Vitamin A Supplementation Increases the Risk of Osteoporosis and Fractures

There is something awfully seductive about the idea that some extra Vitamin A every morning or a dose of ginseng tea twice a day can somehow change your life for the better, particularly for a country full of optimists, an attribute that seems particularly American. This is magical thinking at best, since there is little evidence that vitamins and supplements taken in a pill form are good for our health. In fact, scientific evidence shows that some vitamins are bad for us, increasing risk of cancer and heart disease, hip fracture, and other ailments. Others, taken in high doses, can be toxic. These are findings from well-designed controlled trials with tens of thousands of patients-that have been replicated several times over! In fact, the people in the scientific community are now calling on researchers to stop spending money on vitamin supplement trials because we know these products are either useless or harmful in terms of health.

For instance, Deepak Vivekananthan, Mark Penn, Shelly Sapp, Amy Hsu and Eric Topol from the Cleveland Clinic wrote in 2003 that, "the use of vitamin supplements containing beta carotenes and Vitamin A, beta carotene's biologically active metabolite, should be actively discouraged because this family of agents is associated with a small but significant excess of all cause mortality and cardiovascular death. We recommend that clinical trials of beta carotene should be discontinued because of its risks … we do not support the continued use of Vitamin E treatment and discourage the inclusion of vitamin E in future primary and secondary prevention trials … "

The most important fact to remember about the beneficial effects of vitamins: they are related to the nutritional content of the foods they are found in. The nutritional value and benefits of vitamins in foods is not transferred when vitamins are put into pill form. For example, there are multiple forms of Vitamin C in an orange; vitamins have only one form of Vitamin C. We have no guarantee that the form of Vitamin C in the pill is the helpful form we find in an orange. I understand that for those of you who may be avid vitamin-takers, this information a very hard pill to swallow.

But hear me out: you can get every vitamin you need by eating a variety of whole fresh vegetables, fruits, grains, legumes, and lean protein.

If you take more than you need in pill form, you may be causing yourself harm. The Danes were puzzled by the fact that they had an increase in osteoporosis in their women. They analyzed a number of factors, and found that excessive intake of vitamins, whether through fortified foods or other sources, was associated with an increased risk for osteoporosis in their county. They found a link with excessive intake of vitamins through American fortified foods, such as breakfast cereals. It seems the American predilection with fortifying everything with vitamins had gone haywire. As a result, they have banned Kellogg's vitamin fortified cereal. A spokesperson for that country on December 8, 2004 was quoted by as saying that "the Danish population already has a high intake of calcium, iron, B6 and folic acid … the knowledge on toxicity of vitamins and minerals is very limited and practically nonexistent for children … [vitamin deficiencies exist] only in small groups like immigrants who are not getting enough vitamin D or pregnant women who need folic acid. We need to take care of all of the groups in our population. " Since that time the European Union has placed a limit on the amount of vitamins and minerals that can be added to food.

And it is not only in Europe. A study of 72,337 nurses followed from 1980 to 1998 showed that women in the top 20% of Vitamin A intake (through diet and vitamin supplements such as multivitamins) had a 48% increase in hip fracture compared to women in the bottom 20% of Vitamin A intake.

I do not want to leave you with the impression that vitamins and supplements are always dangerous, because they are not. Nor do I want to leave you with the impression that vitamin and nutrient supplementation to the food supply is always a bad thing. However if you are a resident of the US or Europe and have access to a variety of foods you do not need added vitamins, minerals, or supplements, and these things are more likely to cause harm than good. However there are residents of Third World countries who may benefit from the addition of vitamins and supplements to their foods. We are continuously discovering more beneficial effects of the nutrients found in fruits and vegetables, and it is always better to eat these primary sources of vitamins rather than to take them in pill form.