Monday, January 28, 2008

Are Supplements and Vitamins Necessary?

The word vitamin comes from the Latin words, vital (life) and amine (building blocks of DNA). Most vitamins we take in from dietary sources. In an ideal situation (when we're young, disease free, healthy diet), our body receives and manufactures all the essential vitamins and minerals that it requires for maintaining physical, emotional and mental health. However, for various reasons vitamin deficiency has been a significant problem, mostly due to poor diet. Although agricultural practices have increased the world's food capacity, there are still to this day many areas of the world in which food is not readily available. Thus, these societies do not receive important nutrients simply due to starvation. In addition to present day famines , western cultures have developed unhealthy lifestyles, specifically with respect to diet and exercise.

The fact that we are becoming obese and live sedentary lifestyles is not earth shattering news. What has not been emphasized enough however, is that while we are taking in more calories, they are not necessarily healthy ones; in fact the opposite seems to be true. Less than a century ago, we were more active. Having to walk to where ever it was we had to go, exposed us to the outdoors, which in turn increased our bodies ability to produce its own vitamin D; a vitamin that research is looking more and more into and finding benefits for use in various diseases. The point is this: yes it's true that if (and in this day and age, it's a big if), you are a healthy person, with a healthy lifestyle, most likely you don't require supplements of any kind. But if you fall into the group of people, who have not been able to maintain a healthy diet regimen due to long hours at work, busy schedule at home and overall lack of knowledge on what it constitutes to eat healthy, then more than likely you could benefit from some supplements added to your diet.

Which supplements to consider, will be age specific and also dependent on your physical, emotional, and mental condition. Are you looking for supplementing overall health? Or do you have specific illnesses and symptoms you want to target? Supplement selection should be carefully researched on an individual basis and discussed with your physician or health practitioner. What I see most often in the pharmacy are clients who come to the counter and ask about a particular supplement in which someone they know has recommended. There is nothing wrong with listening to suggestions as long as you do the follow up which is to ask if that particular supplement would be of benefit to you. Supplements can be expensive, especially if your personal physical condition warrants that you take more than one, so it becomes imperative from a health stand point but also a financial stand point that you take the time to educate yourself thoroughly about which supplements would be of most benefit to you.

There are many places to educate yourself. The internet is a great source if you know where to look. You can ask your doctor or a pharmacist. A pharmacist who specializes in Integrative Medicine would be especially appropriate. They can guide you through what can be at times an overwhelming plethora of information. This is a fairly new field of medicine, but an invaluable one. The role of an Integrative Pharmacist is to evaluate your circumstances and educate you as to what options you might have or would be most appropriate for your condition and your financial situation. It may be as simple as making you aware of less expensive alternatives. For example, I have had several clients who have been switched from antidepressant to antidepressant, it isn't unusual for someone to be on two at a time, only to be switched yet again to a more expensive drug new to the market. In frustration, they tell me they can't afford the medication and that as soon as the doctor finishes handing out his samples, they will have to stop taking it. I explain that very often patients who don’t respond well to antidepressants, especially if they have already tried several, might have low levels of folate or folic acid. More often than not folic acid supplementation along with vitamin B6 (pyrodoxine) and vitamin B12 (cyanocobalamin) significantly improves their response to a less expensive generic drug. This is merely one example of how supplements, in this case vitamins, can make a significant impact on therapy response and effectiveness.

Contemporary medicine is more and more complex. Physicians are finding it necessary to specialize more and more, being able to keep up with the most recent research, and understanding in depth what therapy will be most effective for each individual can be an overwhelming if not impossible task. The benefit of this specialized approach to medicine would seem to be obvious. A physician is able to be an expert in his field. But this has also created a problem in our medical system. So many medical students today are specializing, that we are losing the glue that holds it all together. This glue that I'm referring to, which is essential to practicing good medicine, is our front line doctors and practitioners. The family physicians and pediatricians for example, who are responsible for practicing preventive medicine (educating the patient on staying healthy), identifying and treating diseases when they arise, but they are also the ones responsible for collecting all the data and reports that are being produced by the specialists that their patients have been referred to. If this seems like a mouthful, it's more than that, it's more than a handful. Because of the increase in rate of physicians who become specialists, there are less and less front line physicians. The ones that remain are overworked and at times overwhelmed.

There is a medical crisis in this country for various reasons, but substandard communication between health professionals and their patients is of major concern, in part because there is so much information to keep track of. We need an integrative approach to medicine. Dr. Andrew Weil is a physician who has developed an Integrative Medicine program at the University of Arizona Medical School and there are other universities across the country that have begun to incorporate this idea into their medical schools. The basic philosophy is this: you treat the body as a whole and you treat the patient with a team of physicians that work closely together. Their clinic works with family practitioners, specialists, as well as alternative practitioners; acupuncturists, massage therapists, physical therapists, psychotherapists, pharmacists, nutritionists, etc. Although integrative medicine is becoming prevalent, it is by no means a part of mainstream medicine.

In the meantime, patients need to do the best with what they have available to them. Towards that goal is familiarizing yourself with what types of therapies are available and being able to decide which ones are credible and which ones aren't and that most certainly includes supplements. Knowledge is power. It is not enough to explain the benefits and risks of taking supplements. We are people first and patients second and we are responsible for our own health. In order to make informed decisions we need to understand why vitamins are necessary or "essential" to good health and how they work. The words essential and non-essential are often used to describe vitamins. These terms can be misleading. An essential vitamin is one that can only be found in the diet. A non-essential vitamin is also necessary for good health, but it can be manufactured by the body through other biochemical reactions. This however does not mean that non-essential vitamins are less important or that additional supplementation is never required. There are conditions in which the pathways in which these non-essential vitamins are formed are inefficient. Under these circumstances additional supplementation would be necessary. For example, a supplement and vitamin-like substance called Coenzyme Q is necessary for the proper cell function. The levels of CoQ diminish with age and are also diminished in people who take cholesterol lowering drugs called statins. In this case and there are others, external supplementation could be helpful in maintaining overall health. It is not possible to explain in detail all of the various vitamins, supplements, and vitamin-like substances in the scope of this article. I have thus focused on the most important and effective supplements; supplements that also are backed with a significant amount of credible research.

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