Vitamins, Minerals, and Dietary Supplements for Optimum Health
Disclaimer (11/24/07): The following is intended as educational material, and not as individual treatment recommendations.
I believe that everyone should take a multivitamin with mineral as a form of health insurance, in addition to eating a healthy diet. Read the label when choosing a multivitamin, and consider choosing one with 3000 IU of preformed vitamin A or less, and no iron (unless you are a menstruating woman). Many multivitamins have small amounts of multiple botanicals or herbs – I recommend choosing a multivitamin without these additional ingredients. With regard to quality, Consumer Reports has found that as long as multivitamins are not purchased as “deep discount” stores, quality of virtually all brands tested was good, so the choice of a brand name is not that important. Most multivitamins contain 400 IU of vitamin D - I recommend an additional 1000- 2000 IU/day vitamin D from November – April in northern climates. I recommend supplemental magnesium 100-200 mg/day, as most multivitamins contain relatively little of this mineral (it is bulky, and thus a small quantity takes up a lot of physical space in a multivitamin) and a USDA survey has concluded that 62% of Americans don’t obtain the RDA! Finally I recommend either selenium 200 micrograms daily or 2 brazil nuts per day, and fish oil, such that daily consumption of EPA + DHA from food plus the fish oil is at least 1 gram per day. Some multivitamins may have 200 mcg selenium in them, thus eliminating the need to consume additional selenium, but the vast majority of multivitamins do not have fish oil in them. Data published in 2007 indicates that selenium intake of 200 mcg daily may increase the risk of developing diabetes. Nonetheless, I believe that for most individuals, the benefits of selenium 200 mcg per day outweigh the risks.
For women, I recommend calcium 500 mg daily in supplement form (it is fine to take a combined calcium/magnesium supplement or a combined calcium/vitamin D supplement). I don’t in general recommend supplemental calcium for men based on data that calcium intake in men in excess of 1200 mg/day is correlated with an increased risk of prostate cancer. I concur with Walter Willett, MD, DrPH that the RDA for calcium is currently set too high and that with sufficient intake of vitamin D, total intake of 800-1000 mg of calcium per day in men and women is adequate. Dr. Willett in Chapter 9 of his superb book, Eat, Drink and Be Healthy, fully explains the rationale for a lower RDA for calcium. Green leafy vegetables are a good food source of calcium.
For individuals over age 50, the amount of vitamin B12 in a multivitamin may not be sufficient. Most individuals as they age produce less stomach acid, and thus absorb less of the protein-bound vitamin B12 in food (B12 is found only in animal foods, so vegans obtain no vitamin B12 from their diet). If ones multivitamin does not contain 100 mcg of vitamin B12 per serving, consider additional vitamin B12 100 mcg daily.
If finances permit, I suggest that everybody also take a ‘green supplement’ daily as well as coenzyme Q10. With regard to the oxidative stress to which we are all subject as a byproduct of energy production in each of our cells and exposure to the sun (as well as exposure to environmental pollutants), I have come to realize that the antioxidant vitamins (beta-carotene, vitamin C, vitamin E) and the anti-oxidant minerals (zinc, copper, selenium, and manganese) are ‘the tip of the iceberg’ with regard to antioxidants which we obtain from our food and/or dietary supplements. The ‘iceberg’ is the hundreds and thousands of antioxidants found in the dozens of different fruits and vegetables. Thus, along with eating a variety of fruits and vegetables every day, I suggest a ‘green supplement’ daily. The green supplement which I take is Juice Plus +. I chose this brand because it is produced via high quality manufacturing practices, including a low heat process which does not destroy the phytonutrients present in the fruits and vegetables, and because there is a substantial body of published research in peer-reviewed journals showing a variety of health benefits associated with this product. This product is available only through network marketing - it can be ordered on line at www.juiceplus.com.
Coenzyme Q 10 (Co Q 10), which is consumed in our diets and can be synthesized in the body, is an essential cofactor with regard to energy production in our bodies at a cellular level. It is also a potent antioxidant. The quantity which we synthesize steadily decreases with age. Thus, if affordable, all individuals over age 40 should consider taking a supplemental dose of 50-100 mg daily of Co Q 10. For many years, Co Q 10 was available as a dietary supplement only in its oxidized form (ubiquinone). It is the reduced form of Co Q 10 (ubiquinol) which functions as the antioxidant in our bodies, and the reduced form became available as a dietary supplement in 2006. Ubiquinol is marketed as various brand names by several different companies, and is an alternative to ubiquinone supplementation. The supplement I now take is UBQH, which is ubiquinol, marketed by Integrative Therapeutics. For years prior to the availability of reduced Co Q 10 as a dietary supplement, I took Q gel, a highly absorbable form of ubiquinone which can be ordered on line at www.solanova.com.
My thoughts on supplemental vitamin C and vitamin E have been in a state of flux for the past several years, as I continue to read and study more about these anti-oxidant vitamins. I no longer recommend supplemental vitamin C for a healthy adult, although I do recommend high dose vitamin C (500-1000 mg every 3-4 hours) short-term when one feels as if one is coming down with an infection. Vitamin E exists in nature (in the oil of plants, to prevent oxidation of the oil in the plant) as a complex of 8 chemicals – alpha, beta, gamma, and delta tocopherol and alpha, beta, gamma, and delta tocotrienol. Most vitamin E on the market is d,l alpha tocopherol. ‘Natural’ vitamin E, which in the test tube has greater anti-oxidant effects than synthetic vitamin E, is d-alpha tocopherol. I believe that if one takes supplemental vitamin E, it should be in a form in which all 8 chemicals are present in the supplement. A product which contains all 8 chemicals is TocoSential E, available on line at www.solanova.com. While 400 IU of a ‘mixed’ vitamin E product such as TocoSential E is probably safe, I have reduced my daily supplemental intake to 400 IU once a week (my multi, which is also marketed by Solanova, contains 100 IU/day of vitamin E in the form of mixed tocopherols and tocotrienols). E Gems Elite, marketed by Carlson Labs, is another vitamin E product containing all tocopherols and tocotrienols in each capsule.
Dietary supplement
quality: due to lack of federal regulation in the
[Last updated August 10, 2008] [Return to Home Page]