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.