Revision as of 20:01, 20 June 2009 editImperfectlyInformed (talk | contribs)Autopatrolled, Event coordinators, Extended confirmed users, IP block exemptions, Pending changes reviewers13,371 edits →Criticism: fix the dramatically incorrect citation to Hemila. Vitamin B12 is not generally considered toxic -- that's why it has no Tolerable Upper Limit. That's what the paper says as well.← Previous edit | Latest revision as of 18:43, 10 October 2024 edit undoDavid notMD (talk | contribs)Extended confirmed users, Rollbackers59,377 editsm →Vitamin E | ||
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{{short description|Form of alternative medicine}} | |||
'''Megavitamin therapy''' is the use of large doses of ]s, often many times greater than the ] (RDA) in the attempt to prevent or treat ]s. It is typically used in ] by practitioners who call their approach "]", but also used in mainstream medicine for "exceedingly rare" genetic conditions which respond to megadoses of vitamins.<ref name="Menolascino">{{cite journal |author=Menolascino FJ, Donaldson JY, Gallagher TF, Golden CJ, Wilson JE |title=Orthomolecular therapy: its history and applicability to psychiatric disorders |journal=Child Psychiatry Hum Dev |volume=18 |issue=3 |pages=133–50 |year=1988 |pmid=2898324 |doi= 10.1007/BF00709727|url=}}</ref> In 2002, a review of these conditions identified about 50 which respond to "high-dose vitamin therapy".<ref>{{cite journal |author=Ames BN, Elson-Schwab I, Silver EA |title=High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased K(m)): relevance to genetic disease and polymorphisms |journal=Am. J. Clin. Nutr. |volume=75 |issue=4 |pages=616–58 |year=2002 |month=April |pmid=11916749 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=11916749}}</ref> Further understanding of these conditions is expected to play a part in the emerging field of ].<ref>{{cite journal |author=Kaput J, Rodriguez RL |title=Nutritional genomics: the next frontier in the postgenomic era |journal=Physiol. Genomics |volume=16 |issue=2 |pages=166–77 |year=2004 |month=January |pmid=14726599 |doi=10.1152/physiolgenomics.00107.2003 |url=}}</ref> | |||
{{cs1 config|name-list-style=vanc}} | |||
{{Infobox pseudoscience | |||
|image = | |||
|image_width = | |||
|caption = | |||
|claims = Health effects from very high doses of vitamins. | |||
|topics = ]s, ]s | |||
|origyear = 1930s | |||
|origprop = | |||
|currentprop = | |||
|notableprop = Frederick Klenner, ] | |||
}} | |||
{{Alternative medicine sidebar |fringe}} | |||
⚫ | '''Megavitamin therapy''' is the use of large doses of ]s, often many times greater than the ] (RDA) in the attempt to prevent or treat ]s. Megavitamin therapy is typically used in ] by practitioners who call their approach ].<ref>{{cite journal |vauthors=Zell M, Grundmann O |title=An orthomolecular approach to the prevention and treatment of psychiatric disorders |journal=Adv Mind Body Med |volume=26 |issue=2 |pages=14–28 |date=2012 |pmid=23341413 }}</ref> Vitamins are useful in preventing and treating illnesses specifically associated with dietary vitamin shortfalls, but the conclusions of medical research are that the broad claims of disease treatment by advocates of megavitamin therapy are unsubstantiated by the available evidence.<ref name="isbn1-55009-213-8">{{cite book |vauthors=Aaronson S, etal |title=Cancer medicine 6 (Frei, Emil; Kufe, Donald W.; Holland, James F., eds) |publisher=BC Decker |location=Hamilton, Ont |year=2003 |pages= |isbn=978-1-55009-213-4 |chapter=Cancer medicine |chapter-url=https://archive.org/details/cancermedicine60002unse/page/76 }}</ref><ref name=References1990>{{cite journal |author1=Nutrition Committee |author2=Canadian Paediatric Society | date=1990| title = Megavitamin and megamineral therapy in childhood. Nutrition Committee, Canadian Paediatric Society | journal = CMAJ | volume = 143 | issue = 10 | pages = 1009–1013 | pmid = 1699646 | pmc = 1452516 }}</ref> It is generally accepted that doses of any vitamin greatly in excess of nutritional requirements will result either in toxicity (vitamins A and D) or in the excess simply being metabolised; thus evidence in favour of vitamin supplementation supports only doses in the normal range.<ref>{{cite web | url=http://healthyeating.sfgate.com/body-excess-vitamin-b-c-might-consume-3056.html | title=What Does Your Body do to Excess Vitamin B or C That You Might Consume?| date=16 June 2012}}</ref><ref>{{cite web | url=http://www.webmd.com/vitamins-and-supplements/nutrition-vitamins-11/fat-water-nutrient | title=Vitamins & Supplements Center – Nutritional, Herbal, Dietary, and More - WebMD}}</ref><ref>Novella, S: ''Medical Myths, Lies, and Half-Truths: What We Think We Know May Be Hurting Us'', ]</ref> Critics have described some aspects of orthomolecular medicine as ] or even ].<ref name="autogenerated3">{{cite journal |author=Jarvis WT |title=Food faddism, cultism, and quackery |journal=Annu. Rev. Nutr. |volume=3 |pages=35–52 |year=1983 |pmid=6315036 |doi=10.1146/annurev.nu.03.070183.000343}}</ref><ref name=Jukes1990>{{cite journal |author = Jukes TH | year =1990 | title = Nutrition Science from Vitamins to Molecular Biology | journal = Annual Review of Nutrition | pmid = 2200458 | volume = 10 | issue = 1 | pages = 1–20 | doi = 10.1146/annurev.nu.10.070190.000245| doi-access = free }} A short summary is in .</ref><ref name="autogenerated2">{{cite journal | author = Braganza, S.F. |author2=Ozuah, P.O. | year = 2005 | title = Fad Therapies | journal = Pediatrics in Review | volume = 26 | issue = 10 | pages = 371–376 | doi = 10.1542/pir.26-10-371 | pmid = 16199591}}</ref> Research on nutrient supplementation in general suggests that some nutritional supplements might be beneficial, and that others might be harmful;<ref>{{cite journal |title=NIH State-of-the-Science Conference Statement on Multivitamin/Mineral Supplements and Chronic Disease Prevention |journal=NIH Consens State Sci Statements |volume=23 |issue=2 |pages=1–30 |year=2006 |pmid=17332802 |url=http://consensus.nih.gov/2006/2006MultivitaminMineralSOS028main.htm |access-date=2009-02-18 |archive-date=2009-02-21 |archive-url=https://web.archive.org/web/20090221024345/http://consensus.nih.gov/2006/2006MultivitaminMineralSOS028main.htm |url-status=dead }}</ref><ref>{{cite journal |vauthors=Huang HY, Caballero B, Chang S, etal |title=The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference |journal=Ann. Intern. Med. |volume=145 |issue=5 |pages=372–385 |date=2006 |pmid=16880453 |url=http://www.annals.org/cgi/pmidlookup?view=reprint&pmid=16880453 |doi=10.1001/archinte.145.2.372}}</ref><ref>{{cite journal |vauthors=Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C |title=Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases |journal=Cochrane Database Syst Rev |volume=2012 |issue= 3|pages=CD007176 |year=2012 |pmid=22419320 |doi=10.1002/14651858.CD007176.pub2|pmc=8407395 |hdl=10138/136201 |hdl-access=free }}</ref> several specific nutritional therapies are associated with an increased likelihood of the condition they are meant to prevent.<ref name="AmJEpidem2009">{{cite journal |vauthors=Satia JA, Littman A, Slatore CG, Galanko JA, White E |year = 2009 |title = Long-term Use of {beta}-Carotene, Retinol, Lycopene, and Lutein Supplements and Lung Cancer Risk: Results From the VITamins And Lifestyle (VITAL) Study | journal = American Journal of Epidemiology | volume = 169| issue = 7| pages = 815–828| doi = 10.1093/aje/kwn409 | pmid = 19208726 | pmc=2842198}}</ref> | ||
== Multivitamin vs megavitamin == | |||
⚫ | |||
Megavitamin therapy must be distinguished from the usual "vitamin supplementation" approach of traditional multivitamin pills. Megavitamin doses are far higher than the levels of vitamins ordinarily available through western diets. A study of 161,000 individuals (post-menopausal women) provided, in the words of the authors, "convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women".<ref name="WHI">{{cite journal |vauthors=Neuhouser ML, Wassertheil-Smoller S, Thomson C, etal |title=Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts |journal=Arch. Intern. Med. |volume=169 |issue=3 |pages=294–304 |date=2009 |pmid=19204221 |doi=10.1001/archinternmed.2008.540 |pmc=3868488 }}</ref> | |||
==History== | ==History== | ||
In the 1930s and 1940s, some scientific and clinical evidence suggested that there might be beneficial uses of vitamins |
In the 1930s and 1940s, some scientific and clinical evidence suggested that there might be beneficial uses of vitamins C, E, and niacin in large doses. Beginning in the 1930s in ], a megadose vitamin E therapy for cardiovascular and circulatory complaints was developed by ] and colleagues, named the "Shute protocol".<ref name="pmid18911314">{{cite journal |vauthors=Vogelsang A, Shute E, Shute W |title=Some medical uses of vitamin E |journal=Med World (New York) |volume=161 |issue=2 |pages=83–89 |date=1948 |pmid=18911314 }}</ref> Tentative experiments in the 1930s by ]<ref>{{cite journal |last=Jungeblut |first=CW |year=1937 |title=Vitamin C Therapy and Prophylaxis in Experimental Poliomyelitis |journal=The Journal of Experimental Medicine |volume=65 |pages=127–146 |doi=10.1084/jem.65.1.127 |pmid=19870585 |issue=1 |pmc=2133474}}</ref> with larger doses of vitamin C led to Frederick Klenner's development of ] intravenous vitamin C treatments for polio and other viruses in the 1940s.<ref name="pmid18147027">{{cite journal|author=Klenner, Fred R. |title=The treatment of poliomyelitis and other virus diseases with vitamin C |journal=Southern Medicine & Surgery |volume=111 |issue=7 |pages=209–214 |date=1949 |pmid=18147027 }}</ref> William Kaufman published articles in the 1940s that detailed his treatment of arthritis with frequent, high doses of niacinamide.<ref name="pmid13060032">{{cite journal |author=KAUFMAN W |title=Niacinamide therapy for joint mobility; therapeutic reversal of a common clinical manifestation of the normal aging process |journal=Conn State Med J |volume=17 |issue=7 |pages=584–9 |date=July 1953 |pmid=13060032}}</ref> Rudolf Altschul and ] applied large doses of the immediate release form of ] (Vitamin B<sub>3</sub>) to treat ].<ref>{{cite journal |vauthors=Altschul R, Hoffer A, Stephen JD |title=Influence of nicotinic acid on serum cholesterol in man |journal=Arch. Biochem. Biophys. |volume=54 |issue=2 |pages=558–559 |date=1955 |pmid=14350806 |doi= 10.1016/0003-9861(55)90070-9}}</ref><ref name="pmid13792994">{{cite journal |vauthors=Altschul R, Hoffer A |title=The Effect of Nicotinic Acid on Hypercholesterolæmia |journal=Can Med Assoc J |volume=82 |issue= 15|pages=783–785 |date=1960 |pmid=13792994 |pmc=1938010}}</ref> In a 1956 publication entitled ''Biochemical Individuality'', ] introduced concepts for individualized megavitamins and nutrients.<ref name="isbn0-87983-893-0">{{cite book |author=Williams, Roger Lawrence |title=Biochemical Individuality |publisher=McGraw-Hill |location=New York |year=1998 |isbn=978-0-87983-893-5 }}</ref> Megavitamin therapies were also publicly advocated by ] in the late 1960s.<ref name="isbn0-399-50764-7">{{cite book |author=Stone, Irwin |title=The healing factor: "vitamin C" against disease |publisher=Perigee Books |location=New York |year=1982 |isbn=978-0-399-50764-9}}</ref> | ||
⚫ | ==Usage as therapy== | ||
In 1954, ] and ] applied large doses of the immediate release form of ] (Vitamin B-3) to treat ] (high cholesterol).<ref name="pmid13792994">{{cite journal |author=ALTSCHUL R, HOFFER A |title=The effect of nicotinic acid on hypercholesterolaemia |journal=Can Med Assoc J |volume=82 |issue= |pages=783–5 |year=1960 |month=April |pmid=13792994 |pmc=1938010 |doi= |url=}}</ref> The 1956 publication of ] <i>Biochemical Individuality<i> introduced concepts for individualized megavitamins and nutrients.<ref name="isbn0-87983-893-0">{{cite book |author=Williams, Roger Lawrence |title=Biochemical Individuality |publisher=McGraw-Hill |location=New York |year=1998 |pages= |isbn=0-87983-893-0 |oclc= |doi= |accessdate=}}</ref> In the 1960s, biochemist ], author of ''The Healing Factor'', observed that vitamin C's utility in the megadose treatments of human disease parallels the amounts of ] physiologically produced in most animals and postulated humans' evolutionary loss of this capability. Megavitamin therapies were also publicly advocated by ] in the late 1960s.<ref name="isbn0-399-50764-7">{{cite book |author=Stone, Irwin |title=The healing factor: "vitamin C" against disease |publisher=Perigee Books |location=New York |year=1982 |pages= |isbn=0-399-50764-7 |oclc= |doi= |accessdate=}}</ref> | |||
⚫ | Although megavitamin therapies still largely remain outside of the structure of ], they are increasingly used by patients, with or without the approval of their treating physicians, often after recommendations by practitioners of orthomolecular and ].<ref name="pmid10893280">{{cite journal |vauthors=Richardson MA, Sanders T, ], Greisinger A, Singletary SE |title=Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology |journal=J. Clin. Oncol. |volume=18 |issue=13 |pages=2505–2514 |date=2000 |pmid=10893280 |doi= 10.1200/JCO.2000.18.13.2505}}</ref> The proposed efficacy of various megavitamin therapies to reduce cancer risk has been contradicted by results of one clinical trial.<ref name="pmid19116389">{{cite journal |vauthors=Lin J, Cook NR, Albert C, et al |title=Vitamins C and E and Beta Carotene Supplementation and Cancer Risk: A Randomized Controlled Trial |journal=J. Natl. Cancer Inst. |volume=101 |issue=1 |pages=14–23 |date=2009 |pmid=19116389 |doi=10.1093/jnci/djn438 |pmc=2615459}}</ref> | ||
===Vitamin C=== | |||
Several orthomolecular megavitamin protocols have been publicized.<ref name="urlCancer Survival - Cancer Help">{{cite web |url=http://www.cancersurvival.com/help_pauling.html |title=Cancer Survival - Cancer Help |format= |work= |accessdate=2009-02-18}}</ref> While formal medical recognition of niacin therapy for hypercholesterolemia followed confirmation by William Parsons of the Mayo Clinic (1956) and the Canner study (1986), the success of several popular books since the 1980s has made the public more aware of niacin's role in combination with other medications, for ]s (abnormal ] levels in the blood).<ref name="pmid18973399">{{cite journal |author=Sanford M, Curran MP |title=Niacin extended-release/simvastatin |journal=Drugs |volume=68 |issue=16 |pages=2373–86 |year=2008 |pmid=18973399 |doi= 10.2165/0003495-200868160-00008|url=}}</ref> Pauling's advocacy of megadoses of vitamin C for colds, beginning in the 1960s, and later for cancer, made millions aware of the concept of megavitamin treatment in disease. Pauling's vitamin C recommendations are lower than some modern recommendations.<ref name="pmid5107925">{{cite journal |author=Pauling L |title=Vitamin C and common cold |journal=JAMA |volume=216 |issue=2 |pages=332 |year=1971 |month=April |pmid=5107925 |doi= 10.1001/jama.216.2.332b|url=}}</ref> | |||
⚫ | {{Main|Vitamin C megadosage}} | ||
The US ] for ] for adult women is 76 mg/day and for adult men 90 mg/day. Although ] was known for highly respectable research in chemistry and biochemistry, he was also known for promoting the consumption of vitamin C in large doses.<ref>{{cite journal | vauthors = Cameron E, Pauling L | title = Supplemental ascorbate in the supportive treatment of cancer: Prolongation of survival times in terminal human cancer | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 73 | issue = 10 | pages = 3685–9 | date = October 1976 | pmid = 1068480 | pmc = 431183 | doi = 10.1073/pnas.73.10.3685| bibcode = 1976PNAS...73.3685C | doi-access = free }}</ref> Although he claimed and stood firm in his claim that consuming over 1,000 mg is helpful for one’s immune system when fighting a head cold, the results of empirical research do not align with this view. A meta-analysis concluded that supplementary vitamin C significantly lowered serum ], considered a risk factor for ].<ref>{{cite journal |vauthors=Juraschek SP, Miller ER, Gelber AC |title=Effect of oral vitamin C supplementation on serum uric acid: a meta-analysis of randomized controlled trials |journal=Arthritis Care & Research |volume=63 |issue=9 |pages=1295–306 |date=September 2011 |pmid=21671418 |pmc=3169708 |doi=10.1002/acr.20519 }}</ref> One population study reported an inverse correlation between dietary vitamin C and risk of gout.<ref>{{cite journal |last=Choi |first=Hyon K. |author2=Xiang Gao |author3=Gary Curhan |date=2009|title=Vitamin C Intake and the Risk of Gout in Men – A Prospective Study|journal=Archives of Internal Medicine |volume= 169 |issue= 5|pages=502–507|doi=10.1001/archinternmed.2008.606|pmid=19273781|pmc=2767211}}</ref> A review of clinical trials in the treatment of colds with small and large doses of Vitamin C has established that there is no evidence that it decreases the incidence of ]s.<ref>{{cite journal|last1=Hemilä|first1=Harri|last2=Chalker|first2=Elizabeth|date=2013-01-31|title=Vitamin C for preventing and treating the common cold|journal=The Cochrane Database of Systematic Reviews|volume=2013|issue=1|pages=CD000980|doi=10.1002/14651858.CD000980.pub4|issn=1469-493X|pmid=23440782|pmc=1160577}}</ref> After 33 years of research, it is still not established whether vitamin C can be used as a treatment for cancer.<ref>{{cite journal | last1 = Cabanillas | first1 = F | title = Vitamin C and cancer: what can we conclude--1,609 patients and 33 years later? | journal = Puerto Rico Health Sciences Journal |volume = 29 |issue = 3 |pages = 215–217 |year = 2010 |pmid = 20799507}}</ref> | |||
===Vitamin E=== | |||
Other treatments include orthomolecular oral dosing schedules for an early treatment of colds,<ref name="urlThe Vitamin C Foundation - Cold Cure">{{cite web |url=http://www.vitamincfoundation.org/surefire.htm |title=The Vitamin C Foundation - Cold Cure |format= |work= |accessdate=2009-02-18}}</ref> and for bowel tolerance for more established colds.<ref name="pmid7321921">{{cite journal |author=Cathcart RF |title=Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy |journal=Med. Hypotheses |volume=7 |issue=11 |pages=1359–76 |year=1981 |month=November |pmid=7321921 |doi= 10.1016/0306-9877(81)90126-2|url=http://linkinghub.elsevier.com/retrieve/pii/0306-9877(81)90126-2}}</ref> | |||
The US ] for ] for adult women and men is 15 mg/day. The US Food and Nutrition Board set a ] at 1,000 mg (1,500 IU) per day derived from animal models that demonstrated bleeding at high doses.<ref name="DRItext">{{cite book | last1 = Institute of Medicine | title = Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids | chapter = Vitamin E | publisher = The National Academies Press | year = 2000 | location = Washington, DC | pages = 186–283 | doi = 10.17226/9810 | pmid = 25077263 | isbn = 978-0-309-06935-9 | chapter-url = https://www.nap.edu/read/9810/chapter/8| author1-link = Institute of Medicine }}</ref> In the US, the popularity for vitamin E as a dietary supplement peaked around 2000, with popular doses of 400, 800 and 1000 IU/day. Declines in usage were attributed to publications of meta-analyses that showed either no benefits or negative consequences from vitamin E supplements.<ref>{{cite journal |vauthors=Kim HJ, Giovannucci E, Rosner B, Willett WC, Cho E |title=Longitudinal and secular trends in dietary supplement use: Nurses' Health Study and Health Professionals Follow-Up Study, 1986-2006 |journal=J Acad Nutr Diet |volume=114 |issue=3 |pages=436–443 |date=2014 |pmid=24119503 |pmc=3944223 |doi=10.1016/j.jand.2013.07.039 }}</ref><ref>{{cite journal|last1=Eidelman |first1=RS|last2=Hollar |first2=D|last3=Hebert |first3=PR|last4=Lamas|first4=GA| last5=Hennekens|first5=CH|title=Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease|journal= Archives of Internal Medicine|date=2004|pmid=15277288| doi=10.1001/archinte.164.14.1552|volume=164|issue=14|pages=1552–56|doi-access=}}</ref><ref name=Abner2011>{{cite journal | vauthors = Abner EL, Schmitt FA, Mendiondo MS, Marcum JL, Kryscio RJ | title = Vitamin E and all-cause mortality: a meta-analysis | journal = Current Aging Science | volume = 4 | issue = 2 | pages = 158–70 | date = July 2011 | pmid = 21235492 | pmc = 4030744 | doi = 10.2174/1874609811104020158 }}</ref><ref name=Curtis2014>{{cite journal |vauthors=Curtis AJ, Bullen M, Piccenna L, McNeil JJ |title=Vitamin E supplementation and mortality in healthy people: a meta-analysis of randomised controlled trials |journal=Cardiovasc Drugs Ther |volume=28 |issue=6 |pages=563–73 |date=December 2014 |pmid=25398301 |doi=10.1007/s10557-014-6560-7 |s2cid=23820017 }}</ref><ref name=Miller2005>{{cite journal | vauthors = Miller ER, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E | title = Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality | journal = Annals of Internal Medicine | volume = 142 | issue = 1 | pages = 37–46 | date = January 2005 | pmid = 15537682 | doi = 10.7326/0003-4819-142-1-200501040-00110 | s2cid = 35030072 }}</ref><ref name=Bjelakovic2014>{{cite journal | vauthors = Bjelakovic G, Nikolova D, Gluud C | title = Meta-regression analyses, meta-analyses, and trial sequential analyses of the effects of supplementation with beta-carotene, vitamin A, and vitamin E singly or in different combinations on all-cause mortality: do we have evidence for lack of harm? |journal = PLOS ONE| volume = 8 |issue = 9 |pages = e74558 |date = 2013 |pmid = 24040282 |pmc = 3765487 | doi = 10.1371/journal.pone.0074558 | bibcode = 2013PLoSO...874558B | doi-access = free }}</ref> | |||
===Niacin=== | |||
⚫ | ==Usage |
||
The US ] for ] for adult women is 14 mg/day and for adult men 16 mg/day. Niacin is available as a prescription product, either immediate release (500 mg tablets; prescribed up to 3,000 mg/day) or extended release (500 and 1,000 mg tablets; prescribed up to 2,000 mg/day). In the US, niacin is also available as a ] at 500 to 1,000 mg/tablet. Niacin has sometimes been used in combination with other ]s.<ref name=TabletLabel> Updated March 14, 2013. Page accessed Feb 11, 2016</ref> Systematic reviews found no effect of niacin on ] or death, in spite of raising ] (HDL) cholesterol. Reported side effects include an increased risk of ].<ref name=Kee2014>{{cite journal | vauthors = Keene D, Price C, Shun-Shin MJ, Francis DP | title = Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117,411 patients | journal = BMJ | volume = 349 | pages = g4379 | date = July 2014 | pmid = 25038074 | pmc = 4103514 | doi = 10.1136/bmj.g4379 }}</ref><ref>{{cite journal | vauthors = Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ | title = Niacin for primary and secondary prevention of cardiovascular events | journal = The Cochrane Database of Systematic Reviews | volume = 2017 | pages = CD009744 | date = June 2017 | issue = 6 | pmid = 28616955 | doi = 10.1002/14651858.CD009744.pub2 | pmc = 6481694 }}</ref><ref>{{cite journal | vauthors = Garg A, Sharma A, Krishnamoorthy P, Garg J, Virmani D, Sharma T, Stefanini G, Kostis JB, Mukherjee D, Sikorskaya E | title = Role of Niacin in Current Clinical Practice: A Systematic Review | journal = The American Journal of Medicine | volume = 130 | issue = 2 | pages = 173–187 | date =2017 | pmid = 27793642 | doi = 10.1016/j.amjmed.2016.07.038 | doi-access = free }}</ref> | |||
⚫ | |||
In 2008 researchers established that higher vitamin C intake reduces serum ] levels, and is associated with lower incidence of ]. The effect is more pronounced as intake increases into the megavitamin range <ref>{{cite journal|last=Choi, MD, DrPH|first=Hyon K.|coauthors=Xiang Gao, MD, PhD; Gary Curhan, MD, ScD |date=March 9, 2009|title=Vitamin C Intake and the Risk of Gout in Men|journal=Archives of Internal Medicine. |volume=Vol. 169 |issue=No. 5|pages=502–507|url=http://archinte.ama-assn.org/cgi/content/abstract/169/5/502|doi=10.1001/archinternmed.2008.606|pmid=19273781}}</ref> | |||
==Criticism == | |||
The efficacy of various megavitamin therapies has been contradicted by results of numerous clinical trials.<ref name="WHI"/><ref name="pmid19116389"/><ref name="pmid14563626">{{cite journal |author=Johnson LJ, Meacham SL, Kruskall LJ |title=The antioxidants--vitamin C,vitamin E, selenium, and carotenoids |journal=J Agromedicine |volume=9 |issue=1 |pages=65–82 |year=2003 |pmid=14563626 |doi= 10.1300/J096v09n01_07|url=}}</ref> A thorough review of clinical trials in the treatment of colds with small and large doses of Vitamin C have established that it does not reduce the incidence of vitamin C. It does reduce the duration and severity, although the effect is so small that there is doubtful clinical significance. Vitamin C supplementation has shown an effect in reducing the incidence of colds in people exposed to severe ] and cold environment.<ref name="pmid17636648">{{cite journal |author=Douglas RM, Hemilä H, Chalker E, Treacy B |title=Vitamin C for preventing and treating the common cold |journal=Cochrane Database Syst Rev |volume= |issue=3 |pages=CD000980 |year=2007 |pmid=17636648 |doi=10.1002/14651858.CD000980.pub3 |url=}}</ref> | |||
Toxic effects of high doses of vitamin A,<ref name="pmid1463588">{{cite journal |author=Snodgrass SR |title=Vitamin neurotoxicity |journal=Mol. Neurobiol. |volume=6 |issue=1 |pages=41–73 |year=1992 |pmid=1463588 |doi= 10.1007/BF02935566|url=}}</ref> and vitamin D<ref name="pmid1463588"/> and well-established. The ] establishes a maximum intake level for most vitamins, at which no adverse effects should occur including many infrequent or minor effects. These are part of the ] (UL) recommendations. Some vitamins such as ] have no Tolerable Upper Limit; although "it is not known whether maintaining a prolonged high level of vitamin B12 is harmful", there is some concern over vitamin B12's safety based on epidemiological and animal evidence.<ref name="pmid3818116">{{cite journal |author=Mangiarotti G, Canavese C, Salomone M, ''et al.'' |title=Hypervitaminosis B12 in maintenance hemodialysis patients receiving massive supplementation of vitamin B12 |journal=Int J Artif Organs |volume=9 |issue=6 |pages=417–20 |year=1986 |month=November |pmid=3818116 |doi= |url=}}</ref> | |||
==See also== | ==See also== | ||
Related topics | |||
* ] | * '']'' | ||
* ] | * ] | ||
* ] | * ] | ||
* ] | * ] | ||
* ] | |||
⚫ | * ] |
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Vitamin topics | |||
⚫ | * ] | ||
* ] | * ] | ||
* ] | * ] | ||
* ] (toxic vitamin intake) | |||
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** ] | |||
** ] | |||
** ] | |||
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==References== | ==References== | ||
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Latest revision as of 18:43, 10 October 2024
Form of alternative medicine
Claims | Health effects from very high doses of vitamins. |
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Related scientific disciplines | vitamins, dietary supplements |
Year proposed | 1930s |
Notable proponents | Frederick Klenner, Linus Pauling |
(Overview of pseudoscientific concepts) |
Megavitamin therapy is the use of large doses of vitamins, often many times greater than the recommended dietary allowance (RDA) in the attempt to prevent or treat diseases. Megavitamin therapy is typically used in alternative medicine by practitioners who call their approach orthomolecular medicine. Vitamins are useful in preventing and treating illnesses specifically associated with dietary vitamin shortfalls, but the conclusions of medical research are that the broad claims of disease treatment by advocates of megavitamin therapy are unsubstantiated by the available evidence. It is generally accepted that doses of any vitamin greatly in excess of nutritional requirements will result either in toxicity (vitamins A and D) or in the excess simply being metabolised; thus evidence in favour of vitamin supplementation supports only doses in the normal range. Critics have described some aspects of orthomolecular medicine as food faddism or even quackery. Research on nutrient supplementation in general suggests that some nutritional supplements might be beneficial, and that others might be harmful; several specific nutritional therapies are associated with an increased likelihood of the condition they are meant to prevent.
Multivitamin vs megavitamin
Megavitamin therapy must be distinguished from the usual "vitamin supplementation" approach of traditional multivitamin pills. Megavitamin doses are far higher than the levels of vitamins ordinarily available through western diets. A study of 161,000 individuals (post-menopausal women) provided, in the words of the authors, "convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women".
History
In the 1930s and 1940s, some scientific and clinical evidence suggested that there might be beneficial uses of vitamins C, E, and niacin in large doses. Beginning in the 1930s in Canada, a megadose vitamin E therapy for cardiovascular and circulatory complaints was developed by Evan Shute and colleagues, named the "Shute protocol". Tentative experiments in the 1930s by Claus W. Jungeblut with larger doses of vitamin C led to Frederick Klenner's development of megadose intravenous vitamin C treatments for polio and other viruses in the 1940s. William Kaufman published articles in the 1940s that detailed his treatment of arthritis with frequent, high doses of niacinamide. Rudolf Altschul and Abram Hoffer applied large doses of the immediate release form of niacin (Vitamin B3) to treat hypercholesterolemia. In a 1956 publication entitled Biochemical Individuality, Roger J. Williams introduced concepts for individualized megavitamins and nutrients. Megavitamin therapies were also publicly advocated by Linus Pauling in the late 1960s.
Usage as therapy
Although megavitamin therapies still largely remain outside of the structure of evidence-based medicine, they are increasingly used by patients, with or without the approval of their treating physicians, often after recommendations by practitioners of orthomolecular and naturopathic medicine. The proposed efficacy of various megavitamin therapies to reduce cancer risk has been contradicted by results of one clinical trial.
Vitamin C
Main article: Vitamin C megadosageThe US Recommended Dietary Allowance for vitamin C for adult women is 76 mg/day and for adult men 90 mg/day. Although Linus Pauling was known for highly respectable research in chemistry and biochemistry, he was also known for promoting the consumption of vitamin C in large doses. Although he claimed and stood firm in his claim that consuming over 1,000 mg is helpful for one’s immune system when fighting a head cold, the results of empirical research do not align with this view. A meta-analysis concluded that supplementary vitamin C significantly lowered serum uric acid, considered a risk factor for gout. One population study reported an inverse correlation between dietary vitamin C and risk of gout. A review of clinical trials in the treatment of colds with small and large doses of Vitamin C has established that there is no evidence that it decreases the incidence of common colds. After 33 years of research, it is still not established whether vitamin C can be used as a treatment for cancer.
Vitamin E
The US Recommended Dietary Allowance for vitamin E for adult women and men is 15 mg/day. The US Food and Nutrition Board set a tolerable upper intake level (UL) at 1,000 mg (1,500 IU) per day derived from animal models that demonstrated bleeding at high doses. In the US, the popularity for vitamin E as a dietary supplement peaked around 2000, with popular doses of 400, 800 and 1000 IU/day. Declines in usage were attributed to publications of meta-analyses that showed either no benefits or negative consequences from vitamin E supplements.
Niacin
The US Recommended Dietary Allowance for niacin for adult women is 14 mg/day and for adult men 16 mg/day. Niacin is available as a prescription product, either immediate release (500 mg tablets; prescribed up to 3,000 mg/day) or extended release (500 and 1,000 mg tablets; prescribed up to 2,000 mg/day). In the US, niacin is also available as a dietary supplement at 500 to 1,000 mg/tablet. Niacin has sometimes been used in combination with other lipid-lowering medications. Systematic reviews found no effect of niacin on cardiovascular disease or death, in spite of raising high-density lipoprotein (HDL) cholesterol. Reported side effects include an increased risk of diabetes.
See also
Related topics
- Codex Alimentarius
- Essential nutrient
- Health freedom movement
- Life extension
- List of ineffective cancer treatments
Vitamin topics
- Multivitamin
- Naturopathic medicine
- Orthomolecular medicine
- Hypervitaminosis (toxic vitamin intake)
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