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A hard pill to swallow

Patients are frequently asking me what vitamins to take and are surprised if I tell them to save their money and simply try to eat at least five portions of fruits, vegetables and legumes every day. Some vitamins can be very expensive and I try to help my patients spend their healthcare dollars wisely.

There is no evidence a multivitamin in a healthy person eating a balanced diet has any significant benefit. Research shows vitamin pills do not prevent chronic diseases such as cancer or heart disease, or in any way help you live longer. Some vitamins such as beta carotene, vitamin A and vitamin E can actually be harmful, particularly in high doses and can even increase the risk of death.

The most common reason people buy vitamins is for a feeling of low energy when something other than an actual vitamin deficiency usually is responsible. Many still believe vitamin C prevents the common cold but there is no evidence in research to support this old fashioned idea.

On the positive side, there are certain exceptions where vitamins and supplements can be helpful. This includes the regular use of folic acid for women of childbearing age to prevent birth defects, calcium to prevent osteoporosis, and vitamin D which lowers the risk of fractures and can help with brain function in the elderly. Quite a large percentage of otherwise healthy folks are low in vitamin D, especially in winter in the northern climates where sunshine is a rare commodity. Elderly patients often can benefit from taking B12.

The bottom line is there is no strong evidence most vitamins really help and people are generally wasting their money. A woman of childbearing age should probably take calcium and folic acid. A senior should take calcium with vitamin D and a generic, cheap multivitamin once a day probably won't put a deep dent in your budget, but is actually a waste of time in the absence of nutritional deficiency. I would not recommend taking extra doses of any other vitamins or supplements and would particularly avoid high doses of vitamins A, E or beta carotene.

If you don't "buy this" just take two vitamins and "call me in the morning."

Dr. Josh Schwartzberg practices in Lake Placid, Willsboro and Burlington. He can be reached at www.docjosh.com or 518-963-4355

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