Vitamin supplement use in people with spinal cord injury: Results from the FRASCI study
Coker J, Morse L, Charlifue S
Craig Hospital, Englewood, CO, US
Objective: Dietary supplements are the most commonly used complementary and integrative healthcare approach in the US, with over 50% of adults reporting use of any supplement in 2012. The Office of Dietary Supplements (ODS) was created in 1994 with the mission to study the health effects of supplements and enhance health for the US population. ODS notes that extensive scientific research has not been done on health effects of vitamin and mineral supplements in the general population nor in populations at increased risk for health conditions, such as people with spinal cord injury (SCI). Multivitamins, vitamin D, and calcium are the most common supplements used by people with SCI, but research is limited. The objective of this analysis was to describe vitamin supplement usage in a cohort of people with SCI.
Design: We analyzed data from 348 individuals with SCI who were enrolled in the longitudinal Fracture Risk after SCI (FRASCI) study. Inclusion criteria were at least 22 years of age, at least 1 year post-injury, not ventilator dependent, no tracheostomy, and no other neuromuscular disease. Participants reported current supplement use, frequency of use, and number of years taking multivitamins, vitamins A, B6, C, D, and E, calcium, and vitamin D + calcium supplements.
Results: Multivitamins were the most commonly used supplement in this sample, with 55.5% reporting current use of multivitamins. Participants had been taking multivitamins for an average of 13.26 years (sd = 14.70). 26.4% were currently taking vitamin C, but 30.3% of participants reported using vitamin C at least seasonally in the last year; average years used was 13.15 years (sd=12.80). Vitamin D (21.0%) and vitamin D + calcium (17.8%) supplements were the next commonly used, for an average time of 3.90 years (sd=5.12) and 3.47 years (sd=3.66), respectively. Participants also reported current use of calcium (10.6%), vitamin E (5.7%), vitamin B6 (2.6%), and vitamin A (0.3%). Use of vitamin A and vitamin C was significant in people with current pressure ulcers, vitamin E in people who had had pneumonia since their injury, vitamin D in people who reported heart trouble, and calcium and vitamin D in people with osteoporosis.
Conclusion: The most common supplements taken were multivitamins, calcium, and vitamin D. More research needs to be done to find out why people with SCI are taking vitamin and mineral supplements and if people are self-treating or if their doctors are recommending the supplements. Many supplements may be helpful in reducing risk of secondary conditions common after SCI: vitamins A and C aid in wound healing, vitamin E reduces risk of pneumonia, vitamin D reduces risk of heart problems, calcium and vitamin D help with bone health. However, high levels of certain vitamins and minerals can be detrimental to health and have dangerous interactions with medications for people with SCI. This research has important implications for future interventions to improve patient-physician communication on the need for and safety of dietary supplementation.
Support: NICHD (R21HD057030 and R21HD057030‐ 02S1), National Institute of Arthritis & Musculoskeletal & Skin Diseases (1R01AR059270‐01), and NIDILRR (90SI5015).
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