What You Need to Know About Vitamins and Supplements.

By Aparna Asher, MD

We live in the 21st century, where fast-food restaurants and drive-throughs are the norms in our action-packed lives, whether you are a working professional or a retired senior possibly living alone and it’s a chore cooking for a single person. We are used to taking nutritional supplements on a daily basis, whether to improve our health, appearance or because our mammas or girlfriends told us so. But do we really know if this is what our bodies need to be healthy? And, more importantly, how much is enough?

The definition of the word “vitamin” says it in a nutshell: a group of organic substances essential for normal cell function, growth and development, which are found in trace amounts in natural foodstuffs or occasionally synthesized. Vitamins are good for our health when we lack them, either because of poor nutrition, dietary choices or because our bodies are unable to make them in sufficient quantities.

Taking vitamins in higher amounts than the body requires may, in certain cases, do more harm than good. On the other hand, a vitamin deficiency can also lead to certain health disorders. It’s always a good idea to consult your provider before taking vitamins, especially if you’re taking other drugs, as they may interfere, reduce or increase the impact of certain medications, or increase the likelihood of negative medical outcomes.

What your body needs:

There are 13 essential vitamins that are required for the body to work properly.

  • Vitamin A
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • Vitamin K
  • Vitamin B1 (thiamine)
  • Vitamin B2 (riboflavin)
  • Vitamin B3 (niacin)
  • Pantothenic acid (B5)
  • Biotin (B7)
  • Vitamin B6
  • Vitamin B12 (cyanocobalamin)
  • Folate (folic acid and B9)

The use of dietary supplements is common in the U.S. adult population. According to the Centers for Disease Control and Prevention (CDC), Supplement use is more common in women than in men. About 49% of adults used at least one dietary supplement between 2007 and 2010 and 32% reported using a multivitamin-multimineral supplement, according to a recent study. Some of the most popular antioxidants used are Vitamin C, selenium and carotenoids, such as beta-carotene.

Facts of Vitamin Supplementation:

In the senior population, there is a high risk of simultaneously taking multiple drugs with the addition of supplements to their ongoing prescriptions. The United States Preventive Task Force (USPSTF) found inadequate evidence on the benefits of supplementation with multivitamins to reduce the risk of cardiovascular disease or cancer. In cognitively healthy adults 40 years and older, vitamin and mineral supplementation has little to no benefit in preserving cognitive function or preventing dementia.

Screening average-risk adults for vitamin B12 deficiency is not recommended. However, a screening may be warranted in patients with one or more risk factors, such as gastric or small intestine resections, inflammatory bowel disease, use of metformin for more than four months, use of proton pump inhibitors or histamine H2 blockers for more than 12 months, vegans or strict vegetarians and adults older than 75 years. Initial laboratory assessment should include a complete blood count and serum vitamin B12 level.

Harms of Vitamin Supplementation:

The USPSTF found insufficient data on the risks of taking multivitamins and most single vitamins, minerals and functional pairs. Recent trends in vitamin D testing and supplementation strongly suggest that physicians and patients believe that identifying and correcting vitamin D deficiency improves health outcomes. In most cases, a test does not improve treatment. Many people have low vitamin D levels but only a few have dangerously low levels.

Discuss with your provider whether a supplement is truly necessary, and make sure you only receive the necessary tests or screenings to avoid unnecessary or potentially harmful treatments. For example, if you take too much vitamin D, it can damage your kidneys and other organs. There are certain diseases for which it is necessary like osteoporosis, chronic kidney disease, inflammatory bowel disease, etc. People on restricted or special diets or those living in regions of the world with widespread malnutrition may have additional needs for vitamin supplementation. Talk to your primary care provider if any of these factors apply to you.

What you can do to maintain your nourishment:

Simple lifestyle changes such as weight management, being physically active, drinking vitamin D-fortified dairy products and quitting smoking can make a difference. An all-natural diet is strongly encouraged, rather than processed and restaurant-based foods. Incorporating fruits and vegetables is beneficial to one’s health not only because it contains recognized vitamins, but also because it contains fiber and other less well-defined nutrients. A well-balanced diet can help eliminate the need for supplementation and will help improve your overall health and wellness, chronic illness prevention, life expectancy optimization, and clinical management of virtually all disease states.

Be sure to talk to your provider if you have any questions or concerns about which vitamins or supplements you should be taking. Refrain from starting a vitamin or a mineral supplement unless your provider feels it is what you need. High-dose vitamin guidelines should be personalized to specific patients since some vitamins in higher doses can be toxic to some people.

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