When it comes to your health, the best supplement may be a grain of salt. I’m currently participating in a pilot program at the local medical school in which patients meet with researchers to learn about the research process and how we can participate beyond being research subjects. The program is fascinating. It gives us a glimpse into current trends in medical thought, and it makes us highly aware of the limits that plague medical research, the most frequent being time and money.
Limited time and/or money usually lead(s) to smaller studies. Smaller studies are less representative of the population as a whole and thereby less definitive. Studies get published in medical journals, and along the way some ideas take hold in the medical community. Sometimes these ideas are incorporated into standard medical care even when there’s little evidence to support their clinical relevance.
A recent example of this is the practice of testing vitamin D levels when patients report malaise, fatigue or other nonspecific complaints. According to the CDC, the number of blood tests for vitamin D among Medicare recipients increased 83-fold from 2000-2010 and 2.5-fold from 2009-2014 for those with commercial insurance. At the same time, labs performing these tests started reporting normal levels of 20 to 30 nanograms vitamin D per milliliter of blood as insufficient.(1) As a result, many healthy people began to believe they had a deficiency.
When numerous studies over the past decade linked low levels of vitamin D to cancer, heart disease, and diabetes, the millions who believed themselves to be deficient began, or were advised, to consume vitamin D supplements. I am one of those who received such advice after routine blood work. The problem is that the existing studies do not provide widely accepted evidence that vitamin D is helpful in preventing or treating these diseases. In fact, current evidence suggests that the main beneficial effects of vitamin D supplements relate to conditions of the muscles, bones, and joints.
And the vitamin D deficiency movement isn’t the first physician advanced idea based on insufficient evidence. Last year, newly issued dietary guidelines removed the restriction on cholesterol consumption because “it is now acknowledged that the original studies purporting to show a linear relation between cholesterol intake and coronary heart disease (CHD) may have contained fundamental study design flaws, including conflated cholesterol and saturated fat consumption rates and inaccurately assessed actual dietary intake of fats by study subjects.”(2)
And the possibly well-intentioned, oft repeated advice to add multivitamins to your regimen because they will make you healthier turns out to be false as well. A growing body of evidence suggests that multivitamins offer little to no health benefits. A study published in the December 17, 2013 issue of the journal Annals of Internal Medicine found that multivitamin and mineral supplements did not work any better than placebo pills.
We tend to regard science as infallible or research as indisputable. It’s not. We only know as much as we know in this moment. Our knowledge base will always be growing. Today’s theories will sometimes be proven wrong. Some studies will be statistically significant, but clinically irrelevant. Many studies will have too narrow a focus, too small a sample, or too short a term for the results to be taken as definitive on their own.
As patients, we are vulnerable to misinformation bombarding us from corporations that create supplements, food, and medications. Unfortunately, we are also vulnerable to imperfect science and bias within the medical community. To some degree this is unavoidable. This is where a grain of salt can come in handy. Skepticism can lead you to seek additional information.
If you are not medically trained, you cannot assume you know more than your doctor. You can, however, recognize that you have the final word regarding your healthcare. You have every right to ask questions with the expectation of a well-supported, forthright answer. You have the right to your health records. You have the right to seek a second opinion or a third. A second doctor may interpret your test results in a different manner than the first.
And barring an emergency situation, I’ll posit that you have a responsibility to yourself to remain skeptical regarding treatment recommendations until you become well-informed. That being said, the best supplement available for healthcare may be a grain of salt.
Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”
1)https://www.nytimes.com/2017/04/10/health/vitamin-d-deficiency-supplements.html?_r=0
2)https://www.ncbi.nlm.nih.gov/pubmed/19751443
https://people.hss.caltech.edu/~camerer/Ec101/JudgementUncertainty.pdf
http://www.medlabme.com/magazine-issues/2016/diagnostics/vitamin-d-assays/
https://www.hsph.harvard.edu/nutritionsource/2016/01/07/new-dietary-guidelines-remove-restriction-on-total-fat-and-set-limit-for-added-sugars-but-censor-conclusions/
http://annals.org/aim/article/1767855/vitamin-mineral-supplements-primary-prevention-cardiovascular-disease-cancer-updated-systematic