Saturday, February 24, 2007

Vitamin C, Niacin, and Multivitamins Can Help Children Grow

I’ve written previously about vitamins and children. I’ve taught that vitamins help children fight off colds by helping to build the immune system, and that vitamins help children with hyperactivity or eating disorders by helping to build (or rebuild/heal) the nervous system. I’ve taught that vitamins heal skin burned by heat or the sun’s radiation. To me, this is evidence that vitamins help healing any kind of wound.

In each case I showed that the doses of vitamins used by physicians to treat all of these conditions is far higher than can be obtained by eating a healthy diet. Food is not enough.

When children grow up disabled by learning disabilities, mental illness, and/or poor immunity to diseases, everyone suffers. Our society needs as many well educated, energetic, and productive citizens as possible. Few investments yield as high a return to society as those that meaningfully help ensure no child is left behind.

The debate over the usefulness of vitamin supplements is over. Physicians routinely prescribe doses of vitamins 10 to 100 times higher than can be obtained from a typical recommended diet. Severe vitamin deficiency in childhood causes terrible diseases with permanent consequences. Eating vitamins is not a choice. A healthy diet typically provides more vitamins than an unhealthy diet, and most parents work to help their children eat better. Until 30 years ago, that was the only choice parents had. Today, vitamin supplements are readily available. Supplements enable parents to easily decouple feeding children calories vs. micronutrients. Parents can choose what they feel is the right dose.

Adding supplements to a healthy diet provides higher doses of vitamins than can be consistently obtained from eating food. Based on the evidence, I believe all parents should explore the idea of using vitamin supplements for their children. I recommend 2000-4000 mg/day of vitamin C and a multivitamin every day. I also recommend 125 mg of time-release niacin once or twice per week.

Choosing vitamin doses for children is a difficult task, and parents should not be left on their own. Pediatricians are the obvious group to turn to for help. I also believe that all parents should consult with their pediatricians before starting their children on vitamin supplements. When my children were young, I discussed their supplement program with their pediatricians every year when they had their regular physical.

A primary function of vitamins is to catalyze the growth and development of children into adults. I believe every child should be provided with the opportunity to grow up as healthy, strong and intelligent as possible. I believe this means that all parents should consider vitamin supplements for their children.

Heart Disease, Colds, Burns, Damaged Skin, and Vitamin Deficiency – Vitamin Supplements Are Safe and Effective

Scientific and clinical evidence has now proven that high doses of vitamins are a safe and effective treatment for the following four conditions:

• heart disease
• colds
• burns
• damaged skin
• vitamin deficiency (scurvy, pellagra, beriberi)

In each case the prescribed doses of vitamin are high. The prescribed doses can’t be obtained by eating food. Food is not enough.

Cardiologists prescribe niacin in order to control blood cholesterol level. 2000 to 3000 mg/day of niacin is the only treatment proven to both raise good cholesterol (HDL) and lower bad cholesterol (LDL). An undefined but significant fraction of heart disease patients achieve the full benefits of niacin treatment without any side effects. A typical diet contains 20 to 40 mg/day of niacin. The levels used to treat high LDL cholesterol are therefore almost 100 times higher than the doses readily obtained from food.

Physicians prescribe two to ten g/day of vitamin C as a treatment for colds. At least 29 controlled clinical trials (many double-blind and placebo-controlled) involving a total of over 11,000 participants have been conducted. These trials were reviewed in the 1990's and again recently. The trials show that vitamin C reduces the duration and severity of colds but not the duration. The data indicate that there is a normal dose-response relationship. Vitamin C is more effective the higher the dose. The data also indicate that vitamin C is more effective treating children. Reports from physicians have provided ample clinical confirmation. Interviewing 10 Americans with post graduate educations is usually sufficient to find one who takes 5 g per day or more of vitamin C to ward off an incipient cold. A typical diet contains 100 to 300 mg/day of vitamin C. The levels needed to effectively reduce the duration and severity of colds is 10 to 100 times the amounts readily obtained from food.

Extraordinary doses of vitamin C are used to treat burns. The recommended dose is close to 100 g/day injected intravenously supplemented by a topical application of a 3 wt% vitamin C solution. This vitamin treatment has received little attention, and is unfortunately not yet standard practice. The reported work, both scientific studies on animal models and clinical trials with patients, is consistent and conclusive. I expect it receives so little attention because it is unusual to suffer from a serious burn injury.

Dermatologists prescribe vitamin A to repair skin damaged by the sun. Wrinkles and pigmentation are examples of damage caused by the sun. Combining vitamin A with vitamins C and E has been shown to improve the effectiveness of vitamin A for this health problem. The skin ordinarily obtains these vitamins from the bloodstream. The levels of vitamins in the blood are not high enough to achieve the desired skin repair. Dermatologists achieve the high levels of vitamin A needed in skin tissue by providing patients with skin cream containing a high concentration of vitamin A. The prescribed doses of vitamin A in skin tissue can’t be achieved by eating an ordinary diet, and probably can’t be achieved by eating any kind of diet, no matter how enriched in vitamin A.

Physicians prescribe 2000-4000 mg/day of vitamin C for scurvy. Niacin and/or niacinamide at 100 to 1000 mg/day are prescribed for pellagra. B-complex vitamins containing 50 to 100 mg/day of vitamins B1 and B2 are prescribed for beriberi. The food in a healthy diet contains plenty of vitamins to prevent these deficiency diseases. Although the amount of vitamins in food prevents vitamin deficiency diseases, treating a vitamin deficiency disease with food alone is not standard practice. Thanks to standardization, diversification, supplementation and access to abundant supplies of meat in a modern American diet, classic vitamin deficiency diseases are almost unknown today. That does not mean that deficiency disease is not a problem in America.

Today vitamin deficiency in America presents itself as self-starvation – primarily of teenage women. The most common conditions are known as anorexia and bulimia. The brain and nervous system are the most vulnerable to the combined simultaneous vitamin deficiencies caused by self-starvation, explaining why anorexia and bulimia need to be treated as both a psychological and a nutritional problem. The tragedy is that many parents of underweight school age teenage women don’t understand that they can prevent vitamin deficiency from damaging the minds and nervous systems of their daughters by requiring them to take a vitamin supplement every morning. Supplementation alone won’t put an end to anorexia and bulimia, but it may go a surprisingly long way.

The debate about usefulness of vitamin supplements is over. Vitamin supplements are useful.

Sunday, February 18, 2007

Vitamin C, Niacin, and Multivitamins Can Help Hyperactive Children (ADD/ADHD)

The claim that vitamin C, niacin, and B-complex vitamins can help hyperactive children has growing scientific support. I wrote a booklet that is posted at www.healthier-kids.com. The booklet describes why I decided to raise my kids on vitamin supplements. One reason was that my three year old son was borderline hyperactive, and after studying the scientific literature I concluded the vitamins would help. The booklet reviews the scientific literature supporting the logic of my decision. At the time there were no literature reports documenting results using the same vitamin doses I chose for my children.

In 2003 a paper on vitamins and hyperactivity was published by an independent group of authors. The authors used similar doses of vitamins along with other nutritional supplements in a clinical trial. The supplements were compared with Ritalin. The results showed conclusively that the supplements were just as effective as the drug. The paper, Harding 2003, is available on-line at www.feingold.org. (Click on scientific studies, then ADD/ADHD).

Two trials in different places at different times with different children obtain the same results with almost the same vitamin doses. The odds are high that the vitamins work to treat ADD/ADHD. I was surprised that the paper didn’t comment on what I believe is a key difference between vitamins and Ritalin. Parents believe in the effectiveness of ritalin because when the children stop taking it, behavior deteriorates. In my experience the vitamins are different. Once the ADD/ADHD behaviours are gone, they are gone for good. When vitamins work, (and they don’t always work) they are a cure.

The paper also didn’t comment on the difficulties of the supplement treatments. In my experience it is very difficult to get children to eat lots of supplements every day. The treatment in my booklet is too hard for most parents and children, and the treatment in the Harding paper is even more difficult. As a result, I have simplified my recommendations. Most children are happy to eat chewable multivitamins and 500 mg chewable vitamin C tablets. For ADD/ADHD I recommend three 500 mg chewable vitamin C tablets and a chewable multivitamin with breakfast and dinner every day. I also recommend time-release niacin. The time-release niacin is the only toddler-unfriendly ingredient. Fortunately, niacin has a mild flavor. Time-release niacin is available in 250 mg gel caps. The gel caps are filled with tiny spheres. Pull the 250 mg gel cap apart and add half of the spheres to ice cream or pudding, or some other soft, sweet, toddler-friendly food. I recommend 125 mg (one half of a gel cap) every day with breakfast.

Vitamins are not a substitute for treatments recommended by pediatricians and physicians. I recommend following the advice of the medical community and also providing children with optimal nutrition in the form of vitamin supplements. I will be posting soon about the side effects of B-complex vitamins and vitamin C.

Saturday, February 10, 2007

Heart Disease, Colds, Burns, and Damaged Skin – Vitamin Supplements Are Safe and Effective

Scientific and clinical evidence has now proven that high doses of vitamins are a safe and effective treatment for the following four conditions:

• heart disease
• colds
• burns
• damaged skin

In each case the prescribed doses of vitamin are high. The prescribed doses can’t be obtained by eating food. Food is not enough.

Niacin is prescribed by cardiologists in order to control blood cholesterol level. 2000 to 3000 mg/day of niacin is the only treatment proven to both raise good cholesterol (HDL) and lower bad cholesterol (LDL). An undefined but significant fraction of heart disease patients achieve the full benefits of niacin treatment without any side effects. A typical diet contains 20 to 40 mg/day of niacin. The levels used to treat high LDL cholesterol are therefore almost 100 times higher than the doses readily obtained from food.

Two to ten g/day of vitamin C is prescribed by physicians for colds. At least 29 controlled clinical trials (many double-blind and placebo-controlled) involving a total of over 11,000 participants have been conducted. These trials were reviewed in the 1990's and again recently. The trials show that vitamin C reduces the duration and severity of colds but not the frequency. The data indicate that there is a normal dose-response relationship. Vitamin C is more effective the higher the dose. The data also indicate that vitamin C is more effective treating children. Reports from physicians have provided ample clinical confirmation. Interviewing 10 Americans with post graduate educations is usually sufficient to find one who takes 5 g per day or more of vitamin C to ward off a cold. A typical diet contains 100 to 300 mg/day of vitamin C. The levels needed to effectively reduce the duration and severity of colds are 10 to 100 times the amounts readily obtained from food.

Extraordinary doses of vitamin C are used to treat burns. The recommended dose is close to 100 g/day injected intravenously supplemented by a topical application of a 3 wt% vitamin C solution. This vitamin treatment has received little attention, and is unfortunately not yet standard practice. The reported work, both scientific studies on animal models and clinical trials with patients, is consistent and conclusive. I expect it receives so little attention because it is unusual to suffer from a serious burn injury.

Vitamin A is prescribed by dermatologists to repair skin damaged by the sun. Wrinkles and pigmentation are examples of damage caused by the sun. Combining vitamin A with vitamins C and E has been shown to improve the effectiveness of vitamin A for this health problem. The skin ordinarily obtains these vitamins from the bloodstream. The levels of vitamins in the blood are not high enough to achieve the desired skin repair. Dermatologists achieve the high levels of vitamin A needed in skin tissue by providing patients with skin cream containing a high concentration of vitamin A. The prescribed doses of vitamin A in skin tissue can’t be achieved by eating an ordinary diet, and probably can’t be achieved by eating any kind of diet, no matter how enriched in vitamin A.

The debate about usefulness of vitamin supplements is over. Vitamin supplements are useful.

Sunday, February 04, 2007

The Right Dose – Vitamin C and Niacin

The safety of extra vitamin C and B-complex vitamins is well understood. It is a fact that these vitamins can be safely consumed every day in doses at least double what is obtained by eating a healthy diet containing all recommended food groups. At Cforyourself.com, doses of vitamin C from 10 to 200 times higher than readily obtained from food are recommended (1000 to 20000 mg/day). Cforyourself provides evidence of a healthy debate amongst adult users about the side effects, benefits, and risks of taking higher or lower vitamin C doses within this range. It appears unlikely that there is a single, correct answer. Within the range of 1 to 20 gm/day, it is highly likely that there will be a broad distribution of answers. More and more physicians are beginning to participate in the debate. Physicians are an important resource, because optimizing vitamins is not easy. It is not a simple matter of finding your own right dose between 1 and 20 gm/day. The right dose changes with age and state of health.

Unlike for vitamin C, there is little evidence of a healthy debate about optimal B-complex vitamin doses between regular B-complex vitamin users. Here’s my view. A good starting place is an ordinary multivitamin and mineral tablet. In addition to the multivitamin, take extra vitamin B3 as time release niacin. Time release niacin tablets are typically sold in a 250 mg dose. I recommend cutting them in half and taking half a tablet 3 times a week so long as this dosage can be taken without side effects. It’s hard to discuss the frequency of side effects from long term users of niacin at this dose due to the absence of published data. If you have published information, please let me know. It is a fact that many people can tolerate far higher doses of time release niacin without experiencing unmanageable side effects. Time release niacin is the preferred treatment for controlling blood cholesterol levels. Niacin is the only treatment that both lowers bad cholesterol (LDL) and raises good cholesterol (HDL). The decision about whether to take time release niacin or statin drugs to normalize blood cholesterol levels is not the only way to think about this problem. If your cholesterol shows you at risk of a heart attack, I am unaware of any reasons not to take both niacin and the statin drugs at the same time. As long as both niacin and a statin are taken, cholesterol levels will improve.

Heart disease treatment has shed light on niacin side effects. A large fraction of patients taking the 2000 to 3000 mg/day dosage of niacin that is known to be most effective for normalizing cholesterol suffer from intolerable side effects. I do not recommend that these patients stop consuming niacin. In fact, they can’t. If they don’t consume any niacin, they will die from the niacin deficiency disease pellagra. I recommend that they drop to a dosage between 100 and 1000 mg/day. If the side effects disappear, I recommend that they stick to a dose in this range.

The experiences of heart disease patients have proven that 2000-3000 mg/day of niacin is safe, and also that most people can not tolerate niacin within this dose range. This is why far more heart disease patients take statin drugs than niacin. It has also proven that a significant fraction of heart disease patients can tolerate niacin within this dose range. At the other end of the spectrum, studying pellagra proved that people need between 5 and 15 mg/day of niacin to prevent this terrible disease. Almost everyone’s health will be optimized by a dose between 15 and 3000 mg/day. Like vitamin C, it will not be a simple matter of individuals each finding their own right dose. The optimal dose of niacin will likely prove to change with age and state of health. I recommend seeing a cardiologist for help.

Niacin has been readily available for over 30 years. Millions have purchased niacin supplements and presumably experimented with taking them. I have not found any web sites devoted to niacin. I have asked around and found no one who takes it regularly except for heart disease patients. I believe the presence of niacin supplements, and the absence of regular niacin consumers is strong evidence that most people experience side effects from 250 mg/day of niacin when taken regularly. My recommendation of 125 mg, three times a week is based upon the experiences of a handful of friends and family. Within this handful, not everyone takes even this much because of side effects.

B-complex vitamins including niacin are well known in the world of alternative medicine as a recommended treatment for children with behavior disorders. Unlike the cholesterol situation, B-complex vitamins should never be used as the sole treatment for childhood behavior disorders. Their effectiveness is not sufficiently well understood. On the other hand, B-complex vitamins should always be a part of the treatment. They are safe, there is a strong case for effectiveness, and they can be taken to complement any and all treatments recommended by physicians. One reason B-complex vitamins may be used so infrequently is that vitamin advocates often recommend doses that are too high for the majority. To be specific, Cforyourself has a section on ADD/ADHD. This section references 1000-2000 mg/day of niacin, 150 to 450 mg/day of vitamin B6, and a B-100 B-complex tablet. If you accept my logic that the absence of regular consumers of 250 mg time release niacin (the most common form, available over the counter at every drug store) is evidence that this dose causes side effects, then you will understand why references to 1000-2000 mg/day of niacin make me uncomfortable.

In summary I see a healthy debate underway between vitamin C users concerning optimum dosage. I think it is important to keep it up. I encourage more Cforyourself readers to write in and explain their vitamin C doses. Do readers regularly take extra vitamin C when they feel a cold coming on? How much? Have any readers been taking more or less vitamin C because of aging? Concerning niacin, I don’t see a debate. If you take niacin, please come to Cforyourself and help me find and organize user information.