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Vitamin supplements
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Vitamin supplements - April 10, 2005 10:16:00 AM
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Randy Dixon
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I know the issue of vitamin supplementation, herbs and other nutritional supplements is controversial but does anyone here recommend any of these to their patients.
Here is one you might consider:
http://www.sciencedaily.com/releases/2005/03/050309102649.htm
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Re: Vitamin supplements - April 10, 2005 12:21:00 PM
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nari
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I do not, because apart from folic acid and blatant vitamin deficiency, there does not seem to be any evidence coming from those who should know that they are of any value. Large doses of any of them would appear to be a risk.
I leave all that to the dietitians.
Nari
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Re: Vitamin supplements - April 10, 2005 2:24:00 PM
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PTupdate.com
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A very interesting article is in the most recent issue of, I believe Discover, that really covers the topic, including use in various psychological issues.
I once posted a similar question this site, titled "supplementation", but did not get many responses.
Quite a few studies have been published using creatine monohydrate on persons, and showing definite strength and/or girth gains, including elderly persons. With no adverse effects (except cramps) documented for normal dosage, why don't we recommend these products to people? Why dont' we recommend Andro 150 poppers either? If someone is struggling to maximize thier therapy and exercise routine, shouldn't they have every advantage in thier corner?
After having our first child, my wife's usually quite thick, curly Italian hair began thinning and falling out. MD said just changes due to giving birth and all the stress that comes with raising a child. When we decided to start working on number two (always such fun "working" on them, isn't it?), her hair quit falling out and got thick again. Why? she began her pre-natal vitamins. When I asked if she was taking vitamins all along, as I had asked, she wasn't.
Most people's diets nowadays do not afford them the total package they should be recieving. I personally many people should be supplementing, and I personally do so myself.
John Duffy, PT OCS
[URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
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John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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Re: Vitamin supplements - April 10, 2005 3:41:00 PM
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jma
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Will take a course on clinical nutrition and hope to learn what is out there in there that can help answer these questions.
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Re: Vitamin supplements - April 10, 2005 8:30:00 PM
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Randy Dixon
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Nari,
I would have some disagreement with you about supplements not having any value, but we would just be going in circles. However, in the case of homocysteine levels, it's linkage to many diseases and conditions including heart attacks, stroke, diabetes, osteoporosis etc. and the effects of vitamins B6, B12 and folic acid in reducing them, I think the research all falls on the side of supplementation. This is becoming pretty well accepted among physicians and dieticians.
You can google scholar homocysteine and read lots about it if you are interested. Later research may discount some of that being done today but the possible benefits so outweigh the possible risks in this case I think that this is one case where it should be considered.
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Re: Vitamin supplements - April 11, 2005 3:22:00 AM
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Dr.Wagner
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Since this study was done on the Japanese...you gotta wonder if there is something in their diet they aren't recieving that we ARE or vice versa. Granted we are all humans, but there are significant small differences between the two cultures.
At the very least this study needs to be duplicated in a larger and more diverse US population.
Until then...take a Centrum.
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Dr. Wagner DO
Moderator of Medical Complexity Forum
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Re: Vitamin supplements - April 11, 2005 3:39:00 AM
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Randy Dixon
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Yeah, the study does warn that it was done on a Japanese pop. and that it doesn't necessarily carryover. However, there are some studies done on Osteoporotic breaks and homocysteine done in the US which point to the same thing.
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Re: Vitamin supplements - April 11, 2005 5:38:00 AM
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JLS_PT_OCS
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I think that it is always misleading to take small nutritional changes out of context and attempt to ascribe certain specific vitamins or chemicals with certain specific effects.
Anyone concerned about osteoporosis or these fatigue fractures needs to stop eating animal protein and stop drinking acidic soda drinks, for starters.
Regular weightbearing exercise appropriate to the individual is also important.
There is abundant evidence, both at the basic science and epidemiological level, that a whole foods, plant-based diet can reverse or prevent many of the diseases we are cursed with in the western world, and osteoporosis and fatigue fractures are another example of that.
I highly recommend the book "The China Study" by T. Colin Campbell, PhD. Dr Campbell is a very well-respected and experienced nutrition researcher.
[URL=http://www.thechinastudy.com]www.thechinastudy.com[/URL]
He makes only those claims he can directly substantiate with the available published scientific research.
There is a good explanation in his book (extensively referenced in the peer-reviewed literature)of why the interaction of effects is more important than the single actions of specific nutrients. If we approach nutritional research the way we do drug research, we are bound to be disappointed and confused by the conflicting results.
This is a matter of classification, as so many other things are.
It is likely that the levels of Folic Acid and B12 in patients who don't fracture and aren't in the study represent not specific supplementation but rather qualities of the overall diet that make a difference.
I think a standard multivitamin is a pretty good bet for general use and has a great cost vs benefit ratio.
I found my knowlege of nutrition, especially sports nutrition, really increased in studying for and passing the CSCS exam. But Wags knows that's just a gym rat's test, so what do I know?
:)
I recommend to patients with joint pains or arthritis the supplement Glucosamine 1500mg per day and have them discuss it with their family physician if they have any ongoing health issues or are taking a lot of medications.
I recommend Creatine at times for patients who are training regularly and otherwise are not showing gains or improvement in their rehab course.
I find that I am better off emphasizing sound program design first, and supplementation issues later, if at all. It has been my experience that most of the people who come asking about supplements are not following a quality, well-designed training program, and are thus more likely to benefit from better program design than from a supplement.
But all else being equal, I do recommend them at times.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Vitamin supplements - April 11, 2005 6:23:00 AM
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chiroortho
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Can tell you this, when I supplemented with creatine, I for the first time did reps with the stack on my tricep presses, to the extent that I injured my elbows. Tendons were sore for WEEKS. But no way can I be convinced that it was placebo. Without the creatine that stack doesn't go up without much cheating.
I use the Labrada Nutrition Creatine Monohydrate. I like the purity guarantee. I also like the Pharmax fish oil. Can't taste the fish at all.
For what it's worth (essentially nothing, I know).
_____________________________
Greg Priest, DC, DABCO
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