Over the past few years, there has been much debate about the benefits of taking vitamins, especially vitamins E and C, at a higher dosage than the body's daily requirement, in the hope that they can prevent heart diseases and hardening of the arteries. These two vitamins have antioxidant properties, but can they also prevent disease?
Vitamin C and vitamin E occur naturally in the food that we eat, so essentially they pose no harm. They are also affordable and widely available, so they are quite popular because most people think they are "natural" substances and won't do any harm to their health. They hope that they will help them stay forever young and healthy. The truth is, too much of a good thing can have the opposite effect.
There have been several systematic experiments to determine whether these vitamins do what they are claimed to do. Comparing a group of people who received vitamin E and vitamin C to a group of those who did not, it was evident that after a year, there was no significant indicator that the vitamins helped with the arteries or the heart in general.
In fact, it was found that vitamin E could have a negative effect on some treatments for the heart. It might also reduce the effectiveness of stain drugs used in reducing blood cholesterol. Now it is believed that supplementary vitamins, especially the two in question, cannot really prevent heart diseases, and might even do the opposite.
Another popular supplement is hormone replacement for menopausal women. Since certain hormones take a dip after women reach menopause, and since many menopausal women have heart diseases, especially myocardial infarction, it was speculated that hormone replacement therapy (HRT) might help reduce the risk of heart diseases and hardening of arteries in women.
Menopausal women also display certain unexplainable symptoms, so a lot of doctors believe HRT will help them feel better.
I had a patient in her early 50s. She was fit, active and in good shape. She told me that her heart felt light sometimes and every once in a while she would wake up with a sharp pain in the left side of her chest. The condition was irrelevant to exercise _ strangely she felt better, not worse, after working out. She exercised regularly, walking and jogging for 30-40 minutes every day. Sometimes she felt hot flushes for no reason. Sometimes she couldn't sleep. Sometimes she felt sleepy all day. Sometimes walking up the stairs made her tired, while exercising was never a problem.
I found that there was nothing wrong with her physically. Her blood pressure, pulse and cholesterol level were not something to worry about. Everything else also seemed fine to me.
However, she said that she might have narrowed arteries because her father did, and he had the same symptoms as she did at the time. She also said that her periods had always been regular when she was younger, but recently they had been irregular.
I told her that the symptoms did not point to narrowed arteries, but to menopause and recommended that she to talk to a gynaecologist. I also told her to watch her cholesterol level if she was worried about having narrowed arteries.
Two months later she came back to see me and said that she felt much better after undergoing hormone replacement therapy, but she would like to check her cholesterol level just in case. She told me she had been watching her food intake and exercising more often.
To my surprise, her cholesterol level had gone up to 300mg/dl. She told me that she had been eating healthy food and exercising more. Could the hormone replacement be the reason?
We used to believe that HRT could help prevent heart disease in menopausal women, but then again, women's hearts are always unpredictable. Many studies have shown that hormone replacement could lead to a higher risk of heart and artery diseases. Paralysis is more common in women who receive HRT compared to those who don't. In other words, hormone replacement can reduce the effectiveness of medicine that is supposed to keep the cholesterol level in check.
Hormone replacement is something that should be reserved for menopausal women who have very severe symptoms. Mild symptoms can be treated by following a healthier lifestyle. It only takes a while for hormones to adjust themselves, so the nasty symptoms will go away on their own.
Back to that patient, I told her to stop her hormone replacement and exercise more. I complimented her on her strict diet and told her to continue eating fruits and vegetables. About three or four months later, she came back to see me and her cholesterol level had gone down to 180 mg/dl without any help from medicine.
So, let me conclude my point here. Supplementary vitamins and hormones do not really help with menopause, if a woman lives a healthy lifestyle by eating plenty of vegetables, fruits and nuts as well as exercising. They might even have adverse effects. There is no reason why you should take them, except if your doctor recommends them.
Personally, I would recommend exercise instead because it doesn't come with any undesirable side effects.
Dr Nithi Mahanonda is a consultant cardiologist and interventionist at Perfect Heart Institute, Piyavate Hospital. Visit his website at www.drnithi.com