Vitamins as therapy in the 1990s.

Background: At one time vitamins were considered as essential nutrients needed only in very small amounts to prevent deficiency syndromes. Many vitamins and their derivatives, however, are currently being used in the mainstream of medicine as therapeutic modalities.

Methods: A MEDLINE literature search for clinical reviews and original studies on the use of vitamins in medicine was conducted along with a search of the obtained papers' bibliographies. The primary years of search were 1990-1994. Research reports written before 1990 were used after cross-referencing from more recent articles.

Results And Conclusions: Based on the literature review, several recommendations for the use of vitamins for treatment and prevention are presented. They include topical vitamin A derivatives (tretinoin) for the treatment of acne and age-related skin damage, oral vitamin A derivatives for severe cystic acne (isotretinoin) and psoriasis (etretinate), vitamin D3 for the treatment and prevention of osteoporosis in postmenopausal females, topical vitamin D in psoriasis patients, and niacin for serum cholesterol reduction. Folate appears to decrease the incidence of neural tube defects if given in the preconception phase of pregnancy. Finally, recent preliminary evidence suggests the possible benefit of antioxidants (vitamins C, E, and beta-carotene) in the prevention of atherosclerosis and cancer.