Which vitamins and minerals to take at what age

Once again, we give way to the many queries we received from our readers. Though we cannot print all of them, here are my choices of the most interesting questions we’ve received. Hope you’ll all find them informative.
When To Start
At what age should I start taking supplements and which vitamins and minerals should I be taking? – A.P., Baguio City

Here’s a quick rundown of the right vitamins and minerals to take at the right time:

In your 20s, 30s, and 40s:
The US National Academy of Sciences recommends that all women capable of being pregnant take a daily multivitamin containing 400 micrograms of folic acid to reduce the chances of having a baby with a neural tube defect.

In your 50s:
After age 50, the daily need for vitamin D, crucial for calcium absorption, doubles from 200 International Units to 400. It’s hard to get that much from food. Milk, the richest source, has only 100 units per cup. To be on the safe side, take a multivitamin that contains 400 units of D (the daily value)-200 units if you drink at least 2 cups of milk daily.

In your 60s:
An estimated one out of five persons over 60 (and two out of five over 80) don’t get enough vitamin B12, necessary for proper brain and other neurological functioning. It’s not because they don’t take in enough from foods. It’s because their stomachs don’t have enough gastric juice to allow it to be absorbed by the body. Taking a multivitamin with 2.4 micrograms of B12 (40 percent of the daily value) gets around the problem.

In your 70s:
Vitamin D needs go up to 600 International Units (150 percent of the daily value). A number of multivitamins formulated for older people contain that amount.
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Iridology
I saw TV ads claiming that iridology is beneficial for many illnesses. If so, why are you doctors against it? What’s the real truth? – R.A., Quezon City

Iridology is defined by its proponents as "the art and science of assessing physical health by examining a person’s iris." Local medical doctors, however, led by the Philippine Academy of Ophthalmology, Inc. (PAO) and the Philippine Medical Association (PMA), have called it a "pseudo-science," a "scam," and an "unproven clinical method" of diagnosing physical ailments.

Indeed, iridologists have failed to provide scientific proof of the value of their field in accurately diagnosing various diseases and medical conditions. For instance, I am not aware of a single scientific investigation published in a peer-reviewed medical journal which shows a positive result for iridology.

On the contrary, as pointed out by PAO’s Dr. Ma. Dominga Padilla, the "latest scientific evidence based on extensive systematic review of iridology has shown that it is not a useful diagnostic tool, and that it has the potential to do damage in economic and health terms."

According to Quackwatch, Inc., a US-based organization whose purpose is to combat health-related frauds, myths, fads and fallacies, tests conducted on iridology have so far been inconclusive. In a recent study, five leading Dutch iridologists failed to correctly distinguish between patients with gallbladder disease and those who were healthy. Nor did their diagnoses match.

I agree that we should keep an open mind as regards the possible value of the different complementary and alternative approaches to health care. But we should not be afraid to also abandon those practices which cannot pass scientific scrutiny.

May I, therefore, reiterate the advisory of the American Academy of Ophthalmology (published in the Archives of Ophthalmology, 118:120-121, 2000) which has been translated into Filipino as follows:

• HINDI ito sangay ng medisina.

• WALA itong siyentipikong batayan.

• Ayon sa masusing pag-aaral ng mga dalubhasa sa buong mundo, HINDI ito mabisang paraan ng pagsuri o pagtuklas ng sakit o kahinaan ng katawan.
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Hospice Care
My mother is dying of cancer of the breast. She said she wants to die at home "in dignity." I’m scared. Who can I turn to in situations like this? – M.S., Makati

Many people with terminal illness could be helped by a hospice program – a comprehensive set of services, including visits by a health team, that offers care for the terminally ill patients in the comfort of their own homes, so that they can "live the rest of their lives in peace with their family." People with advanced cancer are the ones who most likely will benefit from hospice care. Others include patients with advanced heart, kidney, or Alzheimer’s disease.

When should you consider hospice care? "If someone is sick enough that life expectancy is not more than six months, it’s worth getting in touch with a local hospice program," says Joanne Lynn, MD, director of RAND Center to Improve Care of the Dying, in Arlington, Va., USA.

We are lucky in the Philippines to have a newly-established hospice program, HOME Inc., (Hospice of Manila Empowerment Inc.), established by three caring friends – Susan Reyes, Tess Escaler and Annette Sumulong – and headed by Dr. Josefina Magno, an outstanding Filipino physician who is the recognized founder of hospice care in the United States, and who has come back to introduce this concept of care in her home country.

HOME Inc., has a team of medical doctors, nurses, counselors, clergy and administrators, all of them hospice-trained and oriented, who can go to patients’ homes several times a week. If necessary, they can provide medical equipment, hospital beds and private-duty nurses. Their aim is to assist both the patient and the family by taking care not only of the medical requirements of patients but also of their emotional and spiritual needs.

"We at HOME Inc. firmly believe and dedicate ourselves to helping terminally-ill patients die in silence and serenity. It has been said that the best gift of love we can give a dying person is to help him to die well," says Reyes.

For more information on HOME Inc., call 750-5143, 814-0602, and 814-0645. They can be contacted 24 hours a day, seven days a week.
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Gerovital
Does Gerovital really help prevent aging and senility? My doctor claims it does. – P.C., Quezon City

It won’t prevent or cure anything. Gerovital, called GH3, has been around for years – it’s also one of those crazy ideas that never die. Many readers have questioned me about it and I have written on gerovital in the past.

It focuses on fears of senility, and actually claims that age spots on the skin are the first sign of impending memory loss, which is baloney. Previous ads were even more sweeping: "Famous Romanian anti-aging formula will make you younger overnight." Ads also claim that gerovital or GH3 is a new vitamin or a drug that can cure arthritis, heart disease, depression, diabetes, and many other ills.

Gerovital is supposedly a derivative of procaine (Novocain), the local anesthetic used by dentists. The ads say that gerovital was created at the Geriatric Institute of Romania. There actually is such an institute in Bucharest where, starting in the 1940s, Dr. Anna Aslan experimented with procaine injections as an anti-aging drug. However, no one has been able to replicate her experiments. Studies have never shown that procaine – gerovital – is of any use in combating the effects of aging.

Moreover, though the current makers of gerovital claim that it’s a derivative of procaine in pill form, that is wrong. Actually, the pill contains only one of the components that procaine breaks down into the body: PABA (a sunscreen and also a constituent of some foods). It also contains a synthetic mood-altering substance, as well as an amino acid and a hodgepodge of vitamins and minerals.

Gerovital is sold as a "nutritional supplement" – not a drug. In the US, the FDA has periodically pursued it. In theory, even in the Philippines, marketers cannot make explicit health claims for such stuff, but that doesn’t stop them in the current free-for-all market. This is an excellent example of how our own BFAD is unable to protect us from quack products.

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