Are vitamin supplements necessary for all? A role for vitamin status assessment
The word ’vitamine‘ was first used in 1911 by the Polish scientist Dr Kazimierz Funk who, while working in London, referred to an amine-containing compound which was found to be vital for life – thiamine (now also known as vitamin B1). It was subsequently found that vitamins do not share any commonality in their structure, nor do they all contain amines, hence the word ‘vitamin’ was coined. Today, although the role that 13 recognised vitamins now play in numerous developmental and metabolic processes has been well defined, many other functions need to be better understood.
Similarly, the clinical utility of vitamin supplementation in the treatment and prevention of disease has been well established for some disorders (ie vitamin C to prevent scurvy, vitamin D for rickets and vitamin K prophylaxis to prevent bleeding) while controversies exist regarding others (ie folic acid fortification leading to the presence of unmetabolised folic acid in blood, or vitamin E supplementation in smokers).
Deficiencies of some vitamins are prevalent in patients and general populations, and it is important that these are diagnosed and treated early. However, the prevalence of elevated vitamin concentrations is much more common, often resulting from excessive intake. The adverse effects of oversupplementation for many vitamins have not yet been very well studied. These need to be taken into consideration when treatment is takes place. Assessment of vitamin status coupled with investigations of causes of vitamin status should precede any future treatment.
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