Safety of megavitamin therapy.

Carbon compounds that are needed in small amounts in the diet because they are not made in the body of vertebrates are defined as vitamins. Excluded from this definition are vitamins D, K, and niacin which can be synthesized by the organism or, as in the case of vitamin K, by the host's intestinal bacteria. Lack of such vitamins can result in characteristic deficiency diseases. The therapeutic use of such compounds (megavitamin intake) is based on the spectacular effect of vitamins on deficiency diseases; however, evidence that the ingestion of large amounts of vitamins beyond the "Recommended Daily Allowances" (RDA) is beneficial is not within the basic concept of nutrition. Vitamins, like many substances, may be toxic when taken in large quantities, especially the fat-soluble vitamins, and the concept of "more is better" is a common misconception. Vitamin supplements can be suggested only in the unusual cases of patients having inadequate intake, disturbed absorption (genetic or otherwise), or increased tissue requirements. A well-balanced diet that includes a wide variety of foods from each of the four food groups is adequate for the supply of vitamins, as well as other nutrients, in healthy people. This paper will review some of the recent findings regarding vitamin toxicity and the mechanisms of toxicity.