Supplements: The daily dose

Find out if you really need to take diet supplements every day

a plate with pills on it

Is it necessary to take a daily vitamin supplement because we may not be getting enough of vitamins from the diet?

It is difficult to get all the vitamins and minerals we need from our food unless we are eating wholesome meals that include plenty of fresh produce. Most of us eat a lot of processed and packaged food, which may not be rich in nutrients. Therefore, we can benefit from dietary supplements.

However, consuming excess fat-soluble vitamins [vitamin A, D, E and K] may lead to hypervitaminosis. This is because these vitamins get absorbed in the body through our intestines, and are more likely to get accumulated.

Water soluble vitamins [vitamins B and C], on the other hand, are required on a daily basis as the body does not store them. So, supplementing your intake of these vitamins does not cause any harm, except that they may interfere with the absorption of certain medications like ones used for Parkinsonism.

You do not need vitamin supplements, only if you are eating a balanced diet on a daily basis.

Are dietary supplements like calcium a must after 45, especially for women?

Yes. After 45, most women are post menopausal. In this stage, the lack of oestrogen in their bodies prevents absorption and utilisation of calcium increasing their chances of osteoporosis.

Moreover, with age, the production of hydrochloric acid in the stomach decreases, which further affects calcium absorption. And about 40 % post menopausal women are severely deficient in hydrochloric acid. Calcium supplements reduce the risk of bone loss in post menopausal women by about 50 %.

Daily intake of calcium [1000mg] and vitamin D [400IU] supplementation is an essential component to prevent osteoporosis and bone fracture. People with high calcium intake also have a reduced risk of colorectal cancer and intestinal polyp.

In addition to supplementation, women above 45 years of age should not consume high phosphate processed food, meat and fizzy drinks to prevent the deleterious effects of calcium on their hearts. Further, they should also avoid eating a diet rich in phytic acid [bran of whole grains], sodium, coffee, cocoa, soybean, sugar, cashew, beans and spinach as it hampers availability of calcium.

They should also check their serum calcium, phosphorus and vitamin D levels at regular intervals.

What are the benefits of taking dietary supplements?

Dietary supplements offer many benefits.

  1. They contain vitamin C, which helps the body absorb iron and promotes healing of wounds.
  2. They contain vitamin D, which helps the body absorb calcium that is required for strong bones and teeth.
  3. They contain vitamin B12 that is required to produce red blood cells.
  4. They contain calcium, which strengthens the bones.
  5. They have potassium that facilitates proper functioning of the kidneys.
  6. They have omega-3 fatty acids, which are good for the heart.
  7. Some supplements contain herbs such as St. John's Wort [treats mild to moderate depression], garlic [reduces blood pressure and cholesterol], dandelion [helps digestion and cleansing of the liver], chamomile and lavender [calm the nerves].

What are the risks of taking supplements?

The calcium in the supplements can meddle with some heart medications; the ones with magnesium can hamper furosemide, a diuretic; vitamin K can interfere with blood thinners; and St. John's Wort can interfere with some antidepressants and birth control pills.

Taking a vitamin supplement daily without knowing if you are deficient in any vitamin can be harmful for your health.

Consuming vitamin A in excess can cause blurred vision, headaches, hair loss, and liver damage; vitamin B6 in excess leads to difficulty in walking and numbness in the hands; extra vitamin D in the body can cause a build up of calcium deposits, which may interfere with functions of the muscle, even the heart muscle.

Is it okay for children to take supplements?

Kids who eat a balanced diet should get all the vitamins and minerals they need from the foods they eat, so supplementation in usually not necessary.

Encourage your child to eat plenty of fresh fruits, vegetables, whole grains dairy products and healthy fat sources like nuts and seeds. You can even include breakfast cereals, breads and juices fortified with vitamins and minerals in their diet.

Claims by dietary supplements such as improved brain function or immune system function are usually unsustainable.

Which vitamins can I safely take on my own?

Water soluble vitamins [B vitamin and C] as with them there is a less chance of toxicity. Remember, do not take fat-soluble vitamins without medical guidance.

How do I find out if I am lacking in any mineral/vitamin?

Your healthcare provider will help you find out if you have a nutrient deficiency. If you have, you are likely to experience some symptoms [refer table].

Vitamins Symptoms of deficiency Sources
Vitamin A Susceptibility to infection; poor vision in twilight,retarded growth Milk, butter, eggs, liver,margarine, tomatoes, carrots, fish liver oils
Vitamin B1 thiamine Loss of appetite; nerve disorders; fatigue; poor digestion, retarded growth Meat, especially pork,wholemeal bread and cereals, milk, vegetables
Vitamin B2 riboflavine Sores at corners of the mouth; other skin and membrane disorders Meat, milk, green vegetables, eggs, poultry
Vitamin C Slow healing; tendency to bruise and bleed easily;sore gums, scurvy Many raw fruits, especially the citrus group, and vegetables, tomatoes, melon
Vitamin D Weak bones and teeth Fish liver oils, liver, fortified milk and baby cereals, irradiated margarines and sunshine
Vitamin E Fertility problems Seed germs, green vegetables
Vitamin K Improper clotting of blood, bleeding Meat, poultry, fish, potatoes, peanuts; whole grain cereals

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Arpita Dwivedy
Arpita Dwivedy, MD[ANAES], is a critical care consultant and heads the ICU department at Dr L H Hiranandani Hospital, Mumbai. She has special interest in management of infectious diseases in the elderly. She has handled difficult cases of pneumonia trauma sepsis and multiple organ failure.

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