Are multivitamins bad?

Has anyone else seen this? It seems strange to me.

http://jnci.oxfordjournals.org/cgi/c...ract/99/10/754

Multivitamin Use and Risk of Prostate Cancer in the National
Institutes of Health-AARP Diet and Health Study

Background: Multivitamin supplements are used by millions of Americans
because of their potential health benefits, but the relationship
between multivitamin use and prostate cancer is unclear.

Methods: We prospectively investigated the association between
multivitamin use and risk of prostate cancer (localized, advanced, and
fatal) in 295344 men enrolled in the National Institutes of Health
(NIH)-AARP Diet and Health Study who were cancer free at enrollment in
1995 and 1996. During 5 years of follow-up, 10241 participants were
diagnosed with incident prostate cancer, including 8765 localized and
1476 advanced cancers. In a separate mortality analysis with 6 years
of follow-up, 179 cases of fatal prostate cancer were ascertained.
Multivitamin use was assessed at baseline as part of a self-
administered, mailed food-frequency questionnaire. Relative risks
(RRs) and 95% confidence intervals (CIs) were calculated by use of Cox
proportional hazards regression, adjusted for established or suspected
prostate cancer risk factors.

Results: No association was observed between multivitamin use and risk
of localized prostate cancer. However, we found an increased risk of
advanced and fatal prostate cancers (RR = 1.32, 95% CI = 1.04 to 1.67
and RR = 1.98, 95% CI = 1.07 to 3.66, respectively) among men
reporting excessive use of multivitamins (more than seven times per
week) when compared with never users. The incidence rates per 100000
person-years for advanced and fatal prostate cancers for those who
took a multivitamin more than seven times per week were 143.8 and
18.9, respectively, compared with 113.4 and 11.4 in never users. The
positive associations with excessive multivitamin use were strongest
in men with a family history of prostate cancer or who took individual
micronutrient supplements, including selenium, -carotene, or zinc.

Conclusion: These results suggest that regular multivitamin use is not
associated with the risk of early or localized prostate cancer. The
possibility that men taking high levels of multivitamins along with
other supplements have increased risk of advanced and fatal prostate
cancers is of concern and merits further evaluation.

I heard a radio talk show doctor discuss this study and one of his
hypotheses is that vitamin/mineral supplements that are supposed to
promote good health in normal cells also provide beneficial nutrients
to cancer cells. He suggested that people without cancer may benefit
from taking these things but those who have had cancer treatment and
are concerned about recurrence may want to think twice about these
high supplement doses. In other words, do the supplements help the
cancer more than they help us fight the cancer?

I'm especially concerned about these high doses since I'm in the early
stages of macular degeneration and a study suggested high doses of
some vitamins and minerals including copper (which has some tenuous
links to a variety of ills) may reduce the incidence and severity of
the disease. However the over-the-counter eye supplements my eye doc
has me taking have almost four times the proposed maximum recommended
amount of copper. In fact, even our copper pipes provide more than
all the copper we need (except for our eyes apparently). So, now
what? If I reduce the odds of going blind, I increase the odds of
cancer recurrence? "Now what, doc?"
Dave Perry

On Jun 5, 8:32 am, JohnHace <j...@amcoex.com> wrote:
> Has anyone else seen this? It seems strange to me.
>
> http://jnci.oxfordjournals.org/cgi/c...ract/99/10/754
>
> Multivitamin Use and Risk of Prostate Cancer in the National
> Institutes of Health-AARP Diet and Health Study
>
> Background: Multivitamin supplements are used by millions of Americans
> because of their potential health benefits, but the relationship
> between multivitamin use and prostate cancer is unclear.
>
> Methods: We prospectively investigated the association between
> multivitamin use and risk of prostate cancer (localized, advanced, and
> fatal) in 295344 men enrolled in the National Institutes of Health
> (NIH)-AARP Diet and Health Study who were cancer free at enrollment in
> 1995 and 1996. During 5 years of follow-up, 10241 participants were
> diagnosed with incident prostate cancer, including 8765 localized and
> 1476 advanced cancers. In a separate mortality analysis with 6 years
> of follow-up, 179 cases of fatal prostate cancer were ascertained.
> Multivitamin use was assessed at baseline as part of a self-
> administered, mailed food-frequency questionnaire. Relative risks
> (RRs) and 95% confidence intervals (CIs) were calculated by use of Cox
> proportional hazards regression, adjusted for established or suspected
> prostate cancer risk factors.
>
> Results: No association was observed between multivitamin use and risk
> of localized prostate cancer. However, we found an increased risk of
> advanced and fatal prostate cancers (RR = 1.32, 95% CI = 1.04 to 1.67
> and RR = 1.98, 95% CI = 1.07 to 3.66, respectively) among men
> reporting excessive use of multivitamins (more than seven times per
> week) when compared with never users. The incidence rates per 100000
> person-years for advanced and fatal prostate cancers for those who
> took a multivitamin more than seven times per week were 143.8 and
> 18.9, respectively, compared with 113.4 and 11.4 in never users. The
> positive associations with excessive multivitamin use were strongest
> in men with a family history of prostate cancer or who took individual
> micronutrient supplements, including selenium, -carotene, or zinc.
>
> Conclusion: These results suggest that regular multivitamin use is not
> associated with the risk of early or localized prostate cancer. The
> possibility that men taking high levels of multivitamins along with
> other supplements have increased risk of advanced and fatal prostate
> cancers is of concern and merits further evaluation.

On Tue, 05 Jun 2007 09:29:58 -0700, dave perry <judamd@aol.com> wrote:

>In fact, even our copper pipes provide more than
>all the copper we need

Although in hard water areas - these abound in the UK, but perhaps not
in the US - it takes very little time for a calcium lining to form
inside the tube, thus screening the copper content. I've done more
than my share of home plumbing with redirection of water supplies. A
cross section of relatively new pipe shows surprisingly fast build-up
of hard-water.

JohnHace wrote:
> Has anyone else seen this? It seems strange to me.

> Results: No association was observed between multivitamin use and risk
> of localized prostate cancer. However, we found an increased risk of
> advanced and fatal prostate cancers (RR = 1.32, 95% CI = 1.04 to 1.67
> and RR = 1.98, 95% CI = 1.07 to 3.66, respectively) among men
> reporting excessive use of multivitamins (more than seven times per
> week) when compared with never users. The incidence rates per 100000
> person-years for advanced and fatal prostate cancers for those who
> took a multivitamin more than seven times per week were 143.8 and
> 18.9, respectively, compared with 113.4 and 11.4 in never users. The
> positive associations with excessive multivitamin use were strongest
> in men with a family history of prostate cancer or who took individual
> micronutrient supplements, including selenium, -carotene, or zinc.
>
> Conclusion: These results suggest that regular multivitamin use is not
> associated with the risk of early or localized prostate cancer. The
> possibility that men taking high levels of multivitamins along with
> other supplements have increased risk of advanced and fatal prostate
> cancers is of concern and merits further evaluation.
>

Some health newsletter (thus, we hope, reliable and fairy accurate)
reports of this study add that taking a MVMM tablet daily proved
beneficial to men, including PC pts. *IF* both statements really emerged
from the study, we're to believe that 7 MVMMs a week is benefcial and 8
is dangerous.

Yeah, right.

I hope someone with more time on their hands will study and summarize
the original study (its *abstract* runs 18 pages!) and resolve that
apparent dilemma for us so I can make an informed decision. Until then,
I suspect the problem is men taking extra supplements on top of MVMMs
and/or high-dosage MVMMs.

To wit, from the abstract obtained by clicking on the menu in the
referenced article:
"Among men who reported using a selenium supplement, heavy multivitamin
use (versus never use) was associated with a statistically significant
37% increased risk of localized prostate cancer, whereas no association
was apparent among those who did not report using selenium (P value for
test of interaction = .008). Similar effect modification was noted for
use of supplemental folate and vitamin E (P values for tests of
interaction = .012 and .028, respectively). There was also a
statistically significant interaction between daily dose of supplemental
vitamin E and multivitamin use for localized prostate cancer (P value
for test of interaction = .019), with those reporting the highest daily
dose of vitamin E supplement intake (≥800 IU) having the highest risk of
localized prostate cancer associated with multivitamin use (Table 4).
Thus, despite the overall lack of association between multivitamin use
and risk of localized prostate cancer, we found a statistically
significant increased risk of localized prostate cancer among heavy
multivitamin users who consumed a selenium, folate (Oops; my food
includes several time the recommended daily dose of folates, largely due
to supplementation mandated by the gum'mint.), or vitamin E supplement.
Use of selenium, vitamin E, or folate as individual supplements was not
associated with prostate cancer".

This, in the same week in which flax is reversed from dangerous to
beneficial for us. It almost makes me want to start living on bacon fat
and Haagan Daaz.

I'm not saying the MV study is wrong, or being reported wrongly; it's
just that it's so long and complex that we casual readers (and probably
many journalists) haven't read it closely enough and enough times to
decipher it. In the mean time, I'm not throwing out my half-bottle of
basic MVMM tablets; the dang things cost a whopping two cents a day.

I.P.

It seemed to me that there might be another explanation for this. For
example, suppose men with a family history were more prone to take
supplements.

Then I see buried in the paragraph under Table 5. the following
statement:

"Multivitamin use at more than seven versus seven or fewer times per
week was related to increased risk of advanced and fatal prostate
cancers but only among men with a positive family history of prostate
cancer, with P values for the tests of interaction for advanced and
fatal prostate cancers of .002 and .043, respectively."

Does that say what I think it says?

John

JohnHace wrote:

> It seemed to me that there might be another explanation for this. For
> example, suppose men with a family history were more prone to take
> supplements.

This business of the multivitamin study has come up a couple of times
recently.

In fact, the NCI suggests precisely what you said as a possible explanation,
John. If you have a family history of PCa, you are more likely to: (a) get
PCa; and (b) take multivitamins containing stuff that is supposed to
prevent PCa. So, there's a potential lurking variable in the association.
Unless they have controlled for that variable, then there's no reason to
draw any conclusion about multivitamin use.

And once again, I'd caution everyone reading studies like this that
associations, by themselves, never prove a causal link and cannot possibly
prove a causal link. Please do not overreact to this.

I have some time on my hands now that the academic year is over. I'll go
over this study in the next few days and tell you what I find.

--charlie

--
6/2006 PSA 5.2
DRE suspicious
7/2006 Biopsy
2 of 10 positive
Gleason 7(3+4)
11/2006 LRP
Clear margins
1/2007 PSA < 0.01
3/2007 PSA < 0.01
so far, so good

JohnHace wrote:
> It seemed to me that there might be another explanation for this. For
> example, suppose men with a family history were more prone to take
> supplements.
>
> Then I see buried in the paragraph under Table 5. the following
> statement:
>
> "Multivitamin use at more than seven versus seven or fewer times per
> week was related to increased risk of advanced and fatal prostate
> cancers but only among men with a positive family history of prostate
> cancer, with P values for the tests of interaction for advanced and
> fatal prostate cancers of .002 and .043, respectively."
>
> Does that say what I think it says?

That implies we have a clue what you think it says. I think it says my
cancer-free brother better stop taking MVs, but I can keep taking them,
because he has a positive family PC history (*me!*) but I don't.

Go figure!

I'm still waiting for some generous, motivated, discerning, bored,
perhaps even gullible statistician to wade through that dissertation and
tell me whether I need to stop taking my daily MMMV. ;-)

Now, about flax.
And soy.
And walnuts.
And pomegranate.
And urine.
No, scratch that one.
Did I sound cynical? *Moi?*

I.P.

chasjac too wrote:

> I have some time on my hands now that the academic year is over. I'll go
> over this study in the next few days and tell you what I find.

Good. I'm waiting with a MMMV tablet in one hand and a foamy glass of
warm . . . urine . . . in the other for your conclusion. ;-)

(Whether that makes any sense depends on one's order in reading this
thread.)

I.P.

I stopped taking my multi, Dr. Weil's in fact because of the Vitamin A
issue. Matti Narkiss who is a frequent contributor to these groups
mentioned the fact that the A that is used in multis are of the
cheapest type that is not only not good for us but possibly
detrimental to our prostate issues.

WhiteSoxFan