VITAMINTESTING.COM: Test Your Vitamin Levels

Vitamin D deficiencies are now thought to be rampant amongst kids.  While pediatricians thought the problem had been solved amongst children with Vitamin D fortification of milk, crereal and other foods, a number of studies shows that Vitamin D deficiency is much more of a health problem than anyone realized according to Catherine Gordon, director of the bone health program at Children’s Hospital Boston.  In the June issue of the Archives of Pediatrics and Adolescent Medicine, Gordon found that a whopping 40% of toddlers and infants tested below average for Vitamin D. 

A review of Vitamin D research published last July in the New England Journal of Medicine indicates that sunlight (15 minutes a day), diet and supplements are all good sources of this important Vitamin.  While the Nationhal Institutes of Medicine suggest 200 IU per day for children and 400 IU for adults, some doctors suggest doubling this dose as overdosing on Vitamin D is thought to be highly unlikely. 

As many of 95% of older Americans are also thought to be Vitamin D deficient.  Besides helping with bone health, Vitamin D is also thought to play a role in preventing diabetes and hypertension as well as decreasing heart attack risk according to the National Institutes of Health.

So how do you know if you are Vitamin D deficient?  Follow our proven process to get your Vitamin Levels checked !!!

Several reports have come out, most recently by the Associated Press, that so-called “natural sexual enhancers” mjay contain unregulated versions of the very pharmaceuticals they are intended to replace.  While this may not sound dangerous, it is for tbe millions of men who take nitrates, drugs that help regulate blood pressure and treat heart disease.  As you may know, the ingredients in nitrates can interact with the ingredients in Cialis, Levitra and Viagra and cause heart issues.

Emergency rooms and hospitals are logging more incidents of these drug interactions, especially in men who are older and more likely to need both blood pressure medication and help with erectile dysfunction.

Estimates by the Nutrition Business Journal are that almost $400 million of these herbal remedies were sold last year, a 400% increase in just 5 years!  Moreover, many of the ingredients for these pills come from China and can cost from $1 - $5, just a fraction of the cost of Cialis, Levitra or Viagra.  In fact, the FDA has placed such pills, made by two manufacturers in China and one from Malaysia, on an import watch list.

Bottom line:  If you suffer from erectile dysfunction and are on any prescription drugs, unregulated “herbal” remedies can pose real dangers and should be avoided. 

According to recent studies reported in Parade Magazine, more than half of American women don’t get enought Vitamin D.  Our bodies manufacture Vitamin D when we’re out in the sun, yet many of us actively avoid the sun, use sunscreens and otherwise limit our exposure.  While all multivitamins contain vitamin D, and fortified foods also contain vitamin D, many of us still don’t get enough.  The recommended dosage of vitamin D is between 1000 and 1500 IU of vitamin D3 daily.  The best way to tell if you’re vitamin D deficient is via a blood test.

Vitamin D is essential for healthy bones because it’s needed for calcium absorption.  New research also indicates that vitamin D is important for immune system health as well as for the prevention of cancer, including breast and prostrate cancers.

According to recent reports on ABC News and Good Morning America, up to 60% of Americans may be deficient in Vitamin D, particularly Vitamin D3.

Why are we deficient?  A primary source of Vitamin D is sunlight, and we’re told to stay out of the sun.  Likewise, darker-skinned people absorb less Vitamin D from sunlight. 

Why is this deficiency an issue?  Men and women who don’t get enough vitamin D from their diets or exposure to the sun are at increased risk for muscle weakness and poor physical performance.

How much do we need?  The National Academy of Sciences says that for people older than 50, 200 international units (iu) of vitamin D per day is adequate. People between 51 and 70 need 400 iu and people older than 70 need 600 iu.  But many experts think that amount is too low, according to ABC News medical editor Dr. Tim Johnson.

Johnson recommends people get 1,000 iu of vitamin D a day. One of the best sources of Vitamin D is the sun.  “The sun’s ultraviolet rays cause us to manufacture vitamin D,” Johnson said, “but that’s problematic because we are all told to stay out of the sun and to wear sunscreen, which means less vitamin D.”

Dark-skinned people often don’t get enough vitamin D, because the sun doesn’t penetrate their skin. And the elderly often miss out on vitamin D in their diets, Johnson said.

Can I get too much Vitamin D?  Johnson said risks associated with getting too much vitamin D include too much calcium buildup in the blood, which can lead to kidney and bone problems, buildup of calcium in muscles, and heart trouble.

VitaminTesting.com recommends you follow our process to get your Vitamin D level assessed and then, under the guidance of a medical professional, take appropriate supplements to get your vitamin levels in balance.

Even if you buy vitamin supplements that are manufactured in the US, chances are that the ingredients came from China.  In fact, a majority of vitamins A, B12, C and E are made in China.  In fact, in less than a decade, China has captured 90 percent of the U.S. market for Vitamin C.

So, why be concerned?  China has few regulatory controls on the manufacture of vitamins and other products.  Recent analyses of vitamin supplements have found dangerous levels of lead and other substances in some supplements.   In a number of product areas, including toys, pet foods and drugs, Chinese producers have been found to produce substandard and sometimes dangerous products.   And, since U.S. vitamin supplement manufacturers are also not regulated, the possibility of vitamin supplement contamination or abnormalities are further increased.

Vitamintesting.com suggests you research the supplements you take and make sure they’ve passed the content and quality analyses from one of the four, independent testing laboratories (see Vitamin Potency Testing).  You take vitamins to improve your health…it would be a shame for them to have the opposite effect.

Source of Information for this Post:  Article entitled “Pet food scandal has Chinese drugs under microscope” by Tim Johnsonn, MCT News Service.  June 3, 2007. 

By Craig Arnoff, VitaminTesting.com Publisher - June 26, 2007
      
This is a continuation of Case Study #1C in which “Al” (all names changed to protect privacy) wrote to the registered dietician his physician said was more knowledgeable than he about dietary supplements.  Now, the dietician responds. 

Note that again, studies showing vitamin deficiencies in HIV patients were discounted because they were conducted in third-world countries.  Yet, neither the doctor nor dietician could provide evidence of studies conducted in the U.S. which either disproves the other studies or indicates that HIV patients do NOT have similar vitamin deficiencies.  In fact, there is a body of evidence, albeit not from large-scale studies, that vitamin deficiencies are prevalent in HIV patients.

Also note that the actual testing of vitamin levels was not recommended because vitamin-testing panels were not available at the institution’s laboratory and insurance was said to be unlikely to pay for the tests.  Lastly, the dietician acknowledges that when supplements are recommended, it’s often based on educated “hunches” or general-population studies.   

=============== LETTER FROM THE DIETICIAN TO AL ===============

Hi Al,

Very good questions.  Unfortunately all of the studies regarding vitamin/mineral deficiencies in HIV patients that I’ve read have been in third world countries on malnourished individuals who have poor food access.   I checked on the labs test available at our hospital and, unfortunately, they don’t have a vitamin/mineral blood panel.  Each test must be ordered separately and most aren’t covered by insurance.  For example, there is no selenium test here, and that’s one of the common HIV-related deficiencies cited in the third-world studies. Malabsorption can involve both macronutrients such as protein, carbohydrates and fat as well as micronutrients which are vitamin and minerals.  An indication of serious malabsorption problems is that you cannot maintain a healthy weight.  If you can maintain a healthy weight for your height, then you likely don’t have major malabsorption issues.  The most serious malabsorption occurs with chronic diarrhea.  In that case, the diarrhea should be resolved rather than overloading the person with extra vitamin/mineral supplements. So, because of the lack of first world studies, it makes my job more difficult when it comes to recommending supplementation.  I like my recommendations to be based on evidence-based research.  More often they have to be based on a hunch or general population studies (not HIV only).

So, here’s what I would recommend based on not getting a full medical history from you.  Take 2 general multivitamins each day.  One in the morning and one before bed.  You may have also heard of KPAX.  These supplements contain extra ingredients that are not found in a general multivitamin and are thought to have a beneficial affect on HIV status although a study that was done on this supplement, which showed improved CD4 count, wasn’t well designed and had a small number of participants.  Since the beta carotene levels are pretty high, I wouldn’t recommend more than the single strength dose.  I think this supplement is probably okay but again, it’s based on a hunch and not evidence-based research.

Finally, you can be proactive and do your own research to keep up on the latest studies. Check out www.medscape.com where you type a topic in and it will bring up the latest research.  This information will be more valid than trying to sift through all the wacky stuff if you did a google search.  When you read a study, look at the sample size (how many people were part of the study) and be critical of the methods that were used.  You might type in something like “HIV/AIDS Vitamin Deficiencies”.  This is how I keep up on the latest research.  If you would like to discuss this topic further, I would recommend that you call the clinic and make an appointment to see me.  I can provide you with a full nutritional assessment and recommendations.  Have a great day.

Sally Dietician

 By Craig Arnoff, VitaminTesting.com Publisher - June 12, 2007

This is a continuation of Case Study #1B in which “Al” (all names changed to protect privacy) learned from his physician that the dietician at the hospital is probably more knowledgable about dietary supplements than the physician is.  The physician suggested contacting the dietician and that’s what Al does in the letter below:

=============== LETTER FROM AL TO THE DIETICIAN =============== 

Hi Sally: My primary physician Dr. C referred you to me yesterday via email.  I was interested in getting my vitamin/mineral levels tested. But Dr. C does not recommend it and says it wouldn’t be covered by insurance.  He says that the standard American diet is usually sufficient, and any deficiencies could be rectified with a good multi-vitamin.  Still I’m wondering, if vitamin levels are rarely checked among HIV patients in the USA, how do we know that specific deficiencies are uncommon, especially among patients like myself who have digestive problems and mal-absorption?This is of concern to me, because I know that good heart health and overall organ health are dependent on adequate levels of vitamins, minerals and anit-oxidants.  Are there any clinical research results obtained in the USA regarding vitamin/mineral levels in HIV patients that you could refer me to for clarification?

According to an article published in Men’s Health Magazine (June, 2007 issue, page 47), taking the following types of prescription drugs over time leads to nutrient deficiencies.  Men’s Health Magazine is a highly-respected source of health information and presents information that has been reviewed by its well-staffed medical advisory board. 

The following drugs, taken over time, deplete your body of the following nutrients:

ACID BLOCKERS:  Depletes you of Folic Acid, Iron, Vitamin B12.  Side Effects that vitamin supplementation can help guard against include: Gingivitis, Irritability, Weakness, Diarrhea.

ANTIOBIOTICS: Depletes you of Calcium, Magnesium and Zinc.  Side Effects that vitamin supplementation can help guard against include: Muscle pain, Insomnia, Loss of Taste and Smell.

ASPIRIN:  Depletes you of Folic Acid, Iron and Vitamin C.  Side Effects that vitamin supplementation can help guard against include: Gingivitis, Irritability, Weakness, Poor Wound Healing.

CORTICOSTERIODS: Depletes you of Calcium, Magnesium and Potassium.  Side Effects that vitamin supplementation can help guard against include: Muscle Pain and Spasms, Insomnia, Confusion, Arrhythmias.

STATINS (Cholesterol Lowering Drugs):  Depletes you of Coenzyme Q10.  Side Effects that vitamin supplementation can help guard against include: Fatigue.

VitaminTesting.com recommends that you research the specific prescription drugs you take, using our Research Process, prior to forming any conclusions about the vitamin deficiencies that may be associated with prescription drugs you take. 

By Craig Arnoff, VitaminTesting.com Publisher - June 7, 2007

This is a continuation of Case Study #1A in which “Al” (name changed for confidentiality reasons) contacted his MD and requested vitamin testing.  Al felt, after conducting the research suggested on our website, he may be deficient in a number of vitamins and that this could be contributing to his stomach issues.

Here is a summation of the response he received from his physician.  We’ve re-worded the text of the message and removed all identifying information since the physician/hospital state that private, confidential emails cannot be published. 

================= RESPONSE FROM AL’S PHYSICIAN =================

Al, thanks for your request to get your vitamin and mineral levels tested.  It is rare to conduct the tests you are asking for.  The only levels we test are iron and vitamin B12 levels as those can be associated with certain anemias. I talked to our dietician and she said that a standard American diet does not lead to many vitamin deficiencies.  The only deficiencies that might be seen in HIV patients are zinc, selenium, B12 and iron deficiency.  She suggests a standard multivitamin, which takes care of pretty much all of these deficiencies.  Another issue is that the cost of the tests are not likely covered by your insurance.

There are many articles linking HIV infection and vitamin deficiencies.  There was a recent study evaluating selenium deficiency in HIV patients in Africa which found that adding selenium may help one’s immune system. The problem with this study and other studies looking at vitamin deficiencies are that several were studying people in 3rd world countries where vitamin deficiencies are much more common.  So, these study results probably don’t apply as much to us in the US, where vitamin deficiencies are rather unlikely, even in HIV positive patients.  The fact that you are having less diarrhea likely improves your absorption and makes the likelihood of any vitamin deficiency lower at this time. 

You are correct that K-pax (a popular HIV Vitamin Supplement) can oversupplement and lead to vitamin excess and this is why we do not recommend K-pax.  However, we do recommend a standard multivitamin, which should be sufficient to provide the recommended daily allowances.  Thus, I do not recommend checking vitamin levels.  If you are interested in talking to our dietician, who probably knows the most about these issues, her name is Sally Dietician, and you can either make an appointment or email her.  Dr. Smith is a D.O. (doctor of osteopathy) here, but she does not have any expertise in vitamin and mineral deficiencies.  I hope this helps you.  Dr. C

================= COMMENT FROM THE PUBLISHER ==================

This doctor wrote a compelling response that suggests that vitamin testing is not needed.  While the doctor suggests that the studies showing HIV-related vitamin deficiencies may not be valid (done in third world countries), he cites no evidence or research that HIV patients in the US are NOT vitamin deficient.  In fact, he states that there may be deficiencies in zinc, selenium, B12 and iron in HIV patients.  He does not state that there have been studies showing that a “standard multivitamin” will correct these deficiencies or that these deficiencies could pose long-term problems.  While he states that vitamin deficiencies are not common based on the American diet (he cites no research proving this and, in fact, there is research showing several deficiencies are common), he fails to acknowledge that chronic diseases and prescription drugs can cause deficiencies unrelated to diet.  He does concede that the dietician may be a better resource than he in the area of vitamins and deficiencies.  

       June 4, 2007

A lengthy expose was published across the USA regarding the safety of vitamins that are manufactured in China.  What spurred recent safety concerns was the deaths of thousands of pets from pet food manufactured in China which contained adulterated wheat gluten.

China manufactures huge amounts of vitamin supplements sold in the USA, including over 90% of Vitamin C.  The former chief of the state Food and Drug Administration, Zheng Xiaoyu, was sentenced to death for taking $832,000 inn bribes to let unsafe drugs on the market in China.  And, according to He Jiguo, a food safety expert at China Agriculture University, it’s difficult to deter comjpanies with criminal or fraudulent intent before a mistake is reported.  He adds, “There are thousands of illegal things you can add to a product.  The supervisory authorities can’t literally test for each one of them.”

 See the full text of the article at the link below.

 http://www.fortwayne.com/mld/newssentinel/news/editorial/17306227.htm?template=contentModules/printstory.jsp