Pills, pills, pills: Can a diabetic take too many vitamins?

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Growing up with type 1 diabetes, one of the sticking points (pun intended!) was always that it couldn’t be managed with oral medication. Nope– “Shots, shots, shots!”  it was, and not in a fun, drinky way. And then in 2005, I graduated to an insulin pump, but that’s just a more mechanically complex syringe. Treatment, for me, is about blood and tissue and infusion.

So it’s a little disorienting to find myself popping handfuls of pills every day now that I’ve entered adulthood. Granted, most of them are over-the-counter vitamins, but still– I count nine caps a day:

  • Synthroid (for autoimmune thyroiditis)
  • Estrogen (to keep hormone levels in balance)
  • A salt cap (my blood pressure runs low, and this seems to help)
  • A multivitamin (from GNC; two pills, each of which is pretty big as is, so I’m glad it’s not combined into one)
  • A Vitamin D/Calcium supplement (from Costco; two pills, to meet the 1000mg/day bone health recommendation from my doctor)
  • Fish oil supplement (from Costco; I hate taking this one, because I can taste the fish oil)
  • Low-dose aspirin (from CVS, a sugar-free, safe for diabetics version)

 

Looking at this list, I get slightly worried. Should I be taking so many vitamins? Doesn’t that seem like maybe it could have unforeseen negative effects? Is it too much? Should I go all natural?

Then my more rational side kicks in and reasons, well, everything I eat and breathe all day is full of synthetic everything; these vitamins and medications were carefully selected (I read reviews and Consumer Reports, and I read the FDA statement on lead content in women’s vitamins), so really the question is not nothing versus a set of supplements, but rather tons of engineered input versus some additional engineered input that is specially selected to be helpful. But, still. Nine pills a day? That’s weird, right?

The aspirin is the most recent addition. I feel like I’m young to begin worrying about cardiovascular health and cancer, but, then again, I’m a diabetic, and I seem to aim for high-intensity life rather than carefree, stress-free living, so heart disease and cancer are real risks. And the scientific pendulum has swung back in favor of daily low-dose aspirin as a “We don’t understand why it works, but it seems to help,” long term preventative for cancer (see, for example, the recent piece in Science Magazine on the controversy over aspirin).

However, if we don’t really understand the mechanism behind things like aspirin, but we theorize that somehow over the long term they have measurable effects that we think right now are positive, then it is easy to imagine that over the long term these seemingly innocuous pills could be having measurable negative consequences as well. How can I know? To paraphrase Milan Kundera, if I only live once, I cannot test both scenarios– taking these vitamins every day versus not, all else being equal. I can read studies and consider the aggregate statistics, but without understanding how exactly they work, I can only guess what the exact effect will be on me, for my body. Maybe taking Vitamin D will make me 1% less likely to get a bone fracture down the line. But maybe the molecular formulation of the capsules interacts with some errant cells lodged in my bones somewhere, and day after day helps those cells get stronger, and actually I’m 1% more likely to get bone cancer in sixty years.

And then I pause this stream of thought and I consider: sixty years! Think of how far we have come, that I, a diabetic, think nothing of forecasting my life sixty years out.

Besides, statistically speaking, my worrying about the outcomes of taking so many pills is more likely to cause long term damage than just taking the pills.

Put more poetically (and to make up for the fact that I began this post with a reference to LMFAO), consider the passage from one of my most favorite books, Kundera’s Unbearable Lightness of Being:

“There is no means of testing which decision is better, because there is no basis for comparison. We live everything as it comes, without warning, like an actor going on cold. And what can life be worth if the first rehearsal for life is life itself? That is why life is always like a sketch. No, ‘sketch’ is not quite the word, because a sketch is an outline of something, the groundwork for a picture, whereas the sketch that is our life is a sketch for nothing, an outline with no picture.

Einmal ist keinmal, says Tomas to himself. What happens but once, says the German adage, might as well not have happened at all. If we have only one life to live, we might as well not have lived at all.”

Which brings me to the most reasonable conclusion I see possible: que sera, sera. And with that, it’s 78F and sunny in October in San Diego, so I’m going to go outside and enjoy that– the threat of skin cancer be damned!

 

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Comments (3)

  1. david at

    Do you think that is a lot of pills?  i give my daughter vitamin C, Apple Pectin, Glutathione, Vitamin D (5,000 iu) multi vitamin, anastaxin (sp), xeanathin (sp) mineral drops, l carnitine, fish oil, and that is just the basics.  i give her alpha lipoic acid and other stuff when i can slip it by her.  oh yes, sub lingual vitamin b as well.

  2. Catherine at

    Hi Karmel, 

    That’s one of my favorite books, too! As for the pill question, as you may know, I’m working on a book about vitamins at the moment (the substances in general, not just the pills) — and all the things you mention seem totally reasonable to me based on my research thus far. (I take fish oil and D, too.)  The thing to keep in mind (to anyone out there who goes beyond basic multivitamins and things like the stuff Karmel mentioned) is that there is no FDA oversight/preapproval for supplements in the US. In the case of normal multivitamins, usually the biggest issue is whether it truly contains the amount the label says it does. But the more exotic products in GNC, like weight loss, sexual enhancement and body building supplements, are much, much sketchier, and can have some truly dangerous substances (including illicit pharmaceuticals) in them. Also, it’s worth noting that some of the herbal stuff, like St. John’s Wort, can interact with medications (including birth control in the case of St. John’s Wort). So while I personally see little risk in taking basic vitamin and mineral supplements, you should definitely exercise caution/talk to your doctor before taking some of the more exotic stuff. And always remember that the FDA is not proactively testing any supplement for anything — drug interactions, purity, strength, quality, actual ingredients, etc — it’s only after market, if it happens at all. ALso, a good resource for picking a supplement is consumerlab.com — they actually pull samples off the shelves and do spot testing to see if they contain what they claim to. And lastly, if you’re worried about how much of a particular vitamin you’re taking (I don’t know as much about minerals), the one to really worry about is A (and, to a lesser extent, D, E and K since those are the fat soluble ones that can build up in your tissues; the others are excreted in your urine). Whew! Sorry for the long comment (more of a riff off your post than a response, I guess!). 

  3. Jess at

    Yikes.  I just bought a bottle of vitamin A.  

    This is a really interesting topic.  I think about it a lot, like every time I take my vitamins.  And then if I think about it too much I don’t take my vitamins.  

    I despise the fish oil capsules.  Recently bought flax seed oil.  It also tastes terrible, like grass, but I guess I prefer that over fishy. 

     

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***The opinions and views expressed in this blog belong to the individual contributor and not to ASweetLife or its editors. All information contained on this blog is intended for informational purposes only. The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.