Saturday, August 31, 2019

Less may be more

Homeopathy is a medical system based on the belief that the body can cure itself. Those who practice it use tiny amounts of natural substances, like plants and minerals. They believe these stimulate the healing process. While homeopathy has never caught on as well in America as it has in Europe, there is something to be said for “less.”
Most Americans have always equated “more” with “better,” but several recent studies have pointed to the fallacy of this belief. We need iron to build hemoglobin as well as many other functions of the body, but too much iron is toxic. Our bodies have thus cleverly built in a mechanism to protect us from excessive iron. A protein made in the liver, hepcidin, stops iron absorption when too much iron is sensed. We were taught in medical school to treat iron deficiency anemia with as much oral iron as the patient could tolerate (excessive iron causes a lot of stomach distress). Well, it turns out that by upping the dose of oral iron simply turns on the hepcidin and blocks iron absorption. The optimal dose of iron to treat patients with iron deficiency is not the traditional 300 mg/day, but 200 mg every other day!
Vitamin D gives another example. We need Vitamin D for strong bones; it is needed for our bodies to absorb calcium. Since the main sources of Vitamin D are sunshine acting on our skin to let us produce our own Vitamin D or milk fortified with Vitamin D, many adults are deficient in this crucial vitamin, particularly those living in Northern climates, where for much of the year there is not enough sun exposure for us to manufacture our own. Deficiency of Vitamin D leads to osteoporosis and falls, with resulting fractures. National guidelines recommend that adults take 600-800 Units of D daily. Well, if 600 is good, more must be better, right? If you go to your pharmacy, you will see Vitamin D capsules of 1000, 2000, and even 5000 Units. Unfortunately, studies have shown that older adults who took 4000 Units daily had slower reaction times than those who took the recommended 800 U and were more likely to fall. A more recent study has shown that those taking 5000 U or more paradoxically had more fractures than those taking lower doses. High doses of Vitamin D can lead to excess calcium absorption, with high blood levels, and this in turn can cause nausea, constipation and excess urination or even kidney failure.
So, take the recommended dose, but do not think that doubling it up will be better!

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