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| Supplements
After months of deliberation and research, we have decided to begin selling supplements to our patients. This decision came about because we became interested in finding quality supplements for ourselves and also because so many of our patients were already on supplements and asked us if we knew a reliable source from which to buy them. We began doing research and quickly realized that the supplement market is tricky because it is not regulated by the Food & Drug Administration in the same way as the pharmaceutical industry. In much research, we decided to use a company called Pure Encapsulations, largely because they have an independent laboratory test all of their finished products to assure quality and they do not put any additives in their supplements. Their website is www.purecaps.com and is an excellent resource not only on the specifics of their products, but also general information on supplements. Their "Health Library" section is a very valuable tool.
We do not pretend to be experts on supplements; however, as we learn new information about a particular supplement we will pass it on to you in our newsletter and here on our website. We do not believe in mega-dose supplements, and feel that it is important that your physician knows what you are taking in addition to the prescriptions that she or he is giving to you in case there are any harmful interactions. We also do not mean to imply that supplements are a substitute for healthy nutrition, excellent medical care and modern medical techniques. They simply "supplements" to good personal healthcare.
Vitamin D
Vitamin D is what got us started on this slippery supplement slope that we now find ourselves on. Vitamin D is a fat-soluble vitamin that helps us absorb calcium and keep the right balance of calcium and phosphorus in our bodies. There are some new studies that suggest it may help reduce inflammation helping with arthritis and autoimmune disorders and may make the body more sensitive to insulin improving blood sugar control in diabetics. Vitamin D is made by our skin when is it exposed to sunlight and stored in our fatty tissues. Vitamin D has become increasingly hard for our bodies to manufacture both because we spend so much more time inside and also because sunscreen prevents any absorption of Vitamin D. Consequently, during the winter months in New England we are probably all Vitamin D deficient. We would prefer that all vitamins and minerals be obtained through a healthy diet and Vitamin D can be found in foods such as fish, oysters and fortified dairy products. Unfortunately, you would need 10 glasses of milk or 2 tablespoons of cod liver oil daily to get enough Vitamin D to satisfy your daily requirements.
Over the past 6 months there have been multiple news stories discussing Vitamin D and its possible benefits. For example, last year Memorial Sloan-Kettering Cancer Center posted on its website results from a study published in 2007: Vitamin D and calcium supplementation reduces cancer risk. This federally-funded investigation had followed more than a thousand post-menopausal women, some of whom were given calcium + vitamin D3 supplements, some just calcium and some placebo. When researchers looked at the data, they reached this conclusion: "Improving calcium and vitamin D nutritional status substantially reduces all-cancer risk in postmenopausal women". (www.mskcc.org/mskcc/html/77779.cfm - 24k) In addition, the Framingham Heart Study researchers reported in Circulation: Journal of the American Heart Association that "Vitamin D deficiency is associated with increased cardiovascular risk, above and beyond established cardiovascular risk factors," said Thomas j. Wang, M.D., assistant professor of medicine at Harvard Medical School in Boston, Mass. "The higher risk associated with vitamin D deficiency was particularly evident among individuals with high blood pressure". http://circ.ahajournals.org/cgi/content/abstract/117/4/503?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=vitamin+d&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
The current RDA for Vitamin D is 400 IU per day and it is clear that this amount is insufficient. Experts vary in their opinion of the optimal dose from 1000-5000 IU per day. Most agree that 1000-2000 IU daily is safe and probably effective. Taking 5000 IU daily would require a person to check baseline and interval blood levels of calcium and Vitamin D 25-OH, and not surprisingly some insurance companies don't cover the cost of the blood work which can range from $150-$250. So we currently suggest that you take 1000-2000 IU daily. Most multivitamins and calcium supplements have about 400-600 IU per dose and you can also get a supplement of just vitamin D3.
1. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial.
Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP.Am J Clin Nutr. 2007 Jun;85(6):1586-91.
2. Vitamin D Deficiency and Risk of Cardiovascular Disease
Circulation, Jan 2008; 117: 503 - 511.
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