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  • Matthew Minson, M.D.

Supplemental Vitamins or "Food Glorious Food."


The conversation started the way most of them start.

“Hey, Doc, quick question….”

That part was true. The question was quick. The question is always quick, like “Hey, quick question, how do you play baseball?”

It’s the answer that is never quick.

So this time it was, “Hey Doc, quick question, do you think I should take a vitamin?”

My quick answer, “Well… maybe… sorta… perhaps not.”

If you watch television you are constantly told you have to take them. The manufacturers would have you believe that they are even critical to the prevention of aging, debilitation, eyesight, joint protection and and assurances of a reliable erection. Is this true? Are they lying?

Well, maybe… sorta… perhaps not.

The fact is that vitamins are a part of the substrate in our food that make up our physical structure and they also play roles in the function of membranes , biological processes and more. So, yes, we need them. Ideally, we should get what we need from the food we eat. The question that arises from the barrage of commercial supplemental vitamin manufacturers and sellers is, do we need more than we are getting in our diet?

That depends.

If you have an active disease process, are undernourished, are pregnant or have been diagnosed with a deficiency, then yes, a supplemental vitamin may, and likely would be, in order. The way to determine this, see your healthcare provider. If you have had any symptoms or complaints express them. Additionally, blood tests may be in order. If it is determined that you need a vitamin supplement, then go for it.

A Word About Oil and Water:

Most people don’t realize that all vitamin supplements are not the same. In fact vitamins can be classified in many different categories, but the most basic have to do with their solubility, or the extent to which the vitamin dissolves in a substance Many vitamins are soluble in water, others dissolve more readily in oil or fat.

Does it matter? You bet.

Water soluble vitamins tend to “clear” the human body a little more easily that those that are retained in our body fat. What does that mean, well it means that despite some common misinformation, you can overdose on vitamins, especially fat soluble ones and iron supplements. This is not all that uncommon.

Here are some of the most commonly vitamins that can be over ingested and the problems they can cause.

Vitamin A is fat soluble vitamin, as are K, D, and E. I like mnemonics to remember such as Eating Kale Aids Digestion… or something like that. These are the vitamins that tend to dissolve and retain in fat.

Vitamin A, specifically retinol or retinoic acid, can be really toxic. It can build up in the body leading to hair loss, confusion, liver damage and bone loss. Symptoms include drowsiness, sluggishness, irritability, severe headache, bone pain, blurred vision and vomiting. One horrid side effect is the peeling off of body skin, even on the bottom of the feet. Severe cases of toxicity can end in liver damage, hemorrhage, coma and death.

Taking very high doses of vitamin E may interfere with the body's ability to clot blood, posing a risk to people taking prescribed blood thinners or aspirin. If you’re on these drugs, take vitamin E supplements only under physician supervision.

Now this doesn’t mean that water souble vitamins can be taken excessively or irresponsibly.

For example, water-soluble B vitamins, as you now know, do not accumulate in the body, however, getting too much of some of them can still cause problems. Vitamin B6 in excess can damage nerves, although that is unlikely in doses lower than 300 mg per day. Taking a total of 2,000 to 3,000 mg per day of niacin (vitamin B3) to lower cholesterol can cause reversible nausea, jaundice and elevated liver enzymes, a toxic picture mimicking hepatitis. Some conditions of particular scrutiny include: pregnancy, ulcers, gout, diabetes, gallbladder disease, liver disease or having had a recent heart attack. Anyone taking niacin to lower cholesterol should only do so under the supervision of a physician and should have liver function tests done before the start of therapy and periodically thereafter.

Minerals:

Iron is one of the few minerals we cannot eliminate at all except by blood loss and I don’t recommend that! Accumulations of this metal ion in the body can actually, easily rise to toxic levels. Too much iron can increase the risk of cancer and heart disease. You should never take iron supplements unless advised to do so by a physician and only after tests have revealed an iron deficiency anemia. Also if you have iron deficiency make sure your provider determines the cause.

If you watch television at all you know that we are constantly being bombarded with sales pitches for vitamins and dietary supplements. If you believe what they say you’d think we were on the verge of starvation every second of every day. This isn’t the case for most Americans.

So how do you know? Well, it’s pretty easy. See your healthcare provider and ask them. Follow that guidance and if necessary, have the tests necessary to make sure your consumption is safe.

The fact is that most people should be able to get their necessary vitamin content from a nutrient dense diet. I have written about it before but Iowa State University has done a great thing in describing and creating cost saving menus that are savory and nutritious. Visit

http://www.extension.iastate.edu/humansciences/healthy-living-and-eating-families

for more information.

With that I’ll offer… bon apetit and I mean that in the truest sense of “bon” meaning “good”. In order to achieve that, maybe don’t trust all those ads that you see in between the fast-food commercials .

That really means you may not want to swallow everything they’re selling.

Be Well!


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