September 15, 2010
Vitamins make me sick. I really don’t like the way they hurt my stomach, burp up later and certainly the color and smell in the bathroom. So the question is do I really need to take them and if I do, which ones?
I do take daily vitamins and give them to my kids even if there is not overwhelming data to support the practice. Ideally everyone should get all their nutrition from a diet rich in fruits, vegetable, fiber and lean protein. We do better than most in getting the fruits, vegetables and fish down but there are still too many drive through dinners in our life. There is also enough evidence to the benefit of certain supplements that makes me think it worthwhile.
You can spend a fortune on vitamins but my motto is to take the simplest formulation that you are most likely to stick with. If you can’t afford it, tolerate it or fit it into your life then find something else that works. Vitamins sitting on the shelf are certainly of no benefit.
Here are Dr Deb’s recommendations for supplements
1. Multivitamin Without Iron
The data on the benefits of a multivitamin is limited but I still believe it is a good idea for everyone to take a multi vitamin, especially if they are trying to lose weight, have any health problems or are older than 60.
The vitamin with the most proven health benefit is FOLIC ACID. Every girl should take folic acid supplements from puberty through menopause or permanent sterilization as proper folic nutrition has been shown to decrease birth defects. The kick is that the supplement needs to be taken BEFORE she is pregnant into the first few months of pregnancy. Half of all pregnancies are unplanned, so it is important for every woman to take folic acid.
You do not need a multivitamin with iron unless you have known anemia, which is most likely to happen to women of reproductive age with heavy cycles. Too much iron can lead to heart disease in adults and poisoning in children. (My 2 year old twins once, climbed up the counter, went in the cabinet, broke into a bottle of vitamins with a knife, finished off the bottle and hid the evidence under the dining room table! How grateful I was that the vitamins did not have iron and the overdose did not hurt them!)
Iron also causes stomachaches and constipation so many people think they can’t tolerate vitamins, but do well when they don’t contain iron. Some people are have a low red blood cell count and need iron, but don’t take extra iron unless you have blood tests that confirm your anemia.
It is best to take your vitamin twice a day but once is OK too. I even tell my adult patients, take a kid’s gummy vitamin if that is all you can tolerate. At least you are getting some vitamins (most importantly folic acid) as opposed to none.
2. Calcium, 1000 mg, Magnesium 400mg and Vitamin D 400iu. (Taken in one tablet)
Calcium is important for building bones and preventing osteoporosis but is also involved in many key chemical reactions like contracting your muscles, releasing hormones and sending nerve signals. Bones are built in childhood and adolescence and start to be broken down in our 30s. Calcium intake helps to prevent further bone breakdown. If you don’t store the calcium in the bones as a child your bones will be very weak as an adult.
Teens need 1300mg of calcium or over 5 glasses of milk. Energy drinks have replaced the fluid of choice for kids, so most are not getting enough calcium. Calcium also helps with PMS so those teens girls are hard enough, calcium may add to your sanity.
The AAP states that children who do not drink a quart or 4 cups of milk should supplement with Vitamin D.
The Magnesium helps absorption and prevents constipation that is often seen with calcium supplements. Magnesium is also involved in over 300 biochemical reactions in the body. It helps regulate blood sugar and may help regulate blood pressure.
Vitamin D has become the latest wonder vitamin. In addition to promoting calcium absorption and bone growth, it boosts the immune system and decreases inflammation. It may protect against cancer, heart disease, MS, and thyroid disease. Latest research believes that it may decrease the risks of influenza.
Right now I recommend 400iu but many in the field promote 1000iu or more. This is an area of ongoing research that we will have to watch.
The primary source of Vitamin D is the sun. It only takes about 15 minutes of sun a day but anyone living north of Atlanta in winter months, and especially people of color, are likely to be Vitamin D deficient. Nearly 100 million Americans are not getting enough vitamin D either through diet, supplements or sun exposure.
The best is to take all 3 supplements in the form of one pill. You should not take calcium and iron (if you need it) at the same time as calcium blocks the absorption of iron. If you get a lot of sun exposure you can just take calcium in the form of TUMS or an antacid. Again, not ideal, but practical, especially for children.
3. Omega 3 Fatty Acids
Women need about 1000 mg while men only need about 600mg. This is best met through the diet with 2-3 servings of oily fish like salmon but a handful of walnuts or flaxseed can easily provide you with enough omega 3’s.
4. Other Vitamins
For many years, anti oxidants such as Vitamin E and C were touted as the cure all. Studies have not shown that to be the case but many still swear by their 500mg of Vitamin C at the onset of a cold. There are studies to show that it will decrease the risk of complications of a cold.
A few that I think are worth considering are
Coenzyme Q 10
Coenzyme Q10 is used in the body for cell growth and protects from cell damage.
I have seen remarkable improvement in my son’s headaches after COQ10 supplementation. It works about 50% the time but is hard to keep stable. I recommend Epic4Health as a supplier. This is also very important for people on statins to take 200mg as they are more likely to be CoQ 10 deficient. It is being studied in heart disease and cancer.
Vitamin B is used a many chemical reactions including the blood, immune system and nervous system
It may help with weight loss and stress.
Recently it has been shown to decrease the progression of dementia by lowering the homocysteine levels.
So many vitamins, so little time. (and money). Vitamins are not regulated so it is important to buy quality products (that DOES NOT mean the most expensive.) Other supplements not mentioned have risks so check labels and look out for these herbals in your vitamins. In the confusing world of supplements, I do think these are worth it although there is no magic in a bottle that can replace good nutrition!