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Do Vitamin C Supplements Cause Kidney Stones? – Care2.com

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Mainstream medicine has long had a healthy skepticism of dietary supplements, extending to the present day with commentaries like “Enough is enough.” In an essay entitled “Battling quackery,” however, published in the Archives of Internal Medicine, it’s argued that we may have gone too far in our supplement bashing, as evidenced by our “uncritical acceptance” of supposed toxicities; the surprisingly “angry, scornful tone” found in medical texts using words like “careless,” “useless,” “indefensible,” “wasteful,” and “insidious”; and ignoring evidence of possible benefit.

“To illustrate the uncritical acceptance of bad news” about supplements, the authors discussed the “well-known” concept that high-dose vitamin C can cause kidney stones, as I highlight in my video Do Vitamin C Supplements Prevent Colds but Cause Kidney Stones?. Just because something is well-known in medicine, however, doesn’t mean it’s necessarily true. In fact, the authors couldn’t find a single, reported case.

We’ve known that vitamin C is turned into oxalates in the body, and, if the level of oxalates in the urine gets too high, stones can form, but, even at 4,000 mg of vitamin C a day, which is like a couple gallons’ worth of orange juice, urinary oxalates may not get very high, as you can see at 1:10 in my video. Of course, there may be the rare individuals who have an increased capacity for this conversion into oxalates, so a theoretical risk of kidney stones with high-dose vitamin C supplements was raised in a letter printed in a medical journal back in 1973.

When the theoretical risk was discussed in the medical literature, however, the researchers made it sound as if it were an established phenomenon: “Excessive intake of vitamin C may also be associated with the formation of oxalate stones.” Sounds less like a theoretical risk and more like an established phenomenon, right? That statement had seven citations supposedly suggesting an association between excessive vitamin-C intake and the formation of oxalate kidney stones. Let’s look at the cited sources, which you can see from 1:47 in my video. One reference is the letter about the theoretical risk, which is legitimate, but another listed citation, titled “Jaundice following the administration of niacin,” has nothing to do with either vitamin C or kidney stones. What’s more, the other five citations are just references to books. That may be acceptable if the books cited primary research themselves, but, instead, there was a kind of circular logic, where the books just cite other books citing that theoretical risk letter again. So, while it looks as if there’s a lot of evidence, they’re all just expressing this opinion with no new data.

By that time, there actually were studies that followed populations of people taking vitamin C supplements and found no increased kidney stone risk among men, then later, the same was shown in women. So, you can understand the frustration of the authors of “Battling quackery” commentary that vitamin-C supplements appeared to be unfairly villainized.

The irony is that we now know that vitamin-C supplements do indeed appear to increase kidney stone risk. The same population of men referenced above was followed further out, and men taking vitamin-C supplements did in fact end up with higher risk. This has since been confirmed in a second study, though also of men. We don’t yet know if women are similarly at risk, though there has now also been a case reported of a child running into problems.

What does doubling of risk mean exactly in this context? Those taking a thousand milligrams or so of vitamin C a day may have a 1-in-300 chance of getting a kidney stone every year, instead of a 1-in-600 chance. One in 300 “is not an insignificant risk,” as kidney stones can be really painful, so researchers concluded that since there are no benefits and some risk, it’s better to stay away.

But there are benefits. Taking vitamin C just when you get a cold doesn’t seem to help, and although regular supplement users don’t seem to get fewer colds, when they do get sick, they don’t get as sick and get better about 10 percent faster. And, those under extreme physical stress may cut their cold risk in half. So, it’s really up to each individual to balance the potential common cold benefit with the potential kidney stone risk.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations—2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not to Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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Global Dietary Supplements Market Overview 2019-2026 : Amway, Bayer, Glanbia, Herbalife International of America, Abbott – Industry News Network

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Best supplements for tiredness – the 1p a day capsules to boost energy and prevent fatigue – Express

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Feeling tired all of the time could be caused by not getting enough sleep, or by spending too much time at work. Tiredness that goes on for long periods of time isn’t normal, and may be caused by an underlying medical condition. But, taking some supplements may help you to feel more energetic, and less lethargic. You could lower your chances of feeling tired, and improve your day-to-day energy by taking vitamin B12 supplements, it’s been claimed.

Feeling fatigued more than usual could be a sign of a vitamin B12 deficiency, warned Harvard Medical School.

Vitamin B12 is needed to make red blood cells, DNA and nerves. But it can’t be made naturally in the body, and is needed from your diet.

You could top up on vitamin B12 by eating more clams, liver, beef, Greek yogurt, or even eggs.

“Vitamin B12 deficiency can be slow to develop, causing symptoms to appear gradually and intensify over time,” said the medical school.

“Given the array of symptoms a vitamin B12 deficiency can cause, the condition can be overlooked or confused with something else.

“Vitamin B12 deficiency symptoms may include weakness, fatigue, strange sensations, numbness, or tingling in the hands, legs, or feet.

“A standard multivitamin delivers 6 micrograms, more than enough to cover the average body’s daily need.

“If you are over age 50, the Institute of Medicine recommends that you get extra B12 from a supplement, since you may not be able to absorb enough of the vitamin through foods.”

You could also be at risk of a vitamin B12 deficiency if you develop a swollen, or inflamed tongue, or difficulty walking.

Most people should be able to get enough vitamin B12 from their daily diet, said the NHS.

But, if you do decide to take vitamin B12 supplements, you should avoid taking more than 2mg a day, as it could be harmful.

Other than a vitamin B12 deficiency, your persistent tiredness could be caused by stress or anxiety.

Anaemia, an underactive thyroid and sleep apnoea could also lead to feeling tired all of the time.

If you’ve been feeling tired for more than four weeks, it’s a good idea to speak to a doctor, said the NHS.

Making sure you get enough sleep could help to prevent you from feeling sleepy the next day.

Most adults need between six and nine hours of sleep every night to perform at their best the next day.

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FDA proposes overhaul of dietary supplement industry – Healio

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The dietary supplement world is a murky place where you spend your money on a product that may or may not have any active ingredient in it, may not contain the promised dosage or concentration of the active ingredient, or it might include adulterants and contaminants.

I have read and written about many examples of this.

For example, some natural products for male enhancement, muscle building and weight loss that have been adulterated with unlabeled prescription drugs, including those banned by the FDA because they have been proven to be unsafe. In addition, the dietary supplement Kava had been considered safe for years before cases of liver toxicity suddenly started popping up, leading to worldwide restrictions and cautionary messages from the FDA. Kava didn’t suddenly become more dangerous; what likely occurred is that its growers started substituting a variety of the plant that grew faster to create greater yields, but the locals knew they should never use for medicinal purposes. 

The list goes on: some kratom products contain a far greater concentration of 7-hydroxymitrogynine than would occur naturally, leading to suspicion that it is enriched with a chemical that has stronger opioid effects and addiction potential; some cannabidiol products had only 12.5% of vaporization liquids, 25% of tinctures, and 45% of oils labelled correctly (plus or minus 10% of the labeled value). In most cases, these products contained far less cannabidiol than promised and some cannabidiol products contain enough THC to put the user in legal jeopardy of marijuana possession. Some dietary supplements have been shown to contain excessive amounts of cancer-causing polycyclic aromatic hydrocarbons and contaminants such as heavy metals and mold.  

How many more debacles must occur where the public trust is shoved aside to make a quick buck before people turn their back on natural remedies? The FDA can take decisive action that can reduce misinformation, fraud, abuse and unintentional poor cultivation and manufacturing practices. This can enhance the safety of dietary supplements sold in the U.S. and actually sustain this marketplace over the long-term.

No dietary supplement should be touted to prevent or cure any disease. Using a mouse study, in vitro cell study, or case report to market a dietary supplement’s disease modifying effects is fraudulent and hurts the public’s trust.

The FDA already had guidance on good manufacturing practices, but following them is not compulsory before placing a dietary supplement product on the U.S. market. Manufacturing plants, including those overseas, need to be personally inspected by the FDA. We know from the generic drug market and now the debacle with angiotensin receptor blocker manufacturers that the FDA’s history of inspecting foreign manufacturers is poor. Furthermore, all products should be tested periodically by an outside lab certifying that the products are free from contamination and adulteration, while possessing the promised dosage of the active ingredient, before it is allowed to be sold and randomly checked periodically thereafter. This would protect consumers and put the onus on the final manufacturer to ensure the quality of the products they are receiving from other cultivators or manufacturers. All of the costs of this outside testing should be borne by the manufacturers plus a surcharge to pay for additional FDA inspectors overseas. The current system where an overwhelmed FDA tries to fit in oversight of dietary supplements has to change.

Commissioner Gottlieb’s most recent proposal is sound and would go a long way in ensuring dietary supplement safety, but the agency will need a marked increase in resources to bring it to reality.

References:

Alltucker K, Hafner J. USA Today. “Why do blood pressure medications keep getting recalled? Here’s what we do know.” Accessed Feb. 12, 2019.

Liva R. Integrative Medicine: A Clinican’s Journal. “Facing the problem of dietary-supplement heavy-metal contamination: How to take esponsible action.” Accessed Feb. 12, 2019.

Tournas VH. Journal of Food Safety. 2009;doi:10.1111.j.1745-4565.2009.00167

White CM. Am J Health Syst Pharm. 2018;doi:10.2146/ajhp161035.

White CM. J Clin Pharmacol. 2018;doi:10.1002/jcph.1263.

White CM. J Clin Pharmacol. 2019;doi:10.1002/jcph.1387.

White CM. The conversation. “Beware of natural supplements for sex gain and weight loss.” Accessed Feb. 12, 2019.


  • C. Michael White, PharmD, FCP, FCCP

  • department of pharmacy practice, University of Connecticut

Disclosures: White reports no relevant financial disclosures.

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