Blog

Five centuries before Christ, Greece was in its elements. Athens, emboldened after defeating the Persians, was particularly prosperous. With economic comfort, art and literature flourished. But so did philosophy. It was the era of Greek thinkers whose ideas shaped Western civilizations.

Patients who have been to my consulting room often comment on my degree certificates—apart from medicine and skin cancer—in law, ethics, and philosophy. I confess I am full of useless information, much of it superfluous in the real world. However, I must say I do admire the free thinkers of the Greek world such as Aristotle, Socrates, and Plato. Socrates, for example had a heavy face, stub nose, bushy eyebrows, big beard and was usually seen barefooted. He was also a man with no money—in short, he may have been full of great ideas, but was a kind of fellow our immigration department would immediately dismiss, detain or deport.

That was an era in Greece when there were no instruments of precision. Microscopes and telescopes came many centuries later. People like Aristotle were armed only with powers of observation and reasoning. Yet, they came very close to answering many questions posed by physics and biology. But free thinking led to many schools of thought, sometimes different and confusing to the common man. Whom and what to believe? That seems to be a question relevant even today. In today’s world, we have precision instruments, but fake news and AI-generated reality are creating a different kind of battle in medicine—science vs pseudoscience. Charisma, lies, paranoia and elitism confuse people even further, especially as everyone seems to have powers of overconfidence and a disregard for differing opinions.

I have often said that the word “doctor” derives from the Latin word docēre, meaning “to teach.” That suits me just fine as I am a compulsive student anyway and always seeking to learn new things. So I’m doing a bit of weekly reading for you, conducting little studies, and making observations—ignoring unconvincing science but searching for answers to questions many of you ask me. So here we go. A long winded way of explaining why I am talking about vitamins today. Because this is a question you have asked me about.

Vitamins are interesting research topics because results of studies when extrapolated often lead to different conclusions. As a medical doctor, I know—and have joked about this is lectures—that supplements mostly lead to expensive urine i.e., the chemicals are excreted as our bodies can generally obtain all we need from our diet. In my book, The Genetics of Health (Simon and Schuster) and in my upcoming book, Biohacking Your Genes—due to be released later this year—I advocate personalised healthcare for wellness, not illness. One achieves better health by targeting your diet and supplements according to your gene type.

Multivitamins exhibit an extraordinary degree of metabolic incoherence between individuals, with differing effects at cellular and metabolic levels. As we become older, especially from our fifties onwards, we seem to buy more vitamins hoping to recreate our youth as we begin to notice what’s declining. In medicine, we have been slow to understand that many of our patients take supplements anyway. We should be helping them decipher the research available and understanding drug interactions better.

Until now, the results from vitamin-related studies were confusing because some studies suggested that multivitamins could increase a person’s risk of developing bowel cancer, but other studies showed that certain vitamins—especially vitamin C and D—had anti-cancer properties and could be beneficial. So what should we be doing? A recent study—published in the journal, Cancer, tried to answer this question. I must add that because of the study’s observational design, confounding variables include reverse causation and recall bias. Otherwise, it seems to be a better-designed study compared to many others that had tried to answer this question.

The study was conducted on over two thousand patients (2424 patients with stages I-III colorectal cancer), using detailed information from patients in the Nurses’ Health Study and Health Professionals Follow‐Up Study. This study not only looked at the potential association between multivitamin use and bowel cancer-related death rates but also all‐cause mortality. I have summarised the findings for you below.

People were followed up for 11 years, during which 343 died due to cancer, and there were 1512 deaths overall. For patients that were diagnosed with bowel cancer, taking multivitamins three to five times a week—for example, taking them during weekdays and skipping weekends—was associated with a 45% reduced risk of cancer-related mortality. Mortality from all causes was also reduced at doses of six to nine tablets a week, but once someone started taking over 10 tablets per week, it paradoxically increased their risk for cancer-related death by 60%! This may explain the confusing results seen in previous studies where some showed benefits from taking vitamins and others showed an increase in risk. If seems to be how many pills you take, and how often, matters. A simple and effective way may be to take vitamins only on weekdays or have a couple of vitamin-free days a week for maximal benefit.

I am currently reading Plato’s chronicles of the last days of Socrates. A bit depressing read actually. Reading this took me back to a time I visited Athens, a terrible chaotic city full of amazing history. A sharp contrast to the idyllic Greek isles. I remember a trip to the ruins of the Temple of Apollo where the Oracle of Delphi—the shrine where Greeks asked questions about their own, or the world’s future—was preeminent. It is said that Socrates himself received permission for his life’s mission of challenging conventional wisdom and pursuing independent thought from this Oracle. On one side of the building, one can see the inscription: “Know Thyself”. On the other, it reads “All things in Moderation”. It seems that five centuries later, the message is the same. Even for vitamin consumption.

THE END