When to Supplement and How to do so Safely

Created by: Kristiann Frisby Champion, Dietetic Intern

Do you need vitamin and mineral supplements?

Supplements are a booming industry in this country and it’s easy to see why.  Our bodies need vitamins and minerals to function, and we don’t want to be found lacking. So how do we know if the food we are eating is enough?

There are a few lifestyle situations that can make it difficult to get all the necessary vitamins and minerals and that is when supplementation is helpful. But it is not necessary for everyone. According to the 2015 Dietary Guidelines for Americans, “Nutritional needs should be met primarily from foods. Individuals should aim to meet their nutrient needs through healthy eating patterns that include nutrient-dense foods … [which] contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects.”

Consuming too much of certain vitamins and minerals can cause toxicities, or health issues, so it is advised to not exceed these recommended amounts.

The link below is to a chart describing how much we need of each essential vitamin and mineral and what they help our bodies do.

–          https://www.accessdata.fda.gov/scripts/interactivenutritionfactslabel/factsheets/vitamin_and_mineral_chart.pdf

When supplementation may be necessary:

1.   Pregnant or may become pregnant

a.   Women who could become pregnant need to obtain adequate folic acid from fortified foods (cereals and other grains), supplements or both, in addition to consuming folate from foods in a varied diet. Because it helps reduce the risk of some birth defects, folic acid is very important during childbearing years. Iron and calcium stores may also be low before and during pregnancy, so a supplement may be  helpful.

2.   Food allergies or restrictions

a.  Vegetarians or vegans are likely to be low in vitamin B12, as it comes from animal sources.

3.   Eating less than 1600 calories

a.  Not eating enough food is an easy way to be deficient in nutrients. This can happen due to economic issues, struggling with numerous allergies, or restricted yourself from eating for other reasons. Consult a dietitian if you are trying to lose weight, they can help you do so safely and recommend any necessary supplements.

4.   Aging population

a. As the body ages, the need for certain nutrients increase. These nutrients include, B12 and Vitamin D. Appetite changes may make it difficult to eat enough foods to meet these requirements so a supplement may be beneficial.

5.   Teen girls

a.    Teen girls are often low in iron and a supplement may be beneficial

6.   Growing population

a.       Babies being breastfed are likely to be low in vitamin D.

As it turns out, the best way to stay healthy is to choose a wide variety of nutritious foods from all five MyPlate food groups. Nutrient deficiencies are not common among Americans but can occur due to reasons mentioned above. It is in these situations, or when recommended by a physician, where additional supplementation may be needed.  

Consult with your doctor if you think you need to supplement your diet. Your doctor can run tests and see if you are deficient.

Safety concerns when taking supplements

Some vitamin and mineral supplements can interact with prescriptions, causing them to work less efficiently.

Vitamin A interacts with 18 known drugs. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/vitamin-a.html

Niacin (vitamin B3) has interactions with 95 different medications including aspirin, atorvastatin, cerivastatin, leflunomide, lomitapide, lovastatin, mipomersen, pexidartinib, pitavastatin, red yeast rice, rosuvastatin, Simvastatin, and teriflunomide. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/niacin-index.html

Pyridoxine (vitamin B6) has interactions with altretamine, amobarbital, butabarbital, butalbital, levodopa and more. The full list and details on the interactions is included here: https://www.drugs.com/drug-interactions/pyridoxine.html

Vitamin B12 (in the form of cyanocabalamin) interacts with aminosalicylic acid, arsenic trioxide,  chloramphenicol and more. The full list and details on the interactions is included here: https://www.drugs.com/drug-interactions/cyanocobalamin,vitamin-b12.html

Vitamin C interacts with Adderall (amphetamine / dextroamphetamine), amlodipine, aspirin and more. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/ascorbic-acid,vitamin-c.html

Vitamin D interacts with 59 known medications. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/cholecalciferol.html

Vitamin E interacts with 197 known medications including ibrutinib and tipranavir. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/vitamin-e.html

Vitamin K interacts with 9 known medications. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/phytonadione.html

Calcium interacts with 83 known medications. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/calcium-acetate.html

Iron interacts with 25 known medications. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/iron-dextran.html

Chloride interacts with 117 known medications. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/potassium-chloride.html

Chromium interacts with 70 known medications. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/chromium-picolinate.html

Iodine interacts with 2 known medications. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/iodine-topical.html

Zinc interacts with 101 known medications. The full list and details on interactions is included here: https://www.drugs.com/drug-interactions/zinc-sulfate,zinc.html

Folate interacts with 4 known medications. The full list and details on interactions is included here: https://www.drugs.com/mca/folate-folic-acid#interactions

Even your daily multivitamin may interact with 11 known medications. The full list is included here: https://www.drugs.com/drug-interactions/multivitamin.html

How to know if the supplement contains what it says it does?

Supplements are not as well-regulated as real food is, so the best way to make sure the supplement contains what is says it does is to check the label. Choose brands labeled with the NSF International, US Pharmacopeia, Underwriters Laboratory, or Consumer Lab seal. These groups verify the products ingredients and check for any potentially harmful ingredients.

Material adapted from Eatright.org and Drugs.com

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