Why Do We Need Vitamins?

According to the U.S National Cancer Institute 2003 data, the survival rate one year after diagnosis is quite low, 24%, 36%, 43%, 51%, and 58%, for cancer of the pancreas, liver and bile duct, lung and bronchus, stomach, and brain and nervous system, respectively, for examples. There is no doubt about the need for prompt and accurate diagnosis and effective treatment of these diseases, and other diseases, if even not for their prevention in the first place. We could be saving many lives and substantial amounts of money.

To be sure, the path toward realizing these goals is long and convoluted in many countries, given for examples, the obstacles in the way of jettisoning some of the more entrenched practices in the medical sector, including the atavistic paternalism that characterize the healthcare delivery enterprise. This latter, which makes it important to the doctor for example, to stick with the customary approach to diagnosis as opposed to embracing the evolving diagnostic opportunities that personalized medicine offers, could create the very delay antithetical to diagnostic agility, crucial to saving lives, not mention lots of healthcare dollars.

We now know that many of the medications we currently use to treat diseases do not work for some individuals, for a variety of reasons, including mutation-induced variations in gene expressions. Indeed, gene sequencing has given us the tools to identify the links between specific genes and diseases, hence the subtypes of diseases hitherto deemed one disease, sharpening diagnostic focus, and improving treatment effectiveness. No doubt, advances in medical knowledge would continue to shape practice, but could we afford this to be at snail’s speed, literally, with many lives lost, significant health spending also resultant as diagnostic ineptitude compromise treatment success?

Do we not need to identify and engage the obstacles to acknowledging the significance of the individual rather than a motley yet holistic entity for whose health conditions we adopt a generic perspective in disease diagnosis and treatment, even prevention? Given these and other considerations, it seems certain that we cannot ignore the role that vitamins could play in the context of our efforts to curtail the human and material costs of such a viewpoint. The answer to the question posed in this article seems self-evident after all many would heard about the deficiency diseases the lack of certain vitamins cause, and for example, the scourge of scurvy on many a sailor in years past on voyages too long to sustain their supplies of citrus and other vitamin C-rich fruits.

What is not that obvious is the place of vitamins in the paradigmatic shift in practice that progress in medical knowledge and technology would impel. Thus, would it be necessary and would we be able, in the new dispensation to tailor vitamins to individuals, in other words, to personalize vitamins? Would we need vitamins for reasons other than preventing the deficiency diseases associated with their lack, for instance? If in fact, we are able to link vitamins to other diseases, how and to what extent could such knowledge change our current perspectives on vitamins? Consider a study published on October 30, 2007 in the Journal of the National Cancer Institute1.

The study noted no linkage between serum vitamin D levels and overall cancer mortality. On the other hand, it found a probable link between high levels of the vitamin and reduced mortality from colorectal cancer, particularly. What could such findings mean for preventing colorectal cancer in the tropics, or even among individuals anywhere in the world who have abundant exposure to the sun? Do we not need more research into variations in the expression of the benefits of this and other vitamins on particular individuals for example? Thus, the researchers, D. Michal Freedman, and colleagues observed that Vitamin D had been thought to reduce cancer mortality via its effects on incidence and/or survival, but the restriction to incident cancers at a few of epidemiologic studies of the link of 25-hydroxyvitamin D [25(OH)D] and cancer risk.

Their multivariate analysis of data from Third National Health and Nutrition Examination Survey (NHANES III,) 16818 individuals aged 17 years or older at enrollment followed from 1988–1994 through 2000, found no link between vitamin D and overall cancer mortality, even on stratifying by sex and ethnicity. Rather, it revealed an inverse relationship between 25(OH) D levels and colorectal cancer mortality, colorectal cancer mortality decreasing significantly as vitamin D level increased.

Yet the journal’s editors did not hesitate to warn that, "While vitamin D may well have multiple benefits beyond bone, health professionals and the public should not in a rush to judgment assume that vitamin D is a magic bullet and consume high amounts of vitamin D." Such studies would no doubt raise perhaps even more questions than the answers that they provide in future given what some would consider the frenetic pace of progress in medical and technological knowledge, which, in tandem, would move us ever closer to the era of customized vitamins.

 

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