What my doctor advised about vitamins and supplements

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  • LKArgh
    LKArgh Posts: 5,179 Member
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    lauragreenbaum wrote: »
    Basically, that the only vitamin worth taking is D and that most people who take other vitamins are getting too much when combined with vitamins naturally obtained through food. As for supplements (such as glucosamine and turmeric), she said if I really feel like they make a difference, they won't hurt, but her opinion is it's a just a huge industry that makes a lot of money and not worth it.

    I'm sure there are many threads on this subject, but I'm curious about current opinions. Thoughts?

    It is pretty much standard dr's recommendation where I live.
  • SuzySunshine99
    SuzySunshine99 Posts: 2,987 Member
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    netitheyeti wrote: »
    I took a risk and decided on my own to supplement iron 2 years ago (after having several months of super heavy periods followed by a period that lasted TWO MONTHS), and it seemed to get rid of my bruising, lack of energy, and weird food cravings... to this day I still take an iron supplement 2-3x a week and occasionally a multivitamin/mineral tablet and it seems to keep those symptoms away... I do think I get enough of other stuff through my diet tho (I'm admittedly occasionally a bit low on calcium), I was also put on b vitamins for a few months for some nerve issues I was having, tho unfortunately that didn't seem to change anything at all... water soluble ones aren't usually an issue anyway, from what I've read about it, but I wouldn't play around with just taking anything/everything

    I'd also like to emphasise my symptoms were SO strong (for iron) I was almost 100% sure it was the issue

    Couldn't you have had a blood test done to be TOTALLY sure that was the issue? Your example is an extreme one, and you were probably correct, but in general, it can be dangerous for people to supplement iron on their own, without proof of a deficiency. As you said, it's not something people should paly around with.
  • nooshi713
    nooshi713 Posts: 4,877 Member
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    Many people are deficient in Folate as well as calcium. These are worth taking if you can’t get them through diet. Women of child bearing age should take folic acid.

    I recently found out that I’m vitamin D deficient despite living in Sunny Southern California, and I have already been taking 200% RDV for years. My doctor now recommended taking a jumbo dose.

    I agree that most other vitamins are probably not worth taking as supplements.
  • AnnPT77
    AnnPT77 Posts: 32,838 Member
    edited June 2020
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    Lietchi wrote: »
    YellowD0gs wrote: »
    I had my blood tests done at the end of a wet, cold dreary March, and my Vit. D was just under the normal range (28.9 or something). The Neurologist put me on Vit D3 supplements. A week later my GP fairly strongly advised not to take them as they may complicate my existing cardiac stents, but I should work at getting more sun. Registered Dietician said I should take the Vit D, but also with K3, to help with osteoporosis. When I checked in with my Cardiologist, she became unglued at the thought of Vitamin K supplements, as that's the blood clotting vitamin, and that would definitely interfere with my cardiac stents, so hell no to the Vitamin K! And another very strong recommendation against the Vit D as well, with instructions to try to get more sun. So, now I have 2 DR's opinions that I should avoid supplements and work on getting a killer tan! :smiley: 20 minutes a day without sunscreen, and not just forearms and calves, either.

    On the topic of doctor 'madness'... I went to the doctor a few months ago saying I felt tired, so he drew blood. I was very deficient in vitamin D (16.4 with the optimal range being 30-100) but he 'didn't see anything in my blood results that could explain my fatigue'... OK...
    When I mentioned a vitamin D supplement, he suggested it wasn't necessary and it would be resolved when spring arrived with more sun exposure. When I said I avoided the sun (very fair skin) he recommended a good sun screen (well duh, but that's not going to help my vitamin D much then...?).

    So vitamin D supplements it is, and looking for a new doctor :tongue:

    I don't think either of these is "doctor madness", personally.

    It's sadly not uncommon to get to a point in one's health were strategies that will help relieve one problem will aggravate another problem. This can be true of supplements (but also of other things*), and I think that's what we're seeing in the Vitamin D/K anecdote. *For example, there are physical therapy exercises that might help one body part's problem, but aggravate a pre-existing condition for another - exercises that would be totally non-problematic for a person with neither underlying physical problem.

    I admit it can be extremely difficult to get multiple specialists, each of whom is correct for their specialty, to communicate among themselves to reach a consensus, and that can be a problem for patients.

    As far as vitamin D and fair skin: Speaking as a naturally skim-milk blue-white kind of person, very prone to sunburn, I think the amount of sun exposure needed is not necessarily in the sunburn zone, especially if one gradually builds up to it over a couple of weeks. PP mentioned 20 minutes, for example.

    I agree that your doctor's advice seems . . . unusual, based on my experience, if your D was really that low per blood test, but I didn't see the whole panel, and I'm not a doctor, so what the heck do I know.

    Did you take a D3 supplement instead? Did it help?

    FWIW: I take supplements when a doctor tells me to, unless I have reasons to believe they might be contraindicated, in which case I'd argue with him/her. I've also experimented with other supplements occasionally, after researching them quite carefully (including potential interaction with other drugs/supplements) to reassure myself that harm was unlikely. Yes, fat-soluble vitamins and minerals can be cumulatively over-dosed. I believe some water-soluble vitamins can also be acutely overdosed (i.e., bad effects from taking way too much in a short time period).

    I've actually spoken with supplement/vitamin researchers (there's a big research university in my town, with two med schools, a nursing school, and the usual sciences, so one meets such people). They don't advocate supplementing if no specific trigger to do so, but agreed that a (moderate) multivitamin probably won't hurt most people.

    For those taking multis: Check your label. Some commercial brands, at recommended dosage, are mega-dosing you (way over RDA) on certain vitamins. If yours are, are you sure that's a good idea, in your particular case?
  • Lietchi
    Lietchi Posts: 6,333 Member
    edited June 2020
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    AnnPT77 wrote: »
    Lietchi wrote: »
    YellowD0gs wrote: »
    I had my blood tests done at the end of a wet, cold dreary March, and my Vit. D was just under the normal range (28.9 or something). The Neurologist put me on Vit D3 supplements. A week later my GP fairly strongly advised not to take them as they may complicate my existing cardiac stents, but I should work at getting more sun. Registered Dietician said I should take the Vit D, but also with K3, to help with osteoporosis. When I checked in with my Cardiologist, she became unglued at the thought of Vitamin K supplements, as that's the blood clotting vitamin, and that would definitely interfere with my cardiac stents, so hell no to the Vitamin K! And another very strong recommendation against the Vit D as well, with instructions to try to get more sun. So, now I have 2 DR's opinions that I should avoid supplements and work on getting a killer tan! :smiley: 20 minutes a day without sunscreen, and not just forearms and calves, either.

    On the topic of doctor 'madness'... I went to the doctor a few months ago saying I felt tired, so he drew blood. I was very deficient in vitamin D (16.4 with the optimal range being 30-100) but he 'didn't see anything in my blood results that could explain my fatigue'... OK...
    When I mentioned a vitamin D supplement, he suggested it wasn't necessary and it would be resolved when spring arrived with more sun exposure. When I said I avoided the sun (very fair skin) he recommended a good sun screen (well duh, but that's not going to help my vitamin D much then...?).

    So vitamin D supplements it is, and looking for a new doctor :tongue:

    I don't think either of these is "doctor madness", personally.

    As far as vitamin D and fair skin: Speaking as a naturally skim-milk blue-white kind of person, very prone to sunburn, I think the amount of sun exposure needed is not necessarily in the sunburn zone, especially if one gradually builds up to it over a couple of weeks. PP mentioned 20 minutes, for example.

    I agree that your doctor's advice seems . . . unusual, based on my experience, if your D was really that low per blood test, but I didn't see the whole panel, and I'm not a doctor, so what the heck do I know.

    Did you take a D3 supplement instead? Did it help?

    Yeah, I took a few doses over the following weeks (no extreme doses) which did the trick. We were mid February and I wasn't going to spend a month or more being exhausted and waiting for sunshine.

    Something I didn't mention (to add to how I feel about this doctor) is that my BF also went to this doctor saying he felt tired. And the doctor didn't even test his vitamin D (despite my BF having had very low vitamin D in the past, even lower than mine) or any other vitamins or minerals. The only reason he did a full blood panel for me was because I said I had been (intentionally) losing weight.
    Anyhow, now that the sun is out I do try to get direct sunlight and I've cut down on the vitamin D supplements.
  • cozypearyakima
    cozypearyakima Posts: 3 Member
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    For me personally, D is VERY important. As for everything else I get that through foods when eating a balanced diet. D is not really a vitamin, most of the medical community now reference it as a hormone. Two times in the last 15 years my D level has been crucially low---and they way I found that was that I was very unwell....I could not even grasp my cup of coffee, I had no strength in my hands and wrists, thought I needed Carpel Tunnel surgery ---NOPE, D level was at an 8. Got it up and felt so much better, less brain fog, more energy, and it did help with weight loss as well....then let it slide, 5 years later I was at an 11. I am currently up to 36, goal is 70-100---not sure if I can ever get there, but I will continue to respect the D!
  • glassyo
    glassyo Posts: 7,650 Member
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    A little more on vitamin d. This was the convo my oral surgeon and I had when he saw I was doing a bad job of healing after having...er...oral surgery:

    OS: (paraphrasing) Get your vitamin d levels checked. I've had cases of people who took a long time to heal and that was their problem.
    Me: I'm out in the sun A LOT!
    OS: Are you naked? (it wasn't as creepy as that probably sounded. At least not as creepy as the dentist who said I'd have sexy teeth after my root canal.)
    Me: Hell no. I wouldn't do that to the good people of the SFV.

    So basically, apparently, just being out in the sun doesn't always do it. :)
  • MikePfirrman
    MikePfirrman Posts: 3,307 Member
    edited June 2020
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    YellowD0gs wrote: »
    I had my blood tests done at the end of a wet, cold dreary March, and my Vit. D was just under the normal range (28.9 or something). The Neurologist put me on Vit D3 supplements. A week later my GP fairly strongly advised not to take them as they may complicate my existing cardiac stents, but I should work at getting more sun. Registered Dietician said I should take the Vit D, but also with K3, to help with osteoporosis. When I checked in with my Cardiologist, she became unglued at the thought of Vitamin K supplements, as that's the blood clotting vitamin, and that would definitely interfere with my cardiac stents, so hell no to the Vitamin K! And another very strong recommendation against the Vit D as well, with instructions to try to get more sun. So, now I have 2 DR's opinions that I should avoid supplements and work on getting a killer tan! :smiley: 20 minutes a day without sunscreen, and not just forearms and calves, either.

    It's K2, not K (or K3), so perhaps your doc needs to do more research. There's nothing to indicate that K2 causes clotting, but since docs error on the side of safety, they don't like to combine it with blood thinners.

    It's not uncommon for docs not to know anything about Vitamin K2. And it does not cause blood clotting (there hasn't been any significant research on it so far but, again, they weigh on the side of safety). So I hate to tell you but she's misinformed. It's confusing, even for docs, but K2 isn't the same Vitamin as Vitamin K, though a miniscule amount of Vitamin K gets converted to K2 in the body.

    But the science of K2 is completely irrefutable. It's good both for the heart and the bones. If you're on Warfarin or other blood thinner, it's just a precaution not to take K2. K2 seems to only interfere with Warfarin but not some other blood thinners and over 50mg.

    Good article on this. Basically, this article is what I've read too. K2 is too important to ignore and warfarin can cause calcification without it. But as this article mentions, just eat some good Gouda cheese on occasion (it has K2 in it but not in megadosing that would interfere with Warfarin).

    https://innovixlabs.com/blogs/insights/vitamin-k2-and-coagulation
  • MikePfirrman
    MikePfirrman Posts: 3,307 Member
    edited June 2020
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    nooshi713 wrote: »
    Many people are deficient in Folate as well as calcium. These are worth taking if you can’t get them through diet. Women of child bearing age should take folic acid.

    I recently found out that I’m vitamin D deficient despite living in Sunny Southern California, and I have already been taking 200% RDV for years. My doctor now recommended taking a jumbo dose.

    I agree that most other vitamins are probably not worth taking as supplements.

    I disagreed with you for one reason. MTHFR is a very common genetic defect. My wife has it. It's estimated as much as 1/3 of the population has some form of it, though it can be much worse in some.

    MTHFR is the inability to convert Folic Acid into Folate. They (people like my wife with this genetic defect) don't make the enzyme that processes it (and synthetic B12) into downstream molecules the body can use. So for a large percentage of the population, "methyl Bs", which are a different form of Folate (as opposed to Folic Acid), are preferred. And better quality prenatal supplements are now nearly all the "methyl" versions. Folic Acid can potentially be harmful for those with this genetic defect, mostly because they can be vitamin B deficient and not know it. My wife can take synthetic Bs all day and not be able to use them. There is now a bit of a movement away from cereal fortification with Folic Acid because of this, though it's still common.
  • nooshi713
    nooshi713 Posts: 4,877 Member
    edited June 2020
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    MikePfirrman wrote: »
    nooshi713 wrote: »
    Many people are deficient in Folate as well as calcium. These are worth taking if you can’t get them through diet. Women of child bearing age should take folic acid.

    I recently found out that I’m vitamin D deficient despite living in Sunny Southern California, and I have already been taking 200% RDV for years. My doctor now recommended taking a jumbo dose.

    I agree that most other vitamins are probably not worth taking as supplements.

    I disagreed with you for one reason. MTHFR is a very common genetic defect. My wife has it. It's estimated as much as 1/3 of the population has some form of it, though it can be much worse in some.

    MTHFR is the inability to convert Folic Acid into Folate. They (people like my wife with this genetic defect) don't make the enzyme that processes it (and synthetic B12) into downstream molecules the body can use. So for a large percentage of the population, "methyl Bs", which are a different form of Folate (as opposed to Folic Acid), are preferred. And better quality prenatal supplements are now nearly all the "methyl" versions. Folic Acid can potentially be harmful for those with this genetic defect, mostly because they can be vitamin B deficient and not know it. My wife can take synthetic Bs all day and not be able to use them. There is now a bit of a movement away from cereal fortification with Folic Acid because of this, though it's still common.

    Thanks for the insight. I suspect your wife’s condition must be uncommon since I work in healthcare and am unfamiliar with it. I am in Emergency Medicine though, and bet that primary care providers are probably more familiar with it. I am curious now and plan to research this a bit.

    I still recommend folic acid to women of childbearing age. There is a reason it is recommended to all pregnant women and women potentially planning to conceive. Many processed foods like cereal and bread are fortified nowadays but many people still don’t get adequate amounts. It is a vitamin naturally found in produce, which the average American doesn’t get enough of in their diet.
  • MikePfirrman
    MikePfirrman Posts: 3,307 Member
    edited June 2020
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    nooshi713 wrote: »
    MikePfirrman wrote: »
    nooshi713 wrote: »
    Many people are deficient in Folate as well as calcium. These are worth taking if you can’t get them through diet. Women of child bearing age should take folic acid.

    I recently found out that I’m vitamin D deficient despite living in Sunny Southern California, and I have already been taking 200% RDV for years. My doctor now recommended taking a jumbo dose.

    I agree that most other vitamins are probably not worth taking as supplements.

    I disagreed with you for one reason. MTHFR is a very common genetic defect. My wife has it. It's estimated as much as 1/3 of the population has some form of it, though it can be much worse in some.

    MTHFR is the inability to convert Folic Acid into Folate. They (people like my wife with this genetic defect) don't make the enzyme that processes it (and synthetic B12) into downstream molecules the body can use. So for a large percentage of the population, "methyl Bs", which are a different form of Folate (as opposed to Folic Acid), are preferred. And better quality prenatal supplements are now nearly all the "methyl" versions. Folic Acid can potentially be harmful for those with this genetic defect, mostly because they can be vitamin B deficient and not know it. My wife can take synthetic Bs all day and not be able to use them. There is now a bit of a movement away from cereal fortification with Folic Acid because of this, though it's still common.

    Thanks for the insight. I suspect your wife’s condition must be uncommon since I work in healthcare and am unfamiliar with it. I am in Emergency Medicine though, and bet that primary care providers are probably more familiar with it. I am curious now and plan to research this a bit.

    I still recommend folic acid to women of childbearing age. There is a reason it is recommended to all pregnant women and women potentially planning to conceive. Many processed foods like cereal and bread are fortified nowadays but many people still don’t get adequate amounts. It is a vitamin naturally found in produce, which the average American doesn’t get enough of in their diet.

    It's not uncommon not to hear about it. Up to 40% of the population (some say 50%) have some form of it, but in most cases, it's not that severe. But if you have a double genetic variant, it can have devistating affects on your health. I'd recommend Methyl Folate and Methyl B-12 all day long for pregnant women. It's pennies more and no sense in taking the risk if someone hasn't been genetically tested. Metafolin is the Methyl version of Folic Acid. Sometimes you'll see 5-MTHF as well. Metafolin is the brand name and 5-MTHF is the generic name of the same thing. It's just Folic Acid that someone with this condition can more readily use and since so much of the population has this gene and don't know it, the better brands are switching to it.

    Thorne, PureEncapsulations, Klaire Labs, (I think) Garden of Life, NOW Foods -- most of the better supplement companies only carry Methyl Bs in their Prenatal formulas for this reason.

    Methylcobalamin (not Cyanocobalamin) is the methyl version of B12.

  • MaltedTea
    MaltedTea Posts: 6,286 Member
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    cozypearyakima wrote: »
    For me personally, D is VERY important. As for everything else I get that through foods when eating a balanced diet. D is not really a vitamin, most of the medical community now reference it as a hormone. Two times in the last 15 years my D level has been crucially low---and they way I found that was that I was very unwell....I could not even grasp my cup of coffee, I had no strength in my hands and wrists, thought I needed Carpel Tunnel surgery ---NOPE, D level was at an 8. Got it up and felt so much better, less brain fog, more energy, and it did help with weight loss as well....then let it slide, 5 years later I was at an 11. I am currently up to 36, goal is 70-100---not sure if I can ever get there, but I will continue to respect the D!

    ^^ I read this with my immature Scorpio brain and thoroughly enjoyed all of it.

    As for supplementation, I tend to take whatever quells my health phobia/fascination of the season and then stop when my GP says so. Last year it was "Hair, Skin and Nails Gummies with Biotin." When my biotin levels were insane and she told me to ease up, it was all she could do to not roll her eyes at me.

    Can't wait to see whether my "DIM Plus BioPerine" (for menopause - which I'm not in - but also maybe a little bit but not fully studied...weight loss say the adverts?!) does anything to the bloodwork. It's certainly not doing anything for weight loss.

    Listen, I do what I can to keep my GP entertained and on her toes.

    In the meantime, I have a multivit: Centrum Forte.

    Like medication, none of the supplementation matters if you don't adhere though. So now that summer's here, I exercise outdoors, have fresh local produce available within walking distance, and get all my vitamins that way!
  • psuLemon
    psuLemon Posts: 38,404 MFP Moderator
    edited June 2020
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    Since everyone else hit vitamins and minerals, i will skip that. From a performance standpoint, things that work:

    Creatine Monohydrate (5g) daily
    L-Citrulline (3-5g) or Citrulline Malate (5-8g) pre workout
    Whey/cassein protein (ad hoc if protein is low)
    Caffeine (200-400mg) pre-workout or if you are sensitive, i believe 100mg would work.

    But also consider the below context:

    Eric-Helms-Muscle-Strength-Nutrition-Pyramid.jpg

    Essentially, you are you trying to maximize everything (which most people don't need to), than supplementation makes up the last 1-5%. Essentially, set an appropriate calorie goal, adequate protein with varied foods to maximize nutrients, timed nutrients around a well designed workout program, and then worry about supplements.
  • hawkeye45_
    hawkeye45_ Posts: 812 Member
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    And then some dude with a podcast said something about Vitamin D and nobody could find any.
  • earlnabby
    earlnabby Posts: 8,171 Member
    edited June 2020
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    I am with the majority here. Per my Dr., I take Rx potassium, and OTC D3. I also take Krill oil since I do not eat fish. She feels that a multi is optional but while I am restricting calories wouldn't be a bad idea (and yes, I checked the label to make sure I wasn't overdosing)
  • MaltedTea
    MaltedTea Posts: 6,286 Member
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    ^^ Agreed. As someone with both professionals in her healthcare team (who work out of the same Canadian clinic), they can work in tandem with each other. So, for example, I'm working on lowering my cholesterol and avoiding a lifelong prescription, if possible.

    My GP gave her my bloodwork results and asked me to check in with the nutritionist for, well, nutritional strategies beyond supplements that I could use to (hopefully) lower my cholesterol levels even more. So I've been talking to the same nutritionist every month since February. We'll see if it worked come September when I see the GP again.

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