Coenzyme Q10

Although several naturally occurring forms of coenzyme Q have been identified, Q10 is the predominant form found in humans and most mammals, and it is the form most studied for therapeutic potential.

What is Coenzyme Q10 ?

  • Coenzyme Q10 is made naturally by the human body.
  • Coenzyme Q10 helps cells to produce energy, and it acts as an antioxidant.
  • Coenzyme Q10 has shown an ability to stimulate the immune system and to protect the heart from damage caused by certain chemotherapy drugs.
  • Low blood levels of coenzyme Q10 have been detected in patients with some types of cancer.
  • No report of a randomized clinical trial of coenzyme Q10 as a treatment for cancer has been published in a peer-reviewed scientific journal.
  • Coenzyme Q10 is marketed in the United States as a dietary supplement.

What foods contains Coenzyme Q10?

Meat and Fish

Relatively good food-based sources of CoQ10 include animal products such as beef, pork and chicken with organ meats such as the heart ranking highest. Oily fish such as sardines, herring, salmon and mackerel offer useful quantities of dietary CoQ10. According to the Linus Pauling Institute at Oregon State University, a 3 oz. serving of fried beef contains 2.6 mg of CoQ10 with herring offering 2.3 mg and fried chicken 1.4 mg. Getting all the CoQ10 needed from food presents challenges because of the relatively low amounts available even in foods with the highest content values.

Oils

Two cooking oils provide CoQ10: canola and soybean. Soybean oil contains polyunsaturated fatty acids and a tbsp of soybean oil provides 1.3 mg of CoQ10. To ensure a healthy lifestyle, stay away from hydrogenated soybean oils; select instead the new, low-saturate soybean varieties. Nutritionists and health care providers including those from MayoClinic.com recommend canola oil for its low saturated fat and high proportion of monounsaturated fat. A tablespoon of canola oil provides 1 mg of CoQ10.

Fruits and Vegetables

Small amounts of CoQ10 (less than .5 mg per serving) come from fruits and vegetables. The best sources include spinach, cauliflower and broccoli with strawberries a distant fourth providing only .1 mg in a 1/2 cup serving. Although frying vegetables reduces CoQ10 by approximately 14 to 32 percent, the vegetable’s CoQ10 content did not change when boiled. Adding pistachios or peanuts to vegetable dishes increases the CoQ10 available.

Resources

http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/HealthProfessional

http://www.livestrong.com/article/256149-what-foods-are-rich-in-coq10/

Vitamin B6

What is vitamin B6 and what does it do?

Vitamin B6 is a vitamin that is naturally present in many foods. The body needs vitamin B6 for more than 100 enzyme reactions involved in metabolism. Vitamin B6 is also involved in brain development during pregnancy and infancy as well as immune function.

How much vitamin B6 do I need?

The amount of vitamin B6 you need depends on your age. Average daily recommended amounts are listed below in milligrams (mg).

Life Stage Recommended Amount
Birth to 6 months 0.1 mg
Infants 7–12 months 0.3 mg
Children 1–3 years 0.5 mg
Children 4–8 years 0.6 mg
Children 9–13 years 1.0 mg
Teens 14–18 years (boys) 1.3 mg
Teens 14–18 years (girls) 1.2 mg
Adults 19–50 years 1.3 mg
Adults 51+ years (men) 1.7 mg
Adults 51+ years (women) 1.5 mg
Pregnant teens and women 1.9 mg
Breastfeeding teens and women 2.0 mg

What foods provide vitamin B6?

Vitamin B6 is found naturally in many foods and is added to other foods. You can get recommended amounts of vitamin B6 by eating a variety of foods, including the following:

  • Poultry, fish, and organ meats, all rich in vitamin B6.
  • Potatoes and other starchy vegetables.
  • Avocado
  • Lentils, chickpeas, beans
  • Fruit (other than citrus)

What kinds of vitamin B6 dietary supplements are available?

Vitamin B6 is available in dietary supplements, usually in the form of pyridoxine. Most multivitamin-mineral supplements contain vitamin B6. Dietary supplements that contain only vitamin B6, or vitamin B6 with other B vitamins, are also available.

Am I getting enough vitamin B6?

Most people in the United States get enough vitamin B6 from the foods they eat. However, certain groups of people are more likely than others to have trouble getting enough vitamin B6:

  • People whose kidneys do not work properly, including people who are on kidney dialysis and those who have had a kidney transplant.
  • People with autoimmune disorders, which cause their immune system to mistakenly attack their own healthy tissues. For example, people with rheumatoid arthritis, celiac disease, Crohn’s disease, ulcerative colitis, or inflammatory bowel disease sometimes have low vitamin B6 levels.
  • People with alcohol dependence.

What happens if I don’t get enough vitamin B6?

Vitamin B6 deficiency is uncommon in the United States. People who don’t get enough vitamin B6 can have a range of symptoms, including anemia, itchy rashes, scaly skin on the lips, cracks at the corners of the mouth, and a swollen tongue. Other symptoms of very low vitamin B6 levels include depression, confusion, and a weak immune system. Infants who do not get enough vitamin B6 can become irritable or develop extremely sensitive hearing or seizures.

What are some effects of vitamin B6 on health?

Scientists are studying vitamin B6 to understand how it affects health. Here are some examples of what this research has shown.

Heart disease

Some scientists had thought that certain B vitamins (such as folic acid, vitamin B12, and vitamin B6) might reduce heart disease risk by lowering levels of homocysteine, an amino acid in the blood. Although vitamin B supplements do lower blood homocysteine, research shows that they do not actually reduce the risk or severity of heart disease or stroke.

Cancer

People with low levels of vitamin B6 in the blood might have a higher risk of certain kinds of cancer, such as colorectal cancer. But studies to date have not shown that vitamin B6 supplements can help prevent cancer or lower the chances of dying from this disease.

Cognitive Function

Some research indicates that elderly people who have higher blood levels of vitamin B6 have better memory. However, taking vitamin B6 supplements (alone or combined with vitamin B12 and/or folic acid) does not seem to improve cognitive function or mood in healthy people or in people with dementia.

Premenstrual Syndrome

Scientists aren’t yet certain about the potential benefits of taking vitamin B6 for premenstrual syndrome (PMS). But some studies show that vitamin B6 supplements could reduce PMS symptoms, including moodiness, irritability, forgetfulness, bloating, and anxiety.

Nausea and Vomiting in Pregnancy

At least half of all women experience nausea, vomiting, or both in the first few months of pregnancy. Based on the results of several studies, the American Congress of Obstetricians and Gynecologists (ACOG) recommends taking vitamin B6 supplements under a doctor’s care for nausea and vomiting during pregnancy.

Can vitamin B6 be harmful?

People almost never get too much vitamin B6 from food. But taking high levels of vitamin B6 from supplements for a year or longer can cause severe nerve damage, leading people to lose control of their bodily movements. The symptoms usually stop when they stop taking the supplements. Other symptoms of too much vitamin B6 include painful, unsightly skin patches, extreme sensitivity to sunlight, nausea, and heartburn.

The safe upper limits for vitamin B6 are listed below. These levels do not apply to people who are taking vitamin B6 for medical reasons under the care of a doctor.

Life Stage Upper Safe Limit
Birth to 12 months Not established
Children 1–3 years 30 mg
Children 4–8 years 40 mg
Children 9–13 years 60 mg
Teens 14–18 years 80 mg
Adults 100 mg

Are there any interactions with vitamin B6 that I should know about?

Yes, vitamin B6 supplements can interact or interfere with medicines that you take. Here are several examples:

  • Vitamin B6 supplements might interact with cycloserine (Seromycin®), an antibiotic used to treat tuberculosis, and worsen any seizures and nerve cell damage that the drug might cause.
  • Taking certain epilepsy drugs could decrease vitamin B6 levels and reduce the drugs’ ability to control seizures.
  • Taking theophylline (Aquaphyllin®, Elixophyllin®, Theolair®, Truxophyllin®, and many others) for asthma or another lung disease can reduce vitamin B6 levels and cause seizures.

Resources

http://ods.od.nih.gov/factsheets/VitaminB6-QuickFacts/

Vitamin K

What is Vitamin K?

Vitamin K is a fat-soluble vitamin.

Function

Vitamin K is known as the clotting vitamin, because without it blood would not clot. Some studies suggest that it helps maintain strong bones in the elderly.

Food Sources

The best way to get the daily requirement of vitamin K is by eating food sources. Vitamin K is found in the following foods:

  • Green leafy vegetables, such as kale, spinach, turnip greens, collards, Swiss chard, mustard greens, parsley, romaine, and green leaf lettuce
  • Vegetables such as Brussels sprouts, broccoli, cauliflower, and cabbage
  • Fish, liver, meat, eggs, and cereals (contain smaller amounts)

Vitamin K is also made by the bacteria that line the gastrointestinal tract.

Side Effects

Vitamin K deficiency is very rare. It occurs when the body can’t properly absorb the vitamin from the intestinal tract. Vitamin K deficiency can also occur after long-term treatment with antibiotics.

People with vitamin K deficiency are usually more likely to have bruising and bleeding.

If you take blood thinning drugs (such as anticoagulant/antiplatelet drugs), you may need to limit vitamin K foods. You should know that vitamin K or foods containing vitamin K can affect how these drugs work.

It is important for you to keep vitamin K levels in your blood about the same from day to day. Ask your health care provider how much vitamin K-containing foods you should eat.

Recommendations

The Food and Nutrition Board at the Institute of Medicine Recommended Intakes for Individuals – Adequate Intakes (AIs) for vitamin K:

Infants

  • 0 – 6 months: 2.0 micrograms per day (mcg/day)
  • 7 – 12 months: 2.5 mcg/day

Children

  • 1 – 3 years: 30 mcg/day
  • 4 – 8 years: 55 mcg/day
  • 9 – 13 years: 60 mcg/day

Adolescents and Adults

  • Males and females age 14 – 18: 75 mcg/day
  • Males and females age 19 and older: 90 mcg/day

Resources

http://www.nlm.nih.gov/medlineplus/ency/article/002407.htm

parsley

Vitamin C

What is vitamin C and what does it do?

Vitamin C, also known as ascorbic acid, is a water-soluble nutrient found in some foods. In the body, it acts as anantioxidant, helping to protect cells from the damage caused by free radicals. Free radicals are compounds formed when our bodies convert the food we eat into energy. People are also exposed to free radicals in the environment from cigarette smoke, air pollution, and ultraviolet light from the sun.

The body also needs vitamin C to make collagen, a protein required to help wounds heal. In addition, vitamin C improves the absorption of iron from plant-based foods and helps the immune system work properly to protect the body from disease.

How much vitamin C do I need?

The amount of vitamin C you need each day depends on your age. Average daily recommended amounts for different ages are listed below in milligrams (mg).

Life Stage Recommended Amount
Birth to 6 months 40 mg
Infants 7–12 months 50 mg
Children 1–3 years 15 mg
Children 4–8 years 25 mg
Children 9–13 years 45 mg
Teens 14–18 years (boys) 75 mg
Teens 14–18 years (girls) 65 mg
Adults (men) 90 mg
Adults (women) 75 mg
Pregnant teens 80 mg
Pregnant women 85 mg
Breastfeeding teens 115 mg
Breastfeeding women 120 mg

If you smoke, add 35 mg to the above values to calculate your total daily recommended amount.

What foods provide vitamin C?

Fruits and vegetables are the best sources of vitamin C. You can get recommended amounts of vitamin C by eating a variety of foods including the following:

  • Citrus fruits (such as oranges and grapefruit) and their juices, as well as capsicum (which has almost three times the amount of vitamin c than oranges) and kiwifruit.
  • Broccoli, strawberries, cantaloupe
  • Some foods and beverages that are fortified with vitamin C – read the product labels.

The vitamin C content of food may be reduced by prolonged storage and by cooking. Steaming may lessen cooking losses. Fortunately, many of the best food sources of vitamin C, such as fruits and vegetables, are usually eaten raw.

What kinds of vitamin C dietary supplements are available?

Most multivitamins have vitamin C. Vitamin C is also available alone as a dietary supplement or in combination with other nutrients. The vitamin C in dietary supplements is usually in the form of ascorbic acid, but some supplements have other forms, such as sodium ascorbate, calcium ascorbate, other mineral ascorbates, and ascorbic acid with bioflavonoids. Research has not shown that any form of vitamin C is better than the other forms. Through a healthy diet with lots of fruits and vegetables is should not be necessary to take Vitamin C supplements.

Am I getting enough vitamin C?

Most people in the United States get enough vitamin C from foods and beverages. However, certain groups of people are more likely than others to have trouble getting enough vitamin C:

  • People who smoke and those who are exposed to secondhand smoke, in part because smoke increases the amount of vitamin C that the body needs to repair damage caused by free radicals. People who smoke need 35 mg more vitamin C per day than nonsmokers.
  • Infants who are fed evaporated or boiled cow’s milk, because cow’s milk has very little vitamin C and heat can destroy vitamin C. Cow’s milk is not recommended for infants under 1 year of age. Breast milk and infant formula have adequate amounts of vitamin C.
  • People who eat a very limited variety of food.
  • People with certain medical conditions such as severe malabsorption, some types of cancer, and kidney diseaserequiring hemodialysis.

What happens if I don’t get enough vitamin C?

Vitamin C deficiency is rare in the United States and Canada. People who get little or no vitamin C (below about 10 mg per day) for many weeks can get scurvy. Scurvy causes fatigue, inflammation of the gums, small red or purple spots on the skin, joint pain, poor wound healing, and corkscrew hairs. Additional signs of scurvy include depressionas well as swollen, bleeding gums and loosening or loss of teeth. People with scurvy can also develop anemia. Scurvy is fatal if it is not treated.

What are some effects of vitamin C on health?

Scientists are studying vitamin C to understand how it affects health. Here are several examples of what this research has shown.

Cancer prevention and treatment

People with high intakes of vitamin C from fruits and vegetables might have a lower risk of getting many types of cancer, such as lung, breast, and colon cancer. However, taking vitamin C supplements, with or without other antioxidants, doesn’t seem to protect people from getting cancer.

It is not clear whether taking high doses of vitamin C is helpful as a treatment for cancer. Vitamin C’s effects appear to depend on how it is administered to the patient. Oral doses of vitamin C can’t raise blood levels of vitamin C nearly as high as intravenous doses given through injections. A few studies in animals and test tubes indicate that very high blood levels of vitamin C might shrink tumors. But more research is needed to determine whether high-dose intravenous vitamin C helps treat cancer in people.

Vitamin C dietary supplements and other antioxidants might interact with chemotherapy and radiation therapy for cancer. People being treated for cancer should talk with their oncologist before taking vitamin C or other antioxidant supplements, especially in high doses.

Cardiovascular disease

People who eat lots of fruits and vegetables seem to have a lower risk of cardiovascular disease. Researchers believe that the antioxidant content of these foods might be partly responsible for this association because oxidative damageis a major cause of cardiovascular disease. However, scientists aren’t sure whether vitamin C itself, either from food or supplements, helps protect people from cardiovascular disease. It is also not clear whether vitamin C helps prevent cardiovascular disease from getting worse in people who already have it.

Age-related macular degeneration (AMD) and cataracts

AMD and cataracts are two of the leading causes of vision loss in older people. Researchers do not believe that vitamin C and other antioxidants affect the risk of getting AMD. However, research suggests that vitamin C combined with other nutrients might help keep early AMD from worsening into advanced AMD.

In a large study, older people with AMD who took a daily dietary supplement with 500 mg vitamin C, 80 mg zinc, 400 IU vitamin E, 15 mg beta-carotene, and 2 mg copper for about 6 years had a lower chance of developing advanced AMD. They also had less vision loss than those who did not take the dietary supplement.

More research is needed before doctors can recommend dietary supplements containing vitamin C for patients with AMD. However, people who have or are developing the disease might want to talk with their doctor about taking dietary supplements.

The relationship between vitamin C and cataract formation is unclear. Some studies show that people who get more vitamin C from foods have a lower risk of getting cataracts. But further research is needed to clarify this association and to determine whether vitamin C supplements affect the risk of getting cataracts.

The common cold

Although vitamin C has long been a popular remedy for the common cold, research shows that for most people, vitamin C supplements do not reduce the risk of getting the common cold. However, people who take vitamin C supplements regularly might have slightly shorter colds or somewhat milder symptoms when they do have a cold. Using vitamin C supplements after cold symptoms start does not appear to be helpful.

Can vitamin C be harmful?

Taking too much vitamin C can cause diarrhea, nausea, and stomach cramps. In people with a condition calledhemochromatosis, which causes the body to store too much iron, high doses of vitamin C could worsen iron overload and damage body tissues.

The safe upper limits for vitamin C are listed below:

Life Stage Upper Safe Limit
Birth to 12 months Not established
Children 1–3 years 400 mg
Children 4–8 years 650 mg
Children 9–13 years 1,200 mg
Teens 14–18 years 1,800 mg
Adults 2,000 mg

Are there any interactions with vitamin C that I should know about?

Vitamin C dietary supplements can interact or interfere with medicines that you take. Here are several examples:

  • Vitamin C dietary supplements might interact with cancer treatments, such as chemotherapy and radiation therapy. It is not clear whether vitamin C might have the unwanted effect of protecting tumor cells from cancer treatments or whether it might help protect normal tissues from getting damaged. If you are being treated for cancer, check with your health care provider before taking vitamin C or other antioxidant supplements, especially in high doses.
  • In one study, vitamin C plus other antioxidants (such as vitamin E, selenium, and beta-carotene) reduced the heart-protective effects of two drugs taken in combination (a statin and niacin) to control blood-cholesterollevels. It is not known whether this interaction also occurs with other statins. Health care providers should monitor lipid levels in people taking both statins and antioxidant supplements.

Where to buy Vitamin C

Vitamin C is available in bulk from from online supplement retailers like Powdercity.com. They offer Vitamin C Supplements (Ascorbic Acid) in variants of: 100g, 500g and 1kg. All of their products are 3rd party lab tested and they offer free shipping to orders over $25 in the US!

Resources

http://ods.od.nih.gov/factsheets/VitaminC-QuickFacts/

Iron

Iron: What is it?

Iron, one of the most abundant metals on Earth, is essential to most life forms and to normal human physiology. Iron is an integral part of many proteins and enzymes that maintain good health. In humans, iron is an essential component of proteins involved in oxygen transport. It is also essential for the regulation of cell growth and differentiation. A deficiency of iron limits oxygen delivery to cells, resulting in fatigue, poor work performance, and decreased immunity. On the other hand, excess amounts of iron can result in toxicity and even death.

Almost two-thirds of iron in the body is found in hemoglobin, the protein in red blood cells that carries oxygen to tissues. Smaller amounts of iron are found in myoglobin, a protein that helps supply oxygen to muscle, and in enzymes that assist biochemical reactions. Iron is also found in proteins that store iron for future needs and that transport iron in blood. Iron stores are regulated by intestinal iron absorption.

What foods provide iron?

There are two forms of dietary iron: heme and nonheme. Heme iron is derived from hemoglobin, the protein in red blood cells that delivers oxygen to cells. Heme iron is found in animal foods that originally contained hemoglobin, such as red meats, fish, and poultry. Iron in plant foods such as lentils and beans is arranged in a chemical structure called nonheme iron. This is the form of iron added to iron-enriched and iron-fortified foods. Heme iron is absorbed better than nonheme iron, but most dietary iron is nonheme iron. A variety of heme and nonheme sources of iron are listed in Tables 1 and 2.

Table 1: Selected Food Sources of Heme Iron
Food Milligrams
per serving
% DV*
Chicken liver, pan-fried, 3 ounces 11.0 61
Oysters, canned, 3 ounces 5.7 32
Beef liver, pan-fried, 3 ounces 5.2 29
Beef, chuck, blade roast, lean only, braised, 3 ounces 3.1 17
Turkey, dark meat, roasted, 3 ounces 2.0 11
Beef, ground, 85% lean, patty, broiled, 3 ounces 2.2 12
Beef, top sirloin, steak, lean only, broiled, 3 ounces 1.6 9
Tuna, light, canned in water, 3 ounces 1.3 7
Turkey, light meat, roasted, 3 ounces 1.1 6
Chicken, dark meat, meat only, roasted, 3 ounces 1.1 6
Chicken, light meat, meat only, roasted, 3 ounces 0.9 5
Tuna, fresh, yellowfin, cooked, dry heat, 3 ounces 0.8 4
Crab, Alaskan king, cooked, moist heat, 3 ounces 0.7 4
Pork, loin chop, broiled, 3 ounces 0.7 4
Shrimp, mixed species, cooked, moist heat, 4 large 0.3 2
Halibut, cooked, dry heat, 3 ounces 0.2 1
Table 2: Selected Food Sources of Nonheme Iron
Food Milligrams
per serving
% DV*
Ready-to-eat cereal, 100% iron fortified, ¾ cup 18.0 100
Oatmeal, instant, fortified, prepared with water, 1 packet 11.0 61
Soybeans, mature, boiled, 1 cup 8.8 48
Lentils, boiled, 1 cup 6.6 37
Beans, kidney, mature, boiled, 1 cup 5.2 29
Beans, lima, large, mature, boiled, 1 cup 4.5 25
Ready-to-eat cereal, 25% iron fortified, ¾ cup 4.5 25
Blackeye peas, (cowpeas), mature, boiled, 1 cup 4.3 24
Beans, navy, mature, boiled, 1 cup 4.3 24
Beans, black, mature, boiled, 1 cup 3.6 20
Beans, pinto, mature, boiled, 1 cup 3.6 21
Tofu, raw, firm, ½ cup 3.4 19
Spinach, fresh, boiled, drained, ½ cup 3.2 18
Spinach, canned, drained solids ½ cup 2.5 14
Spinach, frozen, chopped or leaf, boiled ½ cup 1.9 11
Raisins, seedless, packed, ½ cup 1.6 9
Grits, white, enriched, quick, prepared with water, 1 cup 1.5 8
Molasses, 1 tablespoon 0.9 5
Bread, white, commercially prepared, 1 slice 0.9 5
Bread, whole-wheat, commercially prepared, 1 slice 0.7 4

*DV = Daily Value. DVs are reference numbers developed by the Food and Drug Administration (FDA) to help consumers determine if a food contains a lot or a little of a specific nutrient. The DV for iron is 18 milligrams (mg). A food providing 5% of the DV or less is a low source while a food that provides 10–19% of the DV is a good source. A food that provides 20% or more of the DV is high in that nutrient. It is important to remember that foods that provide lower percentages of the DV also contribute to a healthful diet.

What affects iron absorption?

Iron absorption refers to the amount of dietary iron that the body obtains and uses from food. Healthy adults absorb about 10% to 15% of dietary iron, but individual absorption is influenced by several factors.

Storage levels of iron have the greatest influence on iron absorption. Iron absorption increases when body stores are low. When iron stores are high, absorption decreases to help protect against toxic effects of iron overload. Iron absorption is also influenced by the type of dietary iron consumed. Absorption of heme iron from meat proteins is efficient. Absorption of heme iron ranges from 15% to 35%, and is not significantly affected by diet. In contrast, 2% to 20% of nonheme iron in plant foods such as rice, maize, black beans, soybeans and wheat is absorbed. Nonheme iron absorption is significantly influenced by various food components.

Meat proteins and vitamin C will improve the absorption of nonheme iron. Tannins (found in tea), calcium, polyphenols, and phytates (found in legumes and whole grains) can decrease absorption of nonheme iron. Some proteins found in soybeans also inhibit nonheme iron absorption. It is most important to include foods that enhance nonheme iron absorption when daily iron intake is less than recommended, when iron losses are high (which may occur with heavy menstrual losses), when iron requirements are high (as in pregnancy), and when only vegetarian nonheme sources of iron are consumed.

What is the recommended intake for iron?

Recommended Dietary Allowances (RDA), Adequate Intakes (AI), andTolerable Upper Intake Levels (UL).

Recommended Dietary Allowances for Iron for Infants 
Age Males
(mg/day)
Females
(mg/day)
Pregnancy
(mg/day)
Lactation
(mg/day)
7 to 12 months 11 11 N/A N/A
1 to 3 years 7 7 N/A N/A
4 to 8 years 10 10 N/A N/A
9 to 13 years 8 8 N/A N/A
14 to 18 years 11 15 27 10
19 to 50 years 8 18 27 9
51+ years 8 8 N/A N/A

Healthy full term infants are born with a supply of iron that lasts for 4 to 6 months. There is not enough evidence available to establish a RDA for iron for infants from birth through 6 months of age. Recommended iron intake for this age group is based on an Adequate Intake (AI) that reflects the average iron intake of healthy infants fed breast milk.

Iron in human breast milk is well absorbed by infants. It is estimated that infants can use greater than 50% of the iron in breast milk as compared to less than 12% of the iron in infant formula. The amount of iron in cow’s milk is low, and infants poorly absorb it. Feeding cow’s milk to infants also may result in gastrointestinal bleeding. For these reasons, cow’s milk should not be fed to infants until they are at least 1 year old.

Iron intake is negatively influenced by low nutrient density foods, which are high in calories but low in vitamins and minerals. Sugar sweetened sodas and most desserts are examples of low nutrient density foods, as are snack foods such as potato chips.

When can iron deficiency occur?

The World Health Organization considers iron deficiency the number one nutritional disorder in the world. As many as 80% of the world’s population may be iron deficient, while 30% may have iron deficiency anemia.

Iron deficiency develops gradually and usually begins with a negative iron balance, when iron intake does not meet the daily need for dietary iron.

Iron deficiency anemia can be associated with low dietary intake of iron, inadequate absorption of iron, or excessive blood loss. Women of childbearing age, pregnant women, preterm and low birth weight infants, older infants and toddlers, and teenage girls are at greatest risk of developing iron deficiency anemia because they have the greatest need for iron. Women with heavy menstrual losses can lose a significant amount of iron and are at considerable risk for iron deficiency. Adult men and post-menopausal women lose very little iron, and have a low risk of iron deficiency.

Vitamin A helps mobilize iron from its storage sites, so a deficiency of vitamin A limits the body’s ability to use stored iron. This results in an “apparent” iron deficiency because hemoglobin levels are low even though the body can maintain normal amounts of stored iron.

Signs of iron deficiency anemia include :

  • feeling tired and weak
  • decreased work and school performance
  • slow cognitive and social development during childhood
  • difficulty maintaining body temperature
  • decreased immune function, which increases susceptibility to infection
  • glossitis (an inflamed tongue)

Eating nonnutritive substances such as dirt and clay, often referred to as pica or geophagia, is sometimes seen in persons with iron deficiency. There is disagreement about the cause of this association.

Who may need extra iron to prevent a deficiency?

Three groups of people are most likely to benefit from iron supplements: people with a greater need for iron, individuals who tend to lose more iron, and people who do not absorb iron normally. These individuals include:

  • pregnant women
  • preterm and low birth weight infants
  • older infants and toddlers
  • teenage girls
  • women of childbearing age, especially those with heavy menstrual losses
  • people with renal failure, especially those undergoing routine dialysis
  • people with gastrointestinal disorders who do not absorb iron normally

Total dietary iron intake in vegetarian diets may meet recommended levels; however that iron is less available for absorption than in diets that include meat. Vegetarians who exclude all animal products from their diet may need almost twice as much dietary iron each day as non-vegetarians because of the lower intestinal absorption of nonheme iron in plant foods. Vegetarians should consider consuming nonheme iron sources together with a good source of vitamin C, such as citrus fruits, to improve the absorption of nonheme iron.

Does pregnancy increase the need for iron?

Nutrient requirements increase during pregnancy to support fetal growth and maternal health. Iron requirements of pregnant women are approximately double that of non-pregnant women because of increased blood volume during pregnancy, increased needs of the fetus, and blood losses that occur during delivery.

Low levels of hemoglobin and hematocrit may indicate iron deficiency. Hemoglobin is the protein in red blood cells that carries oxygen to tissues. Hematocrit is the proportion of whole blood that is made up of red blood cells. Nutritionists estimate that over half of pregnant women in the world may have hemoglobin levels consistent with iron deficiency.

Some facts about iron supplements

Iron supplementation is indicated when diet alone cannot restore deficient iron levels to normal within an acceptable timeframe. Supplements are especially important when an individual is experiencing clinical symptoms of iron deficiency anemia. The goals of providing oral iron supplements are to supply sufficient iron to restore normal storage levels of iron and to replenish hemoglobin deficits. When hemoglobin levels are below normal, physicians often measure serum ferritin, the storage form of iron. A serum ferritin level less than or equal to 15 micrograms per liter confirms iron deficiency anemia in women, and suggests a possible need for iron supplementation.

Supplemental iron is available in two forms: ferrous and ferric. Ferrous iron salts (ferrous fumarate, ferrous sulfate, and ferrous gluconate) are the best absorbed forms of iron supplements .

The amount of iron absorbed decreases with increasing doses. For this reason, it is recommended that most people take their prescribed daily iron supplement in two or three equally spaced doses.

Therapeutic doses of iron supplements, which are prescribed for iron deficiency anemia, may cause gastrointestinal side effects such as nausea, vomiting, constipation, diarrhea, dark colored stools, and/or abdominal distress .

Who should be cautious about taking iron supplements?

Iron deficiency is uncommon among adult men and postmenopausal women. These individuals should only take iron supplements when prescribed by a physician because of their greater risk of iron overload. Iron overload is a condition in which excess iron is found in the blood and stored in organs such as the liver and heart. Iron overload is associated with several genetic diseases including hemochromatosis, which affects approximately 1 in 250 individuals of northern European descent. Individuals with hemochromatosis absorb iron very efficiently, which can result in a build up of excess iron and can cause organ damage such as cirrhosis of the liver and heart failure. Hemochromatosis is often not diagnosed until excess iron stores have damaged an organ. Iron supplementation may accelerate the effects of hemochromatosis, an important reason why adult men and postmenopausal women who are not iron deficient should avoid iron supplements. Individuals with blood disorders that require frequent blood transfusions are also at risk of iron overload and are usually advised to avoid iron supplements.

What are some current issues and controversies about iron?

Iron and heart disease

Because known risk factors cannot explain all cases of heart disease, researchers continue to look for new causes. Some evidence suggests that iron can stimulate the activity of free radicals. Free radicals are natural by-products of oxygen metabolism that are associated with chronic diseases, including cardiovascular disease. Free radicals may inflame and damage coronary arteries, the blood vessels that supply the heart muscle. This inflammation may contribute to the development of atherosclerosis, a condition characterized by partial or complete blockage of one or more coronary arteries. Other researchers suggest that iron may contribute to the oxidation of LDL (“bad”) cholesterol, changing it to a form that is more damaging to coronary arteries.

As far back as the 1980s, some researchers suggested that the regular menstrual loss of iron, rather than a protective effect from estrogen, could better explain the lower incidence of heart disease seen in pre-menopausal women. After menopause, a woman’s risk of developing coronary heart disease increases along with her iron stores. Researchers have also observed lower rates of heart disease in populations with lower iron stores, such as those in developing countries. In those geographic areas, lower iron stores are attributed to low meat (and iron) intake, high fiber diets that inhibit iron absorption, and gastrointestinal (GI) blood (and iron) loss due to parasitic infections.

Conflicting results, and different methods to measure iron stores, make it difficult to reach a final conclusion on this issue. However, researchers know that it is feasible to decrease iron stores in healthy individual through phlebotomy (blood letting or donation). Using phlebotomy, researchers hope to learn more about iron levels and cardiovascular disease.

Iron and intense exercise

Many men and women who engage in regular, intense exercise such as jogging, competitive swimming, and cycling have marginal or inadequate iron status. Possible explanations include increased gastrointestinal blood loss after running and a greater turnover of red blood cells. Also, red blood cells within the foot can rupture while running. For these reasons, the need for iron may be 30% greater in those who engage in regular intense exercise.

Three groups of athletes may be at greatest risk of iron depletion and deficiency: female athletes, distance runners, and vegetarian athletes. It is particularly important for members of these groups to consume recommended amounts of iron and to pay attention to dietary factors that enhance iron absorption. If appropriate nutrition intervention does not promote normal iron status, iron supplementation may be indicated. In one study of female swimmers, researchers found that supplementation with 125 milligrams (mg) of ferrous sulfate per day prevented iron depletion. These swimmers maintained adequate iron stores, and did not experience the gastrointestinal side effects often seen with higher doses of iron supplementation.

Iron and mineral interactions

Some researchers have raised concerns about interactions between iron, zinc, and calcium. When iron and zinc supplements are given together in a water solution and without food, greater doses of iron may decrease zinc absorption. However, the effect of supplemental iron on zinc absorption does not appear to be significant when supplements are consumed with food.There is evidence that calcium from supplements and dairy foods may inhibit iron absorption, but it has been very difficult to distinguish between the effects of calcium on iron absorption versus other inhibitory factors such as phytate.

What is the risk of iron toxicity?

There is considerable potential for iron toxicity because very little iron is excreted from the body. Thus, iron can accumulate in body tissues and organs when normal storage sites are full. For example, people with hemachromatosis are at risk of developing iron toxicity because of their high iron stores.

Table 5: Tolerable Upper Intake Levels for Iron for Infants 7 to 12 months, Children, and Adults 
Age Males
(mg/day)
Females
(mg/day)
Pregnancy
(mg/day)
Lactation
(mg/day)
7 to 12 months 40 40 N/A N/A
1 to 13 years 40 40 N/A N/A
14 to 18 years 45 45 45 45
19+ years 45 45 45 45

Resources

http://ods.od.nih.gov/factsheets/Iron-HealthProfessional/

Folate (a B Vitamin)

What is folate and what does it do?

Folate is a B-vitamin that is naturally present in many foods. A form of folate, called folic acid, is used in dietary supplements and fortified foods.

Our bodies need folate to make DNA and other genetic material. Folate is also needed for the body’s cells to divide. This is particularly important for people with Cystic Fibrosis to have in their diets.

How much folate do I need?

The amount of folate you need depends on your age. Average daily recommended amounts are listed below inmicrograms (mcg) of dietary folate equivalents (DFEs).

All women and teen girls who could become pregnant should consume 400 mcg of folic acid daily from supplements, fortified foods, or both in addition to the folate they get naturally from foods.

Life Stage Recommended Amount
Birth to 6 months 65 mcg DFE
Infants 7–12 months 80 mcg DFE
Children 1–3 years 150 mcg DFE
Children 4–8 years 200 mcg DFE
Children 9–13 years 300 mcg DFE
Teens 14–18 years 400 mcg DFE
Adults 19–50 years 400 mcg DFE
Adults 51–70 years 400 mcg DFE
Adults 71+ years 400 mcg DFE
Pregnant teens and women 600 mcg DFE
Breastfeeding teens and women 500 mcg DFE

What foods provide folate?

Folate is naturally present in many foods and food companies add folic acid to other foods, including bread, cereal, and pasta. You can get recommended amounts by eating a variety of foods, including the following:

  • Vegetables (especially asparagus, Brussels sprouts, and dark green leafy vegetables such as spinach and mustard greens).
  • Fruits and fruit juices (especially oranges).
  • Nuts, beans, and peas (such as peanuts, black-eyed peas, and kidney beans).
  • Grains (including whole grains; fortified cold cereals; enriched flour products such as bread, bagels, cornmeal, and pasta; and rice).
  • Folic acid is added to many grain-based products. To find out whether folic acid has been added to a food, check the product label.

Beef liver is high in folate but is also high in cholesterol, so limit the amount you eat. Only small amounts of folate are found in other animal foods like meats, poultry, seafood, eggs, and dairy products.

What kinds of folic acid dietary supplements are available?

Folic acid is available in multivitamins and prenatal vitamins. It is also available in B-complex dietary supplements and supplements containing only folic acid.

Am I getting enough folate?

Most people get enough folate. However, certain groups of people are more likely than others to have trouble getting enough folate:

  • Teen girls and women aged 14–30 years (especially before and during pregnancy).
  • Non-Hispanic black women.
  • People with disorders that lower nutrient absorption (such as celiac disease and inflammatory bowel disease).
  • People with alcoholism.

 What happens if I don’t get enough folate?

Folate deficiency is rare in the United States, but some people get barely enough. Getting too little folate can result in megaloblastic anemia, which causes weakness, fatigue, trouble concentrating, irritability, headache, heart palpitations, and shortness of breath. Folate deficiency can also cause open sores on the tongue and inside the mouth as well as changes in the color of the skin, hair, or fingernails.

Women who don’t get enough folate are at risk of having babies with neural tube defects, such as spina bifida. Folate deficiency can also increase the likelihood of having a premature or low-birth-weight baby.

What are some effects of folate on health?

Scientists are studying folate to understand how it affects health. Here are several examples of what this research has shown.

Neural tube defects

Taking folic acid regularly before becoming pregnant and during early pregnancy helps prevent neural tube defects in babies. But about half of all pregnancies are unplanned. Therefore, all women and teen girls who could become pregnant should consume 400 mcg of folic acid daily from supplements, fortified foods, or both in addition to the folate they get naturally from foods.

Since 1998, the U.S. Food and Drug Administration has required food companies to add folic acid to enriched bread, cereal, flour, cornmeal, pasta, rice, and other grain products sold in the United States. Because most people in the United States eat these foods on a regular basis, folic acid intakes have increased and the number of babies born with neural tube defects has decreased since 1998.

Preterm birth, congenital heart defects, and other birth defects

Taking folic acid might reduce the risk of having a premature baby and prevent birth defects, such as congenital heart problems. But more research is needed to understand how folic acid affects the risk of these conditions.

Cancer

Folate that is found naturally in food may decrease the risk of several forms of cancer. But folate might have different effects depending on how much is taken and when. Modest amounts of folic acid taken before cancer develops might decrease cancer risk, but high doses taken after cancer (especially colorectal cancer) begins might speed up its progression. For this reason, high doses of folic acid supplements (more than the safe upper limit of 1,000 mcg) should be taken with caution, especially by people who have a history of colorectal adenomas (which sometimes turn into cancer). More research is needed to understand the roles of dietary folate and folic acid supplements in cancer risk.

Heart disease and stroke

Some scientists used to think that folic acid and other B-vitamins might reduce heart disease risk by lowering levels of homocysteine, an amino acid in the blood. But although folic acid supplements do lower blood homocysteine levels, they don’t decrease the risk of heart disease. Some studies have shown that a combination of folic acid with other B-vitamins, however, helps prevent stroke.

Dementia, cognitive function, and Alzheimer’s disease

Folic acid supplements with or without other B-vitamins do not seem to improve cognitive function, but more research on this topic is needed.

Depression

People with low blood levels of folate might be more likely to suffer from depression and might not respond as well to treatment with antidepressants as people with normal folate levels.

Folic acid supplements might make antidepressant medications more effective. But it is not clear whether these supplements help people with both normal folate levels and those with folate deficiency. More research is needed to learn about the role of folate in depression and whether folic acid supplements are helpful when used in combination with standard treatment.

Can folate be harmful?

Folate that is naturally present in food is not harmful. Folic acid in supplements and fortified foods, however, should not be consumed in amounts above the safe upper limit, unless recommended by a health care provider.

Taking large amounts of folic acid might hide a vitamin B12 deficiency. Folic acid can correct the anemia but not thenerve damage caused by vitamin B12 deficiency. This can lead to permanent damage of the brain, spinal cord, and nerves. High doses of folic acid might also increase the risk of colorectal cancer and possibly other cancers in some people.

The safe upper limits for folic acid are listed below.

Ages Safe Upper Limit
Birth to 6 months Not established
Infants 7–12 months Not established
Children 1–3 years 300 mcg
Children 4–8 years 400 mcg
Children 9–13 years 600 mcg
Teens 14–18 years 800 mcg
Adults 1,000 mcg

Are there any interactions with folate that I should know about?

Folic acid supplements can interact with several medications. Here are some examples:

  • Folic acid could interfere with methotrexate (Rheumatrex®, Trexall®) when taken to treat cancer.
  • Taking anti-epileptic medications such as phenytoin (Dilantin®), carbamazepine (Carbatrol®, Tegretol®, Equetro®, Epitol®), and valproate (Depacon®) could reduce blood levels of folate. Also, taking folic acid supplements could reduce blood levels of these medications.
  • Taking sulfasalazine (Azulfidine®) for ulcerative colitis could reduce the body’s ability to absorb folate and cause folate deficiency.

Resources

http://ods.od.nih.gov/factsheets/Folate-QuickFacts/

Calcium

What is calcium and what does it do?

Calcium is a mineral found in many foods. The body needs calcium to maintain strong bones and to carry out many important functions. Almost all calcium is stored in bones and teeth, where it supports their structure and hardness.

The body also needs calcium for muscles to move and for nerves to carry messages between the brain and every body part. In addition, calcium is used to help blood vessels move blood throughout the body and to help release hormones and enzymes that affect almost every function in the human body.

How much calcium do I need?

The amount of calcium you need each day depends on your age. Average daily recommended amounts are listed below in milligrams (mg):

Life Stage Recommended Amount
Birth to 6 months 200 mg
Infants 7–12 months 260 mg
Children 1–3 years 700 mg
Children 4–8 years 1,000 mg
Children 9–13 years 1,300 mg
Teens 14–18 years 1,300 mg
Adults 19–50 years 1,000 mg
Adult men 51–70 years 1,000 mg
Adult women 51–70 years 1,200 mg
Adults 71 years and older 1,200 mg
Pregnant and breastfeeding teens 1,300 mg
Pregnant and breastfeeding adults 1,000 mg

 What foods provide calcium?

Calcium is found in many foods. You can get recommended amounts of calcium by eating a variety of foods, including the following:

  • Poppy seeds are extremely high in calcium, and sesame seeds are also a good source
  • Milk, yogurt, and cheese are the main stream products, but not necessarily the best
  • Kale, broccoli, and Chinese cabbage are fine vegetable sources of calcium.
  • Fish with soft bones that you eat, such as canned sardines and salmon, are fine animal sources of calcium.
  • Most grains (such as breads, pastas, and unfortified cereals), while not rich in calcium, add significant amounts of calcium to the diet because people eat them often or in large amounts.

What kinds of calcium dietary supplements are available?

Calcium is found in many multivitamin-mineral supplements, though the amount varies by product.  Dietary supplements that contain only calcium or calcium with other nutrients such as vitamin D are also available. Check the Supplement Facts label to determine the amount of calcium provided.

The two main forms of calcium dietary supplements are carbonate and citrate. Calcium carbonate is inexpensive, but is absorbed best when taken with food. Some over-the-counter antacid products, such as Tums® and Rolaids®, contain calcium carbonate. Each pill or chew provides 200–400 mg of calcium. Calcium citrate, a more expensive form of the supplement, is absorbed well on an empty or a full stomach. In addition, people with low levels of stomach acid (a condition more common in people older than 50) absorb calcium citrate more easily than calcium carbonate. Other forms of calcium in supplements and fortified foods include gluconate, lactate, and phosphate. Although you can take supplements it is highly recommended that you aim to get your daily intake through your diet.

Calcium absorption is best when a person consumes no more than 500 mg at one time. So a person who takes 1,000 mg/day of calcium from supplements, for example, should split the dose rather than take it all at once.

Calcium supplements may cause gas, bloating, and constipation in some people. If any of these symptoms occur, try spreading out the calcium dose throughout the day, taking the supplement with meals, or changing the supplement brand or calcium form you take.

For a healthy person with a nutritious and balanced diet, it should not be necessary to take calcium supplements.

Am I getting enough calcium?

Many people don’t get recommended amounts of calcium from the foods they eat, including:

  • Boys aged 9 to 13 years,
  • Girls aged 9 to 18 years,
  • Women older than 50 years,
  • Men older than 70 years.

When total intakes from both food and supplements are considered, many people—particularly adolescent girls—still fall short of getting enough calcium, while some older women likely get more than the safe upper limit.

Certain groups of people are more likely than others to have trouble getting enough calcium:

  • Postmenopausal women because they experience greater bone loss and do not absorb calcium as well. Sufficient calcium intake from food, and supplements if needed, can slow the rate of bone loss.
  • Women of childbearing age whose menstrual periods stop (amenorrhea) because they exercise heavily, eat too little, or both. They need sufficient calcium to cope with the resulting decreased calcium absorption, increased calcium losses in the urine, and slowdown in the formation of new bone.
  • People with lactose intolerance cannot digest this natural sugar found in milk and experience symptoms like bloating, gas, and diarrhea when they drink more than small amounts at a time. They usually can eat other calcium-rich dairy products that are low in lactose, such as yogurt and many cheeses, and drink lactose-reduced or lactose-free milk.
  • Vegans (vegetarians who eat no animal products) and ovo-vegetarians (vegetarians who eat eggs but no dairy products), because they avoid the dairy products that are a major source of calcium in other people’s diets.

Many factors can affect the amount of calcium absorbed from the digestive tract, including:

  • Age. Efficiency of calcium absorption decreases as people age. Recommended calcium intakes are higher for people over age 70.
  • Vitamin D intake. This vitamin, present in some foods and produced in the body when skin is exposed to sunlight, increases calcium absorption.
  • Other components in food. Both oxalic acid (in some vegetables and beans) and phytic acid (in whole grains) can reduce calcium absorption. People who eat a variety of foods don’t have to consider these factors. They are accounted for in the calcium recommended intakes, which take absorption into account.

Many factors can also affect how much calcium the body eliminates in urine, feces, and sweat. These include consumption of alcohol- and caffeine-containing beverages as well as intake of other nutrients (protein, sodium, potassium, and phosphorus). In most people, these factors have little effect on calcium status.

What happens if I don’t get enough calcium?

Insufficient intakes of calcium do not produce obvious symptoms in the short term because the body maintains calcium levels in the blood by taking it from bone. Over the long term, intakes of calcium below recommended levels have health consequences, such as causing low bone mass (osteopenia) and increasing the risks of osteoporosis and bone fractures.

Symptoms of serious calcium deficiency include numbness and tingling in the fingers, convulsions, and abnormal heart rhythms that can lead to death if not corrected. These symptoms occur almost always in people with serious health problems or who are undergoing certain medical treatments.

What are some effects of calcium on health?

Scientists are studying calcium to understand how it affects health. Here are several examples of what this research has shown:

Bone health and osteoporosis

Bones need plenty of calcium and vitamin D throughout childhood and adolescence to reach their peak strength and calcium content by about age 30. After that, bones slowly lose calcium, but people can help reduce these losses by getting recommended amounts of calcium throughout adulthood and by having a healthy, active lifestyle that includes weight-bearing physical activity (such as walking and running).

Osteoporosis is a disease of the bones in older adults (especially women) in which the bones become porous, fragile, and more prone to fracture. Osteoporosis is a serious public health problem for more than 10 million adults over the age of 50 in the United States. Adequate calcium and vitamin D intakes as well as regular exercise are essential to keep bones healthy throughout life.

Cardiovascular Disease

Whether calcium affects the risk of cardiovascular disease is not clear. Some studies show that getting enough calcium might protect people from heart disease and stroke. But other studies show that some people who consume high amounts of calcium, particularly from supplements, might have an increased risk of heart disease. More research is needed in this area.

High blood pressure

Some studies have found that getting recommended intakes of calcium can reduce the risk of developing high blood pressure (hypertension). One large study in particular found that eating a diet high in fat-free and low-fat dairy products, vegetables, and fruits lowered blood pressure.

Cancer

Studies have examined whether calcium supplements or diets high in calcium might lower the risks of developing cancer of the colon or rectum or increase the risk of prostate cancer. The research to date provides no clear answers. Given that cancer develops over many years, longer term studies are needed.

Kidney stones

Most kidney stones are rich in calcium oxalate. Some studies have found that higher intakes of calcium from dietary supplements are linked to a greater risk of kidney stones, especially among older adults. But calcium from foods does not appear to cause kidney stones. For most people, other factors (such as not drinking enough fluids) probably have a larger effect on the risk of kidney stones than calcium intake.

Weight loss

Although several studies have shown that getting more calcium helps lower body weight or reduce weight gain over time, most studies have found that calcium—from foods or dietary supplements—has little if any effect on body weight and amount of body fat.

Can calcium be harmful?

Getting too much calcium can cause constipation. It might also interfere with the body’s ability to absorb iron and zink, but this effect is not well established. In adults, too much calcium (from dietary supplements but not food) might increase the risk of kidney stones. Some studies show that people who consume high amounts of calcium might have increased risks of prostate cancer and heart disease, but more research is needed to understand these possible links.

The safe upper limits for calcium are listed below. Most people do not get amounts above the upper limits from food alone; excess intakes usually come from the use of calcium supplements. Surveys show that some older women in the United States probably get amounts somewhat above the upper limit since the use of calcium supplements is common among these women.

Life Stage Upper Safe Limit
Birth to 6 months 1,000 mg
Infants 7–12 months 1,500 mg
Children 1–8 years 2,500 mg
Children 9–18 years 3,000 mg
Adults 19–50 years 2,500 mg
Adults 51 years and older 2,000 mg
Pregnant and breastfeeding teens 3,000 mg
Pregnant and breastfeeding adults 2,500 mg

Are there any interactions with calcium that I should know about?

Calcium dietary supplements can interact or interfere with certain medicines that you take, and some medicines can lower or raise calcium levels in the body. Here are some examples:

  • Calcium can reduce the absorption of these drugs when taken together:
    • Bisphosphonates (to treat osteoporosis)
    • Antibiotics of the fluoroquinolone and tetracycline families
    • Levothyroxine (to treat low thyroid activity)
    • Phenytoin (an anticonvulsant)
    • Tiludronate disodium (to treat Paget’s disease).
  • Diuretics differ in their effects. Thiazide-type diuretics (such as Diuril® and Lozol®) reduce calcium excretion by the kidneys which in turn can raise blood calcium levels too high. But loop diuretics (such as Lasix® and Bumex®) increase calcium excretion and thereby lower blood calcium levels.
  • Antacids containing aluminum or magnesium increase calcium loss in the urine.
  • Mineral oil and stimulant laxatives reduce calcium absorption.
  • Glucocorticoids (such as prednisone) can cause calcium depletion and eventually osteoporosis when people use them for months at a time.

Tell your doctor, pharmacist, and other health care providers about any dietary supplements and medicines you take. They can tell you if those dietary supplements might interact or interfere with your prescription or over-the-counter medicines or if the medicines might interfere with how your body absorbs, uses, or breaks down nutrients.

Where to Buy:
Calcium Citrate is available to purchase online from Powder City.

Resources:

http://ods.od.nih.gov/factsheets/Calcium-QuickFacts/

Vitamin A

What is vitamin A and what does it do?

Vitamin A is a fat-soluble vitamin that is naturally present in many foods. Vitamin A is important for normal vision, the immune system, and reproduction. Vitamin A also helps the heart, lungs, kidneys, and other organs work properly.

There are two different types of vitamin A. The first type, preformed vitamin A, is found in meat, poultry, fish, and dairy products. The second type, provitamin A, is found in fruits, vegetables, and other plant-based products. The most common type of provitamin A in foods and dietary supplements is beta-carotene.

How much vitamin A do I need?

The amount of vitamin A you need depends on your age and reproductive status. Recommended intakes for vitamin A for people aged 14 years and older range between 700 and 900 micrograms (mcg) of retinol activity equivalents (RAE) per day. Recommended intakes for women who are nursing range between 1,200 and 1,300 RAE. Lower values are recommended for infants and children younger than 14.

However, the vitamin A content of foods and dietary supplements is given on product labels in international units (IU), not mcg RAE. Converting between IU and mcg RAE is not easy. A varied diet with 900 mcg RAE of vitamin A, for example, provides between 3,000 and 36,000 IU of vitamin A depending on the foods consumed.

For adults and children aged 4 years and older, the U.S. Food and Drug Administration has established a vitamin A Daily Value (DV) of 5,000 IU from a varied diet of both plant and animal foods. DVs are not recommended intakes; they don’t vary by age and sex, for example. But trying to reach 100% of the DV each day, on average, is useful to help you get enough vitamin A.

What foods provide vitamin A?

Vitamin A is found naturally in many foods and is added to some foods, such as milk and cereal. You can get recommended amounts of vitamin A by eating a variety of foods, including the following:

  • Some types of fish, such as salmon.
  • Green leafy vegetables and other green, orange, and yellow vegetables, such as broccoli, carrots, and squash.
  • Fruits, including cantaloupe, apricots, and mangos.
  • Dairy products (try to avoid too much dairy)

What kinds of vitamin A dietary supplements are available?

Vitamin A is available in dietary supplements, usually in the form of retinyl acetate or retinyl palmitate (preformed vitamin A), beta-carotene (provitamin A), or a combination of preformed and provitamin A. Most multivitamin-mineral supplements contain vitamin A. Dietary supplements that contain only vitamin A are also available.

Am I getting enough vitamin A?

Most people in the United States get enough vitamin A from the foods they eat, and vitamin A deficiency is rare. However, certain groups of people are more likely than others to have trouble getting enough vitamin A:

  • Premature infants, who often have low levels of vitamin A in their first year.
  • Infants, young children, pregnant women, and breastfeeding women in developing countries.
  • People with cystic fibrosis.

What happens if I don’t get enough vitamin A?

Vitamin A deficiency is rare in the United States, although it is common in many developing countries. The most common symptom of vitamin A deficiency in young children and pregnant women is an eye condition called xerophthalmia. Xerophthalmia is the inability to see in low light, and it can lead to blindness if it isn’t treated.

What are some effects of vitamin A on health?

Scientists are studying vitamin A to understand how it affects health. Here are some examples of what this research has shown.

Cancer

People who eat a lot of foods containing beta-carotene might have a lower risk of certain kinds of cancer, such as lung cancer or prostate cancer. But studies to date have not shown that vitamin A or beta-carotene supplements can help prevent cancer or lower the chances of dying from this disease. In fact, studies show that smokers who take high doses of beta-carotene supplements have an increased risk of lung cancer.

Age-Related Macular Degeneration

Age-related macular degeneration (AMD), or the loss of central vision as people age, is one of the most common causes of vision loss in older people. Among people with AMD, a supplement containing antioxidants, zinc, and copper with or without beta-carotene has shown promise for slowing down the rate of vision loss.

Measles

When children with vitamin A deficiency (which is rare in North America) get measles, the disease tends to be more severe. In these children, taking supplements with high doses of vitamin A can shorten the fever and diarrhea caused by measles. These supplements can also lower the risk of death in children with measles who live in developing countries where vitamin A deficiency is common.

Can vitamin A be harmful?

Yes, high intakes of some forms of vitamin A can be harmful.

Getting too much preformed vitamin A (usually from supplements or certain medicines) can cause dizziness, nausea, headaches, coma, and even death. High intakes of preformed vitamin A in pregnant women can also cause birth defects in their babies. Women who might be pregnant should not take high doses of vitamin A supplements.

Consuming high amounts of beta-carotene or other forms of provitamin A can turn the skin yellow-orange, but this condition is harmless. High intakes of beta-carotene do not cause birth defects or the other more serious effects caused by getting too much preformed vitamin A.

The safe upper limits for preformed vitamin A in IU are listed below. These levels do not apply to people who are taking vitamin A for medical reasons under the care of a doctor. Safe upper limits for beta-carotene and other forms of provitamin A have not been established.

Life Stage Upper Safe Limit
Birth to 12 months 2,000 IU
Children 1–3 years 2,000 IU
Children 4–8 years 3,000 IU
Children 9–13 years 5,667 IU
Teens 14–18 years 9,333 IU
Adults 19 years and older 10,000 IU

Are there any interactions with vitamin A that I should know about?

Yes, vitamin A supplements can interact or interfere with medicines you take. Here are several examples:

  • Orlistat (Alli®, Xenical®), a weight-loss drug, can decrease the absorption of vitamin A, causing low blood levels in some people.
  • Several synthetic forms of vitamin A are used in prescription medicines. Examples are the psoriasis treatment acitretin (Soriatane®) and bexarotene (Targretin®), used to treat the skin effects of T-cell lymphoma. Taking these medicines in combination with a vitamin A supplement can cause dangerously high levels of vitamin A in the blood.

Tell your doctor, pharmacist, and other health care providers about any dietary supplements and medicines you take. They can tell you if those dietary supplements might interact or interfere with your prescription or over-the-counter medicines or if the medicines might interfere with how your body absorbs, uses, or breaks down nutrients.

Resources

http://ods.od.nih.gov/factsheets/VitaminA-QuickFacts/

Vitamin E

What is vitamin E and what does it do?

Vitamin E is a fat-soluble nutrient found in many foods. In the body, it acts as an antioxidant, helping to protect cells from the damage caused by free radicals. Free radicals are compounds formed when our bodies convert the food we eat into energy. People are also exposed to free radicals in the environment from cigarette smoke, air pollution, and ultraviolet light from the sun.

The body also needs vitamin E to boost its immune system so that it can fight off invading bacteria and viruses. It helps to widen blood vessels and keep blood from clotting within them. In addition, cells use vitamin E to interact with each other and to carry out many important functions.

How much vitamin E do I need?

The amount of vitamin E you need each day depends on your age. Average daily recommended intakes are listed below in milligrams (mg) and in International Units (IU). Package labels list the amount of vitamin E in foods and dietary supplements in IU.

Life Stage Recommended Amount
Birth to 6 months 4 mg (6 IU)
Infants 7–12 months 5 mg (7.5 IU)
Children 1–3 years 6 mg (9 IU)
Children 4–8 years 7 mg (10.4 IU)
Children 9–13 years 11 mg (16.4 IU)
Teens 14–18 years 15 mg (22.4 IU)
Adults 15 mg (22.4 IU)
Pregnant teens and women 15 mg (22.4 IU)
Breastfeeding teens and women 19 mg (28.4 IU)

What foods provide vitamin E?

Vitamin E is found naturally in foods and is added to some fortified foods. You can get recommended amounts of vitamin E by eating a variety of foods including the following:

  • Vegetable oils like wheat germ, sunflower, and safflower oils are among the best sources of vitamin E. Corn and soybean oils also provide some vitamin E.
  • Nuts (such as peanuts, hazelnuts, and, especially, almonds) and seeds (like sunflower seeds) are also among the best sources of vitamin E.
  • Green vegetables, such as spinach and broccoli, provide some vitamin E.
  • Food companies add vitamin E to some breakfast cereals, fruit juices, margarines and spreads, and other foods – read the product labels. It is always best to get the nutrients naturally.

What kinds of vitamin E dietary supplements are available?

Vitamin E supplements come in different amounts and forms. Two main things to consider when choosing a vitamin E supplement are:

  1. The amount of vitamin E: Most once-daily multivitamin-mineral supplements provide about 30 IU of vitamin E, whereas vitamin E-only supplements usually contain 100 to 1,000 IU per pill. The doses in vitamin E-only supplements are much higher than the recommended amounts. Some people take large doses because they believe or hope that doing so will keep them healthy or lower their risk of certain diseases.
  2. The form of vitamin E: Although vitamin E sounds like a single substance, it is actually the name of eight related compounds in food, including alpha-tocopherol. Each form has a different potency, or level of activity in the body.

For a healthy person with a nutritious and balanced diet, it should not be necessary to take vitamin E supplements.

Vitamin E from natural (food) sources is listed as “d-alpha-tocopherol” on food packaging and supplement labels. Synthetic (laboratory-made) vitamin E is listed as “dl-alpha-tocopherol.” The natural form is more potent. For example, 100 IU of natural vitamin E is equal to about 150 IU of the synthetic form.

Some vitamin E supplements provide other forms of the vitamin, such as gamma-tocopherol, tocotrienols, and mixed tocopherols. Scientists do not know if any of these forms are superior to alpha-tocopherol in supplements.

Am I getting enough vitamin E?

The diets of most Americans provide less than the recommended amounts of vitamin E. Nevertheless, healthy people rarely show any clear signs that they are not getting enough vitamin E (see next question for information on the signs of vitamin E deficiency).

What happens if I don’t get enough vitamin E?

Vitamin E deficiency is very rare in healthy people. It is almost always linked to certain diseases where fat is not properly digested or absorbed. Examples include Crohn’s disease, cystic fibrosis, and certain rare genetic diseases such as abetalipoproteinemia and ataxia with vitamin E deficiency (AVED). Vitamin E needs some fat for the digestive system to absorb it.

Vitamin E deficiency can cause nerve and muscle damage that results in loss of feeling in the arms and legs, loss of body movement control, muscle weakness, and vision problems. Another sign of deficiency is a weakened immune system.

What are some effects of vitamin E on health?

Scientists are studying vitamin E to understand how it affects health. Here are several examples of what this research has shown.

Heart disease

Some studies link higher intakes of vitamin E from supplements to lower chances of developing heart disease. But the best research finds no benefit. People in these studies are randomly assigned to take vitamin E or a placebo(dummy pill with no vitamin E or active ingredients) and they don’t know which they are taking. Vitamin E supplements do not seem to prevent heart disease, reduce its severity, or affect the risk of death from this disease. Scientists do not know whether high intakes of vitamin E might protect the heart in younger, healthier people who do not have a high risk of heart disease.

Cancer

Most research indicates that vitamin E does not help prevent cancer and may be harmful in some cases. Large doses of vitamin E have not consistently reduced the risk of colon and breast cancer in studies, for example. A large study found that taking vitamin E supplements (400 IU/day) for several years increased the risk of developing prostate cancer in men. Two studies that followed middle-aged men and women for 7 or more years found that extra vitamin E (300–400 IU/day, on average) did not protect them from any form of cancer. However, one study found a link between the use of vitamin E supplements for 10 years or more and a lower risk of death from bladder cancer.

Vitamin E dietary supplements and other antioxidants might interact with chemotherapy and radiation therapy. People undergoing these treatments should talk with their doctor or oncologist before taking vitamin E or other antioxidant supplements, especially in high doses.

Eye disorders

Age-related macular degeneration (AMD), or the loss of central vision in older people, and cataracts are among the most common causes of vision loss in older people. The results of research on whether vitamin E can help prevent these conditions are inconsistent. Among people with early-stage AMD, a supplement containing large doses of vitamin E combined with other antioxidants, zinc, and copper showed promise for slowing down the rate of vision loss.

Mental function

Several studies have investigated whether vitamin E supplements might help older adults remain mentally alert and active as well as prevent or slow the decline of mental function and Alzheimer’s disease. So far, the research provides little evidence that taking vitamin E supplements can help healthy people or people with mild mental functioning problems to maintain brain health

Can vitamin E be harmful?

Eating vitamin E in foods is not risky or harmful. In supplement form, high doses of vitamin E might increase the risk of bleeding (by reducing the blood’s ability to form clots after a cut or injury) and of serious bleeding in the brain (known as hemorrhagic stroke). The highest safe level of intake from supplements for adults is 1,500 IU/day for natural forms of vitamin E and 1,100 IU/day for the synthetic form. The highest safe levels for children are lower than for adults. Some recent research suggests that intakes of vitamin E below these upper safe levels could increase the risk of prostate cancer in men. Vitamin E might also increase the risk of death in some adults with chronic health conditions, but this does not seem to be the case in healthy people.

Are there any interactions with vitamin E that I should know about?

Vitamin E dietary supplements can interact or interfere with certain medicines that you take. Here are some examples:

  • Vitamin E can increase the risk of bleeding in people taking anticoagulant or antiplatelet medicines, such as warfarin (Coumadin®).
  • In one study, vitamin E plus other antioxidants (such as vitamin C, selenium, and beta-carotene) reduced the heart-protective effects of two drugs taken in combination (a statin and niacin) to affect blood-cholesterollevels.
  • Taking antioxidant supplements while undergoing chemotherapy or radiation therapy for cancer could alter the effectiveness of these treatments.

Resources

http://ods.od.nih.gov/factsheets/VitaminE-QuickFacts/

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