Vitamin Deficiency, Megadoses, and Some Supplemental History

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Vitamin Deficiency, Megadoses, and Some Supplemental History

 

A letter by William Kaufman, M.D., Ph.D.

April 7,1992

(Reprinted with the kind permission of Charlotte Kaufman)

My attention has been called to the cover story on vitamins which appeared in

the April 6,1992 Time magazine. Another major article on nutrition appeared in

the March 10,1992 New York Times with the heading on page B5 " Vitamins Win

Support as Potent Agents of Health " and on page B9 " New Support for Vitamins as

Agents of Health. " Both articles were probaby inspired by a New York Academy of

Sciences meeting held in Arlington ,Virginia some weeks ago on the theme of

Vitamins, Nutrition and Health.

I will comment on the Time magazine's feature article on Vitamins a little

later. Now, I'll list the vitamins that were first available commercially from

1934 through 1940 from Merck & Co.. More than a half century ago I started to

use these vitamins in the successful treatment of my patients who had a variety

of health problems.

1934 Ascorbic Acid (vitamin C)

1937 Thiamine Hydrochloride (vitamin B 1)

1938 Nicotinic acid (niacin)

1938 Nicotinic acid amide (niacinamide)

1938 Riboflavin (vitamin B 2)

1940 Pyridoxine Hydijphlonde (vitamin B 6)

1940 Alpha-tocopherol (Vitamin E)

1940 Vitamin K I

1940 Menadione (Has strong vitamin K activity)

1940 Calcium pantothenate (vitamin B 5)

Vitamin A and D were available before 1934, Biotin in 1943, and Beta carotene,

vitamin B 12, and folic acid soon thereafter.

Thus, none of these vitamins are " Johnny-come-lately's. In over a half century,

a huge medical literature is available on the diagnosis of vitamin deficiencies

and the safe therapeutic use of vitamins even when some were used in megadoses.

Food as food and additional vitamins, macro- and micro-minerals supplements are

often important factors in improving the health and well being of many millions

of people in this country.

DIET

First of all, food and water must serve as the basis for diets, nutrition and

the support of life provided the food can be eaten by the person, then be

digested, metabolized properly and used to run the machinery of life, supply

needed energy and provide materials for cellular repair. However, it has never

been proven scientifically with double blind controls that food and water alone

can provide all the nutrients in amounts that will ensure optimal long term

health to all individuals.

Humans display considerable biochemical individuality, and therefore there are

also differences in nutritional needs for different people. A diet that is

healthful for a non-allergic person, may make another person allergic to some of

the components of such a diet quite ill. Individuals foods can vary greatly in

their nutritional content at the time of purchase. Food tables will not

dependably tell you the vitamin and mineral content of the food you are

purchasing. Simply putting vinegar on a freshly cut cole slaw salad will cause a

53% loss of vitamin C content in an hour. Potatoes are a good source of vitamin

C. But reconstituting dehydrated potato flakes to make mashed potatoes and

keeping this on the steam table for an hour will eliminate all the vitamin C.

Oranges and potatoes held in storage for many months before being sold to

grocery stores will have a decreased nutritional value. Cooking foods in a

conventional manner can cause considerable loss of both heat labile and heat

stable vitamins as well as of minerals. A nutritionally important oil has been

genetically engineered out of soybeans to decrease spoilage which simultaneously

decreased this type of soybean's nutritional value.

Now that preservation of some foods by exposure to heavy doses of radiation is

being allowed, it would not be surprising if these foods have their nutritional

value diminished plus the possibility that some of the molecular changes in the

foods caused by the radiation may engender toxic substances which over time

might cause ill-health. Milling wheat to make white flour causes a 70 to 80%

loss of vitamins and minerals which, despite the so-called current “enrichment,”

leaves white bread inferior to whole wheat bread nutritionally because the loss

of vitamin B6, vitamin E, chromium, manganese and fiber, all of which have not

been corrected by additional supplementation.

DOCTORS WHO BELIEVE FOOD ALONE SUPPLIES ALL NUTRITIONAL NEEDS

Doctors who believe that you can get all the nourishment including vitamins and

minerals you need to sustain optimal health throughout life from food alone can

be very smug. They have the equivalent of an orthodox religious belief: " food is

everything. " They don't have to concern themselves with the fact that the

nutritional value of foods their patient eats may be greatly inferior to the

listed nutritional values given in food tables. They don't have to concern

themselves looking for evidences of malnutrition as long as the patient eats

food that sustains his weight. The patient's diet may not include whole grains

or organ meats, a diet that will cause the patient to have a chromium deficiency

which deepens over time leading to important and potentially lethal forms of

degenerative diseases which the " food is everything " doctor will mistakenly

ascribe to aging alone These " food is everything " doctors don't have to trouble

themselves with thinking about how a patient's health can be

improved over the long term by providing him with the additional beneficial

vitamins, macro- and micro- mineral supplements tailored to his actual

nutritional needs.

During the early part of World War II, GI's whose severe wound infections were

treated with penicillin had to save all their urine so that the penicillin

which had been excreted in their urine could be recovered and then used to treat

other GI's with life threatening wound infections. If one only considered the

penicillin that was excreted in the urine and not the benefits that the GI had

in having his infection cured by penicillin, one could sneer that penicillin's

only function was to give the GI an expensive urine. If one considered only the

function of penicillin in the GI's body, one would have to marvel at the miracle

of its curing a potentially lethal infection,

The two-liner attributed to Dr. Victor Herbert in the Time magazine's vitamin

article " We get all the vitamins we need in our diets. Taking supplements only

gives you an expensive urine " completely overlooks the benefits vitamin

supplements can produce in our bodies before being excreted in our urine.

MOST DOCTORS ARE NUTRITIONALLY ILLITERATE

The subject of nutrition is not taught well in most medical schools. Thus,

medical students, residents, doctors, and medical faculty may not even be able

to recognize classic vitamin deficiencies. The University of Alabama's Dr.

Butterworth referred to in the Time magazine article on vitamins, was a guest

lecturer at Yale University School of Medicine some twenty years ago when I

attended his lecture. During his talk on the nutrition of surgical patients, Dr.

Butterworth showed a large number of color slides of a patient who had classic

pellagra and of another patient who had classic scurvy. Not a single medical

student, resident, dietician or faculty member attending the lecture was able to

make the correct diagnosis. If doctors fail to recognize classic vitamin these

afflicted patients cannot receive prompt life-saving vitamin treatment. But even

worse, medical students are not taught to recognize the enormously prevalent

non-classic vitamin deficiency (and micro- and

macro-mineral deficiency) disorders which impair the health and well being of

many millions of Americans. Unless such conditions are recognized, they cannot

receive " curative " treatment. Furthermore, such undiagnosed non-classic vitamin

(and mineral) deficiency patients instead of being given the " curative " vitamins

(and minerals) they need, they often are given drugs which they do not need

Thus, in addition to unneeded pharmacologic effects, they are also exposed to

the drugs' health reducing side-effects.

In 1992, what do United States medical schools teach medical students about

nutrition? Marian Burros in her column entitled " EATING WELL " which appeared in

the April 1,1992 New York Times gives a stunning answer to this question.

" Only about one third of the 125 or so medical schools require students to take

courses in nutrition. And, most of the courses are short. The one at Cornell is

eight hours.... " " The University of Alabama at Birmingham in one of the

exceptions requiring 52 hours of nutrition education for its medical

students. " ... " The remaining two thirds of this country's medical schools only

offer elective courses. (Editor's note: Professor Emanuel Cheraskin, M.D.,

D.M.D., is another one of the persons we can thank for the superior nutrition

program at the U. of Alabama at Birmingham.)

" Nutrition, of course is laced through the many departments in medical

school--physiology, gastroenterology, cardiology, biochemistry. But students do

not necessarily recognize that it can be applied to preventive medicine. ... Dr.

Young said " All studies show that if information is not taught as nutrition but

is incorporated into other courses, students come away not knowing that it is

nutrition. They think of it as physiology or whatever and so they do not use it

in terms of practical applications of preventive medical care.”... In a recent

survey conducted in the southeastern region of the United States in 1986,

eighty-five percent of the medical students were dissatisfied with the amount of

medical nutrition education and sixty percent were dissatisfied with the quality

" Without question, " Dr. Weinsier said, " A greater awareness and knowledge (of

nutrition) among physicians could well impact on the prevalence of disease...”

Is it any wonder that most doctors are nutritional illiterates? Is it any wonder

why doctors who are nutritional illiterates, often hide their lack of

nutritional knowledge under the aegis " food provides all the nutrition a person

will ever need " ?

For the last half century, there have been recommendations that nutrition should

be taught in medical schools as a required course. Currently, experts suggest

that all medical schools should devote at least 40 hours to teaching medical

students nutrition.

LINUS PAULING

I have had an " off and on " correspondence with Dr. Linus Pauling for several

decades. He has referred to my use of niacinamide in the treatment of arthritis

in some of his publications on nutrition. Some years ago, Pauling's foundation

invited me to come to California to work with Dr. Pauling on cancer research.

Unfortunately, at that time I could not make such a move.

I think the three reporters who made the denigrating statement in the Time

Magazine's Vitamin article " Certainly Linus Pauling lost much of his

Nobel-Laureate luster when he began championing Vitamin C back in the 1970's as

a panacea for everything from the common cold to cancer " were very remiss in not

first reading and then calling attention in their article to the important

government sponsored meeting which resulted in the following report:

SPECIAL COMMUNICATION:

VITAMIN C: BIOLOGIC FUNCTIONS AND RELATION TO CANCER. SPONSORED BY NATIONAL

CANCER INSTITUTE AND NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES. SEPTEMBER 10-12,1990, BETHESDA, MARYLAND

" (T)here has been considerable public interest in the possibility of a role of

this vitamin (vitamin C) in cancer. In order that this debate might take place

in a rigorous and informed manner, we attempted to bring together not only the

latest research on basic actions, such as free-radical scavenging or enzyme

functions, but also some of the basic laboratory and animal studies relating to

cancer

" The well known anti-oxidant and free-radical scavenging activities (of vitamin

C) are discussed in the first series of papers. Because free-radical damage and

formation of lipid peroxides are suspected in carcinogenesis as well as

cardiovascular disease, this (vitamin C) may be important for disease prevention

" Approximately half of the symposium addressed the role of ascorbate in cancer

prevention or as adjuvant in cancer therapy, primarily in animal models. In

vitro studies included research on oncogenic transformations and effects on the

HIV virus. Moreover, several researchers presented data that suggest a role for

ascorbate in reducing the toxicity or improving the effectiveness of

conventional (anti-cancer) therapies. Finally, a review is presented of all

human epidemiologic studies between vitamin C and cancer prevention. "

Here are a few statement's taken from Gladys Block's abstract, EPIDEMIOLOGIC

DATA ON THE ROLE OF ASCORBIC ACID IN CANCER PREVENTION " .

" Approximately three-fourths of the epidemiological studies (33 of 46) of the

role of vitamin C in cancer incidence or mortality have found statistically

significant protection effects…The evidence for a protective effect of vitamin C

or some component of fruits is strong and consistent for cancers of the

esophagus, larynx, oral cavity and pancreas and there is strong evidence for

cancers of the stomach and cervix….A major meta-analysis of breast cancer

studies suggests a significant protective role for vitamin C in that cancer as

well. While it is likely that ascorbic acid, carotenoids, folate, and other

factors in fruits and vegetables act jointly, an increasingly important role for

ascorbic acid (Vitamin C) in cancer prevention would appear to be emerging. "

I cannot take the time to note all the titles of abstracts that indicate vitamin

C inhibits the growth of cancer. However, to give you the flavor, I will cite

just three:

(1) INHIBITING EFFECT OF ASCORBIC ACID. ON THE GROWTH OF HUMAN MAMMARY TUMOR

XENOGRAFTS IN MICE,

(2) INHIBITION BY VITAMIN C OF INCIDENCE AND SEVERITY OF RENAL TUMORS INDUCED BY

ESTRADIOL OR DI ETHYLSTI LBESTEROL

(3) REDUCED INCIDENCE AND TUMOR BURDEN IN SPONTANEOUS MOUSE MAMMARY TUMORS AND

UV--INDUCED TUMORS WITH INCREASING ASCORBIC ACID.

Thus, Linus Pauling's view that Vitamin C has important anti-cancer properties

is gaining substantial support in current laboratory and animal experiments.

Where are the people who formerly ridiculed his ideas that vitamin C has

anti-cancer actions?

A word about Vitamin C for colds: In the early 1940's, the health service of one

of a mid-west University prescribed vitamin C to relieve students' nasal

congestion associated with colds. Although Charlotte and I go decades without

having colds, we have used 250 milligram doses of vitamin C to decongested our

nasal membranes when these get congested from a variety of allergies. However,

this effect of vitamin C has a short half-life. Thus, it needs to be given at

one and a half to two hour intervals during the day and upon awakening during

the night. This keeps the nasal membranes decongested, reduces pain and

discomfort and prevents sinusitis. Usually, in 24 hours there is no further need

to take vitamin C in this manner.

THE FDA

The Time magazine article points out that the FDA are planning to destroy the

RDA (Recommend Daily Allowance) system as a practical guide to the amounts of

various nutrients that would be required to provide decent nutrition to infants,

children and adolescents, adult males of different ages, women of different

ages, pregnant and lactating women. According to the article in Time magazine,

the FDA plans replacing the RDA system with the so-called Reference Daily

Intake.

The RDI system proposes to ignore the RDA's for different age groups and sexes.

,, " Instead of endorsing an allotment appropriate to ravenousm fast growing

teenage males, it would simply average the RDA's for different age groups. The

new figures are considerably lower, and are a better barometer nutritional

needs. Essentially the reflect the requirements of adult women. " , This new

system the FDA have created slashes the RDA's of Vitamin A, B's, C E and other

nutrients from 10 to 80%. This will allow food manufacturers to put food

products on the market legally that are much less nutritious than the ones that

now have to conform to the RDA system.

There is already an enormous amount of malnutrition in this country because the

large population of the poor cannot afford decent nutrition and much of their

ill-health and lack of initiative is based on such malnutrition. The FDA will

worsen this situation with its reduction of the RDA's.

One of the very important documents in the field of nutrition, is the Bulletin

of the National Research Council Number 109 November 1943 " INADEQUTE DIETS AND

NUTRITIONAL DEFICIENCIES IN THE UNITED STATES, THEIR PREVALENCE AND

SIGNIFICANCE, " published by the National Research Council, National Academy of

sciences, Washington, D.C. This was the " REPORT OF THE COMMITTEE ON DIAGNOSIS

AND PATHOLOGY OF NUTRITIONAL DEFICIENCIES. FOOD AND NUTRITION BOARD.

Its conclusions and recommendations are just as applicable to today's widespread

malnutrition as they were when this report was issued

Items taken from the Summary and Conclusions of this Report:

" All the evidence from numerous surveys over the past ten years to the present

among persons of all ages in many localities is without exception in complete

agreement that inadequate diets are widespread in the nation. Although an

appreciable percentage of diets failing to meet the Council's recommended

dietary allowances were more than 50 percent deficient in amounts of several

essential nutriments, most of the diets were less than 50 percent deficient.

Accordingly, there is widespread prevalence of moderately deficient diets.

" All the data from numerous surveys with new methods among persons of all ages

in many regions are entirely in accord in showing that deficiency states are

rife throughout the nation. Relatively few are the traditional severe acute

types, Most are milder in intensity and gradual in their course. Predominantly

they are subacute or chronic states: some marked, but very many mild or

moderate... "

" From this evidence it is clear that there is both a preventive and corrective

problem. On the preventive side, it is evident that production of sufficient

food should be maintained and that effective distribution of proper food is

needed. For the latter, it would seem advisable to give further consideration to

the program of judicious enrichment of appropriate foods since this would add

much to the guarantee of successful nutrition. It is also evident that diet

education must be intensified and extended to the utmost and raised to new

heights of effectiveness. " ...

" On the corrective side, there is need for detection and therapeutic treatment

of deficiency states among the population. For this project it is necessary to

disseminate the new diagnostic methods among the medical and public health

professions. Foremost among the steps in this direction would be (1) preparation

of a handbook on methods of detecting deficiency states (2) establishment of

training centers for instruction in the medical aspects of nutrition, especially

the diagnosis of deficiency states; and, (3) introduction of adequate courses in

nutrition, particularly its clinical aspects, into medical schools. "

The conditions that existed nutritionally in the 1930's and early 1940's are

just about the same as exist now in the working poor, in those on public

assistance and even in those better off economically. The suggestions made about

the need for prevention and curative measures are just as needed today as they

were in the 1930's and 1940's.. So is the need for adequate instruction in

nutrition for every medical student in every medical school. So is proper

nutritional enrichment of foods.

What the FDA is planning to destroy the RDA system of nutritional standards and

substituting an illogical system, RDI (Reference Daily Intake) that promotes a

severe reduction of nutritional standards in a manner which if followed would

ensure a great increase in nutritional deficiencies in the population of the

United States.

What is astonishing in the Time magazine article is that leaders in nutrition

make such statements " The long term effects of high-dose supplements are still

unknown and doctors warn of dangers even in the short term….Advises Dr. Walter

Willett of the Harvard School of Pubic Health: " At this time I don't take

megadoses, I'm not ruling out that in two or three years we might change our

mind. "

What has been known for more than a half century is that vitamins even in

properly chosen megadoses (and macro- and micro-mineral supplements can greatly

improve the long term health and well-being of many persons eating their

ordinary diets. Some of these older observations that vitamins can improve

health are just being rediscovered as if they were brand new scientific findings

The rediscovery of old and proven observations can't believe their own findings,

They call their conclusions tentative, and seem afraid of recommending vitamin

megadoses that should be widely be used in nutritional treatment.

If doctors want to know the long term effects of various vitamin megadoses, they

have to go back and study the literature. Since most articles and books on this

subject cannot be found by electronic means, it requires that they make such a

literature search manually,

The FDA's rejection of the three nutritional applications (which proposed to use

vitamins to treat disease) as being premature also is part of the

anti-nutritional bias. Just think: if a nutritional approach would delay

myocardial infarctions by ten or fifteen years. Would not this be crippling blow

to the profits of pharmaceutical companies that produce cardiac medications and

cholesterol reducing agents?

(My wife) Charlotte and I have taken megadoses of vitamins (and appropriate

amounts of macro-and micro-minerals). The fact that we are alive today is

attributable to the beneficial effects of this nutritional supplementation. Dr.

Linus Pauling has taken megadoses of vitamin C for decades.

One fascinating thing is that from 2 to 5% of all hospital admissions result

from severe adverse effects from prescription drugs. Yet, doctors have no

compunction in prescribing these.

 

 

 

 

 

 

 

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