In The News
by Seth J. Baum, MD
Why is it that so many scientists and physicians ardently dissuade patients from adding a simple multivitamin / multi-mineral supplement to their daily regimen? We know the importance of vitamins and minerals: they are involved in literally every vital bodily function. Absent adequate concentrations of these substances (which we are unable to produce in sufficient quantities, making their dietary consumption mandatory), maladies from subtle to severe can plague us. We also know that most people fail to consume the recommended daily value of these critical nutrients. For example, over 2/3 of Americans fail to consume the mandatory 400 mg daily of elemental magnesium (Mg). What’s the downside to taking a multivitamin that contains solely the recommended daily value of these nutrients? They are not very costly so the “expensive urine” argument is a bit ridiculous. They are harmless when low doses are utilized. And they may make us feel better or even help us avoid potential physical problems.
This latter benefit was brought to light just a few days ago when a friend and fellow doctor contacted me from the hospital. Troublesome palpitations bought him an ER visit, complete with blood tests, an IV, and the angst associated with any hospitalization. When I spoke with him we discussed Mg and the role it can play in benign (and even malignant) heart rhythm disturbances. We asked his doctor to check not only serum levels of Mg, but RBC levels as well. This was done to ensure that intracellular levels of Mg were okay, as normal serum levels can often create a false sense of security. His levels were low; he received IV Mg, and his atrial and ventricular ectopy promptly dissipated. And so, he was sent home to enjoy his holiday sans palpitations.
The take home message here is for us to become a bit more open-minded. Doctors certainly don’t know everything. We must accept the fact that the absence of solid data does not exclude the importance of that which has been inadequately studied. Our vitamin and mineral trials – much like our diet trials – are woefully inadequate. They are simply too hard to study. Thus, we are left with uncertainty. Instead of blanket rejection of concepts such as taking a daily multiple, we need instead to consider the pros and cons of any intervention. Only after careful deliberation should we weigh in. In this manner we can provide the considered advice our patients need and deserve.
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