The A to Z(inc) of vitamins and minerals you need ~ Let's Get Healthy

MANILA, Philippines — Shopping for a multivitamin is like trying to hit a moving target. Each supplement has at least 20 - and sometimes 40 or 50 ingredients. Combined that with the evolving science (“Beware of excess vitamin E,” “Bones need more vitamin K,” “Don’t overdo vitamin A”) and the claims on the packages (“More energy-boosting ingredients!” “More cell-protecting antioxidant!” “Helps promote a healthy heart!”) and you’ve got the markings of a migraine. That’s just the beginning. How are people supposed to know if they need lycopene, lutein, ginseng, ginkgo, or digestive enzyme? No wonder “stress vitamins” sell so well! Here’s our guide through the multivitamin maze.

Vitamin by vitamin, here’s what you need, according to the Institute of Medicine’s Daily Value (DV) for each nutrient, which usually means the same as RDA or Recommended Daily Allowance. Numbers are different for children, the elderly, and pregnant and lactating women.

Vitamin A. It comes in two forms. Retinol, found in egg yolks, dairy foods, and meat, is used immediately by the body. Beta-carotene, found in yellow, orange and green leafy vegetables, is converted into vitamin A in the body. Vitamin A enhances vision, strengthens bones, teeth, and skin. Recommended daily intake is 700 micrograms (or mcg.) for women and 900 for men (3,000 international units, or IU). Too much vitamin A is highly toxic – regularly taking more than 10,000 IU a day can cause nerve and liver damage, dry lips and nails, hair loss, and might increase the risk of bone fractures. Don’t get more than 4,000 IU or retinol or 15,000 IU of beta-carotene from your multivitamin pill (less retinol would be even better). Instead, load up on beta-carotene-rich fruits and vegetables like carrots, cantaloupe, sweet potatoes and broccoli.

The three Bs – B6, B12, and folic acid. Some studies show that B vitamins might help prevent heart disease and some cancers. Others disagree. All three help us build new proteins, and folate helps the synthesis of DNA, B12 works with folate to maintain the nervous system. Too little folate is a major cause of neural tube defects, such as spina bifida. All women of childbearing age should take folate supplement. Folate may also lower the risk of breast cancer in women who drink alcohol. The recommended amounts are likely to change in the next few years as results come in from ongoing long-term studies. Current recommended intakes are 1.3 mg. of B6, 2.4 mcg ofB12, and 400 mcg of folic acid.

The other Bs – thiamin (B1), riboflavin (B2), and niacin (B3). Thiamin, riboflavin and niacin work together with other B complex vitamins to help turn food into energy. These vitamins also help sustain the nervous system, skin and digestive tract. Low thiamin levels can result in difficulty in concentrating, depression and muscle weakness. (Alcoholics are often severely low in thiamin). Riboflavin works as an antioxidant and deficiencies have been associated with migraine, cataracts and arthritis. Niacin improves circulation and lowers cholesterol levels in the blood. The DVs are 1.2 mg. for thiamin, 1.2 mg. for riboflavin, and 15 mg. for niacin. (These are averages for men and women.)

Vitamin C. Vitamin C has been on the public radar for a long time as immune system enhancer and cold-fighter (necessary for healthy bones, teeth, and vessels). There has been a lot of debate about whether extra-large doses do any good – and studies show no clear link between huge amounts of C and decreases in heart diseases, cancer or eye problems. Because the vitamin is water soluble, you probably pee out anything beyond what your body can use. DVs: 75 ng. for women, 90 for men, more for smokers. Roughly 250 to 500 mg. saturates the body’s tissues, so more than that is probably excreted. Taking more than 1,000 mg. of vitamin C at one time in a supplement may cause diarrhea.

Vitamin D. This one has been getting lots of attention as accumulating studies show that vitamin D helps protect against some cancers, including breast, prostate, and colon. It also helps with bone strength. Current DV is 5 mcg. (200 IU) a day for adults 50 and under, 400 IU for people aged 50 to 70, and 600 IU (some experts say it should be 1,000 IU) for everyone over 70. Those amounts include what you get from the sun, from salmon and other fatty fish, and fortified good like milk, breakfast cereals, and some brands of yogurt, margarine and orange juice. They also include the vitamin D that’s added to many calcium supplements. Keep an eye open for news about this one. Vitamin D is fat-soluble and better absorbed when taken with food.

Vitamin E. Study results are mixed in whether vitamin E supplements can help reduce the risk of heart disease, and the American Heart Association refuses to recommend it. Large, long-term studies may help shed light on this question. One complicated thing about this fat-soluble vitamin is that it comes in eight forms, and our bodies absorb some better than others. “This highlights the challenges of evaluating vitamins,” says Brent Bauer, director of the Complementary and Integrated Medicine Program at the Mayo Clinic in Rochester Minnesota. “Just because something works in the diet doesn’t mean we can extract one part of it, take I in a pill and get the benefits.” Look for “mixed tocopherol” on the label. Recommended intake is 30 IU. Anything more than 1,500 IU can be toxic.

Vitamin K. This fat-soluble vitamin is essential for blood clotting and important for building bone. Supplements are recommended for people who take anticoagulants and for postmenopausal women, but it is abundant in leafy greens and cooking oils. The IOM now recommends 120 mcg. a day, and recent studies suggest that 150 to 250 mcg. a day may be best to reduce the risk of hip fractures. Vitamin K can interfere with blood-thinning drugs like Coumadin, so people who take them should check with their doctor before taking a multi with vitamin K.

Calcium is essential for strong bones, and it also assists with blood clotting, muscle contraction, and communication within the nervous system. Adequate vitamin D and magnesium boost calcium absorption. Any adult who is not getting 1,000 mg. a day through dairy products, broccoli and other greens should take supplements, and people older than 50 should up their intake to 1,200 mg. Calcium comes in several forms. Calcium citrate is easiest to absorb without food, but often costs more than calcium carbonate or other forms. Calcium interferes with iron absorption, so these two supplements should be taken separately.

Selenium is an antioxidant found in meat, fish, and fortified food such as rice and bread. It occurs in high amounts in Brazil nuts. The mineral seems to help prevent cancer, heart disease and arthritis, according to some studies, and HIV patients with low selenium levels appear to be more likely to die. The recommended intake is 55 mcg. and most of us get enough in our diets.

Zinc. This mineral keeps our immune system strong, helps wounds heal, maintains our sense of taste and smell, and helps us grow in the womb and through childhood. Diets rich in meats and seafood (especially oysters) are rich in zinc, which also occurs in beans, nuts whole grains, and fortified cereal. Pregnant women and vegetarians should consider taking zinc supplements and experts debate whether zinc may also shorten the lengths of colds. Taking too much iron can block the absorption of zinc. The DV is 8 mg. for women and 11 mg. for men.

Iron is a crucial player in delivering oxygen to our cells. Low levels of the metal – called anemia – lead to fatigue, difficulty working, and a weakening of the immune system. Iron is abundant in red meats, organ meats, and shellfish, so vegetarians can become deficient, but it also appears in sources such as oatmeal, beans, pumpkin and sunflower seeds, spinach, and fortified cereal. Menstruating women need 18 mg. a day of iron and pregnant women need 27 mg. Men and post-menopausal women need just eight mg. Pregnant women, women who might become pregnant, women with heavy periods, and athletes need to make sure they get enough iron, but there is some evidence that taking extra iron can damage heart health in people who aren’t already anemic. In supplements, look for “ferrous” rather than “ferric” salts to boost absorption. To avoid severe illness from iron toxicity, do not exceed more than 45 mg. a day, and make sure to keep iron supplements away from children.

Remember that the values mentioned in this article are what we need to get every day from food and supplements and that they vary slightly by age and gender. That the best vitamins are those found in food not in pills, and that multivitamin tablets are not substitutes for a healthy diet.

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