines I react badly and for example I had a leg injury which I'm still suffering from and had horrible cramping and I think God my son shared with me that he takes a calcium magnesium supplement and he's extremely healthy works out a lot and I had cramping and almost immediately taking. You know I did try to like your recommendation for the soap in the bed and it did help believe it or not and but to make the cramps absolutely almost completely disappear with calcium magnesium supplement does it and if I skip a day or 2 I immediately start cramping again so when you have these studies that say these things don't work I get so frustrated and I get frustrated because I have . You know parents older people who I recommended that they take vitamins when I see they have issues and their doctors tell them not to do it and so they don't and I think if there's something that comes out of this. You have to be your own physician you have to be aware of your own body you have to do some research you know think God for the Internet in shows like this where. You can say well I'm having this issue and what vitamins would help me and Penny what you just described with your cow see a magnesium is essentially a mini experiment on you. It's it's not you know a big randomized controlled experiment but when you stop and then restart you can tell that it works thanks so much for your call Bye Bye Let's go to la I'm sorry I did the wrong thing what did you do. That I need to do that let's try lying to Ok Dr jock Welcome to the People's Pharmacy What is your story. This doctor Jack and my story is. A nationally woman a Native American woman came to me as a physician with. History of having 3. Miscarriages in a row. And she was asked about the 7th week pregnant. And she was desperate because it was only half and happening symptomatically again and she asked for my help and I got her back to where I got gynaecologists back to a university emergency room because she was having Ashley bleeding and in her placenta and she came back to me for means that it's and said I'm getting worse and worse so I said that you're apparently having some sort of days oh constriction in your placenta. And it would be worth trying although I can't guarantee that it would work then said time. And she tried that and for the 1st time the night after she took the timing she stopped having back muscle spasms and stopped having. She went on to have she went through that time period when she had had her miscarriages and had a full term baby. The baby with a well developed at birth and 3 months beyond normal development according to the nurses and the baby is developed very well sensed and. Is very tall for age started playing lacrosse at the age of. One and a half years old and anyway. So in a place so Dr. I mean a lot of our listeners are going to what is Dr Chuck think when talking about time what what is spent for time mean and we only have a minute or 2 before the break but tell us why you also think it may have other benefits. Well then supply means a vitamin b one program it's now recommended by the Joslin Diabetes. Center for. Diabetic peripheral not drop with a pain there's a study out of China that in people with autism or disease there's actually an improvement in cognition over several years when I take dance a timing versus a decline and I H's doing a study of 75 patients with Alzheimer's disease and the effect of dense a time in sense of timing has mentioned and small studies to decrease the alcohol craving lamb and in any case. If one follows the literature event the timing it's basically exploding and one of the research that I strongly suggest occurred as a result in my experience with 3 women with multiple miscarriages that came to me and had a very successful pregnancy is that they're taking chances I mean and going through the time period when they normally had their miscarriages their role of Denver timing and the development differentiation of stem cells Dr Chuck thank you so much for calling Perry could you spell bend for timing for our listeners please yes I can be an f o t i a m i n e a n i pass my spelling bee did and it's a as as he said it's a derivative of be stymied I mean we need to take a break but when we come back we'll talk more about vitamins We'll also talk about the effect of medications on nutrient levels like proton pump inhibitors or Metformin if you've got a question or you'd like to share a story our lines are open at 88847233. 66 Email us radio at People's Pharmacy dot com. You're listening to the People's Pharmacy with Joe and Terry great. Essential connections exist between nature our gardens and our places in both through thoughtful conversations with growers gardeners naturalists scientists artists and thinkers cultivating place takes you on a weekly exploration about what we mean when we garden join us for cultivating place Thursday mornings at 10. Hi this is Ira Flatow you know science has been fact based since Galileo and if you like science like Guy view you are going to love Friday's our North State Public Radio tuned in to the all new one hour blue doc with host Dave Shalom at 10 am followed by Science Friday with me join us on s.p.r. Welcome back to the People's Pharmacy I'm Joe Graydon and I'm Terry great and if you would like to purchase a cd of this show you can call 807322334 it's Show number 1124 you can get a cd of any of our their broadcasts as well you can also find it at the website People's Pharmacy dot com The People's Pharmacy is made possible in part by Red x. Industries makers of utterly smooth creams and lotions helping dry correct skin feel utterly soft and smooth the numbers 803457339 online it utter cream dot com And by Tonelli a contemporary Mexican restaurant next to Shannon Plaza in Durham regional cuisine made with locally sourced seas knowing gradients 919-489-8000 if you have a question or a story to share about vitamins minerals or other supplements our lines are open at 888-472-3366 our lines are full at the moment you can e-mail us radio at People's Pharmacy dot com We can also be reached through Twitter we're at People's Pharmacy we're also at Facebook so let's go to Tampa Florida dolorous Welcome to the People's Pharmacy What's your comment. I have been diagnosed back in 1995 with goods that particular Right us and them to put and I take it for a month and I have him about 80 in my eighties and I am afraid to stop taking vitamins because even the last times I've gone to the hospital they said I can't have anything roll fruits in the world vegetables. No mangoes no. Stone berries and I get sick of stewing in everything that I'm but the nice I will take the battlements since I can't eat what I want to eat your words used to do to stay on the vitamins I think it is a good thing to do You mentioned Gerd a lot of people have to take an acid suppressing drug if they have Gerd something like Nexium or prolific or purposes and those drugs can interfere with your ability to absorb certain vitamins and minerals particularly vitamin b 12 which is especially important as Dr Low Doug said as we grow older and also the metformin can interfere with that so I think you are doing well to keep on taking your vitamin supplements keep it up thank you for the call Dolores You know Terry I did find that the headlines this week were misleading because they say you know there's no evidence that popular vitamin supplements are helpful they're useless Don't waste your money but you know the thing that's so interesting about the study. Here's the title supplemental vitamins and minerals for cardiovascular disease prevention and treatment they're not talking about everything under the sun they were specifically looking at heart disease and stroke expect late and not only that they actually found some benefit for heart disease and stroke now it was modest and it was limited to folic acid or b. Complex vitamins with folic acid but it's there it's not too bad at all they didn't emphasize that it was sort of the most ignored there's one other point that Dr Low dog made that I think it's worth mentioning and Dr Manson mentioned it as well there are drugs that deplete the body of essential nutrients we've talked about metformin a drug for diabetes and proton pump inhibitors the acid suppressing drugs they deplete in particular vitamin b 12 and that's a really critical vote especially for someone who's older like the loris But you know tens of millions of people take water pills directs drugs like hydrochlorothiazide abbreviated h c t c Well you know direct Don't just deplete the body of potassium they deplete the body of sodium magnesium and zinc to name just a few people who are an ace inhibitors like the center Pearl for example maybe low in zinc and Terry people who drink a lot of iced tea or just tea in general especially this time of year when it's getting hot and humid what happens well they may actually not be absorbing as much iron for example and potentially I haven't looked at this lately so I'm not sure whether any other minerals are affected but definitely iron can be affected let's go back to the phones we go to misc e. Texas Alaina Welcome to the people spiral say tell us about your story. Hello a lot. Nice talking to you I listen to you all the time if you know there's an x. And I am from South America but leaving that alone sticks. You used to when I was young my 2 years were like saving wakes up park and I can listen I hear about those sort of Linus Pauling doing your love research of vitamins and then mention the mission by the many and they start taking like $200.00 units over the next to few months my feet are still getting closer so I did . Increase it to 400 units per day and then my period it would be 28 days regularly and and I had a little pain that I used to have with him it didn't really help that a lot so the vitamin a really straightened out your menstrual cycle yes exactly oh and i never will he go to become pregnant. And able to break the law and I think amended it to the neighbor across the street she had a teenage girl at the meeting painful period. And she said Well that really worked for her too Alaina thank you so much we really appreciate knowing about this this is not something that we had ever heard of before and I know that a lot of our physician listeners and other scientists would say well that's an end of 2 That's not science it's not double blind placebo controlled studies but you know 200 international units of Vitamin e. Probably not a big deal and unless you're a smoker smoker should not probably not demand where do we go next Terry let's go to Annapolis Maryland rye and welcome to The People's Pharmacy. Hello right. Yes we can just barely hear you. Oh hi ago in love with love in the sense of I learned a lot of vitamins and I think this whole time as I'm learning about what vitamins work don't work I keep thinking that as a kid taking the only vitamins and honestly I wasn't whether or not is scientifically proven to help me just taking the made me feel good kind of like getting us out of the fast food place like you know it's not great for you but it just so kind of like helps me think I was being healthy on the health my mood for the day whether or not they actually help me in the long run I think I'm still going to be taken by the cave Ryan thank you so much for that call that that's that I hope a low I have to say I'm not that thrilled with gummy vitamins and the reason is that they're too much like candy and kids might be tempted to take too many exactly the other thing is there's some concern about quality control so yeah I mean I understand that people are going for the gummies because they taste so good. But maybe that's not the best way to get your nutrients and again we want to emphasize and I think Dr Low dog said this very clearly of course we want people to get their nutrients from a plant based diet the more colorful the better. We're not suggesting that pills are a substitute for a good diet Well exactly but Joe We've gotten several e-mails with this idea I'm going to read this one because it's the shortest this person wrote I question if trying to eat a great diet is enough because of our current day agricultural practices that deplete our soils and although I agree cultural practices may not have depleted the soils to the point that you're not getting the vitamins you expect from your from your food there is some evidence that climate change may actually be changing reducing the amount of nutrient certain nutrients in the foods that we eat where to next well I think let's. Let's go to Chapel Hill Samantha Welcome to the People's Pharmacy Hi Good morning I'm so happy to be a part of the show I have been I was diagnosed with cancer about a yarn a half ago and I decided long with my treatment I would go to a natural past and he prescribed a lot of medications for me and can I continue to take it. Even after my treatment. And I think that it really helped me along with the. The medicine that I had to you know the chemo and the radiation that I had to go through I think the supplements and everything that he did along really helped me to battle what I had to put through Samantha that's a wonderful to hear I do hope that you were also consulting with your oncologist to make sure that what the natural path was prescribing was going to be compatible with your chemotherapy because sometimes there can be interference Yes he told me about that and a lot of the times he felt my natural past felt like the oncologist wouldn't be able to understand what he was doing and that was a little bit of a conflict for me. But I trusted my natural path because I just out like he knew what he was doing and I don't think that for everybody but it was for me oh thanks so much. Thank you so Matha And let's go to Carlos in Burlington North Carolina welcome to The People's Pharmacy Are you a physician. Thank you. Gratian I practice for 34 years in West Virginia. 3 years ago I find that. My comments 15 years ago call friends and Washington d.c. . Patients comedia for Responsible Medicine. And one of the centers. Devised . Today and he mentioned. That we need to know the same for 8. Years ago the reasons were. One thing. For I mean it's now it's not the same thing as what used to be many years ago. Each. Time The regain. Given to. My son my. 2. Cents. You know Dr Carlos I think I think you make a really good point the way in which we harvest our fruits and vegetables today especially in the wintertime if you go to your local farmer's market that's a whole different matter and I will be doing that today but a lot of times they're coming from in the wintertime from you know South America for example where you know where it's summertime when we're having winter but they're harvested as Carlos said when they're green and so do they have the same number of nutrients I have similar suspicions that they may not where to next carry Shall we go to and New York Judy welcome to The People's Pharmacy. And this so absolutely. I'm a great. However I did a lot of. We saw blood work. They discovered that my l.d.l. I have the bad cholesterol and I am generally very reluctant to take the what's a chore I would much rather take the Omega story. Do you think that I would be better off taking the omega 3 s. And for the trial that instead of. You know dealing with the side effects of what it's worth what Judy this is actually a. This is a question really that you and your doctor need to discuss You certainly could try fish oil but most people would find that ready strikes would be more effective at lowering l.d.l. Cholesterol but you know what's so interesting about this whole. Controversy especially when it comes to fish oil Terry is that you know there are a lot of studies that suggest fish oil doesn't have any benefit but there is a drug in fact there are a couple of drugs now that are basically pure fish oil and they have been tested. And passthrough the Food and Drug Administration they're fairly pricey but they're fairly high dose fish omega 3 fatty acids you know they're very purified and they lower triglycerides dramatically and that's how they got f.d.a. Approval as drugs so some physicians are actually prescribe being this kind of fish oil in order to get some of those live at levels under control now is a highly purified it's also a lot more expensive than the fish oil but Judy might want to talk to her doctor about that or about it absolutely Terry I've got an interesting e-mail from Jean in Chapel Hill North Carolina she says I'm 91 years old and I have taken vitamins my whole adult life I don't have high blood pressure high cholesterol I have good hearing my mind is still sharp I know the vitamins have contributed to my good health I always ate eggs even during the no egg period and just used my common sense and eating my mother also took vitamins and lived a good life to 97 and my brother was 100 on December 29th also in good health ever since I can remember the medical profession has been trying to discredit vitamins as dangerous a cardiologist who is treating my husband gave me a tongue lashing that some years ago I see all the ads for drugs that overwhelm us on t.v. And listen to the side effects listed and then hear them say ask your doctor I can't believe it. Gene obviously comes from a long lived healthy family and it doesn't seem that vitamins have been doing her any harm if they haven't shortened it is that we have an e-mail from Jim in Winchester Virginia he makes 3 point one he says taking biotin has greatly improved my week brittle fingernails which does help some people too he says I've seen men use in nursing homes the look more like fast food rather than a. Healthy diet with fruits and vegetables and sometimes we have seen that 2 and 3 I have had skin cancer and I wear sunscreen religiously my doctor tested me for vitamin d. And recommends that I take 2000 international units daily Well you know that whole vitamin d. Issue is so intriguing because here we have all of these reports including this latest one saying don't take vitamins. Waste of time waste of money but if you go see the dermatologist what does the dermatologist tell you Terry. Wear your sunscreen Yeah wear your sunscreen stay inside take vitamin d. . So I don't know how you balance that well and we've got a question here from Ophelia who wants to address the gummies she says I have issues with tablets or pills I have no trouble taking gummies doesn't matter the only reason it matters is that Consumer Lab dot com did a test on gummy vitamins several months ago and found that they weren't they were a little less likely to actually have the amount of vitamin in them that said on the package Well that's all the time we have we want to thank Dr Trani low dog and Dr to end Manson for participating in today's show Dr Lo dogs book is a fortified your life your guide to vitamins minerals and more if you're taking any medications that all she has an amazing appendix that will tell you which drugs affect your nutrient levels linseed will produce today's show Pamela Alberta provided technical assistance ski is the engineer Dave great at it's our interviews the People's Pharmacy is produced at the studios of North Carolina Public Radio w u n c The People's Pharmacy theme music is by b.j. Lederman to order today show you can call 87322334 Today Show is 1120 for that number again 807322334 you can find it online at People's Pharmacy dot com at the site you can tell us what you think about the show or find information on prescription drugs herbs home remedies we also have a guide section in the store and you'll find our free guide to drug and nutrient interactions Well they are at the website you can also subscribe to the free podcast of the show so you never miss it again you can. Subscribe to our free e-mail newsletter if you wish and if you do listen to the podcast I will be grateful for a review. In Durham North Carolina I'm Joe great and I'm Terry Great thank you so much for listening and please join us again next week. You are tuned to s.p.r. North State Public Radio k c h o Chico and k f p r reading listener supported public radio connecting the communities of Northern California a broadcast service of California State University Chico on the web at my n.s.p. 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