The Medical Procedures Center, P.C.

“We treat people, not just problems.”


John L. Pfenninger, M.D.

4800 N. Saginaw Road

Midland, MI 48640

(989) 631-4545


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As baby boomers reach their 50’s, the realization that life is limited begins to hit home.  Anything and everything that promises a “longer and healthier life” enjoys vast and swift acceptance.  The real problem is determining what are real and what are false claims. The whole area of vitamin replacement is very promising and yet very confusing.  A recent article in the Midland Daily News took up nearly a half-page of space but merely listed many potential herbal remedies. The money now being spent on vitamins is astronomical.  A survey of cardiologists discovered that more of them take daily vitamins than take daily aspirin!  Hopefully this article will help clear up some issues.


In a recent TV documentary, the head of the National Institute of Health recommended two major changes in health practices to markedly reduce the incidence of cancer:  (1) stop smoking and (2) supplement the diet with vitamins.


Although the cancer prevention diet is very simple (eat five helpings of fruits and vegetables per day – the more red, the more green, the more yellow, the more orange the better!!), we do not eat what we really should. To consume enough folic acid for maximum benefit would require us to eat far more vegetables than we could ever tolerate.  It turns out that the folic acid in fruits and vegetables is not as well absorbed as folic acid in vitamins!


The topic becomes even more confusing because the AMA and many other experts still suggest that taking multivitamins is a waste of money and we do nothing more than pass them through our system into the toilet bowl.  The past director of the NIH, the University of CaliforniaBerkley, the American Cancer Society, and many other organizations now, however, recommend routine supplementation.  One article from the American Cancer Society’s Journal for Clinicians, acknowledges that we do not quite know what to take, how much to take, or when to start.  However, according to them, the evidence is no longer controversial – we do better with supplemental vitamins.


There are as many answers to the question, “What should I take?” as there are doctors.  At this point in time, it would appear prudent that we should do the following: Eat five helpings of fruits and vegetables per day, as noted above, and take a good multivitamin with minerals.  Men should use preparations without iron (iron increases heart disease). Folic acid is extremely beneficial to reduce cancer, birth defects, and heart disease.  It is generally obtained in a good multivitamin. The American Urology Association recommends that men take 400 IU of vitamin E per day to prevent prostate cancer. Women should also take this dose, since it reduces heart disease. A recent review of vitamin C in the Journal of the American Medical Association suggested that we need approximately 200 mg in supplements and should probably not exceed 1000 mg.


In addition to this, those over 35 should probably begin using a baby aspirin (¼ of an adult aspirin) per day.  This reduces strokes, heart attacks, and will also reduce colon cancer by 50%. Ginkgo biloba is an herbal medicine which increases neurological functioning and many recommend 2 or 3 capsules per day after age 40.  Women should take estrogen replacements and calcium (1200 mg per day).


For those who can tolerate it, one tablespoon of flaxseed oil would also be beneficial.  It contains omega 3 oils (the same beneficial ones as those found in fish) which have numerous benefits. Watch out, though, since the oil does have a lot of calories.                                     


I have often been asked about what brand of multivitamins to take.  Personally, I select a different brand each time and actually like many types from the health food store. They give me less of an upset stomach.  Vitamins should be taken with meals for better absorption.  Do not begin taking everything all at once, because it will not be tolerated well. Start off with one vitamin and make sure your stomach can handle that one before adding the others.


There are hundreds of supplements that are now touted as essential for us. Time will help sort out what is actually needed.  The only supplement not recommended presently by most everyone is beta carotene.  It is a precursor to vitamin A and was often recommended in the past.


The evidence for beneficial effects of vitamin supplementation is very strong.  A basic program that would be safe would include a good multivitamin with minerals, vitamin E (400 IU), vitamin C (200-1000 mg), 81 mg of aspirin per day, Ginkgo biloba (1-2 per day), and 1 tablespoon of flaxseed oil. Women should take estrogen and calcium in addition. 


Copyright, 2011. John L.  Pfenninger, M.D                                                                                                                                                  jw03/10