Do B Vitamins Cause Lung Cancer In Men

Written by Dr. Steve Chaney on . Posted in B Vitamins and Cancer

Do B Vitamins Cause Lung Cancer In Men?

Author: Dr. Stephen Chaney

 

do b vitamins cause lung cancer in menLast week one of my readers contacted me and asked me to comment on an article in The Atlantic titled: “Vitamin B6 and B12 Supplements Appear to Cause Cancer in Men”. I did what any good scientist would do. I read the original study (T.M. Brasky et al, Journal of Clinical Oncology, 35: 3440-3448, 2017 ) and analyzed the data, so I could provide you with the truth behind the headlines.  Continue reading to find the answer to “Do  B vitamins cause lung cancer in men?”

I will give you my analysis in a minute. First, let me use the internet chatter about this study as a perfect example of how nutrition myths are born.

 

How Did Journalists Interpret The Clinical Study?

Journalists are not trained scientists. They seldom read the whole article. They rely on the abstract of the article and interpret it through their “filter” of reality. The author of The Atlantic article did a reasonably good job of reporting the information in the abstract. However, news articles need to be spectacular to attract readers, so the information was presented selectively.

do b vitamins cause lung cancer in men headlinesThe author was clearly trying to grab your attention by hyping the risk. For example, in page one of his article, he makes the claim that “taking vitamin B6 and B12 supplements in high doses (like those sold in many stores) appears to triple or almost quadruple some people’s risk of lung cancer.”  That is enough to get your attention!

If you read to page 4 of his article, you discover that the 3-4-fold increase in risk only applies to smokers. If you read to page 5, you discover that this only applies to people taking 20 times the RDA of B6 or B12 from individual supplements.

However, in today’s world many readers have the attention span of gnats. They will read the headline and perhaps the first couple of paragraphs. Most readers of The Atlantic article will conclude that supplementation with B6 and B12 causes a 3-4-fold increase in lung cancer in men.  A nutrition myth will be born!

The headlines were similar from other news sources: CNN led with “High Doses of Vitamin B Supplements Tied to Lung Cancer, Study Says”. Huffington Post said: “Men: Taking Vitamin B6 and B12 Could Increase Your Risk of Lung Cancer.”  USA Today said: “Risk of Lung Cancer Increases with Vitamin B, Study Says.”

In all fairness, the articles themselves offered a more balanced interpretation of the study, but many people do not read beyond the headlines. The headlines alerted people to the potential of B6 and B12 supplementation to increase the risk of lung cancer, but readers may miss the fact that this risk is only seen in men, only associated with mega-doses of individual vitamins, and only seen in smokers.

How Will Bloggers Interpret The Clinical Study?

do b vitamins cause lung cancer in men bloggersIt is only a matter of time before the same headlines start appearing in your favorite nutrition blogs. Many bloggers like to create sensational headlines and hype the results of clinical studies. They don’t let the facts get in the way of a good story. Of course, once the claim that vitamins B6 and B12 increase the risk of lung cancer gets repeated often enough on the internet, people will start to believe it must be true. The food myth will become firmly established.

How Will The Medical Community Interpret The Clinical Study?

The medical community usually filters studies like this through a belief system that supplements do more harm than good. They tend to ignore dozens of studies showing the benefits of supplementation and focus on the one of two suggesting they might cause harm. I predict that doctors may start advising their male patients to avoid supplements with vitamins B6 and B12. I also suspect many doctors may start measuring your blood levels of B6 and B12 and warning you to cut back if they are above average.

How Does A Scientist Interpret The Clinical Study?

do b vitamins cause lung cancer in men scientistDo B vitamins cause lung cancer in men?  For a scientifically accurate evaluation of a study like this, one needs to read the study carefully, analyze the data, and evaluate the statistics. Let me walk you through stepwise what I found when I did that.

  • The increased lung cancer risk was only seen in men, not in women. That would be the expected result for prostate cancer, but it is a bit unexpected for lung cancer. There is no apparent mechanism for explaining this effect.
  • There was no effect of folic acid on lung cancer risk.
  • Vitamins B6 and B12 were associated with a 30-40% increased risk of lung cancer in men.  However, that statistic is misleading because:
    • The increased risk of lung cancer was only seen when B6 or B12 were taken as individual supplements. There was no increased risk when B6 and B12 were in a multivitamin where all the B vitamins are in balance.
    • The increased risk of lung cancer was only seen when B6 or B12 were taken as mega-doses greater than 20 times the RDA. There was no increased risk of lung cancer for doses of B6 or B12 that were less than 20 times the RDA.
  • Mega-doses (>20 times the RDA) of vitamins B6 or B12 were associated with a 2-fold increased risk of lung cancer in men. However, that statistic is misleading because:
    • The increased risk of lung cancer in men taking mega-doses of B6 or B12 was only seen in smokers. In the words of the authors: “There were too few [lung cancer] patients among never smokers to evaluate associations [between B vitamins and lung cancer].”

 

Do B Vitamins Cause Lung Cancer In Men?

do b vitamins cause lung cancer in men answerMuch of what you read on the internet about this study is misleading. For example:

  • The claim that vitamins B6 and B12 increase lung cancer in men by 30% was entirely driven by men who were taking >20 times the RDA of B6 or B12 as individual supplements. The risk was zero for anyone taking lower doses B6 and B12.
  • The claim that mega-doses of B6 or B12 increase lung cancer risk in men by 2-fold was entirely driven by male smokers. The risk was zero for non-smokers, even non-smokers taking mega-doses of B6 or B12.
  • The only unambiguous conclusion from this study is that male smokers who take >20 times the RDA of either B6 or B12 as individual supplements have a 3-4-fold increased risk of lung cancer.

So, do B vitamins cause lung cancer in men?

What Does This Mean For You?

The take home lessons from this study are clear.

  • It is almost never a good idea to take mega-doses of individual vitamin and mineral supplements. The only exception is when they are prescribed for a specific medical condition by your health professional and that health professional is monitoring you for potential toxicity.
  • If you smoke, mega-doses of vitamins won’t protect you, and they may harm you. The best advice is to stop smoking.

Those are the scientifically based recommendations from the study. However, you are more likely to hear recommendations that you shouldn’t take B vitamins if you are a man. After all, nutrition myths don’t need to be based on science.

 

The Bottom Line

 

The internet is ablaze with claims that a recent study shows the vitamins B6 and B12 increase the risk of lung cancer in men. These claims are misleading because:

  • The claim that vitamins B6 and B12 increase lung cancer in men by 30% was entirely driven by men who were taking >20 times the RDA of B6 or B12 as individual supplements. The risk was zero for anyone taking lower doses B6 and B12.
  • The claim that mega-doses of B6 or B12 increase lung cancer risk in men by 2-fold was entirely driven by male smokers. The risk was zero for non-smokers, even non-smokers taking mega-doses of B6 or B12.
  • The only unambiguous conclusion from this study is that male smokers who take >20 times the RDA of either B6 or B12 as individual supplements have a 3-4-fold increased risk of lung cancer.

The take home lessons from this study are clear.

  • It is almost never a good idea to take mega-doses of individual vitamin and mineral supplements. The only exception is when they are prescribed for a specific medical condition by your health professional and that health professional is monitoring you for potential toxicity.
  • If you smoke, mega-doses of vitamins won’t protect you, and they may harm you. The best advice is to stop smoking.

Those are the scientifically based recommendations from the study. However, you are more likely to hear recommendations that you shouldn’t take B vitamins if you are a man. After all, nutrition myths don’t need to be based on science

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

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Comments (3)

  • JaNiece

    |

    B does not cause cancer in men

    Reply

    • Dr. Steve Chaney

      |

      That was my message. B vitamins don’t increase men’s risk of lung cancer unless they are a smoker AND take mega-doses

      Reply

  • Linda Fietz

    |

    Thank you again for reminding us to read such articles in Toto
    And that taking individual vitamins can be risky as the body needs all the essential nutrients not just a select few

    Reply

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Latest Article

Do You Need Supplements?

Posted December 12, 2017 by Dr. Steve Chaney

Supplements As Part of a Holistic Lifestyle

Author: Dr. Stephen Chaney

 

do you need supplementsDo you need supplements?

The headlines about supplementation are so confusing. Are they useful, or are they a waste of money? Will they cure you, or will they kill you? I feel your pain.

I will answer these questions in depth in my upcoming book, but let me give you a quick overview today. I call it: “Do You Need Supplements?” I created the graphic on the left to illustrate why I feel responsible supplementation is important for most Americans. Let me give you specific examples for each of these categories.

 

Examples of Poor Diet

do you need supplements dietDo you need supplements if you have a poor diet? You have heard the saying that supplementation fills in the nutritional gaps in our diets.  So what are the nutritional gaps? According to the USDA’s 2015-2020 Dietary Guidelines for Americans, many Americans are consuming too much fast and convenience foods. Consequently, we are getting inadequate amounts of calcium, magnesium, and vitamins A, D, E and C. Iron is also considered a nutrient of concern for young children and pregnant women. According to a recent study, regular use of a multivitamin is sufficient to eliminate all these deficiencies except for calcium, magnesium and vitamin D (J.B. Blumberg et al, Nutrients, 9(8): doi: 10.3390/nu9080849, 2017 ). A well-designed calcium, magnesium and vitamin D supplement may be needed to eliminate those deficiencies.

In addition, intake of omega-3 fatty acids from foods appears to be inadequate in this country. Recent studies have found that American’s blood levels of omega-3s are among the lowest in the world and only half of the recommended level for reducing the risk of heart disease (K.D. Stark et al, Progress In Lipid Research, 63: 132-152, 2016 ;S.V. Thuppal et al, Nutrients, 9, 930: doi: 10.3390/nu9090930, 2017 ). Therefore, omega-3 supplementation is often a good idea.

In previous editions of “Health Tips From the Professor” I have talked about our “mighty microbiome”, the bacteria and other microorganisms in our intestine. These intestinal bacteria can affect our tendency to gain weight, our immune system, inflammatory diseases, chronic diseases such as diabetes, cancer, and heart diseases, our mood—the list goes on and on. This is an emerging science. We are learning more every day, but for now it appears our best chances for creating a health-enhancing microbiome are to consume a primarily plant-based diet and take a probiotic supplement.

Finally, diets that eliminate whole food groups create nutritional deficiencies. For example, vegan diets increase the risk of deficiencies in vitamin B12, vitamin D, calcium, iron, zinc and long chain omega-3 fatty acids.  A recent study reported that the Paleo diet increased the risk of calcium, magnesium, iodine, thiamin, riboflavin, folate and vitamin D deficiency (A. Genomi et al, Nutrients, 8, 314; doi: 10.3390/nu8050314, 2016. The Keto diet is even more restrictive and is likely to create additional deficiencies.

 

Examples of Increased Need

do you need supplements increasedDo you need supplements if you have an increased need?  We have known for years that pregnancy and lactation increase nutritional requirements. In addition, seniors have increased needs for protein, calcium, vitamin D and vitamin B12. In previous issues of “Health Tips From the Professor” I have also shared recent studies showing that protein requirements are increased with exercise.

Common medications also increase our need for specific nutrients. For example, seizure medications can increase your need for vitamin D and calcium. Drugs to treat diabetes and acid reflux can increase your need for vitamin B12. Other drugs increase your need for vitamin B6, folic acid, and vitamin K. Excess alcohol consumption increases your need for thiamin, folic acid, and vitamin B6. These are just a few examples.

Vitamin D is a special case. Many people with apparently adequate intake of vitamin D have low blood levels of 25-hydroxy vitamin D. It is a good idea to have your blood 25-hydroxy vitamin D levels measured on an annual basis and supplement with vitamin D if they are low.

More worrisome is the fact that we live in an increasing polluted world and some of these pollutants may increase our needs for certain nutrients. For example, in a recent edition of “Health Tips From the Professor” I shared a study reporting that exposure to pesticides during pregnancy increases the risk of giving birth to children who will develop autism, and that supplementation with folic acid during pregnancy reduces the effect of pesticides on autism risk. I do wish to acknowledge that this is a developing area of research. This and similar studies require confirmation. It is, however, a reminder that there may be factors beyond our control that have the potential to increase our nutritional needs.

 

Examples of Genetics Influencing Nutritional Needs

do you need supplements geneticsDo you need supplements if your genetics call for specific nutritional needs?  The effect of genetic variation on nutritional needs is known as nutrigenomics. One of the best-known examples of nutrigenomics is genetic variation in the methylenetetrahydrofolate reductase (MTHFR) gene.  MTHFR gene mutations increase the risk of certain birth defects, such as neural tube defects. MTHFR mutations also slightly increase the requirement for folic acid. A combination of food fortification and supplementation with folic acid have substantially decreased the prevalence of neural tube defects in the US population. This is one of the great success stories of nutrigenomics. Parenthetically, there is no evidence that methylfolate decreases the risk of neural tube defects.

Let me give you a couple of additional examples:

One of them has to do with vitamin E and heart disease (A.P. Levy et al, Diabetes Care, 27: 2767, 2004 ). Like a lot of other studies, there was no significant effect of vitamin E on cardiovascular risk in the general population. But there is a genetic variation in the haptoglobin gene that influences cardiovascular risk. The haptoglobin 2-2 genotype increases oxidative damage to the arterial wall, which significantly increases the risk of cardiovascular disease. When the authors of this study looked at the effect of vitamin E in people with this genotype, they found that it significantly decreased heart attacks and cardiovascular deaths.

This has been confirmed by a second study specifically designed to look at vitamin E supplementation in that population group (F. Micheletta et al, Arteriosclerosis, Thrombosis and Vascular Biology, 24: 136, 2008 ). This is an example of a high-risk group benefiting from supplementation, but in this case the high risk is based on genetic variation.

Let’s look at soy and heart disease as a final example. There was a study called the ISOHEART study (W.L. Hall et al, American Journal of Clinical Nutrition, 82: 1260-1268, 2005 ; W.L. Hall et al, American Journal of Clinical Nutrition, 83: 592-600, 2006 ) that looked at a genetic variation in the estrogen receptor which increases inflammation and decreases levels of HDL. As you might expect, this genotype significantly increases cardiovascular risk.

Soy isoflavones significantly decrease inflammation and increase HDL levels in this population group. But they have no effect on inflammation or HDL levels in people with other genotypes affecting the estrogen reception. So, it turns out that soy has beneficial effects, but only in the population that’s at greatest risk of cardiovascular disease, and that increased risk is based on genetic variation.

These examples are just the “tip of the iceberg.” Nutrigenomics is an emerging science. New examples of genetic variations that affect the need for specific nutrients are being reported on a regular basis. We are not ready to start genotyping people yet. We don’t yet know enough to design a simple genetic test to predict our unique nutritional needs. That science is 10-20 years in the future, but this is something that’s coming down the road.

What the current studies tell us is that some people are high-risk because of their genetic makeup, and these are people for whom supplementation is going to make a significant difference. However, because genetic testing is not yet routine, most people are completely unaware that they might be at increased risk of disease or have increased nutritional requirements because of their genetic makeup.

 

Examples of Disease Influencing Nutritional Needs

do you need supplements diseaseFinally, let’s consider the effect of disease on our nutritional needs. Do you need supplements because of disease?  If you look at the popular literature, much has been written about the effect of stress on our nutritional needs. In most cases, the authors are referring to psychological stress. In fact, psychological stress has relatively minor effects on our nutritional needs.

Metabolic stress, on the other hand, has major effects on our nutritional needs. Metabolic stress occurs when our body is struggling to overcome disease, recover from surgery, or recover from trauma. When your body is under metabolic stress, it is important to make sure your nutritional status is optimal.

The effects of surgery and trauma on nutritional needs are well documented. In my upcoming book, I will discuss the effects of disease on nutritional needs in some detail. Let me give you a brief overview here. It is very difficult to show beneficial effects of supplementation in a healthy population (primary prevention). However, when you look at populations that already have a disease, or are at high risk for disease, (secondary prevention), the benefits of supplementation are often evident.

For example, studies suggest that vitamin E, B vitamins, and omega-3s each may reduce heart disease risk, but only in high-risk populations. Similarly, B vitamins (folic acid, B6 and B12) appear to reduce breast cancer risk in high risk populations.

 

Do You Need Supplements?

 

With this information in mind, let’s return to the question: Do you need supplements? Here is my perspective.

  • The need for supplementation is greatest when these circles overlap, as they do for most Americans.
  • The problem is that while most of us are aware that our diets are not what they should be, we are unaware of our increased needs and/or genetic predisposition. We are also often unaware that we are at high risk of disease. For too many Americans the first indication they have heart disease is sudden death, the first indication of high blood pressure is a stroke, or the first indication of cancer is a diagnosis of stage 3 or 4 cancer.

So, let’s step back and view the whole picture. The overlapping circles are drawn that way to make a point. A poor diet doesn’t necessarily mean you have to supplement. However, when a poor diet overlaps with increased need, genetic predisposition, disease, or metabolic stress, supplementation is likely to be beneficial. The more overlapping circles you have, the greater the likely benefit you will derive from supplementation.

That is why I feel supplementation should be included along with diet, exercise, and weight control as part of a holistic approach to better health.

So, do you need supplements?

 

The Bottom Line

 

In this article I provide a perspective on who needs supplementation and why. There are four reasons to supplement.

  • Fill nutritional gaps in our diet
  • Meet increased nutritional needs due to pregnancy, lactation, age, exercise, many common medications, and environmental pollutants.
  • Compensate for genetic variations that affect nutritional needs.
  • Overcome needs imposed by metabolic stress due to trauma, surgery, or disease.

With this information in mind, let’s return to the question: “Do you need supplements? Here is my perspective.

  • A poor diet alone doesn’t necessarily mean you have to supplement. However, when a poor diet overlaps with increased need, genetic predisposition, or metabolic stress, supplementation is likely to be beneficial. The more overlap you have, the greater the likely benefit you will derive from supplementation.
  • The problem is that while most of us are aware that our diets are not what they should be, we are unaware of our increased needs and/or genetic predisposition. We are also often unaware that we are at high risk of disease. For too many Americans the first indication they have heart disease is sudden death, the first indication of high blood pressure is a stroke, or the first indication of cancer is a diagnosis of stage 3 or 4 cancer.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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