Should I take vitamins? What can I do???

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These two questions are among the most commonly asked in my clinic, particularly from patients who are recently diagnosed with prostate cancer. Numerous studies have been done on adding various supplements to the diet, and anyone who reads this blog has already seen my thoughts on pomegranate, milk thistle, green tea, soy, etc. You can find dozens if not hundreds of references and small studies purporting to show a beneficial effect on cancer.

Further, there are studies that show the likelihood of cancer patients using supplements is higher among those with the most education (and probably with more disposable income). I have contributed my own body to this question by participating in the Physician’s Health Study II. For more than a decade I faithfully took first 3, then 2, then one pill daily that was either placebo or a vitamin/multivitamin. The results of this study so far are a big, fat ZERO. Moreover, in looking at this study along with many others, it is very hard to see any benefit from most supplements. An exception might be Vitamin D since those of us who are cancer phobic do such a good job of wearing sunscreen. And patients on androgen suppression may benefit from calcium supplements, although this, too, is controversial.

In the most recent Annals of Internal Medicine, there is further evidence of futility in the 28 BILLION dollar/year vitamin industry. “This review included 26 studies (24 randomized, controlled trials and 2 cohort studies) that examined the benefits and harms of using vitamin and mineral supplements for primary prevention of CVD, cancer, or all-cause mortality in healthy individuals without known nutritional deficiencies. We found no consistent evidence that the included supplements affected CVD, cancer, or all-cause mortality in healthy individuals without known nutritional deficiencies.” The accompanying editorial is entitled “Enough is enough: Stop wasting money on vitamin and mineral Supplements”

So, you can read it and weep, or save your money and buy more veggies and exotic fruits and nuts and enjoy your diet. It’s all up to you (and maybe how many years you went to school after you “grew up” and could critically analyze data). Remember, the more schooling, the higher the tendency to buy/take vitamins. Welcome to dreamland! What you CAN do is exercise and avoid fat.