I wanted to write a short piece on our new multivitamin, Microtrix, to explain the need for this product.
In late 2018 and early 2019, we found many patients were taking traditional multivitamins and/or vitamins meant for dialysis patients. One of the common questions was “Should I be taking a multivitamin?”
After doing some research we found studies regarding vitamin overload or getting more than the recommended daily amount (RDA).
The B vitamins are a good example. Both vitamin B malnutrition and excess vitamin B intake can increase the speed of kidney function. Vitamin C taken in excess can turn from an antioxidant to a prooxidant if taken in large amounts. The opposite of what we want.
Science from around the world points to three conclusions:
- Multivitamins have not been shown to reduce mortality rates.
- Some studies suggest mortality rates may increase with large doses of multivitamins.
- However, if you are truly deficient in a needed vitamin or mineral than supplementation is valuable but only up to the recommended daily amounts.
Getting more than we need may be bad for us, getting less than we need is bad as well.
As kidney patients, our kidneys cannot process large doses or amounts of many vitamins or minerals. The lower your kidney function, the greater the impairment.
To me, this means only one approach is logical and that is a minimalist approach.
We calculated the daily intake for 52 different vitamins, minerals, and antioxidants using the Stopping Kidney Disease Food Guide and food logs from 28 patients.
We did this for two reasons:
- The diet is working better than we ever expected. We are past the one year mark with hundreds of patients.
- Without knowing dietary intake, multivitamin doses cannot be determined. Every other approach is just guessing. As kidney patients, we can’t leave this up to chance.
Using this data, we solved for any vitamin deficiency and only that amount is included in Microtrix. For example, vitamin B6 is provided at just 15% of the RDA. The reason is you average 85% from dietary intake over one week. There is no need to add vitamin C, as vitamin C dietary intake is above 100% of the RDA.
Only the deficiency was added to Microtrix, with two exceptions:
- Vitamin K2
Selenium was increased due to the fact that selenium intake appears to increase serum Albumin and may reduce inflammation which we need.
Selenium is an antioxidant that appears to benefit Albumin numbers better than it should. Some programs recommended brazil nuts for kidney patients for this reason, as they are high in selenium. The selenium levels in Microtrix are still less than the RDA to be safe. In four of the five test patients, Albumin rose by a measurable amount.
Vitamin K2 has no RDA, so technically it’s not required. However, research indicates the following:
- Vitamin K deficiency is correlated with severe vascular calcification, the number one killer of kidney patients;
- Research suggests that statins (like Lipitor) reduce the amount of vitamin K2 in our kidneys;
- The diet is low in foods that contain vitamin K2, like organ meats and fermented foods.
Vitamin K2 was added at the lowest possible amount for a therapeutic benefit. Vitamin K2 dosages over 50 mcg per day may interfere with blood thinners like Coumadin. Vitamin K2 dosage less than 35 mcg may not be effective. 45 mcg was considered the middle ground.
Vitamin D was not included and should be managed based on your blood test and doctor's guidance.
Here's the new label for Microtrix that shows what's included:
Impossible to do on our own
One of my grievances against dietary advice given to kidney patients by professionals, books, websites etc.. is the lack of understanding on what’s it’s like to be a kidney patient. I have never seen guidance or a diet that provided 100% of the RDA for us. Look for yourself and do the numbers, no kidney diets in the world meets the RDA for everything.
If we did it on our own, we would have to calculate the RDA for at least a dozen vitamins then buy each single vitamin then cut up each vitamin to get the small amount needed to meet the RDA after dietary intake is factored in.
It’s a little crazy for professionals to expect us to do this kind of analysis and work.
Microtrix is time-released over several hours (4 to 5 hours in testing). The primary reason for the time release is to spread any kidney workload over a longer time period. The combination of a low dose and time-release puts the lowest filtering workload possible on our kidneys.
A small number of patients took Microtrix for 30 days after I had personally tested four versions of Microtrix. As a group, those with low Albumin had increases and generally, everyone had more energy or a better sense of wellbeing. This is likely due to the increase in vitamin B intake which can be low for those with vegetarian or vegan diets.
I had planned on a sales price of $24.95, but decided it should be free very early in the process. The two reasons were long term safety and what I now call the three-legged stool of kidney disease treatment.
Any diet runs the risk of not meeting all of the RDAs. This risk will no longer be an issue with Microtrix.
The new analogy you will be hearing more about is the three-legged stool of kidney disease. Patient follow-up combined with medical studies point to the following three legs:
- Lowest nitrogen healthy diet
- Lowest nitrogen protein supplement
- Meeting 100% of the RDAs for essential amino acids, vitamins, and minerals
If you remove one of these legs, results are reduced, considered risky or don’t happen. The wrong diet will negate the effects of #2 and #3. The wrong protein supplement with too much nitrogen will negate the effects of a low nitrogen diet. If you are getting more than the RDA from diet and supplements, you are putting an extra workload on your kidneys with no known benefits, only risks.
Several studies in France from 2014 to 2018 illustrate this concept. The first study shows a benefit, the second study does not show a benefit, and the major difference was the suggested form of protein. We also see this over and over again with patients. Patients trying random diets and random supplements are not getting any improvements or are getting minimal results.
We have to get all three right when our kidneys are functioning at lower than normal capacity. I didn’t want anyone to worry about buying another product. Free seemed like the right thing to do.