Wednesday, January 23, 2013

QA: Vitamin and Minerals Supplementation

vitamins q&a

Q. Who takes supplements?
A. A great many people do. One survey showed that about half the people in the US take nutritional supplements regularly or occasionally. The figure in Britain is probably somewhat lower, in the sales of supplementary vitamins and minerals are still enormous in the last 25 years they have increased some six fold.

Q. Why do people take vitamins?
A. There are several reasons. Many people are uncertain about the nutritional adequacy of their diets. Others think they can improve their health by doing so. Some do it because they have decided to treat themselves for an illness and think that vitamins are bound to help. On questioning may will give as reasons for taking supplements to prevent cold and other illnesses to give me energy, and to make up for what is not in food. Many people use vitamin supplements tend to have low opinion of the quality of today’s foods.

Q.What kinds of vitamin and minerals people are taking?
A. According to one vitamin manufacturer’s trade group sales break down this way.
Multivitamin and mineral supplements 42%
Vitamin C 12%
B complex 9%
Vitamin E 9%
Calcium 7.5%
Iron 7%

Q. some doctors seem concerned that people may harm themselves by over overdosing on vitamins and minerals. Does that actually happen much?
A. Harm from vitamins and minerals over dosage is rare. Most vitamins can safely be taken in doses several times those of the RNI is commonly taken without harm. Some quite massive doses of vitamins have been taken without problems. Vitamins A and d in excess however can certainly cause trouble. Very large doses of vitamin A can cause chronic poisoning with itchy dry peeling skin, irritability an irresistible desire to sleep, headache, loss of appetite, enlargement of the liver and spleen, and painful and tender swellings over the bones.

The vitamin accumulates in the body and the effects take weeks to wear off. Eskimos and their husky dogs never eat polar bear liver because they know of these effects. One gram of polar bear liver contains up to 12 mg of retinol 12 times the minimum daily requirement. Vitamin A is also dangerous to a fetus if taken by mother in doses of 7 to 12 mg a day during the first three months of pregnancy. This can cause congenital abnormalities.

Too much vitamin d causes calcium to be deposited in kidneys, arteries and other tissues, a serious matter that can lead to all sort of problems including kidney failure.

It is comparatively easy to small babies to reach very high levels of vitamin E in the blood and because vitamin e is an anti oxidant vitamin this may interfere with their body’s necessary concentration of vitamin E is about0.8 mg in every 100 cubic centimeters. Some babies treated with vitamin E have had contractions as high 5 mg per 100 cc and an increases incidence o a serious bowel infection occurred in babies on such a dosage.

Q. How are these rare toxic reactions likely to occur?
A. usually because of an exaggerated belief in the power of vitamins to cure and a belief in the illogical proposition that if little of something dose you some good, a lot of it must so you a lot of good. Minerals taken in excess can be dangerous. Iron pills, for instance are quite common use of poisoning, especially in children. Fortunately, most adverse effects are minor and get better when the high dose of the nutrient is stopped.

Most vitamins users take most nutrient in amounts that seldom exceeded one to two times the RNI an amount most experts consider safe. Those taking larger amounts than this are likely to be taking vitamin C and E which most experts agree are quite safe for adults even in large amounts. Some people however take up to several hundred times RNI of several of the B complex vitamins. Those amounts should be taken only with medical supervision.

Q. Why do nutritionist stress that vitamin supplements cant make up for bad diet. I thought that what they were meant do it.
A. Vitamin and mineral supplements can make up for some nutritional shortcomings, but they can overcome a lifetime of dietary indiscretions such as too much fat or salt or too many calories. These are certain components of food, necessary for good health that is not to be found in vitamins pills. These include protein, carbohydrates, fiber, essential for acids and some trace minerals.

Q. If I decide to take vitamin supplements, how do I decide what kind to buy? There are so many to choose from and almost nothing on product tablets that would help me to make a wise choice?
A. Shopping for supplements can be difficult no doubt about that. Hundreds of different formulations exist for multivitamin and mineral supplementation and even single nutrient supplements such as vitamin C and E come in a variety of dosages and types. And in health food shops especially vitamins and minerals may be mixed with herbs and other non vitamins ingredients which can make the selection even more bewildering.

Ideally before you shop you should have reasonably good idea of which nutrients you are looking for and in which amounts. You may want to make up a list of vitamins and minerals you want, based on the strengths and weaknesses of your diet and your needs and preferences. Take the list with you when you go for shopping. Then read the ingredients on the labels a number of different supplements and choose the supplements that most closely match what you believe you needs.

Q. Can you give me an example of how this would work?
A. Lets say that like many of the people who take vitamins you have decided to take a multivitamin and minerals supplement to ensure that you are getting enough of all the essential vitamins and minerals. In that case most experts suggest you buy a multivitamins and minerals supplements contain some but not all of these nutrients in varying amounts. They tend to provide more of the cheaper and less bulky vitamin and less expensive of bulky ones.

Q. Which nutrients are they missing?
A. You should read labels to find out since this varies from brand to brand. In general, most multivitamin and mineral supplements do not contain phosphorus and iodine since we get more of these nutrients than we need and there is no reason to suppose that we could get any benefit what so ever from supplementing these. Also since vitamin K deficiency is rare except in newborn babies this nutrient is not usually included in multivitamin. So unless u have some special problem which you doctor is likely you discover you do not require any of these nutrients as supplements.

Check to see if a supplement contains, an essential nutrient lacking in some people’s diets. Deficiency is however very rare in Britain. Look for that contains 50 to 200 micrograms of selenium.

Some multivitamin and mineral supplements contain iron. Others do not. High body stores of iron may be linked with an increased risk of heart diseases one study from Finland suggests. So unless you are a pre menopausal female you may not want or need supplement iron. Check tablets to make sure there is none in the supplement you are buying. And remember the dangers of iron overdose.

Q. What about nutrients known to be essential but which have no Rni? Should those be in multivitamin and mineral supplement?
A. these nutrients don’t have an RNI because we simply have no idea how much we need. We know that we need very little indeed and most experts would agree that deficiencies are particularly unknown. This group of nutrients includes biotin, pantothenic acid copper, manganese, fluoride, chromium, and molybdenum,. A multivitamin and mineral supplement is less likely to contain these nutrients than those with an RNI. Some experts hold that of this manganese currently has the strongest research support for their use as supplement.

Fluoride is not included in most multivitamin and mineral supplements. Adequate amounts are obtained from drinking water and the element is seriously toxic in over dosage.

Q. What if I also want to get higher that RNI amount of antioxidants such as vitamins C and E and beta carotene?
A. Again, check labels. Some multivitamin and minerals supplements do offer high amounts of these nutrients but most do not if you are using C and E as anti oxidants it is far better to buy the vitamins separately perhaps 1000 mg coated C tablets and 200 or 400mg capsules of vitamin E .his will work out cheaper.

Several brands of multivitamin and minerals supplements are now indicating on their labels that contain beta carotene but they do not state how much beta carotene actually is in the supplement if you want to know how much you are getting fond a brand that list separate amounts of both vitamin A and beta carotene. Most multiplies offers very little beta carotene only 1000 to 2500 IU which is equivalent to 0.5 to 1.5 mg of beta carotene. As a point of comparison you should know that 1 inch of carrot contains about 1.5 mg of beta carotene. The fact is that multiple vitamin supplements will not give you nearly enough to produce a significant anti oxidant effect.

Q. I was surprised to learn that the multivitamin and mineral supplement contains very little potassium too as do single ingredient potassium supplements?
A. This is probably just as well since the requirement for potassium supplementation is really a medical matter and you shouldn’t be dosing yourself with this element without medical advice. So unless you are taking high dose potassium supplements prescribed by a doctor your best bet is to get this mineral from fruits and vegetables and their juices. Wash down you supplements with a cup of orange, grapefruit, carrot or tomato juice for an additional 400 to 500 mg of potassium.

Q. I have seen supplements which contains nutrients you haven’t even mentioned choline, PABA, inositol and others. Should I be looking for a supplement which induces these nutrients?
A. Most experts feel that there is no need for these additional nutrients to be in supplement so don’t be fooled by long list of ingredients which may also include lecithin, glumatic acid, boron, silicon, nikel vanadium, and other nutrients which have not been proven to be necessary in the diets of humans. This kind of thing is just done to impress you. Don’t be impressed.

Q. What about vitamin formula just for men and women and just for older people? Should I be selecting one of them?
A. Probably not. Mush of this just sales promotion. Read the products label to see if it matches your needs. So called special formulations certainly do not take the place of proper medical prescriptions. If you need vitamin and mineral supplementation for a particular medical condition you doctor should indicate what you need and how much. Problems such as premenstrual tension and osteoporosis require informed medical care not vitamin manufacturer’s hype.

Q. The health food shop I use offers a supplement called C complex. I have heard B complex but not C complex what is it?
A. Preparations labeled C complex usually contain bio- falconoid, substances found in fruits containing vitamin C. they may be listed simply as bioflavonoid or as some of more commonly used bioflavonoid rutin, quercetin, hesperidin, catechin. None of these compounds is considered essential for health but several studies suggest the compounds do have some activity in the body. They may act to some extent as antioxidants and anti inflammations. Rutin is thought to help to reverse capillary fragility, which causes easy bruising and bleeding. But if you have spontaneous beading into the skin, see your doctor without delay. Don’t waste time hoping that a C complex will cure you.

Q. A friend of mine takes a whole handful of vitamin supplements every day. Why someone would do that rather than simply takes a multivitamin and mineral tablet?
A. This could be sensible or silly, depending upon how well informed you friend is. A person who uses a large number of single nutrient vitamin and mineral supplements could be wasting his or money. But single nutrients are specific anti oxidant agents such as vitamin C and E this could be the best way. Doctors often recommend individual supplements of at least some nutrients especially minerals because they might be supplied in a form which people with absorption problems cam more easily utilize or because the individual nutrients are available in higher doses than can be found in most multivitamin compounds

Q. What about prices? Is expensive better?
A. Not necessarily. Some sources own brands which are similar in formulations to expensive trade name vitamins bur they cost much less. Vitamin C is ascorbic acid one substance only whatever the price. Again check labels to see exactly what you are getting for you money. If a manufacturer claims its product is more absorbable or better balanced, you may want to contact the manufacturer and ask for research that backs up some marketing claims. Some formulations of plain vitamin C are unpleasantly sour and you may have to pay a little more for a coated tablet you can more easily swallow.

Q. What is the difference between natural and synthetic vitamins?
A. No difference. Natural vitamins are derived from foods. Natural vitamin E for instance, is isolated from soybean oil. Natural beta carotene can be derived from carrots or algae. Natural vitamin C can be taken from citrus fruits. Synthetic vitamins on the other hands are constructed from organic molecules found in an array of substances such as petroleum oil and corn oil. Unless you are being cheated by an unscrupulous purveyor who is not selling you what the label says. It makes no difference whatsoever whether the vitamin was made by nature or in factory or laboratory. Synthetic does not mean inferior or nearly the same as it simply not mean that the atoms have been linked together in a lab or manufacturing process to form a molecule that is identical in every respect to the natural product. Synthetic vitamins have the advantage that they are much less expensive to make than natural vitamins.

Q. What about vitamin E? I have heard there is a difference between the natural and synthetic vitamins?
A. the trouble is that natural vitamin E is not just one substance but actually a mixture of eight very complicated but similar molecules known as tocopherols. Any of these could be synthesized but the usual synthetic version of vitamin E is made up of just one of these. The most active of natural mix of tocopherols has slightly more biological activity in the body that the usual synthetic form. But this just means you have to take a fraction more of synthetic vitamin E to achieve the same effect.

Q. Are there natural and synthetic forms of minerals also?
A. no. pure minerals are elements and come in one chemical form only. You can have isotopes with different atomic weights, but these are all chemically identical and that is another story altogether. Minerals are derived from materials mined from the ground or otherwise found in nature mostly from compounds of the elements. Calcium, for instance is derived from limestone’s, oyster, egg shells or from naturally occurring beds of calcium carbonate. All of these are calcium compounds in which are the element to form molecules. Minerals are commonly taken in the form of compounds which are often easily absorbed in elemental form.

Q. Do I have to worry about whether or not the pills I am buying will dissolve properly and be absorbed?
A. You should be concerned according to experts. They say vitamin manufacturers have addressed but still not entirely cracked problem of dissolvability.
One assurance that vitamin you are buying will dissolve properly is to look for the letters BP. This means the supplements meets the manufacturing standards set by British Pharmacopoeia, an independent publication that sets standards for strength, quality purity, packaging and labeling for medical products used in the UK. Many proprietary vitamin preparations do not mention the Bp. In the US the equivalent authority is the United States Pharmacopoeia and you will occasionally see the letters USP on vitamins sold in Britain which originated in the US.

Q. Can you explain what the amounts used for vitamins and minerals mean? I don’t understand the difference between milligrams, micrograms, international units and all the measurements standards you have been using.

• Fair enough. Here is a quick primer:
• A milligram is 1/1000th gram; there are 2000 milligrams in a gram
• A microgram is 1/1000th of a milligram; there are 1000000 micrograms in a gram in 1 Ounce
• There are 28.35 grams in I ounce which is give you ideas of how small gram is
• An international unit is an arbitrary unit of measure used vitamin A and E, however, even though you may continue to see IU on vitamin bottles for a while longer, it is no longer the official unit of measure for these vitamins.

Q. How are A and E now measured?
A. The official unit of measure is now retinol equivalents for vitamin A and its various forms and tocopherol equivalents for E and it various forms.

Q. But why confuse matters? Why not just use milligrams as for the other vitamins?
A. researchers have found it necessary to use a unit of measure other than milligrams because vitamins A and E are found in several forms with difference levels of activity. These new units of measure make it possible to compare and convert the various forms of these two vitamins taking into account how active those are. As far as you are concerned you will not go far wrong if you work on the assumptions that I TE of vitamin E is the same I mg.

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