Hacker News Reader

Comment by invalidname | Hacker News Reader

This seems odd, as someone who has no medical knowledge. If it's just adding B vitamins, then a lot of people take vitamins. Especially when diagnosed with something as terrible as Parkinson's. I would expect to hear some anecdotal evidence on that for a diseases that is so common.

Edit: Very informative replies. Thanks!

View on HN

If we think about what vitamins are and consider the human body as an interconnected ecosystem with sub-ecosystems such as gut flora and skin flora, vitamins are compounds that your body cannot create from other compounds. Therefore, if these vitamins are not present, it could result in negative outcomes. Yet, the human body is remarkably good at making do, masking issues by priming itself for certain vitamins that are lacking in the diet. However, if this state is maintained for years, something has to give.

Science is finding that many chronic diseases, even some that have been thought incurable, are actually tied to lifestyle and diet. So, expect more of these articles.

The idea that vitamins are substances the body cannot make is somewhat outdated:

* Most of the vitamin D we need is actually synthesized by the body. (You still need sunlight to release it.)

* The body can also make vitamin B3 (niacin).

* Vitamin K and B7 (biotin) are made by gut bacteria.

There is an ongoing debate in science regarding which compounds should or shouldn't be classified as vitamins. But that discussion is beside the point.

Not only are vitamins important, but minerals are too. We cannot produce minerals ourselves. Magnesium is involved in at least 300 different metabolic processes.

If these essential compounds are not available, metabolic processes become difficult or impossible, eventually leading to chronic diseases that had been thought of as inevitable.

The study of the article found that a subset cases of parkinson are related to lifestyle and diet.

They megadosed B2 in the test. Many B vitamins behave differently at those pharmacological doses - for example, B1 will start acting as a carbonic anhydrase inhibitor like acetazolamide beyond 1600mg. B1 at doses over 3000mg is known to slow down some cancers up to 36% but under 100mg to speed up other cancers, over 2000mg it helps with some ALS and MS mimics. B3 at 3000mg seems to alleviate pellagra that is often misdiagnosed as schizophrenia. Daily recommended allowances of all these are like 1-2mg.

So, it turns out many vitamins in supplements are poorly absorbed in the gut. B12 shots are a thing too.

Bioavailability is as important as the nutrient that you're trying to get.

Yes - I was a Chemist in another life and the reality of physiology is that it is insanely complex and "just take vitamin pills" can amount to Dunning Kruger if things like the medium (a suspension, a solid, the solvents around it to think of a few...) can play such a huge role in the body's ready uptake of the active ingredient.

I mean we kind of already know this anyway - "person dies of alcohol poisoning after vodka up the butt" was a legend as a student but also a story of how "x units alcohol" is an oversimplification. There are similar stories with class As and people varying up the modes of ingestion...

Coming back to food I have anecdotally observed that my lactose intolerance reaction is more severe if the lactose is in something creamy. Even lactase pills have reduced effect on that. Although cream may be where the lactose is concentrated for all I know

The dose makes a huge difference. The amount you get in the daily multivitamin pills is minimal really if you have issues with processing those.

But wouldn't patients see deficiency in blood tests and get extra supplements for those two?

From the experience I have from doctors in Portugal, they will ignore that. My brother was not even warned by the doctor that he was pre-diabetic after checking his blood results.

B vitamin levels beyond B12 are rarely tested. You're unlikely to ever get it checked unless you experience specific neurological issues. Overtesting itself is dangerous, so... doctors don't have the incentive.

Dangerous in a sense: costs money right now, we would have to deal with it. My friend once said: “no one is healthy, your doctor just does not have the testing resolution to find the issues” and in 3 years you get parkinsons…

That's too cynical. In reality, you're going to die with a number of completely benign issues. The more issues you find and try to interfere, the more likely you are to have a negative impact. And that's before running into issues with testing failures from a large number of tests. We not only can't find all issues, we can find more other issues than are ever going to be an actual problem.

But it's not really a money issue (not in a lot of cases anyway) - where it leads to better outcomes, doctors do aim for overdiagnosing to a certain % to cover cases which would be otherwise missed.

B12 can be tricky to pin down. It can be falsely elevated by vitamins.

You need cofactors, e.g. a B2 deficiency could falsely give the impression of repletion.

This is ON TOP of the really loose grounding of accepted ranges for various vitamins. Many of the levels are established on the basis of avoiding severe disease like vitamin D: "no rickets above this level" and B12: "no anemia above this level." Which is completely different than assessing optimal levels.

> This is ON TOP of the really loose grounding of accepted ranges for various vitamins. Many of the levels are established on the basis of avoiding severe disease like vitamin D: "no rickets above this level" and B12: "no anemia above this level." Which is completely different than assessing optimal levels.

This is concerning. Is there anyone keeping a database of optimal rather than minimal levels?

You don't see tissue deficiencies in blood tests. You can have a local (e.g. brain) deficiency in the making for 30 years before it hits you and no blood test will show it as your body works hard on having perfect blood all the time.

IF they're tissue deficiencies. Many B vitamins get processed and flushed within hours with some get elevated blood levels for days.

I wonder how that compares to the amount in Marmite, which seems to be often recommended by doctors in the UK for those deficient in vitamin B (and you’re in the lucky 50% of the population that actually likes it).

Reply on news.ycombinator.com