
Vitamin B6 and B12 Supplements Appear to Cause Cancer in Men - simulate
https://www.theatlantic.com/health/archive/2017/08/b12-energy/537654?single_page=true
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saurik
As far as I understand, it is well documented that smoking correlates with B12
deficiency, and so many smokers take this vitamin as a supplement to make
themselves feel better about their smoking habits.

This study then showed, not just that people got cancer, but they got lung
cancer. This study was not a randomized trial that can show causation: it was
a cohort study, where they ask a bunch of questions about peoples' past or
ongoing behavior and then look for correlations from which you can try to
guess at potential causes.

In a cohort study, there are attempts to predict confounding variables and
"control" for them, but this involves essentially assuming the result and
backing out the math, and assumes you trust that the participant is giving you
correct data anyway.

A really fun confounding variable you get in these kinds of studies is that
people who even bother to do your study correctly are also people who probably
listen to their doctor and brush their teeth and wear their seatbelts and
generally lead a safer life. (I am forgetting the name of this, but it is
something like "compliance effect"?)

Further, if you have participants who don't just answer poorly but actively
lie in ways that are correlated with the variables you care about (maybe
"another way I make myself feel better about my smoking habit is to pretend I
smoke half as much as I do or also smoke cigars and not count them"), you are
effectively going to have no hope of "controlling" for that in the way you can
with a blinded randomized controlled trial.

Given this, I read this and only think "that's an interesting hypothesis that
is now worth digging into with real science to figure out what is going on",
not "OK, everyone should stop taking B12 supplements if they don't want to end
up randomly getting lung cancer"... that is just way too specific and too
predictable of a cancer to be associated with this particular supplement.

~~~
bbarn
This is obviously my own anecdata, but up until about 2 years ago I smoked for
close to 20 years. I've never once heard that B12 did anything to prevent
cancer. No smoker I ever interacted with - and I interacted with thousands
over the years I'm sure - has ever said or implied they took vitamins to
offset their tobacco use.

~~~
ship_it
Off topic but, any tips on stopping? What method worked for you?

~~~
toddkazakov
I was smoker for 9 years - I thought I enjoyed smoking, I can't live without
it, etc. A friend recommended a book - Alan Carr's Easy Way. Tried quitting
before and it never worked. After reading the book it didn't feel hard, it
just made sense. Recommended the book to 2 friends who also quit. Give it a
try.

~~~
bbarn
Good book, but a little on the repetitive side. It didn't do it for me, but I
think that's because a lot of the points he makes are things I already thought
of constantly.

~~~
pigeons
The repetition seemed like some form of deliberate hypnosis. I would read the
repetitive parts and my mind would start to criticize how it could be so
poorly written, and by the end of the book I had quit smoking after over 10
years and not even thinking I would ever even want to quit when I started the
book. (and still quit after 10 more years)

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doitLP
Participants took folic acid (lab created), not folate (the form found in
nature) which has been shown to be far more absorbable. Folic acid also binds
to the folate receptors, preventing folate from food being taken up. In people
with MTHFR gene mutations, folic acid is contraindicated. Anyone with such
mutations should be avoiding foods with added folic acid. Folate and folacin
seem to be ok. MTHFR is already associated with increased cancer and heart
disease.

No mention was made whether the participants had MTHFR mutations, perhaps
because the cohorts started 20 years ago and cheap sequencing wasn't yet
available.

All it tells is that more actual science needs to be done here. Also the
article was classic poor science reporting with obvious bias.

~~~
r0ze-at-hn
This really needs to be at the top. It is something 40-60% of the population
have MTHFR mutation. Given the size it is kind of surprising the marketing
departments haven't started touting MTHFR safe foods on their packaging.

After learning about it from my 23andme results I now avoid regularly eating
foods with added folic acid and take a supplement which can't be found at the
grocery store because they will sell the lab created variety which can't be
processed. After these changes various symptoms I have had all my life went
away. But I can only guess what would happen if someone with MTHFR were taking
the lab versions supplements every day for years.

~~~
mlrtime
Can you provide more information on the supplement and which symptoms you had
disappear?

Thanks

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prrls
"Regular" people doesn't need in any way of to these B12 supplements, as there
is plenty of it in animal products, which have already been taking B12
supplements all their lives. However, vegans need to take these supplements if
they want their B12 intake, without animals as the intermediary.

As a side note: B12 is created by micro-organisms in the soil, making our
vegetables and fruits completely covered of it. With our modern lifestyle, the
soil is terribly poor of these micro-organisms and having cleaned-as-hell
vegetables reduces even more the B12 we can find in these vegs.

~~~
pmoriarty
Not only that, but B12 isn't actually produced by any of the animals which
make up those "animal products" which allegedly have "plenty" of B12 in them.
The animals, if they have B12, get it from eating vegetables which have
bacteria on them.

These days, however, many animals destined for the dinner table are pumped
full of antibiotics (which may kill those B12-producing bacteria), are fed
other animals or sterilized grains/vegetables. So it is quite possible that
the animals themselves aren't getting adequate B12, and as a result even
animal eaters might have a B12 deficiency.

My own doctor recommends all his patients, whether or not they're vegetarian,
take B12 supplements.

~~~
cpncrunch
From wikipedia:

"Ruminants, such as cows and sheep, absorb B12 produced by bacteria in their
guts"

~~~
pmoriarty
And how do the bacteria get there? Do they get there if they're fed sterilized
food or other cows? And are the bacteria killed off by the antibiotics they're
given?

~~~
dualogy
> _And how do the bacteria get there?_

Pre-seeded during breast feeding, as happens across all mammals. How many
billions of years do you want to go back on this question?

> _And are the bacteria killed off by the antibiotics they 're given?_

Evidently not, as in developed country sick animals don't get turned into meat
foods on principle and by law --- so they don't show up deficient. If they
lived for 9 decades like we do, they might (or not). But they don't.

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xchaotic
While this study is looking at lung cancer specifically, it's worth
highlighting how much vitamin B6, b12 and other B-family are you getting via
energy drinks. I'm currently hooled on Red Bull sugar free and I believe that
long term consumption may be unhealthy for me due to elevated levels of B
vitamins:

[http://nutritiondata.self.com/facts/beverages/9222/2](http://nutritiondata.self.com/facts/beverages/9222/2)

~~~
DougWebb
More likely that long-term consumption may be unhealthy for you due to the
elevated levels of Red Bull sugar-free you're getting.

Try water.

~~~
d0lph
Because anything called an energy drink must surely be bad for you.

~~~
DougWebb
It's very likely to be bad for you.

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jph
Full text of the published study:
[http://ascopubs.org/doi/full/10.1200/JCO.2017.72.7735](http://ascopubs.org/doi/full/10.1200/JCO.2017.72.7735)

Long-Term, Supplemental, One-Carbon Metabolism–Related Vitamin B Use in
Relation to Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort

~~~
Retric
IMO, Likely just statistical noise, but clearly worth further study.

Link only found among Men. 'Results from previous studies of an association of
B vitamins with lung cancer risk are inconsistent.'

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woliveirajr
> There was no apparent risk among women—which is not to say it doesn’t exist,
> only that it wasn’t apparent.

Or it doesn't exist, or it even lowers the risk of cancer in women, or ...

I hate when something "not found" in some study is streched to fit some
specific tone that the article wants.

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jackweirdy
As someone with an as yet unexplained B12 deficiency (meat eater, never-
smoker, no intrinsic factor antibody) who gets injections via cyanocobalamin
every other month I feel like I’ve just been hit with more FUD

~~~
kobeya
Go about your day. This is not at the level of certainty to be actionable.

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lcurrit
I'm surprised the article doesn't mention energy drinks at all. Isn't one of
the major selling points of many energy drinks is the amount of B vitamins
present? My guess is the amounts the article refers to are much higher
concentrations than your average Monster / Redbull / Rockstar.

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twiss
Vitamin B12 deficiency is common in people who have been vegetarian for many
years. (Others usually have a large reserve.) From the speculation in the
article, it sounds like they'd be better off taking (normal) doses of it,
since it's deficiency or excess that could cause cancer, and not the pills:

> Deficiency can also mean genes that should be inhibited are no longer
> inhibited, also potentially meaning cancer. Sufficiency of certain vitamins
> is important in cancer prevention, but avoiding excess appears to be
> similarly important.

~~~
pera
By vegetarian do you mean vegan right? I have been an ovo-lacto vegetarian
(commonly referred to as "vegetarian" in the US) for 15 years, have never
taken any supplements, and my b12 levels are perfectly fine.

~~~
twiss
Hmm. I meant vegetarian, but upon Googling it seems that you're right that
dairy and eggs contain B12. I've been vegetarian more or less my whole life
but consume lots of dairy and my B12 is low. Maybe the comment sibling to
yours explains it.

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seanwilson
I'm not sure why it would be surprising that any supplement can have a bad
impact on your body. If you're taking a supplement because you believe it has
a potential benefit, it must have some impact on your body so therefore too
little or too much must surely be bad as well?

~~~
blacksmith_tb
In general terms, I agree. Since B vitamins are mostly water-soluble[1],
generally it has been assumed that excess would be excreted, and research that
suggests that some of them are not so harmless is news.

1:
[https://en.wikipedia.org/wiki/Vitamin#List_of_vitamins](https://en.wikipedia.org/wiki/Vitamin#List_of_vitamins)

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tryingagainbro
The vitamin industry is scaring people to prop up sales. Eat a more or less
varied diet and you'll be fine, unless you have a very specific condition
(pregnant for one).

Less Vitamin X today is not going to kill you. It's probably better than, "oh
I need 1000mg so I'll just take 5000 and let the body handle it."

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amriksohata
Such a misleading headline and article, most vitamin tablets (atleast in the
UK) contain no more than 1-2mg of either B1 or B12, if anything you're going
to get more from eating excessive meat which is a higher risk. This study is
extremely suspicious as to who funded both it and whos behind this article.

~~~
phyzome
You're confusing milligrams (mg) and micrograms (mcg or µg). The recommended
daily intake is a few micrograms; those tablets contain 1000 times that
amount.

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culturalzero
Definitely worth more research into possible mechanisms, but until studies
account for the numerous contamination issues (lead, etc.) that many different
home supplements carry, then there is going to be a mystery factor in so many
of these studies sending all kinds of mixed signals.

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nextweek2
The word excessive needs to be in the title.

In 20 years of looking I've never seen a study that links recommended daily
allowance amounts to anything harmful.

Yes 1000x RDA vitamins should be banned, but incendiary titles muddy people's
thinking.

~~~
13years
The reason people take 1000x plus etc is often due to absorption issue.

Many people have problems absorbing B12. That's why they have a deficiency to
begin with. In order for these people to get normal B12, it requires extreme
doses just for their bodies to absorb normal amounts.

~~~
phyzome
It's not just that -- there's an active and a passive pathway for absorption.
The active pathway is limited to 1-2 µg per day by the quantity of "intrinsic
factor" produced by the stomach even for people with no absorption disorder,
but about 1% of oral B-12 can be absorbed through passive diffusion. If you're
trying to remediate a deficiency, intramsucular shots or high oral doses are
the correct approach.

I think there's another limitation in how much the liver can capture and
process per day, and I don't know what that limit is, but it's higher. In any
event, once it is processed (and after excess is eliminated), it is highly
conserved in your body -- a few micrograms can last years, IIRC.

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PerryCox
I have a feeling that a lot of these supplements are doing more harm than
good. I really wish the FDA would step in and regulate the vitamin market the
same way they do with normal medicine like Tylenol, etc.

~~~
mrfusion
Why stop there though. I think we should require a prescription. You shouldn’t
be putting stuff into your body without medical supervision.

I’d even consider it for Foods heavy in certain vitamins. Pineapples have a
mega load of vitamin c. Put those behind the counter as well. Why let people
risk their health.

~~~
flarg
Sarcasm aside, I did read that over consumption of kale results in
accumulation of heavy metals

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gumby
Uh oh, does his mean Vegemite is bad for you!?

Seriously, most people with a western, meat-dominated diet likely get
sufficient B automatically.

~~~
timthelion
vegemite contains almost no B12.

~~~
jlebrech
no B12 but crap loads of monosodium glutamate
[https://en.wikipedia.org/wiki/Glutamate_flavoring](https://en.wikipedia.org/wiki/Glutamate_flavoring)

~~~
ComputerGuru
MSG is perfectly safe.

~~~
gumby
Only if referred to as "kombu" (from which it was first harvested). If you use
that scary chemical name it's bad juju.

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danlash
I guess I'd better stop hitting this VITAMINVAPE

