Supplements found to be fairly useless

Wishful

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https://newatlas.com/vitamins-mineral-supplements-effect-cardiovascular-health-lifespan/60686/

The title is: Massive meta-study finds most vitamin supplements have no effect on lifespan or heart health

Yes, it just focuses on heart health and lifespan, and yes there are specific cases where supplements do make a difference for a person with a health problem, but I hope this finding gets lots of publicity. I like the conclusion:

"In the end, the main takeaway from this growing body of convincing research is that if you exercise, eat well, and are living an otherwise healthy life, then you probably won't get any additional benefit from vitamin supplements. For most people, all these costly vitamin and mineral supplements result in is expensive urine."

The nutraceutical industry is going to hate that. :)
 

JES

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While I don't agree with a general statement like supplements are useless, this would probably hold true for at least 95% of the customers the way they are currently taking them. Most healthy people who buy pills really have no idea, they probably heard a friend is taking "pill X" and decided to try it. When I walk past supermarket shelves I'm baffled by the sheer amount of supplements, most of which probably do nothing. What's worse, many supplements that could in theory be useful come in the wrong form or wrong dosage. Magensium for example is often sold in oxide form, which is the least absorbed. I see no point in this unless you want a solution for constipation.

Probiotics, which is a nutraceutical I reckon that could have some potential, come in hundreds of mixtures, which all more or less contain the same five or six lactic acid strains. What's the point in this? Selenium, which I found somewhat useful at the 200-400 mcg dosage, is usually sold in markets in 50 mcg, which is not enough for more than to prevent obvious deficiency. Herbs are generally a mystery as you don't typically get a good idea about how much of the active ingredient is actually in them. The new buzzword is superfoods, which are more or less the same old herbs now packed in more sexy containers.

I'd reckon it probably took me 2-3 years to get a basic understanding of how supplements could possibly work. None is going to bother with this unless they are stuck with something like ME/CFS...
 

pamojja

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Massive meta-study finds most vitamin supplements have no effect on lifespan or heart health
As massive this meta-study might be in reviewing "a large number of randomized clinical trials examining 16 vitamin supplements and their associations with general mortality and cardiovascular conditions such as heart attack or stroke."

They sure missed such cases like me, who took all vitamins (randomized clinical trials eliminate con-founders by testing 1 vitamin at a time), most minerals and aminos, along with most common herbal extracts all together (while always starting low and increasing slow), along with massive lifestyle changes and partially with mega-doses of vitamins never studied. - And experienced complete remission of a 60% walking-disability from PAD (a form of CVD) after 6 years of committed efforts. Considered non-reversible.

Yes, most vitamin supplements taken in isolation at low doses as designed by randomized trials, always fail.
 

Wishful

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Most healthy people who buy pills really have no idea
I get the impression that many people want magic solutions, even for problems they don't actually have. They want to take a pill a day and feel that they've completely protected themselves from cancer or whatever else. They probably don't want to be convinced otherwise. It's like buying lottery tickets: what you're really buying is a dream of winning. Supplements (for most people) are a dream of perfect health.
 

Wishful

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Yes, most vitamin supplements taken in isolation at low doses as designed by randomized trials, always fail.
Do randomized trials of megadoses of multivitamins always show impressive results? I'm sure there are anecdotal claims of benefits, but I haven't read of any credible trials of megadose nutrients that indicate that they'll provide significant benefit for the typical person.
 

Wishful

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I admit that I have no idea of the scientific credibility of the paper. It does match my observations, so it's human for me to give it a higher value than otherwise.

As for supplements taken in isolation at normal RDA doses failing to show impressive results, that's still an important finding, since few people take them according to a megadose cocktail theory. If the findings show that the typical daily multivitamin or supplement is a waste of money, that's useful to know. If megadose cocktails are actually worthwhile for the typical person, it should be relatively easy to prove. If they only work for a very small minority, there's no point in promoting them for the masses.
 

pamojja

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Do randomized trials of megadoses of multivitamins always show impressive results? I'm sure there are anecdotal claims of benefits, but I haven't read of any credible trials of megadose nutrients that indicate that they'll provide significant benefit for the typical person.
There are no randomized trials of maga-doses of multiple vitamins, minerals, aminos and herbal extract for the simple reason, that the outcome would be terribly confounded. While science is always after 1 agent against 1 symptom. Or 2-3, but never a 100.

There are however case-studies of simple vitamin mega-doses without long-term outcomes. For example the highest-dose study I found for vitamin C is this (now behind a paywall):

Journal of the New Zealand Medical Association, 23-August-2002, Vol 115 No 1160​
Copplestone et al1 (http://www.nzma.org....al/115-1157/25/) identified misleading glycohaemoglobin (GHb) results due to a haemoglobin variant (Hb D Punjab) and listed a number of other possible causes for such false results (ie, haemolytic anaemia, uraemia, lead poisoning, alcoholism, high-dose salicylates and hereditary persistence of foetal haemoglobin).​
We have observed a significant "false" lowering of GHb in animals and humans supplementing ascorbic acid (AA) at multigram levels. Mice receiving ~7.5 mg/d (equivalent to > 10 g/day in a 70 kg human) exhibited no decrease in plasma glucose, but a 23% reduction in GHb.2 In humans, supplementation of AA for several months did not lower fasting plasma glucose.3,4 We studied 139 consecutive consenting non-diabetic patients in an oncology clinic. The patients had been encouraged as part of their treatment to supplement AA. Self-reported daily intake varied from 0 to 20 g/day. The plasma AA levels ranged from 11.4 to 517 µmol/L and correlated well with the reported intake. Regression analysis of their GHb and plasma AA values showed a statistically significant inverse association (eg, each 30 µmol/L increase in plasma AA concentration resulted in a decrease of 0.1 in GHb).
A 1 g oral dose of AA can raise plasma AA to 130 µmol/L within an hour and such doses at intervals of about two hours throughout the day can maintain ~230 µmol AA/L.5 Similar levels could also be achieved by use of sustained-release AA tablets. This AA concentration would induce an approximate 0.7 depression in GHb. The GHb assay used in our study, affinity chromatography, is not affected by the presence of AA.3 Thus, unlike the case with Hb D Punjab, our results were not caused by analytical method artifact. More likely, the decreased GHb associated with AA supplementation appears related to an in vivo inhibition of glycation by the elevated plasma AA levels, and not a decrease in average plasma glucose.3 If this is true, the effect has implications not only for interpretation of GHb but also for human ageing, in which glycation of proteins plays a prominent role in age-related degenerative changes.​
A misleading GHb lowering of the magnitude we observed can be clinically significant. Current recommendations for diabetics suggest that GHb be maintained at 7, a level that is associated with acceptable control and decreased risk of complications; when GHb exceeds 8, re-evaluation of treatment is necessary.6 Moreover, relatively small increases in average blood sugar (ie, GHb) can accompany adverse reproductive effects. A difference in mean maternal GHb of 0.8 was found for women giving birth to infants without or with congenital malformations.7 In either of these circumstances, an underestimation of GHb could obscure the need for more aggressive intervention.​
Vitamin usage is common in New Zealand and after multivitamins, AA is the most often consumed supplement.8 Moreover, diabetics are encouraged to supplement antioxidants, including AA. Thus, it seems prudent for primary care health providers to inquire regarding the AA intake of patients, especially diabetics, when using GHb for diagnosis or treatment monitoring.​
Cheryl A Krone
Senior Research Scientist
John TA Ely
Director
Applied Research Institute
PO Box 1925
Palmerston North
References:
  • Copplestone S, Mackay R, Brennan S. Normal glycated haemoglobin in a patient with poorly controlled diabetes mellitus and haemoglobin D Punjab: implications for assessment of control. NZ Med J 2002;115(1157). URL: http://www.nzma.org....al/115-1157/25/
  • Krone CA, Ely JTA. Vitamin C and glycohemoglobin revisited. Clin Chem 2001;47(1):148.
  • Davie SJ, Gould BJ, Yudkin JS. Effect of vitamin C on glycosylation of proteins. Diabetes 1992;41(2):167–73.
  • Paolisso G, Balbi V, Bolpe C, et al. Metabolic benefits deriving from chronic vitamin C supplementation in aged non-insulin dependent diabetics. J Am Coll Nutr 1995; 14(4):387–392.
  • Lewin S. Vitamin C: Its Molecular Biology and Medical Potential. New York: Academic Press; 1976.
  • Kenealey T, Braatvedt G, Scragg R. Screening for type 2 diabetes in non-pregnant adults in New Zealand: practice recommendations. NZ Med J 2002;115(1152):194–6.
  • Rosenn B, Miodovnik M, Dignan PS, et al. Minor congenital malformation in infants of insulin-dependent diabetic women: association with poor glycemic control. Obstet Gynecol 1990;76:745–9.
  • Allen T, Thomson WM, Emmerton LM, Poulton R. Nutritional supplement use among 26-year-olds. N Z Med J 2000;113(1113):274–7.
The reddened part explains contrary to common scientific knowledge - that vitamin C would not be absorbed beyond a few 100 milligrams and only would create expensive urine - it in fact does raise serum vitamin C levels well correlated to intake.

That it lowered glycated homoglobulin in 20 g/d dosers up to a whooping 1%, with any other patent-able substance would mean the next block-buster drug (immagine the results if they meassured not only 1 marker of glycation, but all other including inflammation..) Not so with high-dose vitamin C, it simply gets ignored and never followed up for long-term outcomes.

An other thesis paper mentioning 10 g/d dose vitamin B5 studies in relation to acne and weight-loss: http://orthomolecular.org/library/jom/1997/pdf/1997-v12n02-p099.pdf

As you can see, these are just 2 of the rare studies where a single vitamin was studied at mega-doses, never combined intelligently with all the other nutrients, or followed up for long-term outcome. And there simple aren't and wont ever be randomized controlled trials with Orthomolecular doses of all vitamins, minerals, amino-acids and plant-extracts, because by limiting them to as few confounders as possible, that would be against the scientific method. Maybe impartial machine-learning one day will bring a change in attitude to these ignored rare high-dose studies.

If the findings show that the typical daily multivitamin or supplement is a waste of money, that's useful to know.
One would have access to the actual paper, to know how much weight they gave to observational studies. In observational studies participants usually start with supplementation after serious health issues have started, and the outcome heavily confounded by the initial disease. Similarly patients having to take blood-pressure medication will still most probably die of blood-pressure complications. Correlation isn't causation.

The authors of this meta-study of mainly other meta-studies do even mention its limitations:

Nine systematic reviews and 4 new RCTs were selected that encompassed a total of 277 trials...

Limitations:
Suboptimal quality and certainty of evidence.
It definitely can't say anything about targeted (taking a vitamin not randomly - as in a RCT - but because of lab-tests) and comprehensive supplementation (keeping in mind all nutrients work in concert).
 
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pamojja

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I tend to listen / read reviews about supplements before i am thinking of trying , if vast majority applaud some supplement i feel it`s worth of trying .
I don't trust online reviews. Because once I was offered a discount for writing one, at an second occasion I was promissed a discount for rewriting a bad one.
 

pamojja

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If megadose cocktails are actually worthwhile for the typical person, it should be relatively easy to prove.
Actually I know of only one who tried. Dr. Dale Bredesen:

http://newsroom.ucla.edu/releases/memory-loss-associated-with-alzheimers-reversed-for-first-time

The study ... is the first to suggest that memory loss in patients may be reversed — and improvement sustained — using a complex, 36-point therapeutic program that involves comprehensive diet changes, brain stimulation, exercise, sleep optimization, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry..

Bredesen’s approach is personalized to the patient, based on extensive testing to determine what is affecting the brain’s plasticity signaling network. In the case of the patient with the demanding job who was forgetting her way home, her therapy consisted of some, but not all, of the components of Bredesen’s program, including:
  • eliminating all simple carbohydrates, gluten and processed food from her diet, and eating more vegetables, fruits and non-farmed fish
  • meditating twice a day and beginning yoga to reduce stress
  • sleeping seven to eight hours per night, up from four to five
  • taking melatonin, methylcobalamin, vitamin D3, fish oil and coenzyme Q10 each day
  • optimizing oral hygiene using an electric flosser and electric toothbrush
  • reinstating hormone replacement therapy, which had previously been discontinued
  • fasting for a minimum of 12 hours between dinner and breakfast, and for a minimum of three hours between dinner and bedtime
  • exercising for a minimum of 30 minutes, four to six days per week
Bredesen said the program’s downsides are its complexity and that the burden falls on patients and caregivers to follow it. In the study, none of the patients was able to stick to the entire protocol. Their most common complaints were the diet and lifestyle changes, and having to take multiple pills each day.

The good news, though, said Bredesen, are the side effects: “It is noteworthy that the major side effects of this therapeutic system are improved health and an improved body mass index, a stark contrast to the side effects of many drugs.”

The results suggest that memory loss may be reversed and improvement sustained with the therapeutic program, but Bredesen cautioned that the results need to be replicated.
Almost as complex as my life-style changes. And there lies the problem, though well worthwhile for the typical person, for the vast majority almost impossible to implement and follow through. But this example also shows the scientific method couldn't even come up with a double blind study design, where it's participants - due do the nature of the interventions - would not know who are the one's on placebo.
 
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Yes, it just focuses on heart health and lifespan, and yes there are specific cases where supplements do make a difference for a person with a health problem, but I hope this finding gets lots of publicity. I like the conclusion:

"In the end, the main takeaway from this growing body of convincing research is that if you exercise, eat well, and are living an otherwise healthy life, then you probably won't get any additional benefit from vitamin supplements. For most people, all these costly vitamin and mineral supplements result in is expensive urine."
Vitamin C is cheap.
 

percyval577

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I am very, VERY thanksfull that supplements can be bought.

In my case they might have only a noticable effect on top of an avoidance (Mn). Only this year I found out what to take and how to take it. It brings an acceleration of my improvement about and I might have been already healthy two or even three years ago if I only had known.


General speaking I think supplements make only sense when:
  • ongoing and overall deficiency (you have an ongoing disease which requires stuff above the natural intake)
  • possibly temporary deficiency
  • you want to retune some cells back to normal although there is no overall deficiency
I like to think that quite some diseases could be at least influenced, one only needed to know what when to which amount.
Here I find it logical that I with my mecfs can feel if a supplement does good or bad. This is a BIG advantage over some other diseases (next to a lot of disadvantages).


Edit: And while I like to have figured out small influences as well which might be in fact a placebo effect,

the whole thing is obviously not a placebo effect, though I cannot prove anything of course.
 
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percyval577

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I don't trust online reviews. Because once I was offered a discount for writing one, at an second occasion I was promissed a discount for rewriting a bad one.
I only trust research, and even there it is difficult matter.

Internet brings much of nonsense about, and nonsense gets cited and quoted ... (never forget to think on my own).
 
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pamojja

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Here I find it logical that I with my mecfs can feel if a supplement does good or bad. This is a BIG advantage over some other diseases (next to a lot of disadvantages).
Agree. Though that might also be a disadvantage in the sence, in that one only trusts supplements one can feel something. I did 'feel' some supplements, but in most cases only beneficial side-effects. I didn't 'feel' anything from a particular supplement which would give me the confidence, that my walking-disabilty would go into remission after 6 whole damn persisting years with comprehensive supplementation and life-style changes. I would have missed the jack-pot, going by feeling alone. Though I wasn't blind either, I went by lab-testing. And though not related to anyone particular supplement, altogether my walking-disabilty improved already after the first year substancially.
 

Archie

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I don't trust online reviews. Because once I was offered a discount for writing one, at an second occasion I was promissed a discount for rewriting a bad one.
Reviewmeta and fakespot also look the reviews, with
algorithms , so can look also what they think the ratings are, and then interpret the big picture, can i trust or not.
 
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They've also found that women taking multivitamins have a shorter life span than those who do not take them. Not sure if they factored in the health status of the patients taking the vits....meaning if the patients were desperately ill and taking them or if the patients were ill and due to brain lock were refusing real medicine and going rogue with fake medicine etc. I think they can help in short term due to lack of absorption issues, but almost all of us are so desperate, we waste so much money on an industry that lacks ethics or morals and just pushes useless pills on vulnerable people. People talk about the pharmaceutical industry but the supplement industry is quite dark and unregulated. You can't be sure what you are even taking since there is no regulation on supplements in the US.
 

pamojja

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They've also found that women taking multivitamins have a shorter life span than those who do not take them. Not sure if they factored in the health status of the patients taking the vits....meaning if the patients were desperately ill and taking them or if the patients were ill and due to brain lock were refusing real medicine and going rogue with fake medicine etc.
Just to give my example very verbose again, why I refused 'real' medicine - certainly not due to a brain block - and went with supplements and life-style changes alone. Which with a remission all my docs considered impossible I never regretted. These are the benefits versus risk of all prescribtion medicine pushed on me to be taken till my death-bed, without informing me of their real risk/benifit ratio, even being rediculed for being informed by
some of my docs:
83 for mortality
In Summary, for those who took the statin for 5 years:
Benefits in NNT
  • 1 in 83 were helped (life saved)
  • 1 in 39 were helped (preventing non-fatal heart attack)
  • 1 in 125 were helped (preventing stroke)
Harms in NNH
  • 1 in 100 were harmed (develop diabetes*)
  • 1 in 10 were harmed (muscle damage)
*The development of diabetes is one such unanticipated harm found in a recent large study and it seems likely therefore that this applies to the data above, although this is a best guess.​
333 for mortality
In Summary, for those who took the aspirin:
Benefits in NNT
  • 1 in 50 were helped (cardiovascular problem prevented)
  • 1 in 333 were helped (prevented death)
  • 1 in 77 were helped (prevented non-fatal heart attack)
  • 1 in 200 were helped (prevented non-fatal stroke)
Harms in NNH
  • 1 in 400 were harmed (major bleeding event*)
*Required hospital admission and transfusion​
125 for mortality
In Summary, for those who took anti-hypertensives:
Benefits in NNT
  • 1 in 125 were helped (prevented death)
  • 1 in 67 were helped (prevented stroke)
  • 1 in 100 were helped (prevented heart attack*)
Harms in NNH
  • 1 in 10 were harmed (medication side effects, stopping the drug)
*fatal and non-fatal myocardial infarction and sudden or rapid cardiac death​
None for mortality
In Summary, for those who took the clopidogrel:​
Benefits in NNT
  • None were helped (cardiovascular problem prevented)
Harms in NNT
  • 1 in 167 were harmed (major bleeding event*)
None for mortality
In Summary, for those who received the stenting:
Benefits in NNT
  • None were helped (life saved, heart attack prevented, symptoms reduced)
Harms in NNH
  • 1 in 50 were harmed (complications such as bleeding, stroke, kidney damage)
People talk about the pharmaceutical industry but the supplement industry is quite dark and unregulated.
The pharmaceutical industry along with their prescribing docs push petro-chemicals the human body isn't used to metabolize. Along with giving a complete unrealistic picture about its efficacy (if for example only 1 in 83 taking a statin for 5 years is saved from earlier mortality, then that's rather a lottery, and unrealistical to asume one could win! Their efficacy has never been really tested beyond 5 years, and are still prescribed till the death-bed).

On the other hand supplements are usually made from food-compounds (or synthesized) which the human body evolutionary since immortial times knows how to metabolize (unless naturally occuring poisons). They don't need to be regulated like pharmaceuticals, since they are considered similiar to food. And of course there are black sheeps in every industry. Especially also the one which produces industrial prepared food. Which every one is free to avoid.

UK_Relative_Risks_2D_2012_9_July_01.jpg
EU_Bubbles_Graph_2012_9_July_01.jpg

If you look at these 2 graphs (click to enlarge), you'll see that the risks of supplements, compared to food-poisoning or even prescribtion meds and malpractice is really neglible. Stricter regulations aren't asked for, and thereby making them even less accessible (for example: can't get some supplements available in the states, because in the EU they are prescribtion-meds, no doc prescribes).

..but almost all of us are so desperate, we waste so much money on an industry that lacks ethics or morals and just pushes useless pills on vulnerable people.
I do however understand the need to vent off frustration. One simple way to circumvent frustration is boycotting the industry you not agree with (after really informing yourself). Like I do with the pharmaceutical industry (only using their lab-tests wisely), the industrially prepared food industry, and the automobile industry.

We are all free to decide which industry to support and which to boycott. No prescirption pushing doc can convince me otherwise.
 
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percyval577

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I didn't 'feel' anything from a particular supplement which would give me the confidence, that my walking-disabilty would go into remission after 6 whole damn persisting years with comprehensive supplementation and life-style changes. I would have missed the jack-pot, going by feeling alone. Though I wasn't blind either, I went by lab-testing. And though not related to anyone particular supplement, altogether my walking-disabilty improved already after the first year substancially.
Interestingly I have an opposite example, well in so far that a test might be currently impossible or very difficult to do.

So, I took vit B2 and it´s one of the great helpers now. But I am obviously not deficient, meaning a lot of the B2 comes out with the pie (which can be seen, it´s shiny yellow). So I guess the blood wouldn´t show any problem with B2. therefore one would needed to test
  • the very cells directly (I suppose they are in the brain, so here impossible if not some of these very cells would occasionally come into the blood what might be unlikely)
  • or additional markers which would indicate that these cells are altered or that a certain percentage of them are altered (and vitB2 would help them), and this is not already known, and maybe there isn´t such a possible marker in the blood anyway
 

pamojja

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So I guess the blood wouldn´t show any problem with B2. therefore one would needed to test..
I tested deficiency or sufficiency of nutrients only with some (vitamin D, A, CoQ10, MMA, HTMA..) and in general avoided expensive speciallity tests. I did however kept an eye on the totallity of my regular lab-tests (CBC, liver and kidney, thyroid and androgens, lipids and inflammation, electrolytes, also in whole blood, glucose metabolism, etc.), while monitoring how they would alter by starting low and increasing slow with any one nutrient over the years, along with general symptoms. Though that's not as direct and fast as for example a NutraEval would be (too expensive for me to do regularly), in the end I till now cought every deficiency or surplus that way.

The bigger problem for me is finding reasonable suppliers, for example the extra riboflavin I need too, I only can get from US companies providing it from within the EU. The only one I know at the moment is 100mg caps from Swanson (if imported directly from the states due to being much above the RDA it could arbitrarily be clasified as illegal medicine import, practically impossible to do legally for private persons. The shipment confiscated and fined up to €260,-. If considered a minor transgression by the custom officer €50,- only. On repeat up to 2600,-! Hapened to me already with TMG, Sillimarin, Nattokinase and Alpha-lipoic acid ordered from the states. Confiscated and fined 50,- each.)

That's also the reason I'm so passionate about being able to have free access to supplements - a real life-safer for me - which the pharmaceutical industry for understandable reasons tries so hard to oppress. Also with scientists in expectation of favors in form of future research funding writting misleading meta-analysis not able to show any causation, as in the OP of this thread. And the usual reader wouldn't be able to catch.