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WHERE ARE THE BODIES? Andrew Saul Speaks Before
the Parliament of |
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Vitamin Toxicity |
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TESTIMONY by Andrew
W. Saul before the Government of VITAMINS AND FOOD SUPPLEMENTS: SAFE AND EFFECTIVE by Andrew W. Saul (Andrew W. Saul has taught
clinical nutrition for OVERVIEW Natural health products, such
as amino acids, herbs, vitamins and other nutritional supplements, have an
extraordinarily safe usage history. In the The most elementary of
forensic arguments is, where are the bodies? To try to answer this
question, we may turn to the 2003 Annual Report of the American Association
of Poison Control Centers Toxic Exposures Surveillance System, published in
the American Journal of Emergency Medicine, Vol. 22, No. 5, September 2004. (http://www.aapcc.org/Annual%20Reports/03report/Annual%20Report%202003.pdf) This report states that
there have been four deaths attributed to vitamin/mineral supplements in the
year 2003. Two of those deaths were due to iron poisoning. That means there
have been two deaths allegedly caused by vitamins, out of over 53 billion
doses. That is a product safety record without equal. Pharmaceutical drugs, on
the other hand, caused over 2,000 poison control-reported deaths, including Antibiotics: 13 deaths Antidepressants: 274 deaths Antihistamines: 64 deaths Cardiovascular drugs: 162
deaths It would be incorrect to
state that only prescription drugs kill people. In 2003, there were 59 deaths
from aspirin alone. That is a death rate nearly thirty times higher than that
of iron supplements. Furthermore, there were still more deaths from aspirin
in combination with other products. Fatalities are by no means
limited to drug products. In the Other deaths reported by
the American Association of Poison Control Centers included: aerosol air fresheners: 2
deaths nailpolish remover: 2 deaths perfume/cologne/aftershave:
2 deaths charcoal: 3 deaths dishwashing detergent: 3
deaths (and interestingly, weapons
of mass destruction: 0 deaths) In A CLOSER LOOK AT
ALLEGATIONS OF VITAMIN FATALITIES Nutritional supplements are
exceptionally safe. In 2003, there were no deaths from multiple vitamins
without iron. There were no deaths from amino acids. There were no deaths
from B-complex vitamin supplements. There were no deaths from niacin. There
were no deaths from vitamin A. There were no deaths from vitamin D. There
were no deaths from vitamin E. There was, supposedly, one
alleged death from C and one alleged death from B-6. The accuracy of such
attribution is questionable, as water-soluble vitamins such as B-6 (pyridoxine)
and vitamin C (ascorbate) have excellent safety records stretching back for
many decades. "Vitamin problem" allegations are routinely
overstated and unconfirmed. The latest (2003) Toxic Exposures Surveillance
System report indicates that reported deaths are "probably or
undoubtedly related to the exposure," a clear admission of uncertainty
in the reporting. (p 340) Even if true, such events
are aberrations. For example, In 1998, the American Association of Poison
Control Centers' Toxic Exposure Surveillance System reported no fatalities
from either vitamin C or from B-6. In fact, that year there were no vitamin
fatalities whatsoever. For decades I have asked my readers, colleagues, and
students to provide me with any and all scientific evidence of a confirmed
death from either of these two vitamins, or from any other vitamin. I have
seen none to date. Even the
mistakenly-believed "side effects" of vitamin C have been found to
be completely mythical. According to a National Institutes of Health report published
in the Journal of the American Medical Association (April 21, 1999), none of
the following problems are caused by taking "too much vitamin C": Allegations of Hypoglycemia Allegations of Rebound
scurvy Allegations of Infertility Allegations of Destruction
of vitamin B-12 Rather than focus on
infinitesimally minimal supplement risk, it is vitamin deficiency that is the
vastly more serious public health issue. For example, B-6 (pyridoxine)
supplementation should be actively encouraged, as larger-than-food quantities
of this vitamin has been demonstrated to prevent both cardiovascular disease
and depression, diseases that are enormous public health problems. Women who
use the birth control pill experience vitamin B-6 deficiency, and need to be
encouraged to supplement with it. (Wynn, V. Lancet, March 8, 1975.) SAFETY OF VITAMIN A AND
CAROTENE Vitamin A, as carotene or
fish oil, gives you healthy mucus membranes, a strong immune system, and
helps prevent cancer. In one review of 50 years
of vitamin research, researchers noted that "approximately 10 to 15
cases of vitamin A toxic reactions are reported per year in the After first taking note
that this review confirms safety, some explanation is necessary. First, a
"toxic reaction" is very different from a "fatality." Had
their been any fatalities, the authors would have said as much.
Unfortunately, "toxic" may erroneously imply "deadly."
That is not the meaning of toxic as it properly applies here: toxic means
"makes you sick." American poison control statistics repeatedly
fail to show even one single death from vitamin A in a given year. Pregnancy is a special case
where prolonged intake of too much preformed oil-form vitamin A might be
harmful to the fetus, even at relatively low levels (under 25,000 IU/day).
Interestingly enough, you can get over 100,000 IU of vitamin A from eating
only six ounces of beef liver. I have yet to see a pregnancy overdose warning
on a package of liver. It is vitamin A deficiency
during pregnancy, and in infancy, that poses the far greater risk. Deficiency
of vitamin A in developing babies is known to cause birth defects, poor tooth
enamel, a weakened immune system, and over 100,000 cases of blindness
annually. Megadoses of vitamin A are considered sufficiently safe to be given
to newborns to prevent infant deaths and disease. (Basu
S, Sengupta B, Paladhi PK.Single megadose vitamin A supplementation of Indian
mothers and morbidity in breastfed young infants. Postgrad
Med J. 2003 Jul;79(933):397-402. And: Rahmathullah
L, Tielsch JM, Thulasiraj
RD, Katz J, Coles C, Devi S, John R, Prakash K, Sadanand AV, Edwin
N, Kamaraj C. Impact of supplementing newborn
infants with vitamin A on early infant mortality: community based randomized
trial in southern India. BMJ. 2003 Aug 2;327(7409):254.) SAFETY OF THE B-COMPLEX
VITAMINS The safety record of the
B-complex vitamins is extraordinarily good. Since their discovery, beginning
with thiamin (B-1) in 1911, many thousands of studies have verified an
unequaled therapeutic value of these essential substances. Side effects have
been rare, and toxicity is nearly nonexistent, even at the highest doses. B-1, B-2, B-12, Biotin,
Folate, Pantothenic Acid Regulating blood sugar,
nourishing your nerves, improving mood, and preventing cardiovascular disease
are just a few reasons people take the B-complex vitamins. They are cheap and
safe. Both the 1998 and 2003 American Association of Poison Control Centers'
Toxic Exposure Surveillance System report shows no deaths whatsoever from
Thiamin (B-1), Riboflavin (B-2), Cobalamin (B-12),
Biotin, Folate or Pantothenic Acid. Furthermore, there are no toxicity
reports published for these vitamins in the Merck Manual, generally regarded
as a particularly authoritative medical reference. Vitamin B-3 (Niacin;
Niacinamide, Inositol Hexaniacinate) For over 50 years,
nutritional (orthomolecular) psychiatrists have used niacin (vitamin B-3) in
doses as high as tens of thousands of milligrams per day. It is an effective
treatment for obsessive compulsive disorder, anxiety, bipolar disorder,
depression, psychotic behavior, and schizophrenia. Niacin has also gained
popularity as one of the cheapest and safest ways to lower cholesterol. The discoverer of niacin
therapy for lowering cholesterol, Canadian psychiatrist Abram Hoffer, M.D.,
says that niacin is very safe. "There have been no deaths from niacin
supplements," Dr. Hoffer says. "The LD 50 (the dosage that would
kill half of those taking it) for dogs is 5,000-6,000 milligrams per kilogram
body weight. That is equivalent to almost a pound of niacin per day for a
human. No human takes 375,000 milligrams of niacin a day. They would be
nauseous long before reaching a harmful dose. The top niacin dose ever was a
16-year-old schizophrenic girl who took 120 tablets (500 mg each) in one day.
All that happened was that the 'voices' she was hearing stopped." Physicians frequently give
patients 2,000–5,000 mg of niacin daily to lower cholesterol. The safety
margin is very large. The 2003 American Association of Poison Control
Centers' Toxic Exposure Surveillance System report indicates no deaths
whatsoever from niacin. Vitamin B-6 Vitamin B-6 (pyridoxine)
improves mood, reduces risk of cardiovascular disease, and has been shown to
be clinically effective against carpal tunnel syndrome. It also has been
occasionally reported to cause temporary neurological symptoms such as
heaviness, tingling, or numbness of the limbs in persons taking very large
doses. It is very important to realize that such cases are not common, and
when they do occur almost always result from huge doses of pyridoxine taken
alone. B-6 by itself in doses of 2,000 to 6,000 mg daily (that is 1,200 to
3,600 times the standard Premenstrual tension
symptoms often improve dramatically with only a few hundred mg/day of extra
B-6 taken in divided doses throughout the day. At least 50 to 100 mg of
supplemental B-6 daily is a virtual necessity for women taking oral
contraceptives. The "pill" causes some abnormal physiological
changes that create a deficiency of B-6, as well as lower serum levels of
thiamine (B-1), riboflavin (B-2), niacin (B-3), folic acid, B-12, and vitamin
C. VITAMIN C The importance of vitamin C
cannot be overemphasized. Vitamin C has been shown to be helpful in fighting
over thirty major diseases, including pneumonia, herpes zoster (shingles), pancreatitis, hepatitis, arthritis, some forms of cancer,
leukemia, atherosclerosis, high cholesterol, diabetes, multiple sclerosis,
and chronic fatigue. (Vitamin C, Infectious Diseases, and Toxins: Curing the
Incurable, by Thomas E. Levy, M.D. Many well designed studies
show that large doses of vitamin C improve both quality and length of life
for cancer patients. (Murata, A., Morishige, F. and
Yamaguchi, H. Prolongation of survival times of terminal cancer patients by
administration of large doses of ascorbate. International Journal of Vitamin
and Nutrition Research Suppl., 23, 1982, p.
103-113. And: Null, G., Robins, H., Tanenbaum, M.,
and "Vitamin C,"
wrote board-certified chest physician Frederick R. Klenner, M.D., "is
one of the safest substances you can put in the human body." Vitamin C
is remarkably safe even in enormously high doses. Compared to commonly used
prescription drugs, side effects are virtually nonexistent. It does not cause
kidney stones. In fact, vitamin C increases urine flow, favorably lowers
urine pH, and prevents calcium from binding with urinary oxalate. All these
features help keep stones from forming. (Gerster H.
No contribution of ascorbic acid to renal calcium oxalate stones. Ann Nutr Metab. 1997;41(5):269-82.
"In the large-scale Harvard Prospective Health Professional Follow-Up
Study, those groups in the highest quintile of vitamin C intake (> 1,500
mg/day) had a lower risk of kidney stones than the groups in the lowest
quintiles.") It was Canadian physician
William J. McCormick, M.D., who first advocated vitamin C to prevent and cure
the formation of kidney stones 50 years ago (McCormick, WJ. Lithogenesis and
hypovitaminosis. Medical Record. 159:7, July, p 410-413). In 1946 he wrote: "I have observed that
a cloudy urine, heavy with phosphates and epithelium, is generally associated
with a low vitamin C status. . . and that as soon as
corrective administration of the vitamin effects a normal ascorbic acid
(vitamin C) level the crystalline and organic sediment disappears like magic
from the urine. I have found that this change can usually be brought about in
a matter of hours by large doses of the vitamin, 500 to 2,000 mg, oral or parenteral." (p. 411) [Journal of Orthomolecular
Medicine, Vol. 18, No. 2, 2003, p 93-96.] Even a modest quantity of
supplemental vitamin C prevents disease and saves lives. Just 500 mg daily
results in a 42 percent lower risk of death from heart disease and a 35
percent lower risk of death from any cause. (Enstrom
J.E., Kanim L.E., and Klein M.A. Vitamin C intake
and mortality among a sample of the VITAMIN D Canadian researcher
Reinhold Vieth, Ph.D., writes, "Published
cases of vitamin D toxicity with hypercalcemia, for
which the 25(OH)D concentration and vitamin D dose
are known, all involve intake of greater than or equal to 1,000 micrograms
(40,000 IU)/day. (T)he weight of evidence shows that the currently accepted,
no observed adverse effect limit of 50 microg
(2,000 IU)/d is too low by at least 5-fold." (Vieth
R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety.
Am J Clin Nutr. May;
69(5):842-56. 1999.) The Nutrition Desk
Reference, Second Edition states that, for vitamin D, "The threshold for
toxicity is 500 to 600 micrograms per kilogram body weight per day." (p
40) The US Environmental Protection Agency's published oral LD50 for female
rats of 619 mg/kg (Cholecalciferol (Vitamin D3)
Chemical Profile 12/84. US Environmental 500 to 600 mcg is the
equivalent of 20,000 to 24,000 IU, per kilogram body weight per day. By
comparison, this would mean that for an average (70 kg) adult human, toxicity
would occur at an astounding 1,400,000 to 1,680,000 IU/day. Yet misconceptions and
misinformation about vitamins persist. Vitamin-scare articles are unduly
popular with the media, sometimes even making it into the pages of the Wall
Street Journal. On April 30, 1992, David Stipp
reported that between 1990 and 1992, "a series of patients with vitamin
D overdoses began turning up at One person subsequently
died from drug complications, and the case went to court. (Tarpey v. Crescent Ridge Dairy, Inc., This is the one and the
only vitamin D-related death I could find confirmation of, ever, anywhere.
And even this one was not directly due to the vitamin, but rather to side
effects of medication. The incident might well be
taken as an unintentional proof of vitamin safety, even in ridiculously high
overdosage situations. It is certainly noteworthy that 580 times the normal
amount of vitamin D produced, at most, one alleged fatality. This borders on
the extraordinary. Events such as this demonstrate that the margin for error
with vitamins is very large indeed. As a former university
nutrition instructor, the classroom textbooks I taught with considered
vitamin D to be perhaps the most potentially dangerous vitamin to chronically
overdose on. If that is true, and there has been not even one confirmed
vitamin-D fatality in the VITAMIN E Poison control statistics
report no deaths from vitamin E. Vitamin E is a safe and remarkably non-toxic
substance. Canadian cardiologists Drs. Wilfrid and
Evan Shute observed no evidence of harm with doses as high as 8,000 IU/day.
In fact, "toxicity symptoms have not been reported even at intakes of
800 IU per kilogram of body weight daily for 5 months," according to the
US Food and Nutrition Board. This demonstrated safe level would work out to
be around 60,000 IU daily for an average adult, some 2,700 times the US RDA. A Overexposure to oxygen has
been a major cause of retrolental fibroplasia (retinopathy of prematurity)
and subsequent blindness in premature infants. Incubator oxygen retina damage
is now prevented by giving preemies 100 mg E per kilogram body weight. That
dose is equivalent to an adult dose of about 7,000 IU for an average-weight
adult. "There have been no detrimental side effects" from such
treatment, said the New England Journal of Medicine. (Hittner
HM, Godio LB, Rudolph AJ, Adams JM, Garcia-Prats JA, Friedman Z, Kautz JA,
Regular supplementation
with vitamin E is likely to save literally millions of lives. The New England
Journal of Medicine published two papers in the May 20, 1993 issue showing
that persons taking vitamin E supplements had an approximately 40% reduction
in cardiovascular disease. Nearly 40,000 men and 87,000 women took part in
the studies. The more vitamin E they took, and the longer they took it, the
less cardiovascular disease they experienced. A 1996 double-blind,
placebo-controlled study of 2,002 patients with clogged arteries demonstrated
a 77% decreased risk of heart attack in those taking 400 to 800 IU of vitamin
E. (Stephens, NG et al. Randomized controlled trial of vitamin E in patients
with coronary artery disease: Cambridge Heart Antioxidant Study
(CHAOS)," Lancet, March 23, 1996; 347:781-786.) Such effective quantities
of vitamin E positively cannot be obtained from diet alone. 800 IU is 2,667%
of the US DRI for vitamin E. (Journal of Orthomolecular Medicine, Volume 17,
Number 3, Third Quarter, 2002 (p 179-181) And: Journal of Orthomolecular
Medicine, 2003; Vol. 18, Numbers 3 and 4, p. 205-212.) HERBAL SUPPLEMENTS The 2003 Report of the
American Association of Poison Control Centers Toxic Exposures Surveillance
System (http://www.aapcc.org/Annual%20Reports/03report/Annual%20Report%202003.pdf) indicates a total of 13
deaths attributed to herbal preparations. Three of these are from ephedra, two from yohimbe, and
two from ma-huang. I have worked extensively in the
alternative health field for nearly 30 years, and I have known of virtually
no one who has taken ephedra, yohimbe,
or ma-huang, and certainly not in the deliberately
abusive high quantities that it takes to kill someone. Nevertheless,
accepting all seven deaths attributed to these products, we still find that
there were 30 times as many deaths from aspirin and acetaminophen. Only three deaths are
attributable to other "single ingredient botanicals," and oddly
enough, their identity remains unnamed in the Toxic Exposures report. Millions of persons take
herbal remedies, and have done so for generations. Indigenous and Westernized
peoples alike have found them to be safe and effective, and the 2003 Report
of the American Association of Poison Control Centers Toxic Exposures
Surveillance System confirms this (p 388-389). There have been no deaths at
all from "cultural medicines," including ayurvedic,
Asian, Hispanic, and in fact, from all others. Additionally, we find: Blue cohosh:
0 deaths Ginko biloba: 0 deaths Echinacea: 0 deaths Ginseng: 0 deaths Kava kava:
0 deaths Valerian: 0 deaths Furthermore, there have
been no deaths from phytoestrogens, glandulars, blue-green algae, or homeopathic remedies. MINERAL SUPPLEMENTS Of the eight deaths in the category,
five of them are from non-supplement sources rightly termed
"electrolytes": two from sodium and three from potassium (p 389).
Two deaths were allegedly due to iron overdose. Since 1986, there has been an
average of two deaths per year "associated with" iron supplements.
The sole remaining death was from calcium, a mineral that is employed
medically for its antidote properties. In fact, in 2003, calcium was used as
a lifesaving antidote in 5,228 cases (p 344). There is no evidence that the single
listed calcium death was from a supplement, and the odds are overwhelming
that it was not. AMINO ACID SUPPLEMENTS In 2003, poison control
centers reported no deaths whatsoever from amino acids. This is in itself a
strong safety statement. IN PERSPECTIVE Supplementation's harshest
critics have traditionally railed against vitamins (especially in large
doses) as being outright "dangerous" and at the very least "a
waste of money." Yet nutritional supplements are very safe, and for much
of the population, very necessary. The Journal of the American Medical
Association has recently published the recommendation that every person take
a multivitamin daily (Fletcher RH and Fairfield KM. Vitamins for Chronic
Disease Prevention in Adults: Clinical Applications JAMA. 2002;
287:3127-3129. And: To illustrate how
extraordinarily important supplements are to persons with a questionable
diet, consider this: Children who eat hot dogs once a week double their risk
of a brain tumor. Kids eating more than twelve hot dogs a month (that's
barely three hot dogs a week) have nearly ten times the risk of leukemia as
children who ate none. (Peters JM, Preston-Martin S, However, hot-dog
eating children taking supplemental vitamins were shown to have a reduced
risk of cancer. (Sarasua S, Savitz
DA. Cured and broiled meat consumption in relation to childhood cancer.
Cancer Causes Control. 1994 Mar; 5(2):141-8.) It is curious that, while
theorizing many "potential" dangers of vitamins, the media often
choose to ignore the very real cancer-prevention benefits of supplementation. Critics also fail to point
out how economical supplements are. For low-income households, taking a
two-cent vitamin C tablet and a five-cent multivitamin, readily obtainable
from any discount store, is vastly cheaper than getting those vitamins by
eating right. The uncomfortable truth is that it is often less expensive to
supplement than to buy nutritious food, especially out-of-season fresh
produce. According to David DeRose, M.D., M.P.H., "300,000 Americans die
annually from poor nutrition choices." Supplements make any dietary
lifestyle, whether good or bad, significantly better. Supplements are an
easy, practical entry-level better-nutrition solution for the public. A
television-educated populace is more likely to take some tablets than to willingly
eat organ meats, wheat germ, bean sprouts and ample vegetables. Media
supplement-scare-stories notwithstanding, taking supplements is not the
problem; it is a solution. Malnutrition is the problem. (Journal of
Orthomolecular Medicine, 2003; Vol. 18, Numbers 3 and 4, p. 213-216.) PUBLIC SUPPORT FOR FREE
ACCESS TO NUTRITIONAL SUPPLEMENTS A recent (March 26, 2003)
and unsuccessful American attempt to restrict free public access to vitamin
supplements was U.S. Senate Bill S. 722, the so-called "Dietary Supplement
Safety Act of 2003." The proposed law attempted to give the Secretary of
the US Food and Drug Administration sole power decide if and when "the
continued marketing of the dietary supplement is disapproved" (2-B: ii)
based on adverse event reporting so vague that the proposed bill specified
that decision was "without regard to whether the event is known to be
causally related to the dietary supplement." (SEC. 416 (a)(1) The intent of S. 722 was to
overturn the main provisions of the U.S. Dietary Supplement Health and
Education Act of 1994 (DSHEA). The US Congress enacted DSHEA specifically to
define vitamins, amino acids, herbs, and other nutritional supplements as
foods, not drugs. DSHEA enjoyed tremendous popular support. More citizen
letters were sent to Congress in 1992-1994 in favor of DSHEA than over any
other issue in American history. Some 2.5 million individual voters' letters
were received by US Senators and Representatives. On the other hand, citizen
opposition to S. 722 was strong. It gathered only four cosponsors, and failed
in committee. The U.S. Congress has
clearly seen that there is overwhelming public support for ensuring free
access to dietary supplements. I believe Canadians have the same keen
interest, and that an affirmative vote on CONCLUSION: As it has been for
thousands of years of human history, so the malnutrition problem remains with
us today. Only in the last century have supplements even been available.
Their continued use represents a true public health breakthrough on a par
with clean drinking water and sanitary sewers, and can be expected to save as
many lives. The number one side effect
of vitamins is failure to take enough of them. Vitamins are extraordinarily
safe substances. Drugs are not. There are over 106,000 deaths from
pharmaceutical drugs each year in the Public supplementation
should be encouraged, not discouraged. Supplements are a cost-effective means
of preventing and ameliorating illness. Supplement safety is outstandingly
high. Natural health products should be classified as foods, not drugs. (end of testimony) Andrew Saul is the author of the books FIRE YOUR DOCTOR! How to be Independently Healthy (reader reviews at http://www.doctoryourself.com/review.html ) and DOCTOR YOURSELF: Natural Healing that Works. (reviewed at http://www.doctoryourself.com/saulbooks.html ) "A lot of people go through life trying to prove that the things that
are good for them are wrong." (Ward Cleaver, on "Leave it to
Beaver") "There is a principle which is a bar against all information, which is
proof against all argument, and which cannot fail to keep man in everlasting
ignorance. That principle is condemnation without investigation."
(Herbert Spencer) |
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