User:Shbrown

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My name is Stephen Brown. I have a doctorate in chemistry from Yale University and work as a research scientist. I am working on adding information to pages concerning the safety and effectiveness of B-complex vitamins and vitamin C. I also plan to contribute to pages concerning petroleum refining to fuels and petrochemicals.

Without vitamins, humans can not survive. Vitamins participate in essential metabolic reactions in every single organ in the body ^[1]. Vitamins can act both as catalysts and participants in the chemical reaction. The body typically assembles vitamin-dependent catalysts from a variety of Nicotinamide adenine dinucleotide including amino acids, sugars, phosphates, and vitamins. Each vitamin is typically used in multiple different catalysts and therefore has multiple functions^[2]. The role of a catalyst is to participate in a chemical reaction without being altered itself. Catalysts function like knitting needles, which convert yarn to mittens without undergoing any change themselves.

From deep prehistory until the 1900's, vitamins could only be obtained by eating food. Each food source contains different ratios of vitamins. Therefore if the only source of vitamins is food, a change in diet from season to season, year to year, or day to day changes the doses of vitamins. Ordinary people do not sense any change in health as a consequence. This leads to the conclusion that the nervous system maintains a feeling of normalcy across a wide range of vitamin dosages.

Vitamins have only been produced as commodity chemicals and made widely available at nominal costs for a few decades^[3]. For the first time in human history, parents are empowered to independently control the doses of vitamins eaten by themselves and their children. Because the catalytic action of vitamins is ordinarily imperceptible except at the extremes of deficiency and overdose, the vast majority continues to depend upon food as the sole source and vitamins.

Contents 1 The Vitamins Controversy 1.1 Colds 2 What Are the RDA's 3 Side Effects 4 Footnotes and Reference links 5 DO11 Chat

[edit] The Vitamins Controversy

Use of vitamin supplements is controversial. Although unproven, it is commonly believed that whole foods (fresh fruits and vegetables, unprocessed meats) raised without synthetic pesticides and fertilizers are healthier than processed foods of equivalent composition (same amounts of proteins, carbohydrates, fats, vitamins, and minerals). Vitamin supplements are available in every pharmacy and grocery store that contain significantly higher doses than can be obtained by eating commonly available, inexpensive foods. There are proven side effects from using vitamin supplements, and the frequency and severity of side effects increases with increasing dose. Many of these side effects cause discomfort that initiates almost immediately after ingesting the offending supplement. Individual vitamin supplements are/have been claimed to be effective treatments for almost every ailment. Most of these claims have proven to be unfounded. On the other hand, vitamins at doses associated with side effects are effective treatments for some specific conditions, and, like drugs, show increasing effectiveness with increasing dose. For example, niacin raises good cholesterol and lowers bad cholesterol. The recommended dose is between 1000 and 2000 mg/day ^[4]. This is far above the UL value for niacin (see side effects section below for the definition of UL). Another example is the use of vitamin C for treating burns. The recommended dose is close to 100 gm/day injected intravenously supplemented by a topical application of a 3 wt% vitamin C solution.^{[5] [6]} This is far above the UL value for vitamin C of 2 gm/day. Unlike many of the side effects, in both these cases the patients are unable to perceive the proven benefits. In light of these facts, it is not surprising that vitamin supplements are controversial. ^[7] The controversy can be viewed as an argument between the large majority of people who believe that optimal amounts of vitamins can be obtained from food, and a minority who believe supplements are often necessary. It can also be viewed as an argument between those who believe they benefit greatly from taking vitamin supplements, and those who have been harmed by vitamin overdose. Resolution of this controversy is particularly important for tomorrow's children. The health of children in the developed world is deteriorating and there is a consensus that diet is an important part of the problem. Seventeen percent of American children are overweight (triple the percentage in 1980), and increasing numbers of children are developing high blood pressure, high cholesterol, and Type 2 diabetes.^[8] Fifteen percent of American children have learning disabilities or more serious neurological disorders,^[9] and these numbers are also trending upward.^[10] It is a reasonable hypothesis that providing vitamin supplements to children can help prevent the rising rates of childhood diseases and disorders.

A large enough number of people believe that supplements are required for optimal health to support a small group of physicians to provide them with guidance. Many of these physicians catagorize themselves as orthomolecular physicians, a term coined by two-time nobel prize winner Linus Pauling. A number of physicians in this group are pediatricians, and have been prescribing vitamin supplements to treat childhood physical and nervous disorders. An account of the experiences of this group is available.^[11] Supplementation during pregnancy is claimed to be the most important preventative measure. Treating childhood obesity, neurological disorders, or any other child health problems with vitamins is outside of mainstream practice despite the positive clinical reports continuously eminating from orthomolecular physicians.^[12]

The credibility of orthomolecular physicians is buttressed by their use of vitamin C supplements to combat colds. At least 21 double-blind, placebo controlled clinical trials involving a total of over 6000 participants have been conducted. These trials were reviewed in the 1990's.^[13][14] Reports from physicians have provided ample clinical confirmation that vitamin C reduces the duration and severity of colds (but not the frequency).^[15] Interviewing 10 Americans with post graduate educations is usually sufficient to find one who takes 5 gm per day or more of vitamin C to ward off an incipient cold.

The credibility of orthomolecular physicians is harmed by their tendency to underplay the side effects of vitamins. Ordinary B-complex tablets contain levels of these vitamins that are difficult to ingest through food. Also unlike food, the contained vitamins release rapidly. Finally, the vitamins contained in the tablets are not always exactly the same as the most common form in food. For these reasons, vitamin levels that are tolerated in food often cause side effects when consumed from supplements. Because the benefits of vitamins are imperceptible, and the side effects feel bad immediately, this understandably leads many people who have trouble with side effects to commit to never taking extra vitamins again and to recommend that others follow their example. Some manufacturers of high potency B-complex vitamins claim that there are no side effects, and few, if any, vitamin manufacturers provide warning labels. In reality, side effects have been reported from supplements containing close to 1 RDA of B-complex vitamins. More troublesome, some of these reports demonstrated that people can take daily supplements for months or even years before the side effects emerge.

Hence the controversy. People who have seen their health improve dramatically after initiating daily supplements, and who do not experience side effects tend to be strong supporters of the view that the RDA's are inadequate. People who did not see dramatic benefits, and who experienced unpleasant side effects tend to be strong supporters of the view that optimal doses of vitamins are best obtained from food. There is a need for better education on both sides, and a more balanced view.

Proof that vitamins far in excess of the R.D.A's are effective treatments for some specific conditions is unsettling because it proves that the full benefits of vitamins can not always be obtained without taking on the risks of side effects. One of the central roles of vitamins is to catalyze the growth and development of children into adults. The R.D.A's were set to ensure that no children were harmed by vitamin side effects. An unspoken assumption is that at the R.D.A values no children are harmed by vitamin deficiency. What if this assumption is not true?

[edit] Colds

At least 29 controlled clinical trials (many double-blind and placebo-controlled) involving a total of over 11,000 participants have been conducted. These trials were reviewed in the 1990's ^[16][17] and again recently.[5] The trials show that vitamin C reduces the duration and severity of colds but not the duration. The data indicate that there is a normal dose-response relationship. Vitamin C is more effective the higher the dose. The vaste majority of the trials were limited to doses below 1 g/day. As doses rise, it becomes increasingly difficult to keep the trials double blind because of the obvious gastro-intestinal side effects. So, the most effective trials at doses between 2 and 10 g/day are met with skepticism. Reports from physicians have provided ample clinical confirmation.[6] Interviewing 10 Americans with post graduate educations is usually sufficient to find one who takes 5 gm per day or more of vitamin C to ward off (reduce the duration of a cold to less than two days)an incipient cold.

The controlled trials and clinical experience prove that vitamin C in doses ranging from 0.1 to 2.0 g/day have a relatively small effect. The duration of colds was reduced by 7% for adults and 15% for children. The studies provide ample justification for businesses to encourage their employees to take 1 to 2 g/day during the cold season to improve workplace productivity and reduce sick days. The clinical reports provide the strongest possible evidence that vitamin C at higher doses is significantly more effective. However, the effectiveness typically comes at the price of gastro-intestinal side effects. It is easy for physicians to minimize these side effects since they cause no lasting harm. Adult patients, however, have proven reluctant to subject themselves to gas and cramping to deliver an unknown benefit (the duration and severity of colds is highly variable so the patient never knows what he/she is warding off). It is well worth the effort of identifying the small subset of individuals who can benefit from high daily doses (>10 g/day) of vitamin C without side effects and training them to regularly take 5 g/day during cold season and to increase the dose at the onset of a cold.

The trials proved that vitamin C is more effective for children. Reports from the field confirm the observations in the trials and suggest that children are less prone to vitamin C side effects.[7] Colds and flu are a servious problem for children. Every time a cold infects a child, its growing mind and body must divert energy from its usual business of growth and development. If the cold is followed by an opportunistic infection, such as bronchitis or ear infection, more energy must be diverted. Colds are the number one trigger for asthma.[8] Pre-school children in daycare are nearly constantly fighting infections (5-10 per year).[9] It is unfortunate that pediatricians and parents are reluctant to using several g/day of vitamin C to treat children with colds during these important years of growth and development. There is little hope of this changing until the controversy surrounding vitamins is resolved.

Use of vitamin supplements is controversial. Although unproven, it is commonly believed that whole foods (fresh fruits and vegetables, unprocessed meats) raised without synthetic pesticides and fertilizers are healthier than processed foods of equivalent composition (same amounts of proteins, carbohydrates, fats, vitamins, and minerals). Vitamin supplements are available in every pharmacy and grocery store that contain significantly higher doses than can be obtained by eating commonly available, inexpensive foods. There are proven side effects from using vitamin supplements, and the frequency and severity of side effects increases with increasing dose. Many of these side effects cause discomfort that initiates almost immediately after ingesting the offending supplement. Individual vitamin supplements are/have been claimed to be effective treatments for almost every ailment. Most of these claims have proven to be unfounded. On the other hand, vitamins at doses associated with side effects are effective treatments for some specific conditions, and, like drugs, show increasing effectiveness with increasing dose. For example, niacin raises good cholesterol and lowers bad cholesterol. The recommended dose is between 1000 and 2000 mg/day.[10] This is far above the UL value for niacin (see side effects section below for the definition of UL). Another example is the use of vitamin C for treating burns. The recommended dose is close to 100 gm/day injected intravenously supplemented by a topical application of a 3 wt% vitamin C solution.[11] ^[18] This is far above the UL value for vitamin C of 2 gm/day. Unlike many of the side effects, in both these cases the patients are unable to perceive the proven benefits.

In light of these facts, it is not surprising that vitamin supplements are controversial. Proof that vitamins far in excess of the R.D.A's are effective treatments for some specific conditions is unsettling because it proves that the full benefits of vitamins can not always be obtained without taking on the risks of side effects. One of the central roles of vitamins is to catalyze the growth and development of children into adults. The R.D.A.'s were set to prevent classic vitamin deficiency diseases and to ensure that no children were harmed by vitamin side effects. An unspoken assumption is that the R.D.A.'s enable the optimal growth and development of every child. What if this assumption is not true?

Use of vitamin supplements is controversial. This controversy is evident in the language used by the government in association with the Dietary Supplement Health and Education Act of 1994. According the government, "Scientific evidence supporting the benefits of some dietary supplements (e.g., vitamins and minerals) is well established for certain health conditions." In this sentence the government admits that vitamins can cure diseases. Yet in a subsequent sentence the government says, "Dietary supplements are not intended to treat, diagnose, mitigate, prevent, or cure disease."[12]

Individual vitamin supplements and/or supplements containing multiple vitamins are/have been claimed to be effective treatments for almost every ailment. This can be verified by typing in the name of a disease and the word vitamin into an internet search engine. Some preparations are claimed to be a panacea.[13] Most of these claims have proven to be unfounded. For example, 50 mg/day of vitamin B6 does not prevent PMS.[14] However, vitamins are effective treatments for some specific conditions, and, like drugs, show increasing effectiveness with increasing dose. For example, niacin raises good cholesterol and lowers bad cholesterol. The recommended dose is between 1000 and 2000 mg/day.[15] This is far above the UL value for niacin. Another example is the use of vitamin C for treating burns. The recommended dose is close to 100 gm/day injected intravenously supplemented by a topical application of a 3 wt% vitamin C solution.[16] ^[19] This is far above the UL value for vitamin C of 2 gm/day. There are proven side effects from using vitamin supplements, and the frequency and severity of side effects increases with increasing dose. Many of these side effects cause discomfort that initiates almost immediately after ingesting the offending supplement. In light of these facts, it is not surprising that vitamin supplements are controversial. Proof that vitamins far in excess of the R.D.A's are effective treatments for some specific conditions is unsettling because it proves that the full benefits of vitamins can not be obtained without taking on the risks of side effects.

Scientific evidence supporting the benefits of some dietary supplements (e.g., vitamins and minerals) is well established for certain health conditions, but others need further study. Research studies in people to prove that a dietary supplement is safe are not required before the supplement is marketed, unlike for drugs. It is the responsibility of dietary supplement manufacturers/distributors to ensure that their products are safe and that their label claims are accurate and truthful. If the FDA finds a supplement to be unsafe once it is on the market, only then can it take action against the manufacturer and/or distributor, such as by issuing a warning or requiring the product to be removed from the marketplace. The manufacturer does not have to prove that the supplement is effective, unlike for drugs. The manufacturer can say that the product addresses a nutrient deficiency, supports health, or reduces the risk of developing a health problem, if that is true. If the manufacturer does make a claim, it must be followed by the statement "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease."

Under the Dietary Supplement Health and Education Act of 1994, the dietary supplement manufacturer is responsible for ensuring that a dietary supplement is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market. Dietary supplements are not intended to treat, diagnose, mitigate, prevent, or cure disease. In some cases, dietary supplements may have unwanted effects, especially if taken before surgery, with other dietary supplements or medicines, or if the person taking them has certain health conditions.

Use of vitamin supplements is controversial. This controversy is evident in the language used by the government in association with the Dietary Supplement Health and Education Act of 1994. According the government, "Scientific evidence supporting the benefits of some dietary supplements (e.g., vitamins and minerals) is well established for certain health conditions." In this sentence the government admits that vitamins can cure diseases. Yet in a subsequent sentence the government says, "Dietary supplements are not intended to treat, diagnose, mitigate, prevent, or cure disease."[2]

Individual vitamin supplements and/or supplements containing multiple vitamins are/have been claimed to be effective treatments for almost every ailment. This can be verified by typing in the name of a disease and the word vitamin into an internet search engine. Some preparations are claimed to be a panacea.[3] Most of these claims have proven to be unfounded. For example, 50 mg/day of vitamin B6 is not a generally effective treatment for PMS.[4] In spite of powerful scientific evidence, the claims are not going away. Worse, the individuals and organizations promoting vitamins as cures sometimes claim that vitamins are safe and minimize the seriousness of proven vitamin side effects. Vitamin advocates contest many alleged vitamin side effects. As a result, few people taking vitamins are aware of the long list of ailments that have been associated with vitamins. A comprehensive discussion of vitamin side effects requires a lengthy discussion.[20]

However, vitamins in very high doses are effective treatments for some specific conditions. For example, niacin raises good cholesterol and lowers bad cholesterol. The recommended dose is between 1000 and 2000 mg/day.[5] This is far above the UL value for niacin of 35 mg/day. Another example is the use of vitamin C for treating burns. The recommended dose is close to 100 gm/day injected intravenously supplemented by a topical application of a 3 wt% vitamin C solution.[6] [21] This is far above the UL value for vitamin C of 2 gm/day.

In light of these facts, it is not surprising that vitamin supplements are controversial. Proof that vitamins far in excess of the R.D.A's are effective treatments for some specific conditions is unsettling because it proves that the full benefits of vitamins can not be obtained without taking on the risks of side effects.

Use of vitamin supplements is controversial. Vitamin advocates believe that vitamin supplements are often required to achieve optimum health. They recommend taking doses of vitamins far in excess of the RDA.[17] The RDA committee of the U.S. Food and Nutrition Board recommends that most Americans get optimal doses of vitamins by eating a healthy diet, since the RDA's of vitamins are readily obtained from food. Vitamin advocates believe that taking doses of vitamins far in excess of the RDA can often be helpful treating health problems. Vitamin skeptics believe vitamins in excess of the RDA do more harm than good.[18] Skeptics made efforts to have vitamin supplements regulated. Vitamin advocates resisted. The negotiations about regulation ended with the Dietary Supplement Health and Education Act of 1994. The controversy remains evident in the language of the act. According to the act, "Scientific evidence supporting the benefits of some dietary supplements (e.g., vitamins and minerals) is well established for certain health conditions." In this sentence the government asserts that vitamins cure diseases. Yet in a subsequent sentence the government says, "Dietary supplements are not intended to treat, diagnose, mitigate, prevent, or cure disease."[19]

Individual vitamin supplements and/or supplements containing multiple vitamins are/have been claimed to be effective treatments for almost every ailment. This can be verified by typing in the name of a disease and the word vitamin into an internet search engine. Some preparations are claimed to be a panacea.[20] Most of these claims have proven to be in need of qualification. For example, a review of the scientific literature investigating the effectiveness of vitamin B6 for the treatment of PMS came to the conclusion that the vitamin was not obviously effective.[21] Despite the scientific evidence, the claims are not going away. Individuals and organizations promoting vitamins as cures often claim that vitamins are safe and minimize the seriousness of proven vitamin side effects. Compared to drugs, vitamins are safe, and reports of vitamin side effects are rare. As a result, few people taking vitamins are aware of the long list of ailments that have been associated with vitamins. A comprehensive discussion of possible vitamin side effects requires a lengthy discussion.^[20]

The credibility of vitamin advocates has been enhanced by the proven effectiveness of vitamins in the treatment of some health problems at doses of >100 [22] and even >1000 [23] ^[21] RDA's. Side effects are common at these doses.

[edit] What Are the RDA's

RDA stands for recommended daily allowance. The RDA's for vitamins are based on something called the "body pool" of vitamins and minerals. The amount of each vitamin in the body ranges from a pinch to a teaspoon. Scientists measured the amount of each vitamin in groups of adult males in stable health. The average amount for these men was named the "body pool".

More experiments showed that vitamins naturally break down in the body over time. The RDA's are an estimate of how much a person needs to take of each vitamin every day to maintain a steady body pool, plus an ample safety margin to account for individual variability.

If more vitamins break down in a given day than the person eats, the body pool starts to empty. Deficiency symptoms start to occur as chemical reactions in the body's cells can't be completed. when the body pool gets too low, the body excretes almost none of the vitamins it takes in. As the body pool rises above the normal range, more and more of vitamins ingested are excreted (a lower and lower percentage of the vitamins are retained). Although the body does excrete a larger percentage of vitamins taken at high dosages, it doesn't excrete all the extra. Like any drug, the total amount of a vitamin in the body increases with increasing dose. Again, like drugs, the effectiveness of vitamins increase with increasing dose, but so do side effects. The optimal doses strikes a balance between the benefits and the side effects.

[edit] Side Effects

All vitamins have well documented side effects.[24] Common awareness of vitamin side effects is small because side effects are largely confined to the minority of people taking vitamin supplements. Supplement users often associate side effects with the supplements at an early stage and tend to reduce dosages long before the high severity symptoms of serious vitamin overdose emerge.

Vitamin advocates tend to confuse vitamin side effects and vitamin safety. Unlike the side effects from many drugs, vitamin side effects rarely cause any permanent harm. There is no known toxic dose for the B-complex vitamins and vitamin C. When vitamin side effects emerge, full and rapid recovery is accomplished by reducing the supplement dosage.

The mission of the Food and Nutrition Board is to prevent side effects rather than to optimize health. The physicians on the board carefully review all the clinical data on supplement use and have determined the upper dosage threshold for each vitamin that can be tolerated as a daily dose by the entire population without side effects. Harrell, RF et al. Can nutritional supplements help mentally retarded children? An exploratory study. Proc Natl Acad Sci 78 (1):574-578, 1981. Tolerance varies with age and state of health.

[edit] Footnotes and Reference links

[edit] DO11 Chat

Thanks for your note at my page.

Tough conversation you're in at the vitamin D page. Builds character and invaluable skills. Excellent job maintaining an even tone. I need to work on that.

I understood RDA is a redirect. Am I correct that there is no link from the vitamin page to the RDA page? It took me long enough to find megavitamin therapy so I'll believe it if the link is already there.

I support the goal of NPOV. I try to be very generous in this area because when I write I read what I write and ask myself if there might be other POV's which would be better supported if I used different words. Invariably I can think of other POV's and other words.

I have found some references on RDA's to give you a head's up on where I'm going. [25] This is a nice page. Why isn't there a page like this at webMD or the likes? Outstanding pages on the vitamin deficiency diseases did show up at a mainstream site. [26][27][28][29] These articles show that the RDA's are not meant as guidance for individuals concerned that they might be vitamin deficient. Surprisingly, large numbers of Americans have a reason to be concerned that they might be vitamin deficient. My evidence for this is that large numbers of Americans exhibit symptoms of vitamin deficiency. I was surprised to learn that one in five Americans has some kind of mental illness [30]. Malabsorption is a recognized risk for the elderly population. Few in the >60 age category would claim that their health is as good as it was when they were young. Chronic problems with some of the same symptoms as some of the deficiency diseases are common in the elderly. I'm only arguing that some mental illness and some chronic problems of the elderly might be caused by vitamin deficiency. Finally, hosptialization and/or severe illness can lead to the onset of deficiency disease. Deficiency disease itself is a "point of view". When exactly does someone cross the border from healthy to vitamin deficient (0.3 RDA, 0.28, 0.25??) Science says with certainty that steadily lowering the dose of a vitamin over time will cause the deficiency disease.

I've started searching the internet on the subject of anorexia. So far I'm having trouble finding the connection between anorexia and vitamin deficiency. Apparently over a million young women suffer from anorexia. Surely starving people should be expected to be suffering from vitamin deficiency? Wouldn't it be a good idea to recommend that all young women take a multivitamin supplement?

Sigh. My POV has gone overboard again.

Cheers. I will happily edit away when I'm ready and look forward to your continued support.