Vitamin and mineral supplementation

With a couple possible exceptions, it is unnecessary for most Marshall Protocol (MP) patients to supplement with vitamins or minerals. A balanced diet of whole foods usually offers a person all the nutrients needed for good health. While nutritional supplements including multivitamins are wildly popular, there is no solid evidence that they contribute to long-term health, reduce symptoms, or cure chronic disease.

Patients who are concerned that their diet is less than ideal should study the Reference Daily Intake (RDI) values of the standard nutrients against their diet to determine if they are deficient. Patients should not consume more nutrients than what is recommended than the RDI. Note that both vitamin D and supplemented (not naturally occurring) folic acid are contraindicated.

Multivitamins and B-complex vitamins can be purchased without vitamin D but they contain folic acid. In order to avoid added vitamin D and folic acid and or potentially immunomodulatory herbs, take each of the vitamins and minerals needed, if any, separately.

• folic acid and folate – folate is a water-soluble B-vitamin that occurs naturally in foods; folic acid is the synthetic form of folate; MP patients must avoid products containing supplemental folic acid as it contributes to bacterial growth
• vitamin B12 – readily available in meat and dairy products so, unless a person is a vegan, he or she is probably not deficient; exceptions include certain malabsorption syndromes and pernicious anemia, conditions where people cannot absorb B-12
• vitamin C – ascorbates promote the transcription of Th1 inflammatory mediators and, therefore, large doses of vitamin C (ascorbic acid) may prove to affect the immune system in a way that is counterproductive; as little as 10mg per day of vitamin C is needed to prevent scurvy
• vitamin E – supplementation has fallen out of favor with healthcare professionals
• vitamin K – promoted for osteoporosis prevention but deficiency in adults is rare

Juicing vegetables can increase the concentrations of individual ingredients to a level which your body cannot handle.

Do not consume vitamin D as it is immunosuppressive and will interfere with progress on the MP.

Note that the ban on vitamin D includes synthetically produced vitamin D analogues, which go by any of the following names: calciferol, calcitriol (Calcijex, Rocaltrol), calcifediol (Calderol), calcipotriol, calcipotriene (Dovonex), cholecalciferol aka vitamin D3, ergocalciferol aka vitamin D2 (Drisdol), Delta-D, Radiostol, Radiostol Forte

• calcium – mineral is important for bone health and may protect somewhat against osteoporosis and osteopenia; available in a ariety of foods
• iron – although physicians frequently prescribe iron supplements in the face of low levels of hemoglobin and hematocrit, they may also want consider an alternate view that, low levels of iron are an adaptive physiologic response to infection
• magnesium – for patients who suffer from constipation, Milk of Magnesia or magnesium oxide tablets will prevent this symptom and provide magnesium supplementation also; Epsom Salt baths may be palliative and can add to magnesium levels (Note: patients with poor kidney function should check with their doctor before supplementing magnesium to avoid hypermagnesemia).
• potassium – do not take potassium supplements without a doctor's approval and periodic testing
• zinc – vegetarians may need supplemental zinc

Do not take iron supplements, multivitamins, calcium supplements, antacids, or laxatives within 2 hours before or after taking minocycline. These products can make minocycline less effective.

According to a 2009 study, approximately 33% of US adults use multivitamin/multimineral supplements (another 50% use dietary supplements).¹

Long-term studies on the use of multivitamins show that the pills tend not to protect against disease:

• Supplements don't prevent infections in the elderly – A 2005 BMJ study said that there was “conflicting data” in their systematic review in the use of multivitamins and mineral supplements in preventing infections in elderly people.² However, in an erratum, the authors retroactively excluded three studies from their analysis and said there was “no benefit.”
• Children who end up taking vitamins in the United States today don't actually need them - A 2009 Archives of Pediatrics and Adolescent Medicine found that about one-third of American children ages 2 to 17 had used a vitamin or mineral supplement within the previous month, but that most of them did not need to supplement their diet.³
• Increased risk of pre-term birth – Regular multivitamin-mineral supplement use during pregnancy, in a developed country setting, is not associated with size at birth. However, a 2010 study of British women found that daily multivitamin use in the third trimester was associated with preterm birth.⁴

Use of vitamin and mineral supplements among cancer survivors is widespread. In studies combining different cancer sites, 64% to 81% of survivors reported using any vitamin or mineral supplements and 26% to 77% reported using any multivitamins.⁵ However:

• Multivitamins don't protect against cancer – A study of more than 160,000 post-menopausal women, published in the Archives of Internal Medicine found that multivitamins did not prevent cancer, heart attacks, or strokes and did not reduce overall mortality.⁶
• Multivitamins may increase breast cancer – A large prospective study of 35,329 cancer-free women found that multivitamin use was associated with a moderate but statistically significant increased risk of breast cancer (breast cancer survivors reported the highest use of multivitamins among cancer survivors⁷) after an average follow-up of 9.5 years.⁸ After adjustment for breast cancer risk factors, women who used multivitamins had a 19% higher risk of breast cancer than those who did not use multivitamins.
• Vitamins don't protect against lung cancer – A 2008 prospective cohort of 77,721 men and women found that supplemental multivitamins, vitamin C, vitamin E, and folate were not associated with a decreased risk of lung cancer. Supplemental vitamin E was associated with a small increased risk.⁹

In a 2010 randomized controlled trial appearing in JAMA, the effect of high-dose vitamin B (folic acid, vitamin B6 and vitamin B12) on diabetics was studied. In the trial, those receiving the B vitamins had significantly greater worsening of kidney function, measured as GFR. (Glomerular filtration rate is the test used to measure the level of kidney function.) The participants also had twice as many heart and stroke incidents.¹⁰

The article on antioxidant supplementation discusses other such research.

• The Vita Myth: Do supplements really do any good?
• Children Who Take Vitamins Often Don’t Need Them
• Megavitamins: the vitamin business thrived through the recession. Why?